Academic journal article The Hastings Center Report

Institutional Care of the Elderly

Academic journal article The Hastings Center Report

Institutional Care of the Elderly

Article excerpt

There is no reason to doubt that a society can, indeed, very well be judged on the basis of how it takes care of its elderly. By assuring high quality care, whether by providing it directly in public institutions or by supporting private caregivers, society could demonstrate its appreciation to a whole generation. High quality care is an ethical concern in at least two senses: providing good care for the elderly is itself an ethical obligation; and care must be provided in an ethical manner--that is, the human dimensions of care ought to take the central place.

Both the elderly themselves and younger generations can benefit when the old are assured good care. .A pleasant, comfortable old age, either in an institution or at home, would show the young and middle-aged generations that they have ample time left in life to achieve certain desires and to realize their human potentials. It would teach that life is not meaningless and devoid of quality beyond the age of retirement, that the young and middle-aged need not be greedy and egotistical, rushing to acquire all that they can before life inevitably ends at retirement.

Only a good old age can give real meaning to the spectacular extension of the life span that medicine now makes possible. And only a good old age can help restore a more balanced model for younger generations.

Given tremendous technical progress, with which a ten-year-old is better acquainted than a seventy-year-old, it might be true today that the old cannot claim much special knowledge that the younger ones would seek to learn from them. Only a good old age can help restore respect for the experiential wisdom that can be passed on from generation to generation.

Hans-Georg Gadamer, the ninety-three-year-old German philosopher, said in an interview, "I am a living anachronism, because I don't belong to this world any more, but I am still here."[1] Various surveys carried out among the elderly show the same or a similar view. We need a culture of old age if we want generations to live in harmony and if we want the elderly to enjoy a certain quality of life, including an acceptable degree of self-esteem and meaningful human relationship. Gadamer refers to social homes or homes for the aged as perfect schools for rapid aging. Some Hungarian health administrators call them "the places for collective dying"; others refer to them as "houses for the poor or forgotten people." In Hungary no humanistic care for the elderly has developed yet that would secure old age against existential fear and anxiety.

Aging in Hungary

In Hungary old age--according to the general view of the society--begins at the time of retirement, even if there are no visible signs of biological or bodily deterioration. At present the retirement age is sixty for men and fifty-five for women. The number of retired people has grown to over two and a half million, from 20.7 percent to almost 22 percent in recent years. Some 43,000 people receive regular social aid, while emergency help is given to over half a million people annually. Yet as the number of people who need them grows, the number of places in social homes is decreasing. And as Laszlo Vertes, the general secretary of the Hungarian Gerontological Society noted, "The number of personnel is inadequate, ... though the care of the elderly is three dimensional: psychic, bodily and social. The old justly feel that they don't deserve such lousy treatment from society after so many decades of work."[2]

Among the institutions providing care for the elderly in Hungary are social homes, day-care centers, home care, and apartments for retired people. Principally there are four types of social homes: for the elderly, for the mentally ill, for alcoholics, and for others. Often, however, the population of these homes is very heterogeneous and the mixing up of relatively healthy people with the retarded, the mentally ill, alcoholics, and young and old homeless individuals creates a number of problems. …

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