By Marc A. Daubenbuechel
We are starting a column on Eldercare this week, authored by Marc Daubenbuechel who has been based in the Philippines since 2006. He is an expert in elderly care and assists in developing the geriatric sector in the Philippines through international projects.
Marc earned a bachelor of arts degree in international business management from the Cologne Business School. He worked for 4 years with the Sozial Betriebe Köln, an operator of nursing homes and home-care services in Germany, and has in-depth experience in running restaurants, hotels, spa and wellness institutions.
From 2009 to 2016 Marc was the executive director of the Retirement and Healthcare Coalition, a project of the European Chamber of Commerce of the Philippines.
Since 2015 Marc has been an independent health-care consultant for various companies interested to get involved in the Philippine geriatric market and for Philippine institutions wanting to learn more about geriatric care and education in Germany.
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A COMMON statement when I bring up the topic of nursing homes, home-care services or geriatric-care services is “We do not need any of these facilities or services. Our tradition is to look after our own elderly.”
I have heard the comment in different ways a few hundred times over the last 10 years in the Philippines. Almost every time, there is a fierce reaction from some people in the crowd when I talk about the necessity of nursing homes. This might be due to the fact that I am a foreigner, but the same reaction can be seen when fellow Filipinos bring up the same topic. So what is leading to this denial?
Why is it okay to have seniors for several months in the most expensive hospitals of the country (which ruins families financially for years)? But the moment you bring up the possibility of transferring your parents to a nursing home, you are criticized for “giving your parents away”, or for “disposing those that loved you all your life”.
This common perception and judgment of society is the cause for many emotional conflicts among families and suffering for the elderly in need of professional care. On one hand, families are in desperate need for help, but on the other, they fear to seek for help as family members, community and society might blame them for not being able to “love and take care of their parents as they are supposed to do”.
Where is geriatric or aged care in the Philippines headed? What are the measures taken to come up with services for local seniors? Have we ever asked ourselves why there is a national government agency mandated to attract foreign retirees to the Philippines, but there is no national agency looking after the welfare of Filipino seniors and their families?
We can argue the Department of Social Welfare and Development is mandated to do so. Yes, but only after the elderly who are “poor, vulnerable and disadvantaged individuals”, leaving seniors and their families who are not “poor, vulnerable and disadvantaged” without anyone to turn to.
To show the urgent need for action, let us look at the statistics from Philippine Statistics Authority (PSA). The number of senior citizens is increasing faster than the growth of the total population in the Philippines. In 2000 there were 4.6 million senior citizens, (6 percent of the total population). By 2010 this grew to 6.5 million seniors, or about 6.9 percent of the total population. The PSA projects that by 2030, older people will make up around 16 million, or 11.5 percent of the total population.
The issue of aging previously merited only little attention in the country. For example, it was only since 2014 that Philhealth was mandated to cover senior citizens. Prior to this, no health-care coverage was available. Sadly, up until now, most of the private insurers do not cover senior citizens, putting families under tremendous financial pressure.
While improvements are happening, the speed in which the Philippines is aging demands faster action and more geriatric services to ensure dignity in growing old.
I visited places for abandoned seniors, and I saw the pressure on the system. Whatever the reasons—family conflicts, financial constraints, fear of judgement and “burned out syndromes” among the family members—seniors from all classes of society are being abandoned at a rate faster than new facilities can be established. Other families hide their “difficult” seniors at home because dementia is still a topic of shame, and families do not know who to turn to for help. Thankfully, this is still the exception, but if you visit or volunteer in a place for the abandoned, you can see it with your own eyes.
Today, nursing homes in the Philippines are associated with the negative perception that only seniors “given away” by their families are living there. Many people do not consider the possibility that nursing homes can be happy places. A home away from home. Places where specialized geriatric nurses, caregivers and dedicated doctors give their loving care to seniors. Some seniors are entirely alone at home as all members of the family are working. Others are stroke victims, have a form of dementia or just simply need assistance in performing the most basic activities of daily living. In some instances, it is simply not possible to age at home. Some seniors also prefer to age in a nursing home to keep the “burden” off of their families.
Without a doubt, most of us prefer to grow old in our own homes together with our family. So do I. This is, however, not always possible. Rapid urbanization, increased cost of living, the fact that 10 million Filipinos are living abroad, are proofs of the burden the traditional family systems are under. To make matters worse, cardiovascular diseases, stroke and dementia are on the rapid rise.
We should start to consider that aged-care services in their various forms are a much-needed service and a direct response to the rapid rise of aging of the Philippines.
I do not claim that nursing homes and geriatric-care services are the ultimate solution. Rather, they should be seen as an option for those in need of health-care services for the elderly. After all, we wouldn’t refuse health-care services for our children. How much more to our seniors?