Over the last 10 years the elderly population (60+ and over) on St. Maarten has doubled. Being able to provide for an aging population has become more prevalent as the number of elderly persons within St. Maarten begins to increase. Such a dramatic change has had consequences on the consumption of services in the medical field and social areas. In the past, Sint Maarten had a system in which (extended family) family and friends would take care of the elderly. Even though for a large part this system is still in place the economic situation makes it necessary that people have to work, meaning that the elderly are less looked after. In addition, the immigrant population might have a less extensive supporting network.
Recognizing the need to ensure social protection and social provisions for the elderly, the Department of Social Development at the Ministry of Public Health, Social Development and Labor (VSA) embarked upon an extensive research project into the needs of the elderly. In 2013, the Ministry of VSA finalized the report. The main research objectives were to provide answers to the following questions:
Q What are the needs of the elderly?
Q Which services are currently being provided to the elderly and what is lacking?
Q Which organizations are involved in providing services for the elderly and are they equipped for the ageing population?
The Ministry of VSA will use the research findings to guide policy development and implementation to remedy some of the various issues facing the elderly population of St. Maarten. The research was carried out by For a Change NV., who conducted a stakeholder analysis with all key organizations and a needs assessment of the elderly (60+yrs) and the aging population (50-59yrs). The sample size of the aging population is not representative of the aging population on St. Maarten, therefore these findings were only used to get an impression of how the needs of the 50-59 years old persons may evolve.
Part one of this series of articles will first present the major research finding about the needs of our elderly population.
Elderly Needs Assessment
An elderly person within this research study was defined as those above the pension age, which is 60 years and older on St. Maarten. In total the Civil Registry (Jan 2012) has 6,320 elderly persons registered. A total of 366 elderly persons and 25 organizations that provide services to the elderly participated in this research.
Social & Emotional Needs
"About 25% experience feelings of being left out and isolated."
Most of the social and emotional support that the elderly receive is from their family, from the existing NGOs and the church. Even though social service providers are doing a good job some elderly are still living in total isolation and are not reached by existing services. On an average 4.1% of the participants have no social support at all. About 25% of the participants experience a lack of companionship some of the time, feelings of being left out and isolated. Cases of poverty, lack of support from family and/or neighbors, lack of community spirit, lack of respect, lack of safety, doubt about help in case of emergency, and risk of physical and mentally abuse were reported. Almost 25% of the participants feel lonely. With limited financial means, the feeling of being unsafe in their neighborhood and the lack of transportation all have a negative influence on their loneliness.
Environmental needs
There were several indications within the report that many of the participants felt that their house is too small, not suitable anymore; too expensive; limits their mobility, and/or needs maintenance. Transportation, shops (grocery), commercial services (GEBE etc.), social services and elderly organizations are often too far away; they are unsafe in their own house; they feel unsafe in their neighborhood. Generally speaking the elderly population are also concerned about the road conditions; running sewage water on the roads; loud music; lack of proper transportation; lack of street lights; nuisance of drug addicts and homeless people; and lack of police control at night.
Health Needs
Of the 366 participants 257 (70.2%) reported that they suffer from one or more chronic illnesses. However, on an average 82.3% of the participants feel positive about their general well-being. About two thirds of the participants (67.5%) indicate that their health is good, very good or excellent. While 29.2% responded that their health is fair and 3.0% considers their health poor. Most of the persons who suffer from a chronic illness have one (50.2%), two (22.2% or three (15.6%) at the same time. Out of the 62 internationally recognized chronic illnesses, 37 where mentioned by the participants. Although many remained positive about their health condition, it was evident that the physical health of the participants limits them from performing in various activities.
More than 70% of the participants are totally independent; they need no help at all to do their regular activities. The other remaining percentage are elderly persons who are co-dependent on the help from family, friends, neighbors, or a professional care taker. Those that are dependent on others need assistance with taking care of their feet, going up and down the stairs, walking outdoors, washing and drying their body, dressing themselves, standing up form a sitting position, getting around the house, getting in and out of bed, going to the restroom, as well as eating and drinking. Majority of assistance needed in their daily activities are to assist with the cleaning of feet and toenails as well as the need for help to go up and down stairs.
Presently 12.3% of the elderly lack medical insurance. Compared with the general health situation of the elderly, especially when it comes to the prevalence of chronic diseases, this situation is alarming. A complicating aspect is that not all health needs (such as diets and household aids) are covered by medical insurance and tend to become an extra burden on the already low incomes.
Do you have enough income:
Financial Needs
More than sixty percent have a household income of ANG 1,500 or lower and twelve percent even have an income lower than ANG 500 a month. About 6% of the elderly use financial assistance, whereas the others receive financial assistance from friends or family.
Based on the research findings several recommendations were given, and the Ministry of VSA is looking into how the priorities of 2014 are reflect in these findings and how can 2015 be planned with the results from this report. The priorities for 2014 will be presented in the upcoming articles. Minister Cornelius de Weever states he is glad this research report is complete. "The information in the report provides the baseline and the data in order for us to continue to review and update policies and legislation. We have already drafted legislation and are awaiting the final signature for implementation."