1. Active and Dignified Ageing in Asia Iris Chi, DSW Golden Age Association/Frances Wu Chair for Chinese Elderly School of Social Work, University of Southern California 2012 Joint World Conference on Social Work and Social Development Stockholm, Sweden July 9th, 2012

2. Country/district composition of Asia regions Countries (excluding North East, Near East and Oceania) Afghanistan, Armenia, Azerbaijan, Bangladesh, Bhutan, Brunel, Burma, Cambodia, China, Georgia, Hong Kong SAR, India, Indonesia, Iran, Japan, Kazakhstan, Kyrgyzstan, Laos, Macau SAR, Malaysia, Maldives, Myanmar, Mongolia, Nepal, N. Korea, Pakistan, Philippines, Singapore, S. Korea, Sri Lanka, Taiwan, Tajikistan, Thailand, Timor-Leste, Turkmenistan, Uzbekistan, Vietnam Sub-regions North Asia (NA) East Asia (EA) Asia Pacific (AP) South East Asia (SEA) South Asia (SA)

3. Size, complexity and diversity The world's largest and most populous Region – 36 countries/districts – Area: 44 million km 2 (44,579,000 km 2 ) – Population: ~4 billion (3.879 billion in 2010) Diversity – More than 1,500 languages – Oldest and youngest; largest and smallest – Among the richest and poorest in the world – Still more developing than developed countries

4. Outline of the presentation Demographic trends in Asia Define active and dignified ageing and trace its theoretical development Policy options to support active and dignified ageing in Asia – Financial security (poverty) – Health & long term care support (disability)

5. Population ageing in Asia, 1950-2050 195020002050 Number of older adults (65 and above) 55 million207 million865 million

9. What is “Active and Dignified Ageing”? Process of optimizing opportunities for health, participation and security in order to enhance quality of life as people age Aims to extend healthy life expectancy and quality of life for all people as they age WHO, 2002

10. Theoretical development of Active Ageing Activity Theory 1963 Productive Ageing 1982 Successful Ageing 1989 Active Ageing 2002 Healthy Ageing 1995

11. Active Ageing: A Public Policy Framework Not only physically active, but also socially, intellectually, culturally, and (for many seniors) spiritually active

12. Every country is looking for ways to meet the needs of its senior citizens How were they doing collectively as a region?

13. Active in considering and reviewing ageing policies Macau Plan of Action on Ageing for Asia and Pacific Second World Assembly on Ageing in 2002 Given the diversity of country features, one should expect a wide-ranging ageing policy in Asia

14. Policy options to support for Asia’s growing elderly population (1)Labor and retirement policies; (2)Policies affecting traditional family support systems; (3)Government and employer-sponsored pension schemes; and (4)Policies that encourage saving and investment East-West Center, 2000

15. Trend towards early retirement in Asia Median age of retirement for men dropped from 67 in 1960 to 63 in 2000 In 1950, 38 percent of Asian men and women age 65 and above were still in the labor force. In 2010, only 22 percent in this age group were still working

16. Labor and retirement Policies Increase mandatory retirement ages Introduce a system of sliding pension benefits Allow flexible and part-time employment options Provide occupational training

17. Family support and living arrangement Families are still the primary source of support for older people in most Asian countries Most older people in Asia reside with family Intergenerational co- residence is on the decline

19. Total fertility rate for selected Asian countries: 2012 Est. Developed countries Singapore0.8 Macau0.9 Hong Kong1.1 Taiwan1.2 South Korea1.2 Japan1.4 Replacement rate: 2.1 live births per woman Developing countries China1.6 Thailand1.7 Iran1.9 Vietnam1.9 Indonesia2.2 India2.6 Malaysia2.6 Source: CIA The World Factbook Decline in Fertility

20. Declining support base Potential support ratio Women labor force participation Pop. 15-64 per person aged 65 and more

21. Family support policies Maintenance of Parents Act: Singapore and China Tax incentives: Malaysian and Hong Kong Subsidize care and support services Public housing policies

23. Demand of long term care About 15 to 20% of older people are estimated to have mild degree of disability in their ADLs Less than 5% need high level of care Even maintain a stable proportion, the absolute number will increase

24. Elderly residents’ perspectives on filial piety and institutionalization in Shanghai (Chen, 2011) Hiring a domestic helper to care for an older parent was interpreted as a form of subcontracting filial care Number of domestic helpers in Hong Kong: 21,500 (in 1982) 292,473 (in 2011)

25. Key Challenges in Caring for Elderly Persons in Asia Lack of an overall strategy in ensuring a continuum of care for older persons; Inadequately addressing older persons’ needs in the health and long term care systems; Lack of elderly-friendly health & social services; and Human resources gaps in elder care Regional Forum on Elderly Care Services in Asia and the Pacific, 2011

26. Recommendations Should develop or strengthen a strategy in providing comprehensive continuum of care; Health and social care systems need to be adapted to address the rising demands for elder care services; Laws and regulations should be put in place to strengthen legal protection; and Should include strengthening caregiving service industry in their national development plans Regional Forum on Elderly Care Services in Asia and the Pacific, 2011

27. Many Asian countries have barely begun to implement programmes for the support of the elderly Some of these countries will have to develop better legal structures, financial markets, professional training and services, and administrative mechanisms Given the pace of population aging in Asia, policy- makers will need to act quickly After all, the Asia region is taking care of the majority of elders in the world!! Conclusion

28. Thank you