We all have an elderly relative, friend or neighbor who requires additional support. Sometimes, we may even have to decide whether sending them to a retirement home is the right thing to do. But we know little about conditions in these places. Oftentimes, the institutionalized end up being invisible and vulnerable.
Most surveys on aging are conducted in family households, so we rarely learn about the lives of elderly people in retirement homes, which provide long-term residential accommodations. In most countries there are too few people in retirement homes for this omission to skew our understanding of the general health of elderly populations, but it nonetheless reveals a lack of understanding about a group of people that appears to be particularly vulnerable.
What do we Know?
- About 166,000 individuals over 60 years old live in retirement homes in 12 Latin American and Caribbean countries with available data. This represents 0.54% of the elderly.
- Chile and Uruguay have the highest percentage of elderly people living in retirement homes, at about 1.9% each.
- Costa Rica also has relatively high rates at 0.89%, and Brazil trails behind at 0.52%.
- For most countries, the proportion of elderly people in retirement homes never exceeds 0.2%.
These figures are calculated using census data in countries that distinguish between types of residences in their census questionnaires, but even they may be imprecise. The language used on census forms to categorize types of residences varies between countries, and categories that include retirement homes sometimes include other types of collective dwellings as well. Recent data are also scarce. Brazil, Costa Rica, the Dominican Republic, Ecuador, and Uruguay all have data from 2010 and 2011, but in countries such as Bolivia, data date as far back as 2001.
Dependency in Retirement Homes
Retirement homes can provide more intensive care, so one can expect that at least some of those living in retirement homes will be significantly dependent, meaning that retirement home populations as a whole are likely to be more dependent than the general elderly population.
This is borne out by the Longevity and Healthy Aging Study in Costa Rica (CRELES, 2009), which shows that 54.29% of elderly retirement home residents have some degree of dependency, a sharp contrast to the 23.83% rate among the rest of the elderly population. As a result, excluding retirement home populations from survey samples can potentially cause misestimations of how many of the elderly are in a state of dependency, leading elderly populations to be described as healthier than they really are. This can have important policy implications, impacting budget and other relevant decisions pertaining this group.
For instance, in Uruguay, which has a higher proportion of its elderly in retirement homes than any country for which there is data, underestimating dependency among the elderly can most likely be problematic. As a back-of-the-envelope calculation, if all individuals in Uruguayan retirement homes had some degree of dependency, adding retirement home populations to the figures in the country would bring the dependency rate for those at least 60 years old up to 7.06%, a fairly significant uptick from the 5.26% calculated without this group.
The Most Important Thing
People living in retirement homes appear to be particularly vulnerable, so scarce information on this group is problematic. The available data suggest that thousands of elderly people in Latin America and the Caribbean live in retirement homes, but there is little reason to believe that all of the challenges they face are shared by the remainder of the elderly population and little data available to shed light on what these challenges may be.
Going forward, it will be important for studies of aging populations to better capture individuals in retirement homes. Figures reported in studies such as the IDB’s “Panorama of Aging and Long-term Care” and calculated from household surveys used elsewhere are likely quite informative. However, obtaining still-scarce data on adults in retirements homes is key, for it may be that they are among the most severely dependent. Surveys that target this population specifically would certainly be useful, but more practically, it may be enough for those designing health surveys to simply ensure that they reach this group of people and interview enough of its members to allow for useful analysis. This information can better inform policy measures to ensure dignified aging environments.
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