Quality of Life for Older People An International Perspective

PREFACE Rapid aging of populations throughout the world is causing major reconsideration of public policies and support programs. The proportion of the population age 65 and older in the economically advanced countries will grow from about 15 percent in the year 2000 to more than 25 percent by 2030, with considerable variation by country. Retirees may grow even faster, from 19 percent in 2000 to approximately 37 percent by 2030. The segment of national resources needed and the social organization required for service provision are thus likely to require major upward revisions. The implications are profound: Financing of Social Security, physical health care, mental health care, long-term care, housing, and expenditures for related services will almost certainly need to be substantially increased. Older citizen dependence on public and private support services is likely to rise significantly as the number of very old individuals increases. The proportion of population under age 65, who will be expected to pay a high proportion of the required taxes, will decline. Financing the needed additional expenditures is likely to mean higher payroll deductions per capita. Professionals in many fields devoted to work with the older population are likely to be under considerable stress and in short supply. The issues have become so significant worldwide that 1999 was declared the United Nations International Year of Older Persons, as a means of focusing on needed changes in policy to accommodate the expanding older population. Social Security, Medicare, Medicaid, and other expenditures to support the elderly were more than one-third of the United States budget in 1998. That proportion could rise significantly if policy changes are not made. GOALS OF THIS VOLUME Our primary goal is to integrate and expand upon knowledge about optimal aging and quality of life in economically advanced nations, while examining the issues, policies, and programs supportive of older people. This volume should serve as a basic resource for students and others who have an interest in knowing more about how to improve quality of life for older people in the United States and other economically advanced countries. We draw upon the extensive experience in a range of countries, although with special emphasis on the United States. More specific objectives include: Development of an analytical framework that identifies important contributing factors to optimal aging and quality of life--related to individuals, social groups, physical health, mental health, long-term care, residential settings, economic issues, and lifestyle choices (Chapter 1). Examination of individual, family, neighborhood, community, and societal participation in optimal aging (Chapters 2 and 3). Review and evaluation of other contributing factors to quality of life such as physical health, mental health, long-term .care, residential environments, economic and financial conditions, and lifestyle (Chapters 4 through 9). A summary of the history, experience, and effectiveness of policies and programs to meet the needs of older people in Canada, Japan, the United Kingdom, the Netherlands, Germany, Sweden, and France (Chapters 10 through 16). A comparison of the international experiences with the United States to develop a framework outlining universal factors associated with optimal aging and quality of life (Chapters 17 and 18). We should acknowledge at the outset that we have prepared this book partially out of personal concern for older relatives and peers, as well as our own future well-being as members of the older population. The quality of life, or lack thereof, among our older friends has had a fundamental impact on us as individuals. We hope this effort to expand knowledge of issues about aging will provide guidance toward improved public and private suLassey, William R. is the author of 'Quality of Life for Older People An International Perspective' with ISBN 9780136287773 and ISBN 0136287778.