SWK358e Eldercare - July 2019 TMA: Global Trends and Impact of Ageing

This report provides a comprehensive analysis of global ageing trends, focusing on the increasing life expectancy and its impact on various aspects of life, including the ageing index, median age, and fertility rates, using data from Singapore and other international sources. It examines the effects of ageing on individuals, families, and societies, addressing financial, social, employment, healthcare, and housing implications. The report further explores integrated care models, defining different types and models, such as the PRISMA model, while appraising their strengths and limitations in meeting the multifaceted needs of frail elderly individuals with co-morbidities. Finally, the report proposes a service delivery model designed to promote successful ageing for older adults, focusing on lifelong employment strategies, financial support, and social integration, addressing the challenges and opportunities presented by an ageing population.

0Running Head: GLOBAL TREND AND IMPACT OF AGEING
GLOBAL TREND AND IMPACT OF AGEING
Name of the Student
Name of the University
Author Note

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Table of Contents
Answer 1:...................................................................................................................................2
Answer 2:...................................................................................................................................5
Answer 3:...................................................................................................................................8
References:...............................................................................................................................10

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Answer 1:
The global trend of ageing
Age is now a more complicated factor because the expectancy of life has been
increasing. People now have higher ages of survival than they had before. This condition
occurred due to behavioural changes where people who were forty years old began behaving
like thirty years old people. The above statement is well supported in a paper (Jacobsen,
2017). The ageing index is measured by the number of older persons present in a population
per hundred young individuals who are less than fifteen years old. This index has been stated
to increase with age (de São José, 2017). According to statistical data prediction, the number
of aged people will increase from 143 million in the year 2019 to 426 million in the year
2025 (Li et al., 2019). In the year 2002, 400 million people who were aged 60, will be
increased up to 840 million for the year 2025. This statistical data has been represented in the
paper which talks about ageing index of the world (Davies & James, 2016). In Singapore,
states that the number of older people (>65 years of age), has been rising from 160,000 for
the year 1990 to 590,000 for the year 2019-2020. The following graphical representation has
well supported this data-
Fig 1: Singapore ageing index

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Source: (AGEING IN PLACE IN SINGAPORE, n.d.)
Median age is another factor of the global trend in ageing. This factor divides any
population into two equal groups. The single index that provides a total of the age distribution
of a particular community is structured under median age. Therefore it defines the point at
which half of the population is older, and half of the population is younger. According to
statistical results, the median age of the total world population has increased from 23.6 to
26.4 from the year 1950 to 2000 (Lutz, Butz, & Samir, 2017). The life expectancy of people
above 65 years of age has been increasing continuously. This condition has given rise to a
hike in the median age and has made median age a factor of a global trend in ageing.
The fertility rate is another major factor that acts as a global trend in influencing
ageing. This rate can be evaluated by calculating the number of children born per one
thousand women of ages 15 to 44 years. The fertility rate has been stated to reduce its value
as the person grows old (Jayachandran, 2017). Although this rate has been said to fall from
20 years of age, it begins to rise from the age of 35. Finally, the rate starts to decline from the
age of 55 to 66 years in women (Coale, 2017). In Singapore, it has been observed that the
total fertility rate has been declining since 1980 from the value of 2 to 1.20 in the year 2011
(Yap & Gee, 2018).
Fig 2: Statistical data f total fertility rate (Singapore)

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Source: (AGEING IN PLACE IN SINGAPORE, n.d.)
Disease rate has a chance of increase during ageing. This condition occurs since the
people of ages above 65 years are more prone to disease than younger people. In old age, the
human body immunity starts to break down, and this leads to many physical and internal
health problems. Chronic diseases are of four types- heart disease, diabetes, cancer and
stroke. These four diseases almost kill two-thirds of people per year (Prince et al., 2015).
Impact of ageing :
Elderly members of the family play an essential role as caregivers. This factor comes
into play when a person grows old. Elderly members of the family are found to be looking
after their grandchildren. This factor is ubiquitous in Singapore. According to statistical data,
one out of three older adults were found to be taking care of their grandchildren in Singapore
(Malhotra et al., 2018). Older adults were stated to be dependent financially, physically and
emotionally on their children. This condition arises due to the fact that ageing decreases the
ability of a person to work with full physical effort. Thus ageing makes people depend on
their family for significant types of support. In Singapore, on an average 87 per cent of the
older people has been found to be dependant on their children for financial aid (Mehta &
Leng, 2017). Physical and emotional supports by their family also ranges from 80 percent to
90 percent, because of the different problems arising due to ageing. Employment is a
significant factor influenced by ageing. Every profession has an age structure, completion of
which leads to the retirement of the employee. According to statistics, people become
unemployed after the age of 65 (Khan & Flynn, 2016). There is a high risk of social isolation
in the case of older adults as they need more top social support. Older people fall sick often
due to the low immunity strength of their body. Therefore they need a regular visit to the
hospital for their checking their current health conditions. As a result, healthcare services

