APPRAISAL OF THE QUALITY AND GOVERNANCE OF CARE OF THE ELDERLY TO IMPROVE THE QUALITY OF LIFE AND HEALTH OUTCOMES IN NIGERIA

Aging is the physiological change that occurs during the passage of one’s lifetime and leading to anatomical and physiologic changes (Mancopes et al ., 2021). Active aging has been defined as the process of optimizing opportunities for physical, social, and mental well-being throughout life to extend healthy life expectancy (Formosa, 2019). The aged and under-five are classified as the most vulnerable groups. The elderly is classified as the most vulnerable among the two sets due to their association with increased morbidity, functional decline, and disability (Daoust, 2020). There are different levels of aging such as molecular, cellular, organ, and individual aging. The different categories of the aged include healthy aged, acutely sick, chronically sick, psychiatric aged. It is pertinent to note that from the third decade of life, several physiologic variables start to decline and further compromise the individual’s ability to respond to pathological changes.

Who is an elderly person? According to the World Health Organization, an elderly is one who is greater than or equal to 65 years old (Lee et al ., 2018). This age has been adopted globally but in low-middle income countries, including the Sub-Saharan, most countries adopt the age of 60 years. An aging population is one with an increase in life expectancy and a reduced fertility rate (Kulik et al ., 2014). Life expectancy in high-income countries has experienced a fast positive growth while the growth curve in Sub-Saharan such as Nigeria has been slow over the decade though on the increase. Currently, the life expectancy for males and females in Nigeria is 54.8 and 56.8 years respectively (Worldometer, 2021). It is universally noted that females tend to have a higher life expectancy than males. On the other hand, the fertility rate has not dropped significantly in developing countries. Taking care of elderly people is becoming one of the greatest challenges in recent times (Biswas et al ., 2013). Nigeria has a population of about 206 million people, a population growth of about 2.62%, and a total fertility rate of 5.4 live births per woman. The total fertility although among the highest in Africa, has been declining at a slow pace. The United Nations (2012) reported that there are about 8.8 million persons aged over 60 years in Nigeria, with a projection of 28 million by the year 2050. In Nigeria, the population of persons older than 65 years and above is about 5,644,234 (World Bank, 2020). It is remarkable to note that there has been an increase in the population of elderly in Nigeria. This has occurred despite the background of poverty, loneliness, neglect, and increased burden of diseases (Tanyi et al ., 2018). The world has experienced a gradual demographic transition from patterns of high fertility and high mortality rates to low fertility and delayed mortality. The transition began with declining infant and childhood mortality due to effective Public Health programs. Globally, the aging population is a global demographic transition. In Nigeria and its sub-regions, with an increasing number of the elderly, the Government still does not have the policy framework or laws to engage in global discussion for the elderly. This age group has been left at the mercy of other stakeholders such as foreign donors and faith-based organizations.

This article can be justified primarily from the fact that there is no existing National policy on the care of the elderly in Nigeria (Tanyi et al., 2018). Rather a Senior Citizens Act was signed in the past years with no sight of the document. It will also critically analyze the ways by which few existing practices of the care of the elderly are being governed. It is projected that the Nigerian population will keep increasing despite the economic hardship. This will further double the proportion of the various age groups of the elderly. In a bid to cater for the economic, health, psychological needs of the elderly, more research should be conducted on the elderly persons. Social support and appropriate care are strongly linked to a better quality of life and life satisfaction for the elderly (Ebimgbo et al., 2018). The establishment of Geriatrics centers started sprouting in Nigeria within the last two decades with only a few accredited centers in existence.