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
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