Care in old age: also take care of who cares for us

If the Population and Housing Census of 2002 warned us that 14.7 % of the Cuban population was 60 years old and older, the population aging index that the country shows today, which amounted to 19.8 %, gives account of an accelerated process in the changes of the demographic dynamics of the country. Likewise, statistics confirm that Cuba is one of the oldest countries in Latin America, while announcing that by 2050 it will be one of the nations with the largest number of older adults in the world.

"In this picture, long-term care is the greatest challenge that face Cuban society as a whole, not only the health sistem, although most of these are now in the health sector. We need to turn our care today to multiple scenarios, such as primary health care, since the community is the main space for care for the elderly, because that is where they spend most of the time, "said Dr. Alberto Fernández Seco, head of the Department of Older Adult, Social Assistance and Mental Health of the Ministry of Public Health, at the International Colloquium "The right of the elderly in the world", which is held at the Convention Center Cojímar, Havana.

Life expectancy today in Cuba is 78.45 years for both sexes, 80 years for women and 76 for men; But the life expectancy of everyone up to six decades old is 22 years, and almost nine years for those who's age is80, explained Dr. Fernández Seco, referring to aging in aging.

«36.6% of the municipalities in Cuba have more than 20% of people aged 60 and over, with Plaza de la Revolución being the oldest in the country, with a rate of 27.5%. Villa Clara (23.1%) and Havana (21.1%) are the provinces with the highest number of older adults, according to the latest estimates. Currently there are 121 older adults in Cuba for every 100 children, "he said.

To address the care of this growing age group is therefore a challenge that involves every sector of the society; the speaker called attention to maximize the strength of the fact that Cuba, in a context where many countries of the world are advocating for the rights of older adults, has already incorporated the policies that govern the update of the economic and social model of the country, which objectively expresses the need to pay special attention to the study and implementation of intersectoral strategies that generate services and environments that are friendly to the elderly.

"This must be accompanied by a change in the vision of aging, which has historically placed the older adult in a position of social disadvantage, almost always as a dependent person, who is not capable of taking initiative and being part of the development of the society. Old age is not a disability, it can be healthy, "he said.

Particular emphasis was placed on the specialist in promoting socialization and strengthening the self-esteem of our elders. In that sense, it meant that 37% of older adults in Cuba are incorporated into grandparent circles, a space that goes beyond physical exercise, because it promotes just the interaction.

He also mentioned that one of the principal strategies that are being developed today are the caregivers' schools, already present in 88% of the polyclinics in our country, with the purpose of teach the family how the elderly should be cared for. Which is not prepared per se, "he said.

For Dr. Lilian Rodríguez, deputy director of the Center for Research on Longevity, Aging and Health (Cited), "when caring is analyzed, it is important to consider that it is a broad spectrum that ranges from informal caregivers - that is, those who do not receive remuneration, have no external support and most lack training on how to deal withr such care - to highly qualified health professionals. "

In this regard, he explained that in low income countries such as ours, one of the best experiences of good practices is precisely how to train these informal caregivers, while one of the pending agendas is also to train paid caregivers.

Regarding the so-called caregiver schools, the interviewee said that they arise from an earlier Cited experience. "We decided to start with caregivers of dependent patients with dementia, and a program was established in which we taught them knowledge of the disease, but above all skills, how to mobilize them, teach them to bathe, etc. We realized that the dependence of older people is not only due to dementia, but also that there are patients with other morbidities, so we extend it to elderly people with a situation of dependency.

Thus, led by the National Department of the Elderly and the Unit for Health Promotion and Prevention of Diseases, we established a program of education and training, in which we train facilitators to replicate health care schools in caregivers, but with the interest not only to teach knowledge and skills, but also to learn how to take care of themselves, explained Rodríguez.

"It is about taking care of who cares for us, because it is known that care generates stress, overload, often even blame what we can do wrong. Caregivers are usually women, daughters, daughters-in-law, but in the face of aging in aging, today we see many older people - with several pathologies including - caring for others. How to teach them to be careful? ", Reflected the researcher.

Hence, after analyzing the results of this project, it was verified that the overload in the caregivers was reduced, they acquired knowledge and skills and somehow they have valued this function that they do. A manual was also prepared by a group of health specialists, which is given along with classes to complement, in non-professional language.

But, to get society to have a positive image of care is in the opinion of the expert also a challenge. We have to change the image and the status of the caregiver, unaccustomed to only the negative.

To implement a long-term care system is even in Cuba, in the opinion of the expert, a task in development and pending; this also includes engaging the mechanisms from the point of view of the rights of caregivers, who feel legally protected, have a remuneration that encourages them, have flexible hours because we are seeing that they have to leave work.

The characteristics of the Cuban family places the family as the main source of care, but the state must monitor and support this family so that it can care for and continue to be economically active and contribute to society. The challenge is to find the balance, he said.

Fuente: Granma

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Translation: RedMaySal