Social and Medical Care Models for Elderly People Living Alone

Social and Medical Care Models for Elderly People Living Alone

Prof. Dr. Lobar Eryigitova

Faculty of Medicine, Department of Social Sciences and Physical Culture

DOI: https://dx.doi.org/10.47772/IJRISS.2025.9020018

Received: 02 December 2024; Received: 18 December 2024; Accepted: 20 December 2024; Published: 27 February 2025

ABSTRACT

This article examines the socio-medical characteristics of the older population through the lens of sociology, social gerontology and medical sciences. It explores strategies to promote active ageing and improve the health of older people, particularly those suffering from loneliness, by engaging them in community-based social health activities. The analysis includes best practices and advanced methods to address the challenges faced by older people. It emphasises the importance of social rehabilitation, wellness programmes and mobile social services in improving quality of life.

Keywords: ageing population; loneliness in older people; sociology of ageing; social gerontology, social medical services, mobile solutions for elderly care.

INTRODUCTION

The increasing proportion of older people in the world’s population has been the focus of scientific interest since the 1960s and marks a decisive phase in which industrialised countries observed significant demographic changes for the first time. Two interlinked processes — — falling birth rates and rising life expectancy — — are central to these changes (Harper, 2014; Lee & Mason, 2006). According to the World Health Organisation (WHO, 2022), the world’s elderly population, which was estimated at 0.5 billion in 1990, is expected to reach 3.2 billion by 2100. The United Nations (UN, 2021) also predicts that the proportion of people aged 65 and over will increase to 1.6 billion by 2050, emphasising the urgency of robust research and policy development in this area.

The implications of these trends go beyond demographic development and also include critical challenges in the areas of healthcare, social protection and social integration for older people. Globally, the need for innovative medical and social services has increased, especially for vulnerable populations such as the disabled and those in need of external support (Phillipson, 2013; Randel et al., 2020). For example, improving rehabilitation services through modern technology and home care for the elderly have been prioritized (Suzuki & Takahashi, 2018; Moen, 2016). In addition, initiatives to promote spiritual, educational and cultural activities at community level have been shown to be effective in improving the quality of life of older adults (Eurostat, 2019).

Alternative approaches to meeting these needs, such as improving hygiene and living conditions for older people living alone, are increasingly being explored. Learning from the experiences of countries with advanced elderly care systems, such as Sweden and Japan, offers valuable insights into creating sustainable support mechanisms (WHO, 2022; Suzuki & Takahashi, 2018). The increasing global emphasis on active ageing emphasises the need to change societal perceptions of old age from a time of dependency to a time of ongoing engagement and contribution (Harper, 2014).

Sociological research on ageing, particularly within the subfield of social gerontology, has made considerable progress in recent decades. In the past, the social role of old age was often limited to the transmission of life experiences across generations (Phillipson, 2013). However, modern changes in age categorization are redefining the social status of older people and promoting trends towards active ageing and the integration of older adults into the broader social framework (Suzuki & Takahashi, 2018). These shifts reflect the growing recognition of older people as important participants in social and economic life.

To summarise, the dynamic interplay between demographic transitions and social transformations requires a multidisciplinary approach to understanding ageing. This paper explores these issues by first analyzing demographic trends and their impact on healthcare and social support systems. It then discusses the challenges faced by older people and presents case studies of innovative policies from around the world. Finally, recommendations for improving the quality of life and social inclusion of older people in Uzbekistan and beyond are provided.

METHOD

The field of social gerontology, through the achievements of interdisciplinary research, initially popularized the role model of ageing as articulated by Cumming and Henry. Their disengagement theory posits that the withdrawal of elderly individuals from societal obligations is a positive and natural process (Cumming & Henry, 1961). However, subsequent studies by Havighurst and Albrecht offered a contrasting perspective, emphasizing old age as a period of activity and creativity, central to the concept of successful ageing (Havighurst, 1963). In contemporary discourse, influenced by postmodernist approaches, ageing is increasingly viewed as a sociocultural construct that eschews traditional stereotypes, allowing adaptability to modern demographic and psychosocial conditions.

