Population Ageing and The Need of Long Term Care for Older Persons in Indonesia
Indonesia‘s older population is growing at an unprecedented rate throughout the period of1990 -2020, as well as experiencing an increase in life expectancy from 66.7 years to 70.5 years. Thus, Indonesia will enter the aging population that is marked with th e percentage of elderly (age 60 and above) reaching 10 percent in 2020. Globally, Indonesia ranks fourth in terms of population density, while in the case of the older population, it is ranked 10th. The number of older persons in Indonesia is expected to increase to 28.8 million (11% of the total population) in 2020, and in 2050, and amount to 80 million (28.68%). Demographic transition is a process of change in population structure as a result of changes in demographic processes, which are currently being experienced by almost all countries in the world in the form of population aging. The problem of the latter is mainly a result of a decrease in fertility rates and an increase of life expectancy. On the other hand, these conditions will be more severe if the aging of the population is accompanied by a pathological condition. The aging process affects the deterioration due to the risk of various diseases, especially chronic/degenerative. The longer the life of a person, the more the person is prone to experience physical, mental, spiritual, economic and social problems. Based on RISKESDAS (Basic Health Research 2013), the diseases found amongst the older persons in Indonesia include hypertension, osteoarthritis, dental-oral problems, chronic obstructive pulmonary disease (COPD) and diabetes mellitus (DM) (The Ministry of Health of the Republic of Indonesia, 2014).The emergence of various diseases and disorders can lead to functional disabilities in older persons, with more severe conditions requiring the help of others, hence the need of long-term care (long term care/LTC). Disability as measured by the ability to perform activities of everyday life or Activity of Daily Living (ADL) affects approximately 51%, with further increase in the age prevalence. Older persons with mild disabilities form around 51% at age 55-64 years, to 62% at age 65 and above. While severe disability affects about 7% of those aged 55-64 years, rising to 10% at 65-74 years, and 22% at age 75 years and above. The conditions above require health and social service delivery. Therefore health service delivery for the older persons will be conducted in a comprehensive manner, starting from families and communities (integrated health service delivery post for the elderly and home care), first level health service facility (Pusat Kesehatan Masyarakat/ Puskesmas or Community Health Center) and referral health service facility (Hospital) in collaboration with other related social sectors.