Sunday, July 24, 2016
Indonesia - Number of elderly people to hit 80m
While Indonesia is currently enjoying a demographic bonus in the shape of a high proportion of young people among its population, the number of seniors is predicted to quadruple to 80 million by 2050.
Analysts have warned that the government must start preparing a robust healthcare system to accommodate this aging population.
Indonesian law stipulates a senior as someone who is more than 60 years old. In 2014, there were 20.24 million seniors, constituting 8.03 percent of the total population, but by 2020, that number will climb to 28.8 million, 11.34 percent of the population.
“If the percentage is over 10 percent, then we’ve already entered the category of an aging country,” Indonesian Gerontology Medical Association (PERGEMI) chairwoman Siti Setiadi said during a discussion at the Health Ministry to mark National Day of the Elderly which falls on Sunday.
The day is celebrated every May 29 to commemorate the first session in 1945 of the Preparatory Body for Indonesian Independence (BPUPKI), with 66-year-old Radjiman Wedyodiningrat as its chairman.
During the discussion, the Health Ministry pointed out that the number of seniors would climb to 41 million by 2035 and 80 million by 2050, leading to concerns about whether the country’s healthcare system will be equipped to handle the soaring number of elderly patients suffering from chronic illnesses.
In 2014 alone, the Healthcare and Social Security Agency (BPJS Kesehatan), which manages the National Health Insurance (JKN) program, had to pay Rp 42.6 trillion (US$3.1 billion) in hospital bills for elderly patients. The premiums that those patients paid to the BPJS Kesehatan were insufficient to cover the bills, forcing the agency to cover the 4 percent deficit.
Hospital bills for the elderly are usually higher as they often suffer from multiple chronic illnesses.
Health Ministry research in 2013 showed 45.9 percent of people aged 55 to 64 and 57.6 percent of those aged 65 to 74 suffered from hypertension.“The most common disease for the elderly in Indonesia is hypertension, or abnormally high-blood pressure. And this can lead to other diseases like heart disease, cardiac arrest, stroke and so on. These diseases almost bankrupted the BPJS,” Siti said.
Moreover, seniors also often suffer from deteriorating cognitive functions, which can lead to dementia, she said.
“[Patients with] these diseases are very difficult to care for. They need caregivers and eat up lots of energy and money. It’s not that the disease is deadly, it’s the demand for long-term care,” said Siti.
The salary of a caregiver for an elderly patient usually starts from Rp 2 million per month and can rise to more than Rp 3 million.
The problem with seniors is that they are often rendered dependent on other people due to poor health, which results in more costly health care. Families usually try to cut the cost of health care by taking care of sick seniors by themselves in their homes.
Furthermore, as in many countries in Asia, the use of government-established elderly care is rare in Indonesia, as there is a tradition of family-oriented care-giving with the younger generation looking after senior family members.
“Indonesian people always care for their families. So if there are seniors, they usually live with their families. But in other countries, these elderly people are usually sent to nursing houses,” Health Ministry secretary-general Untung Suseno said.
However, life expectancy in Indonesia also keeps climbing as health care in the country improves, leading to cases where people in their nineties will be looked after by their children, themselves already in their seventies.
“In the past, seniors were relatively younger and so they could still be taken care of by their children. But one day, there will come a time when our elderly are getting older while we also grow old. There’s no way we can take care of our parents who are in their nineties when we are already in our seventies,” Siti said.
If that is the case, then people will have to hire caregivers or send their parents to nursing homes, further adding to costs. Therefore, the government plans to educate families on how to take care of the elderly.
“Medical workers from community health centers [Puskesmas] will go from house to house, not to take care of the elderly, but to train family members. After the third visit, family members will have the capacity to take care of the elderly in their homes,” the ministry’s family health director, Eni Gustian, told The Jakarta Post.
Hans Nicholas Jong