Sodikova (2020) argues that as children rely heavily on their parents in their early years, the elderly reciprocally depend on their children’s support later in life. However, modern lifestyles characterized by increased employment and urban overcrowding, particularly in developed nations, limit the ability of children to care for ageing parents effectively. For instance, Sweden’s social service centers offer daycare services for elderly individuals whose children are employed, with services tailored to both free and paid models based on need and preference.

Research by Shilina and Nikitina (2018) highlights that elderly individuals often experience a heightened fear of loneliness, which fosters their attachment to consistent communication and a sense of stability. Addressing these needs necessitates fostering vibrant local communities, providing comprehensive social, medical, and household services, and ensuring meaningful engagement through well-structured recreational activities.

The sociological study of old age underscores it as a distinct demographic layer requiring focused social protection. Conceptually, social protection prioritizes the comprehensive needs of elderly individuals, treating them with respect and dignity. Within the framework of network sociology, social gerontological theories align with the sociology of social protection. The following three methodological levels guide this discipline (Figure 1):

1. General Methodological Level: This involves reliance on multidisciplinary methods for studying the social protection of the elderly.
2. Network Sociology: The integration of social gerontological theories within the broader sociology of social protection.
3. Empirical Level: Practical sociological research methods facilitate diagnosis and contribute to methodological and methodological bases.

Figure 1. Three Methodological Levels in Social Protection of the Elderly.

These levels function cohesively, creating a robust framework for studying the elderly within sociological, psychological, and medical contexts. The sociology of social protection examines the stability of societal well-being by addressing social threats through methods of integration and rehabilitation. Internal functions of this system include social security, social protection, and social services. Targeted social protection, informed by scientific assessments, emphasizes personalized support, upholding the principles of social justice.

Old age as a scientific category extends beyond sociology, stimulating interdisciplinary research in fields such as demography, philosophy, history, economics, political science, law, and psychology. Its prominence as an academic subject reflects its critical role in understanding the complex dynamics of ageing populations.

Research in social protection reveals the necessity of improving state mechanisms for elderly support and assistance. This involves innovating modern systems of medical and social care and aligning them with evolving societal needs, thus addressing the challenges posed by aging demographics effectively.

ANALYSIS

The analysis focuses on the demographic distribution of age groups in different countries, including Uzbekistan, and highlights changes in population structure and working-age dynamics. It analyses global patterns of population ageing and predicts future demographic shifts.

Global ageing patterns

Japan has the highest proportion of older people: 45.9% of its population is categorised as elderly. Other countries such as China (35.4%) and Turkey (29.4%) also have a high proportion of older people. Globally, people are categorised into different age groups: young adults (18–44 years), middle-aged people (45–59 years), older people (60–74 years), elderly people (75–90 years), very old people (90–109 years) and very old people (110+ years). These categorisations illustrate an evolving understanding of ageing and life stages (Figure 2).

Figure 2. Proportion of Elderly People in Selected Countries.

Note: Elderly people are aged 75-90 years, part of a categorisation system to understand ageing.

Source: Global Ageing Report, 2024.

National demographic trends

In Uzbekistan, adults of working age (20–59 years) dominate the population and make up 58.3% of the total population. The younger population (0–19 years) accounts for 38%, while middle-aged people (40–59 years) make up 24%. However, the older population (60–85 years) accounts for around 10%, indicating a relatively small but growing segment of older adults (Figure 3).

Future demographic projections

UNICEF’s demographic projections predict significant changes by 2048:

Children and adolescents (4–19 years) will make up 37.1% of the population.

Young adults (20–34 years) will make up 25.4%.

Middle-aged people (35–59 years) will make up 28.7%.

The elderly (60–84 years) will make up 8.6%, while the over-85s will account for 0.2%.

These forecasts indicate a gradual ageing of the population, with the proportion of middle-aged and elderly people increasing significantly.

