Respondendo à revolução da longevidade

Abstract

The longevity we witness today at a global level -and undoubtedly in Brazil -is a revolution. We already live thirty or more years longer than our grandparents. The implications of this process transcend the individual dimension and impact the legal, health, education, culture, labor, social services and social security sectors. Longevity also has a retroactive effect, with impacts on all stages of life: it is not a further thirty years of old age, but a further thirty years of life.My first impression of an aging country was in England where I went to study for a Masters in Public Health in 1975. From that time onwards, I realized that Brazil was also aging quickly, albeit in a context of poverty, unlike developed countries that first evolve, prosper, and then grow old. I realized years later that Brazilian aging occurred in an extraordinarily compressed manner: our life expectancy now exceeds that of England in the 1970s and the fertility rate rose from the threshold to replacement in a few years.My 20 years of academic experience in London and Oxford, in addition to the period when I ran the Department of Ageing and Health of the WHO, helped me formulate Active Aging: a Policy Framework, as defined by the WHO: the process of optimizing opportunities for health, participation and security in order to enhance quality of life as people age. Those who grow old with health and knowledge can participate fully in society. In the absence of such conditions, it is essential to provide protection and security to ensure that the elderly do not feel abandoned. Therefore, a policy that addresses the Longevity Revolution must promote the four major axioms for aging well: health care; access to knowledge; financial conditions, at least a minimum wage; and support and care of family, friends and neighbors.

Instruments for the functional assessment of elderly persons in palliative care: an integrative review

“…Applying the PRISMA protocol adds quality to the article, as such guidelines are focused on helping authors reduce publication bias and are a likely marker of rigor of conduct in Evidence Based Practice (EBP) 30 . From an overall perspective, all 21 articles analyzed are written in English and are based in countries considered to be developed and which have high longevity rates, implying that the Longevity Revolution is a reality that has been widely discussed and studied, unlike Brazil, which remains in the process of aging 31,32 .…”

Idosos dependentes de cuidadores

“…In Brazil, the population count for December 2019 shows that there are already more than 24.1 million people over the age of 60 in the country. And the unprecedented increase in those over 80 years of age has become an irreversible fact, this being the most vulnerable group in social terms and from the health standpoint 3 .…”

O imperativo de cuidar da pessoa idosa dependente

“…Since then, a progressive fall in birth rates has been seen associated with other phenomena such as the universalization of education and primary health care, the intensification of female participation in the job market and the widespread availability of family planning. The growth in the number and the ratio of elderly people -with an exponential increase in the population over 80 years of age -has become an irreversible fact [1][2][3] .…”

“…From the political standpoint, even though several sporadic initiatives have been implemented, Brazilians have still not fully tackled the question of "dependency." Thus, some actions are needed, such as: (1) to define the duty of the State with regards to the irreversible phenomenon of an increase in the population and the dependency on third parties of elderly people who suffer from a loss of autonomy; (2) to establish a formula for joint participation with civil society organizations, the families and the elderly people themselves; (3) to adapt the traditional structure of social security policies to deal with this expanding group; (4) to establish ways to finance the increase in demand and the complexity of services that are becoming increasingly necessary; (5) to improve the situation and training of family caregivers and of formal caregivers; (6) to develop specific local programs and services, to meet the demands of this segment of the population in its varied stages of loss of autonomy.…”

“…From the operational standpoint, Brazil needs an agenda of specific and adequate ser-vices. For this, several questions need to be taken into consideration: (1) to understand the nature of the problem and its meaning for individuals, the family and society. Dependency cannot be restricted to the medical dimension, although it is manifested in functional deficiencies that greatly affect health.…”