The aging are coming and they are us.

Abstract

The United Nations (UN) General Assembly declared 1999 the International Year of Older Persons. This UN international year seeks to have each member country develop specific programs on the national and local level in relation to an intergenerational theme of towards a society for all (United Nations Division for Social Policy and Development, 1998). The 1999 UN year comes at a time when the United States and the rest of the world are recognizing that the world's older population is growing faster than the overall total population. A statistical picture indicates that in 1991 there were approximately 332 million people ages 65 and older worldwide, but by 2000 this figure will reach 426 million (U.S. Bureau of the Census, 1993). The rate of growth of aged people is faster in developing nations compared with developed nations and can be attributed to lower mortality rates. This lower mortality rate indicates that more people survive to old age. Every month the net balance of the world's population of elderly people is increasing by a million, with 70 percent of this increase occurring in developing countries (National Institute on Aging and the U.S. Bureau of the Census, 1993). The world has never experienced such a phenomenon before - an actual demographic graying of the planet. During the 20th century the percentage of Americans 65 and older has more than tripled, and the number has increased nearly 11 times to almost 34 million today (Administration on Aging, 1997). This enormous growth of older people will continue well into the 21 st century, particularly when the Baby Boomer population begins turning 65. What are the implications of this unprecedented worldwide aging phenomenon for the social work profession and particularly social workers whose primary focus of practice is in health? To address this question it is helpful to examine the broader conceptual framework for the International Year of Older Persons. The UN focus is on four major dimensions recognized as critical to this graying phenomenon: the situation of older people, life-long individual development, multigenerational relationships, and the relationship between development and the aging of populations (United Nations Division for Social Policy and Development, 1998). The conceptual framework is accompanied by five principles: independence, participation, care, self-fulfillment, and dignity (United Nations Division for Social Policy and Development, 1998). A brief review of some of the principles and framework issues from a global and U.S. perspective shed light on addressing the UN theme. THE SITUATION OF OLDER PEOPLE How elderly people are regarded in society varies from culture to culture and country to country and affects their care, independence, and participation. A culture's high regard for elderly people can be estimated by the extent to which societal values support positive self-esteem and status of elderly people. In industrialized societies older people are not critical to the functioning of the nuclear family, and extended care of dependent elderly people is often assumed by formal systems of long-term care (Barrow, 1996, Yadava, Yadava, & Vajpeyi, 1997). As nations become more industrialized, there appears to be a trend toward loss of role and status for elderly people, with an accompanying move toward a more nuclear family structure that minimizes the contributions of elderly people (Barrow, 1996; Yadava, Yadava, & Vajpeyi, 1997). Evidence to support these trends can be found in the movement of industrialized countries toward health care reform (Chappell, 1997). One trend in health care reform that has universally occurred is an emphasis on reduction of health care costs (Chappell, 1997). There is an expressed concern that the aging population will be viewed as an increasing and unacceptable burden on health care systems (Chappell, 1997; McDaniel, 1997). Even industrialized countries, which have universal Medicare-type programs, are moving toward limiting the number and types of medical procedures covered by their plans (Chappell, 1997). …