Figure 3. UNICEF’s 2048 Population Projections by Age Group.

Source: UNICEF Demographic Projections, 2024.

Note: Projections show a shift towards an ageing population, with increases in elderly proportions.

Employment dynamics

The indicators for active employment show the development of labour force participation by age group:

In China, 12% of older people remain actively employed.

Russia and the USA both report 20%, while Germany reaches 25%. These figures underline the growing engagement of the older population in the labour force, driven by economic necessities and evolving social norms (Figure 4).

Figure 4. Active Employment Rates of Older Population by Country.

Source: Global Employment Report, 2024.

Note: Shows labour force participation rates of older individuals across selected countries.

Ability to work in Uzbekistan

The working-age population in Uzbekistan accounts for 57.6%, with 31.2% below working age and 11.2% categorised as older people of working age. This distribution reflects the significant potential of the middle-aged and older population groups to influence economic and social dynamics (Figure 5).

Figure 5. Distribution of Working Ability in Uzbekistan.

Source: Uzbekistan Demographic Report, 2024.

Note: Illustrates the potential economic impact of various age groups in Uzbekistan.

RESULTS

The results of this analysis provide important insights into the population structure and ageing trends in the various countries, with a focus on Uzbekistan.

Global ageing dynamics

Countries such as Japan, China and Turkey have a high proportion of older people, reflecting the general global trend of an ageing society. The demographic reorganisation into differentiated age groups shows that the understanding of ageing processes is evolving.

Population shifts in Uzbekistan

The working-age group (20–59 years) makes up the majority (58.3%) of Uzbekistan’s population, indicating a robust demographic capable of driving economic and social activity. The proportion of older people currently stands at 10% and is forecast to grow steadily, requiring the expansion of social support systems.

Future population forecasts

UNICEF’s demographic forecasts indicate that the proportion of middle-aged people in Uzbekistan will increase significantly by 2048, accompanied by a steady rise in the elderly population. These changes point to the need for proactive political measures to overcome age-related challenges.

Employment trends

In countries such as Germany, the US and Russia, a significant proportion of older adults remain in the labour force. This trend underlines the potential for higher labour force participation of older people in Uzbekistan as life expectancy and health improve.

Impact on the social systems

The projected increase in the elderly population will place additional demands on Uzbekistan’s healthcare, social security and employment systems. The gradual ageing of the population will require a reassessment of the current support structures and policy framework.

DISCUSSION

The results show significant demographic shifts in global and national populations, focussing on ageing trends and their socio-economic impact.

The analysis shows that countries such as Japan, China and Turkey are experiencing significant growth in their older populations, a trend that is consistent with global ageing patterns. Japan, for example, leads the way with almost 46% older people in its population, the highest ageing rate in the world (United Nations, 2021). Countries such as China and Turkey are also undergoing rapid demographic change due to rising life expectancy and falling birth rates (World Health Organisation [WHO], 2022). The nuanced reclassification of age groups— – from “middle” age” to “super longevity” – emphasises a more dynamic understanding of ageing that goes beyond static life stage models (Suzuki & Takahashi, 2018). This shift in perspective presents an opportunity to redefine the social roles of older adults, particularly in relation to labour force participation and community engagement (Harper, 2014).

The demographic structure of Uzbekistan is undergoing remarkable change. The majority of the population belongs to the group of people of working age (20–59 years), a population group that contributes significantly to economic productivity (UNICEF, 2020). Although older people currently make up only 10%, their numbers are steadily increasing, reflecting the global ageing trend (World Bank, 2021). In addition, the relatively high proportion of young people (0–19 years) and working-age adults signals a demographic dividend that offers an opportunity for economic growth (Lee & Mason, 2006). However, the gradual ageing of the population requires proactive measures to ensure access to healthcare, social support and opportunities for older people to continue to actively contribute to society (Ikramov et al., 2022).

