Supporting older persons’ right to self-determination:

1. Supporting older persons’ right to self-determination: Insights from low and middle-income countries Peter Lloyd-Sherlock 6 June 2018

2. Population aged 75+ in LMICs 383 million Source: UN Population Division (2018)

3. Social Protection (pensions) http://www.helpage.org/silo/files/un-independent-expert-social-pensions-are-critical-to-human-rights.pdf “The right to social pensions provides older people with security and control over their own lives.” (HelpAge International, 2010).

4. Pensions and financial abuse “My financial situation is better now, since he [husband] died. In the past, I used to go to the bank, collect my money and put it straight into his hands. He was in charge of it, but he wasted it all in the bar…” (older woman, Brazil 2008). “When I developed a walking problem, I asked my daughter to get my pension. I asked her to withdraw 50 Rand from my bank and she agreed. When I [next] had to draw my pension money, I could not find my pension card, only to find that she had taken it. She withdrew 700 Rand from my account. And now we have a misunderstanding” (older man, South Africa, 2011). “I am always getting calls late at night from people trying to trick me…. They even reverse the charges. These days I never pick up….” (older woman, Brazil 2008). Sources: Lloyd-Sherlock, Ayiga and Penhale (2018); Lloyd-Sherlock, Saboia and Ramirez-Rodriguez (2012).

5. Pensions and financial abuse “My financial situation is better now, since he [husband] died. In the past, I used to go to the bank, collect my money and put it straight into his hands. He was in charge of it, but he wasted it all in the bar…” (older woman, Brazil 2008). “When I developed a walking problem, I asked my daughter to get my pension. I asked her to withdraw 50 Rand from my bank and she agreed. When I [next] had to draw my pension money, I could not find my pension card, only to find that she had taken it. She withdrew 700 Rand from my account. And now we have a misunderstanding” (older man, South Africa, 2011). “I am always getting calls late at night from people trying to trick me…. They even reverse the charges. These days I never pick up….” (older woman, Brazil 2008).

6. Social Care in LMICs Minimal state support for family carers Unregulated care providers A discourse of denial

7. Yolanda and Juan He’d fallen...So the first thing I said was, “You know what? You’re coming with me and I won’t take no for an answer”. He said “I kind of miss my house. I want to leave.” So I told him: “When you’re better, yes, dad”. He didn’t want to give me power of attorney, at first, so I said, “If you don’t want me to have it, I’ll still take care of you”. Source: Lloyd-Sherlock et al (2016).

8. Unregulated private provision 4 November 2012 En Rosario hay 30 geriátricos truchos que violaron las fajas de clausura “Overcrowded, lacking any medical care or nursing, poorly fed, living in filthy and dangerous conditions. That’s life for many older people in our city’s illegal care homes...” http://www.lacapital.com.ar/la-ciudad/En-Rosario-hay-30-geriatricos-truchos-que-violaron-las-fajas-de-clausura-20121104-0012.html

9. Argentina

10. Key informant “These days, people don’t even view this practice as abusive. The problem is that it is completely legal… The older person doesn’t see it as an infringement of their rights. They just see it as a natural part of being old. The situation has come to be seen as normal. You get old, the children need a place of their own, so you just sell your house and go into a care home”. Source: Lloyd-Sherlock, Penhale and Redondo (2018)

11. A global issue

12. Health WHO: The right to health must be enjoyed without discrimination on the grounds of race, age, ethnicity or any other status. Sustainable Development Goal target 3.4: By 2030 reduce by one-third premature mortality from non-communicable diseases

13. Health WHO: The right to health must be enjoyed without discrimination on the grounds of race, age, ethnicity or any other status. Sustainable Development Goal target 3.4: By 2030 reduce by one-third premature mortality from non-communicable diseases

14. DEATHS BETWEEN AGE 30 AND 70

15. NCDs and Older People UK prevalence of untreated hypertension < 10% South Africa prevalence of untreated hypertension among adults 50+ > 70%

16. Dignity and self-determination among the oldest Frame this as a global issue Link different constituencies (older people, gender, disabilities, health) Challenge discourses of denial

17. Sources cited and further material UN Population Division (2018) World Population Prospects www.un.org/popin HelpAge International (2010) UN Independent Expert: “Social pensions are critical to human rights” http://www.helpage.org/silo/files/un-independent-expert-social-pensions-are-critical-to-human-rights.pdf P.Lloyd-Sherlock, N.Ayiga and B.Penhale (2018) Financial abuse of older people in low and middle-income countries: the case of South Africa Journal of Elder Abuse and Neglect 30(3): 236-46. https://www.tandfonline.com/doi/full/10.1080/08946566.2018.1452656 P.Lloyd-Sherlock, J.Saboia and B.Ramirez-Rodriguez (2012) “Cash transfers and the wellbeing of older people in Brazil”. Development and Change 43(5):1049-1072. https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1467-7660.2012.01790.x Alzheimer’s Disease International (2015) World Alzheimer’s Report 2015. https://www.alz.co.uk/research/world-report-2015

18. Sources cited and further material P.Lloyd-Sherlock, R.Mayston, A.Acosta, S.Gallardo, M.Guerra, A.Sosa, V.Montes de Oca and M. Prince (2017) “Allocating family responsibilities for dependent older people in Mexico and Peru” Journal of Development Studies. 54(4): 682-701. https://www.tandfonline.com/doi/full/10.1080/00220388.2017.1308489 Roqué, M., Fassio, A., Arias, C. and Croas, P. (2016). Residencias de larga estadía para adultos mayores en Argentina. Relevamiento y evaluación. Ministerio de Desarrollo Social. Buenos Aires. Office of the Health Ombud, Republic of South Africa (2017) The report into the ‘circumstances surrounding the deaths of mentally ill patients: Gauteng Province. No guns: 94+ silent deaths and still counting. Health Ombud, Republic of South Africa http://www.ohsc.org.za/images/documents/FINALREPORT.pdf Disability Rights International (2009) Abandoned and Disappeared: Mexico’s Segregation and Abuse of Children and Adults with Disabilities https://www.driadvocacy.org/wp-content/uploads/Abandoned-Disappeared-web.pdf P.Lloyd-Sherlock et al (2015) “A premature mortality target for the SDG for health is ageist” Lancet 385(9983):2147-8.

19. Sources cited and further material Disability Rights International (2009) Abandoned and Disappeared: Mexico’s Segregation and Abuse of Children and Adults with Disabilities https://www.driadvocacy.org/wp-content/uploads/Abandoned-Disappeared-web.pdf P.Lloyd-Sherlock et al (2015) “A premature mortality target for the SDG for health is ageist” Lancet 385(9983):2147-8. www.thelancet.com/journals/lancet/article/PIIS0140-6736(15)61016-9/abstract

20. P.Lloyd-Sherlock@uea.ac.uk Professor Peter Lloyd-Sherlock School of International Development, UEA. https://www.uea.ac.uk/international-development/people/profile/p-lloyd-Sherlock