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GUEST EDITORIAL

Who will take care of us when we get old?

Quem vai cuidar de nós quando envelhecermos?

Helena Akemi Wada Watanabe hwatanab@usp.br

Universidade de São Paulo, Brazil

Yeda Aparecida de Oliveira Duarte

Universidade de São Paulo, Brazil

Karla Cristina Giacomin

Fundação Oswaldo Cruz, Brazil

National Front for Strengthening Long-Term Institutions for Older Adults, Brazil

Ana Amélia Camarano

Institute of Applied Economic Research, Brazil

Universidade Estadual do Rio de Janeiro, Brazil

Geriatrics, Gerontology and Aging, vol. 17, e0230019, 2023
Sociedade Brasileira de Geriatria e Gerontologia, SBGG

Received: 22 May 2023

Accepted: 26 May 2023

DOI: https://doi.org/10.53886/gga.e0230019

Brazil is aging rapidly: in 1960, only 3.3 million Brazilians (4.7% of the population) were 60 years or older, while by 2020 this number has risen to more than 28 million (13.7% of the population). Given the lower birth rate and the lower mortality rate at all ages, in the 2030s the Brazilian population will begin to shrink.1

Aging, a great achievement for a society, results from improved living conditions and advanced assistance technology, posing new challenges for public policies and society, especially the demand for care. Data from the SABE Study, which has been accompanying older adults in the city of São Paulo since 2000, show that new generations of adults have reached old age with greater functional impairment2 than previous generations, requiring more care.3 Thus, we are living longer, but with chronic diseases and, often, with difficulties in daily activities,4 which raises the question: who will take care of us in the very near future?

In Brazilian society, care for dependent people of any age is provided mainly in the private sector, by families, with women being the central figure. However, the composition of families has undergone profound changes, both numerically (fewer children) and structurally (single-parent families, marriages, divorces, remarriages, etc.).1 Moreover, the progressive inclusion of women in the workforce directly affects the availability of family care, since women are often optionless and unpaid caregivers.1

The cost of care – time, money, and opportunities – should also be recognized. These social and financial costs of long-term care are significant, and many families cannot afford them.1 Family caregivers must often abandon their work and/or studies. Because the task of caring is often unpaid, caregivers are left unprotected in their own old age, since, upon leaving the labor market, they stop contributing to Social Security, losing guaranteed income after retirement.5

The COVID-19 pandemic has also shown that Brazil is an ageist country,6 especially against those requiring continuous care or who live in nursing homes, who remain invisible to public policies.7

Federal Decree 11460 (March 30, 2023)8 has established an Interministerial Working Group to develop a National Care Policy. This important initiative’s responsibility is to structure a care framework that encompasses social and health care for all Brazilians. The interests of current and future populations of older adults must be prioritized in this working group, which includes representatives of government and civil society whose agendas include older adults.

Without such change, Brazil might continue to be thought of, erroneously, as a country ofyoung people, thus contributing to ageism and countless cases of abandonment, negligence, and domestic and institutional violence, which devastate and embarrass our country.