The tenth meeting
under the theme of ‘Talking about the Human Rights of Older Persons’ took place
online on November 23, 2022 with Dr Arne Henning Eide. Dr Eide is Chief
Scientist of Health Research at SINTEF based in Norway. He is also a Professor
at the Department of Social Work, Norwegian University of Science and
Technology. He has extensive experience in research on disability and poverty,
assistive technology, community-based rehabilitation and studies on living
conditions in more than 20 different low-income countries. Dr Eide has
collaborated with World Health Organisation (WHO), UN, UNICEF and other
international organisations over many years and was the lead researcher for the
implementation of the Rapid Assistive Technology Assessment in 35 countries in
collaboration with WHO.
During the meeting, Dr
Eide talked about the history and research fields of SINTEF as well as major research projects
relating to older people that he has taken part in. He shared his thoughts and
insights earned from research he has been involved in, particularly the
specific characteristics of ageing in low- and middle-income countries and how
digital technology can be utilized to support healthy ageing. He then offered
his views on the current global initiative towards adopting an International
Convention on the Human Rights of Older Persons.
1. SINTEF and its Research Areas
SINTEF is an independent research institution based in Norway. It
is among the top five largest research institutions in Europe, employing about
2,000 researchers. It was established more than 60 years ago in the context of
rebuilding Europe with US Marshall aid after the Second World War. It is a
non-profit organization and operates as a foundation. While receiving a basic
grant from the government as most research institutions in Europe, it largely operates
with contract-based funding from various parties. Funders include corporations
in the R & D market, public institutions particularly for research on
health, the EU (Research Council), and international organizations like WHO,
UNICEF and World Bank. SINTEF is a reputable and well-established research institute
in the fields of technology and health.
SINTEF specializes in technology related to construction, industry,
energy, the oceans digitalization, health and buildings. It is also closely
connected to the oil industry, the major economic sector of Norway. There are several
sub-institutes under SINTEF and one of them is SINTEF Digital that specializes
in digital technology, within which the Department of Health Research sits and which
Dr Eide is affiliated with. The Health Research Department is relatively small
within SINTEF, having 60 members, but benefits from carrying out interesting
cross-disciplinary research that intersects technologies, health and sciences.
Among several groups within the Health Research Department, Dr Eide belongs to the
Global Health Group and has been involved in researches focusing on vulnerable
populations in low- and middle-income countries, especially people with
disabilities. He has taken part in researches on different countries across the
world, primarily in Southern and Central Africa, in the Middle East and some
countries in Asia such as Nepal, Indonesia and Vietnam.
Dr Eide has been working for SINTEF for 25 years. His main research
activities have been collecting data through large national representative
studies in 11 different countries on the living conditions of people with
disabilities, compared with those without. The core expertise of the Global
Health Group is to organize, carry out, analyze, publish and utilize these data,
in close collaboration with civil society organizations. There is much room for
further research on older populations on the basis of this available data set.
In fact, SINTEF owns a large pool of household surveys collected over the
years. While SINTEF focuses on the countries that Norway has close relationship
with, such as African countries that Norwegian development aid prioritizes,
other countries, including Korea, that are interested in global ageing, can
adopt them to their particular needs or purposes. If there is an agreement
between the participating institutions on how and for what purpose these data
are to be used, the data can be potentially shared and many interesting
collaborative research projects based on these data can be conducted.
2. Research on Older People in Norway and its Implications
Among numerous
research projects Dr Eide has been involved in, he mentioned two major projects
that directly touches on older people. One of these projects was about elder
abuse and it was one of the largest research projects on the topic that had
ever been conducted in the world. Funded by the Research Council of Norway, it conducted
interviews of staff members at 100 nursing homes in Norway, and came to collect
highly reliable data on the extent and nature of elder abuse in nursing homes. This
research in and of itself is a great achievement and research outcomes have
been and will continue to be published. It also initiated many interesting
reactions among researchers and politicians. He was invited to a meeting with a
minister who wanted to change immediately some of the regulations concerning
reporting of patient safety issues from nursing homes. This is a good example
of research having a direct political impact and initiating political debate
and change.
The
research findings came as a shock to many people as many were not aware of
elder abuse as a serious issue. In reality, elder abuse is more prevalent than
one thinks, particularly under the conditions of a lack of physical and human resources.
They also underlined that one has to be careful about the definition of elder
abuse, to the extent that it covers a wide range of things. In fact, physical
and sexual abuse is less prevalent than psychological verbal abuse or neglect. Furthermore,
the research project has raised a question mark about Norway’s welfare system,
which is often praised and even considered by many a model case. The research
highlighted that Norway, where elder care is highly institutionalized, is also encountering
serious problems including elder abuse. On the other hand, it is not clear if
elder abuse is worse in institutions than at people’s homes. In fact, it is
quite likely that elder abuse in the private sphere is extensive. This is an
issue that needs to be addressed more seriously.
