Long-term care for older people in Indonesia: Unsustainable and unjust?

Abstract

The care needs of older people in most low and middle-income countries are typically met by family members, chiefly women, or remain inadequately acknowledged and met. We know, for example, that older people’s use of health services is low and that informal carers receive little support from the state. Economic pressures, exacerbated by current social distancing measures, leave families with stark choices in terms of which needs to prioritise. While local examples of small-scale programmes run by NGOs or primary health posts exist which successfully assist and empower older people and their carers, little is known yet about whether these initiatives are sustainable in the current climate, much less whether they can be scaled up. Drawing on early empirical and conceptual work on long-term care in Indonesia, this paper argues the need for taking a network approach to understanding the care provision of older people. By this we mean documenting and understanding the multiple minor and major, formal and informal actors involved in the provision of care and support to older people and the factors facilitating or impeding their successful interaction. We further argue for the need to recognise care as a cultural practice in which care needs and preferences are shaped by local values and socio-economic constraints. These values and constraints are likely to be shifting dramatically as a result of the current coronavirus pandemic, exposing fault-lines and exacerbating inequalities in access to health and social care. Uncovering these inequalities and gaps in current long-term care arrangements is a necessary step towards making care more sustainable and equitable.

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ORCID for Elisabeth Schröder-Butterfill: orcid.org/0000-0002-5071-8710

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