Jana Abdul-Samad
GTY 260
Final Reflection Paper
The aging process begins from the moment a person is born. Every choice we make and everything that happens to us has a direct impact on the way we grow older. Each experience is a modification to our current state, influencing our beliefs, our behaviors, and our decisions. Outside factors affect our experience, including government policies, environmental development, and those we interact with. Each of these things can have a negative or positive impact on us, shaping how successfully we age. The aspects that I found most interesting were the age friendliness of a city, the long-term care structure for older adults, and the health care options available to older adults.
The age friendliness of the environment one lives in can affect how comfortable older adults feel in their surroundings. South Korean culture has historically been extremely family-oriented. This included a structure that centered around the extended family, and care for older adults was generally the family’s responsibility.1 Older generations played a vital role in the family, and were extremely respected. As of late, Korean culture has seen a shift from the traditional extended family to more nuclear families. This shift has led older adults to be more likely to live alone, fueling an increase in isolation and risk of suicide. This creates a decrease in the social engagement older adults experience, and moves away from having a role in the family. To prevent this, the South Korean government has enacted initiatives, including older age volunteer opportunities and suicide prevention programs.2 In order to increase the opportunity for social engagement, the government has also attempted to provide age-friendly infrastructure, especially in transportation and accessibility, yet still has progress to make on affordable age-friendly housing.
The lack of an age-friendly environment can make it extremely difficult to feel secure as an older adult. In the disablement process, it becomes very feasible to be considered disabled on the basis that you are unable to adapt to the environment. It is important for us to realize that we need to make the environment more accepting of older adults, giving them the opportunity to take part in day-to-day activities as they have done their entire lives.
This would be a very useful aspect of South Korean government to adopt in the United States. Our culture is extremely independent, with older adults caring for themselves and experiencing isolation frequently. Implementation of these programs would increase the engagement older Americans experience later in life, decreasing depression. The United States also has very limited transportation and unaffordable housing, making it difficult for the older generation to live comfortably. I have been especially able to see this discrepancy with my parents. While they are still young, paying for my sisters’ and my education has limited their savings. As they age, they have already begun worrying about their living situation in the future. It becomes increasingly more difficult to be able to afford housing while retired in the US, and being raised in this country has influenced my sisters’ and my beliefs about allowing our parents to live with us in the future.
Long-term care can also greatly affect the aging experience. The increasing shift from the traditional extended family to more nuclear families that has led more older adults to live alone has also led to changes in the long-term care system in South Korea. In the past, there was no system in place for long-term care for older adults due to traditional expectations that the family would care for the adults of the family.3 More recently, long-term care has become more publicly available for older adults, giving South Koreans more options. The government now provides residential care, home care, and cash for care, which is determined case by case through a standardized questionnaire depending on the needs of the clients. Financing for the Long-Term Care Insurance (LTCI) system comes from a combination of co-payments (based on the type of care), government subsidy, and insurance contributions. South Korea’s long-term care system is much less focused on lengthening one’s life compared to what is usually seen in the United States, as a result of the influence of Confusianism in South Korea. This long-term care, while definitely progress, still does not compensate caregivers sufficiently for the hours they work. While long-term care facilities are available in South Korea, the LTCI does not cover meals and private rooms, making it difficult for this to be an affordable option for older adults in need of these facilities. The system still has much to improve on in order to make this a reliable option for older adults.
A sufficient system for providing long-term care and reimbursing care-givers is essential to providing quality care for older adults. Without these services many activities of daily living become impossible to perform. Caregivers provide the aid needed to continue life as we are used to it. An inability to complete simpler tasks can cause older adults to feel helpless and dependent. Caregivers make these taks doable, and are able to ensure older adults are still able to function normally and maintain living the way they always have. In the United States, we consider long-term care to be a necessity for sustaining the older adults in our lives.
I cannot imagine trading our system for that of South Korea, since it is a less developed version of the system we have in the United States. The system in the United States is much more reliable and has many more options for older adults and their caregivers, including the services offered by South Korea in addition to time off work and many more home and community-based living situations.
Lastly, health care options can have a large influence on the aging experience. The LTCI system is a portion of the overall health care system in South Korea, which is modeled after that of Japan. This health care system also includes the National Health Insurance Program, which is universal coverage for all citizens, and the Medical Aid Program, which is coverage for low-income households.4 These services cover much of typical health care that is provided, yet not all prescription drugs are included and not all over the counter drugs are excluded. There are enough health care providers for the population, despite some regional disparities in more rural areas. Still, South Korea reports the highest out-of-pocket costs for health care spending among all OCED countries. A system such as this one ensures the entire population has access to coverage, but can only provide so much for each person under that insurance. With a rapidly aging population, there is more of a burden on younger generations to provide the funding not only for The National Health Insurance Program, but also the LTCI. This can affect citizens’ life course, as more spending early in life can lead to disparate financial situations in older age, producing a perpetuation of the financial situation.
While it would be ideal to provide universal coverage for the nation’s citizens, this is a system that must still be perfected before I would like to see it in United States policy. Health care systems in most European countries are more sustainable, and could be emulated both in South Korea and the United States. Developing a reliable health care system for citizens of all generations is essential to producing a workable system that will not lead younger adults to financial situations in which the new younger generation suffers.
An aspect of South Korean life that I find extremely beneficial is the view that older adults must be respected, and generally should be cared for by their families. This is a value that I was taught growing up. One of my earlier memories of this was my mother yelling at me for lying down on the couch while my grandfather was present in the room. I’ve learned that older adults deserve more respect than anyone else, mostly for the experience and care they give to their families. While South Korea is moving away from this practice, it is a way of showing older adults the care that we should give back to them.
Aging is a misconceived process and is a natural part of our life course. Understanding why we age and the changes we go through can improve our aging experience. There are many younger people who believe the stereotypes surrounding older generations and these misconstructions can be corrected through education about the aging process and exposure to older adults. Older adults are capable of doing just as much as when they were younger, and they feel they way they did when they were 30 years old, which is generally considered to still be very young by younger people. If we can realize as a global community that aging is not a turning point in our lives, we may be able to improve the older-age experience for the older generation. There is life after 60, and turning 60 doesn’t mean that you are suddenly sedentary and unengaged. The most rewarding experiences can happen later in life, and older age is something to look forward to.