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play an essential role in the case of people of older age. Housing becomes a significant factor
influenced by age. Senior-friendly house and housing plans are established in Singapore.
They provide the senior citizens with good housing plans which gives them comfort as well
as a financially efficient way of living. As a result, the impact of ageing throughout the world
is well described by the above-stated points.
Answer 2:
(a)
Integrated care is defined as an integrated health system or a coordinated care or a
transmural care which focusses on providing people with health provisions. Four types of
integration are present- Functional, Organisational, clinical and service (de Carvalho et al.,
2017). Organisational integration can be defined as bringing different organisations together
to implement a function. Service and functional integration work mostly in the same pattern.
Clinical integration works by integrating healthcare services for the people in need.
Autonomy, integration and coordination and three well-defined terms which are the central
concepts of integrated care. Autonomy refers to the point where there is the least cooperation,
whereas coordination refers to the end at which the health and social care cooperate with each
other to help the older people. Integration refers to the point at which both the above two
defined terms are connected and thus provides the best possible integration care strategy for
the elderly. There are various models established to provide integrated care for individuals
affected by diseases and by ageing. These models are categorised in a way so that more
extensive population models will have narrowly targeted modules (Erens et al., 2016). Other
types of integration are present as horizontal or virtual. However, there are three models of
integration plans: Individual models of integrated care, group and disease-specific models
and population-based models. Individual model of integration stands for taking care of people

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who are at high risk and needs immediate medical service. Disease-specific models include
integration plans for chronic diseases where several healthcare services are grouped together
to solve the health issue (Rodakowski et al., 2017). This section only encompasses healthcare
services and the person’s health condition. However, the individual model selects a particular
individual for the study. Since this topic relates to the integration of health and social care for
older adults, a subpart of the group and disease-specific model can be used. The title of this
subpart of the above-stated model is "Integrated care models for elderly and frail" (Health
Services Delivery Programme Division of Health Systems and Public Health, 2016). This
integrated model represents a set of initiatives to be undertaken by the associated community.
Here the integration process is highly specific, which distinguishes this process from the
other models. PRISMA (Program of Research to Integrate the Services for the Maintenance
of Autonomy) model is used to integrate ageing people who need cooperation between more
than two service plans (MacAdam, 2015). This model can integrate service delivery for any
community people. According to this model, integration can be achieved by a well
established joint board governing social and health care. The integration plan associated with
this model is highly accessible to the concerned people. Hospital admission chances increase
with age amongst human beings. By enrolling this integration plan, it has been stated that the
associated victims later had reduced level of healthcare needs, improved health condition,
lower levels of diseased conditions with age. These conditions are controlled because this
plan is working in both people and public sectors.

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Fig 3: PRISMA model of integration
Source: Health Services Delivery Programme Division of Health Systems and Public Health,
2016
This integrated care is defined by its alignment and collaboration between the care and cure
sectors at administrative levels. On a concluding note, this integration plan can be stated as an
effective strategy in connecting social and healthcare service together for ageing people.
(b)
The main strengths of this integrative plan mainly include the reduction of all the
social and health problems related to the ageing condition in people. The first advantage is
the availability of direct and enhanced expose to services. This fact helps the ageing people
achieve proper social and healthcare services when required while they need. Cost-effective
hospitals, local and non-government agencies fall under this strength category which helps
the aged people in getting proper services (Khan & Flynn, 2016). Another advantage of this
integrated plan is that it works on both people and public levels. Therefore, it can be said that
a higher number of aged people can be helped by this integrated plan. This integration plan
can implement medical need, such as cost-effective diagnostic processes and treatment
strategies of old people. A fact has been stated earlier that older people get exposed to
chronic diseases because of the gradual breakdown of immunity in their body. Therefore this

