This year, persons born between 1948 and 1953 will range in age of 60 and 65; that is to say that Barbados now has an aging population which in many ways is competing for the same services that persons born between 1970 and 1980 also require.
Within 20 years, one in five persons will be over 65 years old, and in 15 years, this group will be severely impacting the general healthcare system. What is even more dramatic is that many persons born between 1928 and 1938 are still alive and fall into the category of “Senior Citizen Under Care”.
Adults over 65 account for nearly half of all physician visits and nearly half of all hospital stays. In addition, nearly one third of all written prescriptions are for seniors, and a similar number account for physical therapy treatments and account for almost ninety prevent for all residential care facility populations. This same estimate will be affected by poverty and or one or more chronic illnesses.
The number of workers in residential care services is actually declining rather than increasing; as many workers do not see it as a care field with a high pay scale. The overall profession is actually aggressively looking for specialists and care givers in all areas of the discipline; as geriatric care is a very demanding discipline which requires both personal commitment and accredited skill if the quality of care received is to be of a high quality of service.
Strengthening the elder care work force is not only vital to a society’s infrastructure, but it is also possesses the potential of actually contributing to long-term economic growth as a functioning industry.
Care of the elderly is projected in many metropolitan countries as the fastest growing employment sector within the health care industry, as people are living longer and overall world population continues to increases steadily each decade.
But what does “Under Care” really mean when one is planning for a catastrophic situation? In most cases it means that there will be a section of the society that will need special consideration if they are to survive the impact of a major disaster scenario.
It means that if there a mandatory evacuation is ordered, these persons will require some level of priority assistance; both in physical assistance to evacuate and in accommodation. They will also need additional personal services to maintain their care at the relocation facilities as their care cannot be suspended due to an evacuation order.
Persons living in residential care facilities receive guarantees on the quality of care provided, however, in the face of a major disaster, those guarantees may no longer be valid, as that quality of care may be drastically affected by the physical conditions that are immediately evident as the impact of the disaster is examined the day after.
Depending on the hazard type, entire facilities may be destroyed or deemed unsafe for continued occupation, and staff may be either be killed, injured, or isolated from the care facility due to impassable roads or other adverse conditions. These staffers may also ultimately be affected by the same disaster scenario if the hazard type is a natural hazard.
Fires as a hazard type will render any facility completely unusable for senior citizens; even if the facility only suffers minor damage, due to the level of smoke damage thereby rendering the entire facility a respiratory hazard for persons residing in the facility.
Hurricanes and earthquakes will have an even more devastating impact on the facility regardless of its location. It may have escaped the impact of the sea, but the category three winds of a hurricane can completely removed its roof, devastating all of the contents of its interior.
And an earthquake will render it unsafe due to severe damage to its physical infrastructure. The problem with guaranteeing the same quality of care at alternate facility, may be multifaceted in content due to many reasons — physical size of the building; bathroom facilities not equipped for the elderly or physically disabled; electricity and access to running water; stairwells, narrow doors and limited space for patients who are bed ridden.
There were many stories coming out of New Orleans following Hurricane Katrina in 2005. One such story related how the hurricane severely impacted the quality of care at the alternate facilities used for emergency shelters. The scandals and legal issues that followed Katrina brought by the families of the victims who either suffered or died on the streets of New Orleans during the first ten days that followed, still reverberate in the Office of the Mayor of New Orleans in 2013.
Claims by families that many of the conditions experienced could have been foreseen and planned for, have been aggressively denied by authorities; and counter claims have surfaced stating that many of the private care facilities did not have any type of plan for major emergencies; and that administrators had expected that the New Orleans city government and the US government would have been responsible for the provision of special care for the elderly and the disable.
In comparing the two societies, there are many in the Caribbean that are of the view that in the event of a major disaster, that regional governments, including Barbados, will assume all responsibility for providing and maintaining the same pre-disaster quality of care in a post-disaster conditions.
Lawyers have said that that may be a very difficult issue to pursue through the court in a post-disaster period; as where government may be liable for providing care to residents in its own public service facilities in a post-disaster period, the same may be extremely difficult to achieve in expecting government to be liable for similar care guarantees if a private facility is devastated.
However, in the event of a national evacuation or where all facilities both private and public will be expected to share one government managed evacuation facility, then it will be expected that the quality of care and service will meet the same standard as required for persons under care.
This is an extremely complicated issue that has not yet been comprehensively addressed as an agenda item during any state planning meeting. Neither has it been addressed by private sectors operators of residential care facilities.
Community workers have commented that this lack of planning on the part of both entities, will contribute to eventual chaos some analysts have predicted, should any Caribbean country fail to address this very important issue.
Is it expected that the Caribbean will be able to avoid a New Orleans scenario? Or will it be another horror story of a cholera epidemic following an 8.0 on an island that has refused to comprehensively plan for any eventuality?