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What the Health – Are we living to die or dying to live?

Have you ever taken a moment to stop and think about what you’ll be doing when you’re 90 or beyond? Or even muster the courage to imagine what you’ll look like then? Scary thought isn’t it? The fact of the matter is that most of us probably don’t want to think about aging at until we get there. And sadly, the same attitude is present today in our healthcare system, and perhaps worse, in the community as well.

According to the World Health Organization, populations around the world are rapidly aging due to lower birth rates and longer life expectancies. Large countries such as the U.S. and Japan are beginning to realize that this will impose enormous costs on all manner of states.

And in our small island nation of Palau, we’ve got a declining life-expectancy rate—also bad—coupled with an annual birth-rate that remains stagnant, if not declining as well; 2016’s 212 total births were the fewest for Palau in history. Concerns about aging and elderly care not only with focus on economic matters, but also touch on social and cultural domains as well.

How about elderly health care facilities? Not unlike other Pacific cultures, Klechibelau or Palauanism sees care of the elderly as a familial responsibility, often expected from the offspring and other immediate relatives of the elderly. However, the issue at hand with the prospect of nursing/resting homes is not in reaction to a disintegrating cultural practice or attitude towards elderly care, but rather on economic constraints perpetuated by ever rising costs of living and low wages. It’s not a matter of personal choice for families whether or not to care for the elderly, it’s a matter of financial ability.

The Belau National Hospital over the years has seen countless elderly patients who could not be released from hospital care after admission simply because their families cannot provide the geriatric care they need at home. And so this redirects societal blame to these families, accusing them of being neglectful and unaffectionate towards their own kin. Of course one could argue that some are indeed neglectful and unabashed in this regard but that’s not the point.

Beyond the medical care and attention we provide the elderly and how much money we are willing to spend for their care, the real issue is our current attitudes towards aging and the resulting social response.

As things stand, our healthcare system, government, community and many of us as individuals are still dreaming of the fountain of youth. We spend thousands of dollars on pharmaceuticals and medicine, medical referrals and dialysis, cosmetics and betel nut stain removal at the dentist, believing that this is what living is all about – the prolonging of a youthful and active life. And so we don’t bother to buy life insurance, attend regular health check-ups and we don’t eat healthy until we have to. We dream of being forever young instead of grasping and accepting the harsh reality of life: death.

Even the healthcare system is set up with youthfulness in mind, prolonging life and alleviating pain though not necessarily sustaining or improving the quality of elderly life. And so as we grow older, attention given to us, medical or otherwise, is diverted from the maintenance and promotion of our happiness and emotional wellbeing to injury and illness prevention and assurance of our physical safety. Somehow, we’ve convinced ourselves that as our physical abilities decline, so too do our emotions and the quality of our relationships with others.

Likewise, current arguments about social security and pension programs center on eligibility and administrative issues rather than seeking ways to alleviate the the social and economic burdens imposed on the elderly. In other words, instead of trying to find the strongest, most reliable horse we can to pull the old-age welfare program first, we are arguing about what color the carriage should be and who should and shouldn’t be allowed to ride in it…

How can we change our attitude towards aging as a society, and as Palauans, to focus more on quality of life rather than just quantity of life? How does this translate to action? Families clearly can’t handle the whole burden of care. We do have state programs and goals for the elderly, but this community and society-wide responsibility requires more than just budget allocations and medical assistance. Perhaps what the elderly need the most from society is respect and acknowledgement and from family, affection and interaction, family time and love.

And just as the saying holds true for children, that it takes a village to raise them, let us also keep in mind that the same is true for the elderly. For without them there wouldn’t even be a village and more importantly, without them we wouldn’t be alive.

Gaafar Uherbelau is a social marketer for the Palau Ministry of Health and is currently studying Social Sciences for Public Health at the University of Auckland, New Zealand. Send feedback to g.uherbelau@gmail.com


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