Another
major project that Dr Eide was involved in in relation to older people was
about how home-based elder care services can contribute to older people’s
engagement in daily lives. This project, too, was conducted concerning the case
of Norway for a period of four years and funded by the Research Council of
Norway. It is well known that an active social life can have a positive health
impact both physically and psychologically. While home-based care is seen as an
alternative to institutionalized care, it has turned out that many people in home-based
care stay inactive and suffer from loneliness, and very often their sole
contact is with home-visit nurses. This shows that home-based elder care can
also create problems of passivity and loneliness. This research also underlined
the importance of building a good working relation between care recipients,
family members and care personnel, to the extent that family members play
important roles and the conflicts and different perspectives between them should
not be allowed to affect the quality of elderly care adversely.
Moreover,
this research also highlighted that home-based care should do more than providing
support for practical matters such as doing shopping and cleaning. Though this
is important, people receiving home-based care want more: they want to have
more engagement with social activities and networks. This highlights that the
home-based care system should be rethought and reorganized in a way that care
recipients expand their participation. Fortunately, gradual change in this
direction is already visible. The principles that guide home-based care should
be participation and inclusion.
3.
Ageing and Technology in Developing Countries
In
low- and middle-income countries, home-based elder care and institutionalized
care are marginal: care for older persons is typically the business of the family.
The strong influence of the family’s perspective in elder care contrasts sharply
with developed countries like Norway, where there is little room for family
intervention as institutions and the welfare-state are in charge, losing the
close human contacts and responsibilities that family members have for each
other. Furthermore, older people in the developing countries tend to play their
roles in the community much longer. While the developed countries look at
home-based elder care as an alternative to institutionalized care, the
developing countries have not started the process of institutionalization. The
predominant form of elder care in the developing countries is, precisely
speaking, family care, rather than home-based care, where professional care
systems are lacking or absent.
In
spite of some positive aspects of the family’s strong involvement in elder care
and the fact that looking after family members in itself has virtuous elements,
there are also flaws. Family care can create serious problems such as abuse and
neglect, caused by a lack of knowledge or awareness. Moreover, family care often
imposes a great burden on working-age family members. These problems are
closely connected to poverty: poverty is the single most serious problem in the
developing countries and is a burden that often spills over in various social
problems. It is important to recognize that poverty has a huge impact on how
people live and relate to each other. It makes people fight for survival and often
has the effect of excluding and marginalizing the vulnerable; for instance,
older persons and people with disabilities are not at the front of a queue for
food distribution.
What
this suggests is that international development projects that address global
ageing and the human rights of older persons cannot but address the issue of poverty
simultaneously. Furthermore, there should be a system in place that provides families
in the poorer regions with access to education to enhance their awareness of human
rights. Ageing is already advancing rapidly in the developing world. Developing
countries would neither be able to, nor wish to, copy the models of the
developed countries. In addition, in many countries, institutionalization is
culturally unacceptable. In this context, a new combination of individualism
and collectivism should be found and built.
4.
Digital Technology in the Developing Countries
Dr
Eide shared his view on how technology can enhance the life of older persons in
low- and middle-income countries on the basis of his experience. He was
involved in WHO-funded research on access to assistive technology among the
world’s older persons and disabled in low- and middle-income countries as a
part of the WHO’s initiative Global Cooperation on Assistive Technology (GATE).
Digital technology can have a greater impact than one thinks, even in poor
countries. A global challenge is to ensure that people have access to
(relatively simple) assistive technology. Digital technology can save time and
enhance efficiency in the healthcare sector, and move healthcare closer to
people. As long as countries are receptive to adopting digital technology and
understand its benefits, and if there is funding to support it, significant
change can happen. For instance, highly competent healthcare exists in most
countries, but very often only in urban areas. Dr Eide was involved in a
project in Malawi that monitored patients, where health workers were trained to
connect patients in the rural areas to specialists in the capital using mobile
phones. In fact, such small but promising projects and trials are being
implemented in many places. This shows that digital technology can be utilized
for the benefit of many people in the context of low- and middle-income countries.
5. A Convention on the Human Rights of Older Persons and Future
Collaboration
Dr Eide has been following the preparatory
work as well as the implementation of the Convention on the People with
Disabilities. From the process he learnt that while many discussions and events
happen at the international top level, its actual impact on the ground takes
much longer. However, the work on the Convention brings many parties together
and makes things move forward collectively and consensually. It can take years
to arrive at a Convention on the Human Rights of Older Persons, but the
preparatory phase is important, bringing all stakeholders on board. A global
dialogue on the content and design of the Convention is highly necessary,
particularly given the immense diversity in cultures and politics among
different countries. Careful finetuning of the content is therefore very much
needed.
Finally,
Dr Eide expressed his interest in cooperating with the ASEM Global Ageing Center
(AGAC), sharing his research findings and knowledge of many experts and
researchers who could be approached for collaboration.
Hae-Yung Song
manji74@asemgac.org