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plan can be said to be helpful for aged people. A fact stated previously states that life
expectancy of people increases as they age. One of the leading causes of this expectancy is
the implementation of this integration strategy which is beneficial for the effects of ageing
phenomena in a population. However, there are some weaknesses in this plan. The first
disadvantage is the requirement of a large number of people to form this integration strategy.
This factor cannot always be met because a human population in a particular region never
consists of social and healthcare workers only. The community is a mixture of people having
different professions. Also, the voluntary participation of people for this plan is not always
possible. Another demerit of this plan is the availability of financial support for the
maintenance of the integration plan (Lutz, Butz, & Samir, 2017). This support is not always
available since a backup from the government is not present. Establishment and maintenance
of a program as this requires a lot amount of monetary assistance. However, solo financial
support is not always possible from the conducting organisation itself. Therefore
governmental support is always required to support the integration strategy. As a result, non-
availability of monetary support form the government and not always active participation of
people becomes weakness of this integration strategy.
Answer 3:
As a policymaker, a well-established service delivery model creation will require both
physical and monetary support from people associated. This service delivery model has been
created according to a paper (Wakerman et al., 2017). This plan will include a format
involving plans for the welfare of the ageing population throughout the world. The population
concerned here in this plan is Singapore’s population. The first feature of this plan is to
ensure a lifelong employment strategy for aged people. This strategy will allow the older
adults to be busy with regular works which will help the older adults in staying well
physically. Educating the seniors about health and social activities will help in generating an

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awareness of the main problems associated with ageing. This feature will help in making the
aged people more conscious about the health-related problems related to the ageing factor.
Community visitation is required for checking the issues associated with social and
healthcare problems in various communities. According to Malcarney, (2017), regular
community visitation by the healthcare and social organisations has improved the living
conditions of the aged people by 1.5 times. This improvement was also supported by a
community health improvement model stated in the above paper. This factor will help in
resolving the current issues related to ageing, which varies among different communities. The
aged care plan will also be included inside this service delivery model. This plan would
ensure the incorporation of three primary criteria into the care plan: Doubling the number of
community hospital beds, increasing the capacity of nursing homes by seventy per cent and
increment of home and community care places by eighty per cent. Active ageing hubs will
also be provided for the senior citizens. This feature will help the aged people in getting
housing supports in case of problems with housing. Transportations can be made more
accessible by incorporating a transport plan in this model. Implementing silver zones will
ensure better road safety with proper transport systems. Silver zones can be described as
improved measures of road safety, road features, markings and signs will ensure better
transportation preventing accidents. Replacing ordinary buses with wheelchair-accessible
buses will help the aged people to travel longer distances on a wheelchair. As an example, a
group of engineers in Singapore discovered wheelchair accessible buses for transportation of
physically disabled old people (Chia, 2015). As a result, this plan can be beneficial for
solving most of the age-related problem in the near future.

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References:
Jacobsen, F. F. (2017). Active ageing.
de São José, J. M., Timonen, V., Amado, C. A. F., & Santos, S. P. (2017). A critique of the
Active Ageing Index. Journal of aging studies, 40, 49-56.
Davies, A., & James, A. (2016). Geographies of ageing: Social processes and the spatial
unevenness of population ageing. Routledge.
Lutz, W., Butz, W. P., & Samir, K. C. (Eds.). (2017). World population & human capital in
the twenty-first century: An overview. Oxford University Press.
Jayachandran, S. (2017). Fertility decline and missing women. American Economic Journal:
Applied Economics, 9(1), 118-39.
Coale, A. J. (2017). The decline of fertility in Europe. Princeton University Press.
Yap, M. T., & Gee, C. (2018). Fertility preferences in Singapore. In Family Demography in
Asia. Edward Elgar Publishing.
AGEING IN PLACE IN SINGAPORE. [Image].
Prince, M. J., Wu, F., Guo, Y., Robledo, L. M. G., O'Donnell, M., Sullivan, R., & Yusuf, S.
(2015). The burden of disease in older people and implications for health policy and
practice. The Lancet, 385(9967), 549-562.
Malhotra, R., Bautista, M. A. C., Müller, A. M., Aw, S., Koh, G. C. H., Theng, Y. L., ... &
Malhotra, C. (2018). The aging of a young nation: Population aging in Singapore. The
Gerontologist, 59(3), 401-410.
Mehta, K. K., & Leng, T. L. (2017). Experiences of formal and informal caregivers of older
persons in Singapore. Journal of cross-cultural gerontology, 32(3), 373-385.

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Khan, H. T., & Flynn, M. (2016). Self-reported health status of older adults in Malaysia and
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Quality of Life, 11(3), 687-705.
de Carvalho, I. A., Epping-Jordan, J., Pot, A. M., Kelley, E., Toro, N., Thiyagarajan, J. A., &
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