Mental health articles

Polices and programs in support of the elderly mentaly ill

The context: informal and formal care systems

The most important system of care for the elderly throughout the world is still informal, as the family orkin group provides the overwhelming majority ofassistance. For example, in an In donesian study, 80% of the elderly in need of care received itonly from their families, whereas the 'community' wasresponsible for caring for sick younger people. Anationally representative survey of persons over 60 inThailand revealed that 88% of all respondents and 91% of respondents with living children either livewith or have daily contact with a child. Data froma study in Kenya demonstrate that 92% of women and 88% of men received help from at least one child.Ninety-three percent of the elderly in a survey fromurban and suburban areas of four major states in Mexico were integrated in their families. Similarrates of caregiving exist in industrialized countries forthe elderly that have become frail and dependent onothers for functional activities of daily living, butrates of coresidence are usually much lower and ratesof institutionalization higher.

The resilience of the family caregiving unit in manyareas of the developing world and the inability ofgovernments in many poor countries, because offinancial reasons, to provide alternative forms of caremeans that the family will remain the primarycaregiving unit for the elderly. At the same time, thestresses on the family's role in providing for the elderlyare likely to increase the need for formal care systemssuch as paid in-home helpers, homes for the aged and nursing homes, especially for those elderly who cannotcare for themselves and who lack family care.

However, formal care systems do not exist indeveloping countries to the extent that they do indeveloped ones. For example, of 12 million elderly people needing assistance in their daily life in China,only 0.05% are cared for in an institutional setting; in comparison, 4-6% of the elderly are insome sort of institution in industrialized countries.In most countries institutionalization remains a lastresort, usually for cases of severe dependence. Policies aimed at strengtheningmechanisms of informal care and developingalternative care mechanisms could help avert pressureto make a more expensive shift toward institutionalcare. 

Tags: elderly, ill, mentaly, mentaly ill