A critical analysis of the demand for residential care : the case of the elderly in Malta

Abstract

Ageing is a gradual, often imperceptible process that takes place in all living creatures. Cells, organs and living organisms change in structure and function over time. This process extends over a life span so that creatures, including human beings, continue to age, grow and develop. However, ageing is not merely a biological process for it simultaneously induces behaviour, cognition and personality adjustments that ultimately ask for modification in social roles, personal interaction and status. Such biological, psychological and social changes are influenced by a range of factors that may vary from heredity to climate and social attitudes. Therefore, chronological ageing will not necessarily coincide with the rate of social, physical or psychological ageing. As a result, although each person is constantly changing the individual variability for the types of ageing may differ widely. All this goes to show that the elderly are definitely not a homogeneous group. However, despite this heterogeneity there is still a universal factor, namely, that the longer a person lives the more frail he is likely to become and the greater the support he would require to retain his human dignity. Longevity of life should therefore ideally be complemented by quality of life. The need for the development of support systems for elderly people arises out of a combination of two phenomena, namely, an increasing share of elderly in the population and changing family structures. These demographic and social changes are emerging in Malta and throughout the world. In 1950 the world population falling within the 60+ age group stood at 201 million or 8% of the total world population at the time. By the year 2025 this cohort is anticipated to grow by a factor of six (600%) so as to reach 1.20 billion or 14.2% of the estimated world population for that year. The highest growth is forecast for the 80 year old and over sector of the population which is expected to rise by a factor of ten (1000%) so that the 13 million figure registered for 1950 is expected to rise to 137 million by the year 2025. At the same time, changing family structures characterised by low fertility as well as a change in the overall household composition 3 should be expected to render more difficult the provision of family support for the elderly in the future. U. N. projections, 1988, forecast a constant decline in the world total fertility rate so that the 4.9 fertility rate per woman registered for the period 1950-1955 is expected to drop sharply to 2.4 by the year 2025 (Table 1 ). […]