Happy Older Age Needs a New Definition of “Healthy”

The mirror image of health is disability. This means that one’s state of health mirrors a potential state for disability. Disability like health and illness, lie on a spectrum, and this is unlike conventional medical thinking, where health is often thought of as a simple presence or absence of health. Therefore, prevention approaches that maintain health also postpone disability or further loss of functionality whenever possible.

From a disability perspective, it means that a continuum of health (from healthy to sick) also translates into a continuum of disability states. Viewed from this perspective and following on from the developments of Tobias and Chung (2000), it isn’t simply healthy life (or health span) that matters – especially in older ages.

Even without the possession of full health, it remains important for an older person to maintain an independent life for as long as is possible. Further on, if further deterioration cannot be prevented any longer, the care system should try to maintain an “active” life that remains engaged with family and communities for as long as is possible. Therefore, it is not just health-span that is important but also extensions of “independent span” and “active span” which are also important.

Disability has a strong correlation with the environment and one’s social context. What one is able to do or not, such as walk around and engage with society, is very much dependent on how disability-friendly the environment is, and the degree of social capital available. The continuum of disability viewed in this way, suggests that joined-up (integrated) care with very strong care management and within an activated community, that all have strong environmental and social awareness, will be crucial for maintaining “independent” and “active” life, even in the face of mounting health problems.

Redefining “healthy” to include independence and the maintenance of an active state even in the presence of disability or increasing health problems will be crucial to the way we understand “healthy ageing” and thus, what brings meaning and purpose to older life in an ageing and successful Singapore.

REFERENCE

1.      WHO (2000). Report of international consultative meeting on healthy ageing development. WHO: Japan