Their future matters
GERONTOLOGIST Lily Fu says there is a need for the government to set up more care homes for the aged – especially the senior B40 community – in Malaysia.
“There are many older persons from the lower-income group who don’t have anywhere to go or anyone to look after them.
“When their children grow up, they leave home to work elsewhere or start their own families.
“So, the older couples live by themselves, and when one partner dies, the other is left alone – what happens if they fall down or become ill?” asks Fu.
“They can’t afford to go to a private retirement home because it’s too expensive. If they go back to live with their grown-up children, there might be increased tension due to cramped living conditions, disagreements with in-laws, and more, resulting in abuse of the seniors,” she adds.
Fu, 74, who is vice president of the University of the Third Age (a programme under the Institute of Gerontology in Universiti Putra Malaysia) and founder of Seniors Aloud (an online platform for seniors), produced a documentary film called Meniti Senja to highlight some of these issues.
“I wanted to raise awareness about the issues faced by the older population, and advocate for better services and provisions for them through the documentary,” she says.
Negative stigma
Fu says there is a negative stigma that surrounds those who send their aged parents to a care home, and it’s not necessarily due to “filial piety” expectations.
“Many of the care homes run by NGOS can only provide basic facilities because of insufficient funding. And they might not be well maintained due to lack of manpower. This often results in a negative perception when the homes look run down, depressing and gloomy.
“There are privatised care homes which are luxurious, well-maintained, and fully-staffed, but these are out of reach to the generation population. This is why the government needs to get involved,” says Fu.
Only the government has the resources to reach the rural population, she says, adding that most awareness campaigns and activities for seniors are carried out only in urban areas which isn’t sufficient.
“Even though they’ve set up over 100 seniors activity centres called Pusat Activiti Warga Emas (PAWE) throughout Malaysia, most people aren’t aware of it and there isn’t much activity at the centres,” she adds.
Fu believes that inter-government ministry involvement is vital to deal with seniors’ issues.
“All the ministries need to work together. It’s not just the responsibility of the Women, Family and Community Development Ministry. Ministries such as Transport (most seniors don’t know bus times and routes, or even how to scan codes at bus-stops), Multimedia (seniors don’t know how to make full use of a smartphone), Home Affairs (housing needs to be senior-friendly), and Education (universities need to get involved in educating seniors) need to be involved,” she says.
Awareness campaigns and educational programmes on active ageing should start from young.
“This can be on health (how to be healthy, prevent diabetes, strokes, and heart disease; exercises for the elderly); digital (how to use a smart phone or computer) and not just in urban but also rural areas,” says Fu.
Independence and autonomy
Most seniors today want to lead independent and active lives.
“Many of them prefer to live by themselves instead of with their children because they can come and go as they please, they don’t have to answer to anyone, and they can meet their friends,” says Fu.
“The last thing they want is to be a burden or dependent on their children,” she says.
Housing developers, she feels, must ensure that developments are senior-friendly to enable older persons to age-in-place without moving to a care home. For example, bathrooms and toilets must have handrails and elevators must be provided for high-rise buildings.
Fu believes having these facilities will not only benefit seniors but also the younger generation.
“When we take care of the seniors, it benefits the whole community because they will be at less risk; they won’t fall down and become immobile, they won’t get ill. And, their families will spend less on hospital care,” says Fu.
Gatekeeper for the aged
According to Universiti Malaya Medical Centre consultant geriatrician Prof Dr Tan Maw Pin, when older persons are abandoned at care facilities, we shouldn’t apportion blame only to the children.
“As outsiders, we can’t point fingers because we don’t know what happened to result in this outcome. We don’t know about their pre-existing relationship with their children, what kind of parents they were, and the values they passed down to their children,” says Dr Tan.
“What we do need to make sure is that aged parents aren’t inappropriately placed in care homes without their consent,” she emphasises.
“There must be some sort of safeguard before the older person ends up in a care facility. Firstly, there must be ‘care needs assessment’ to show whether they need long-term residential care, and secondly, they must have their ‘consent’.
“There needs to be a gatekeeper to ensure the older person’s rights are protected, that they go into a long term care facility only if they need it and that they’re not forced into it,” she says.
“And, even if they need it, rehabilitative processes must be in place so that they’ve a chance to recover and exit the long-term care facility and return home,” she adds.
Dr Tan says the gatekeeping should done by a social worker but there aren’t enough social workers in Malaysia.
“The Social Welfare Department is just a small department within the Women’s Ministry; it should be a standalone ministry because it has an important function in society. This gives people the wrong impression that social welfare is the responsibility of just women, when in actual fact, it should be the responsibility of the whole community,” says Dr Tan.
Law to protect seniors
Advocates have been lobbying for a specific law for senior citizens which will protect them from abuse/neglect, address population
ageing, age discrimination and guarantee them their rights and access to services in their old age.
According to UM law lecturer Dr Zulzahar Tahir, this is necessary because the needs and concerns of senior citizens are very different from the rest of society.
“When they were young and working, they were able to care for themselves and others under their care. But as they grow older, they become more vulnerable due to financial, health and other social factors,” says Dr Zulzahar. “Having a specific law for senior citizens will recognise the changes they face and help address these issues, concerns and challenges.”
Dr Zulazhar and his colleagues, Dr Jai Zabdi Mohd Yusoff, Sridevi Thambipillay and Dr Siti Zaharah Jamaluddin from Multimedia University are part of Prevent Elder Abuse and Neglect Initiative (Peace), a multidisciplinary study involving researchers from UM’S law and medical faculties.
He reveals that the study has been completed and all the relevant documents submitted to the Women, Family and Community Development Ministry in 2021.
The study revealed that one in 10 Malaysians over the age of 60 in urban areas experience abuse, while in rural communities, one in 20 experience neglect, as well as financial, psychological and physical abuse. Although Malaysia’s current legal framework includes statutes that are applicable to the elderly – such as the Domestic Violence Act 1994, the Penal Code, Care Centre Act 1993, Employment Act 1955 (Part –Time Employees) Regulations 2010, Minimum Retirement Age Act 2012, Pensions Act 1980 and the Employees Provident Fund Act 1991 – these are insufficient in addressing the needs of the elderly today, the researchers opine.
Abandonment and neglect of the elderly, for example, are not illegal under current law despite rising incidences of abuse, neglect, exploitation reported in the media.
“The main aim of the statute should be to enable seniors to live independently for as long as possible, so there must be provisions that can help them achieve this,” says Multimedia University law lecturer Dr Siti Zaharah.
The researchers believe that most Malaysians want to care for their elderly.
“It’s not that families don’t want to care for their aged family members. Traditional values have been affected by factors such as migration of children to cities, urbanisation and the change in the family structures. Most family caregivers are also in the sandwich generation. They face immense strain having to make a living and take care of their children and parents, so they might not even realise their actions amount to neglect.
“A law covering not only the rights of the elderly but the roles of stakeholders – the state, service providers (long term residential care homes, daycare centres, housing developments, transportation, commercial outlets, etc), family, non-governmental organisations and the community, will empower and protect the elderly,” says Dr Siti Zaharah.