Projections for 2048 indicate a gradual increase in the proportion of middle-aged and elderly people in Uzbekistan, with the proportion of older people in the total population expected to rise to 8.6 % (UNICEF, 2020). These changes will put significant pressure on social infrastructure, including healthcare, pensions and elderly care (Randel, German, & Ewing, 2020). However, these demographic shifts also present an opportunity to integrate older adults into a broader social environment through active ageing policies, lifelong learning programmes and community-building initiatives (Phillipson, 2013). Such policies could, for example, emulate the successful models of ageing societies such as Sweden and Germany, where older people actively participate in the labour market and social life (Eurostat, 2019).

The employment trends of older adults in countries such as Germany and the United States illustrate the potential of ageing populations to remain economically active. In Germany, 25% of older people are employed, benefiting both economic performance and personal well-being (OECD, 2021). Similarly, flexible work arrangements and lifelong learning opportunities in the United States have enabled older adults to remain in the labour force for longer (Moen, 2016). There are valuable lessons to be learned from these examples for Uzbekistan, where labour force participation of older people is currently limited. Policies to promote flexible working hours and vocational training for older adults could address labour shortages while harnessing the skills and experience of older workers (Ikramov et al., 2022).

The growing proportion of older people in Uzbekistan will test the resilience of the country’s social support systems. While the current infrastructure is adequate for a predominantly young population, it needs to be adapted to the demands of an ageing society (UNICEF, 2020). Key areas that require attention include:

Expanding health services tailored to the needs of older adults, including geriatric care and preventive health programmes (WHO, 2022).

Strengthening the social security framework to ensure financial stability for retirees, especially those without family support (World Bank, 2021)Developing community-based care services for older people to promote social integration and reduce isolation of older people (Suzuki & Takahashi, 2018)Demographic change offers policy makers the opportunity to be innovative. For example, intergenerational programmes that bring young people and older adults together have been shown in other countries to be effective in promoting mutual understanding and breaking down ageist stereotypes (Harper, 2014). Investing in age-friendly infrastructure, such as accessible housing and transport, could significantly improve the quality of life of older people (Phillipson, 2013). In addition, the use of digital health technologies to improve access to healthcare and social engagement of older adults is a promising approach to address age-related challenges (Randel et al., 2020).

The ageing population in Uzbekistan and globally requires a cultural shift in the way society views ageing and older adults. Recognising the potential contribution of older people to economic, social and cultural spheres is crucial. Emphasising inclusivity and adaptability will ensure that ageing is not seen as a burden but as an integral part of societal development (Moen, 2016). Proactive policies and a societal mindset that values the experience and wisdom of older generations can turn the challenges of an ageing population into opportunities for sustainable growth and cohesion.

CONCLUSION AND SUGGESTIONS

To ensure the health and active ageing of the elderly population in Uzbekistan, the national strategy “Population Health 2030” outlines measures for the years 2024–2026. Among the most important initiatives are annual check-ups for around 4.6 million people aged 55 and over. Despite these efforts, the number of elderly people in need of care is increasing and stands at 18,417, according to the National Agency for Social Protection. These people face challenges such as loneliness, reduced mobility, household difficulties, poor nutrition, memory loss and vulnerability to abuse, so they need both family and social work support.

One of the biggest challenges is the lack of accurate and integrated data on older people living alone. To address this, an electronic database for older people is currently being developed to harmonise information between different agencies. Work is also underway to introduce systems to assess the health of older people. Programmes such as “The Pleasure of Old Age” athletics competitions encourage seniors to be physically active and promote community involvement.

Efforts to improve the quality and accessibility of social services for older people have led to alternative forms of support, including mobile social services for older people who need ongoing care. While these services work in central cities, they remain inadequate in remote areas. The need for support with everyday tasks, medical treatment, first aid and meaningful employment is particularly urgent in underserved regions.

Social service reforms aim to close these gaps. For example, social health centres and “Inson” centres identify the individual needs of older people and coordinate tailored services. These centres keep detailed records and offer services such as medical rehabilitation, psychological support and participation in small-scale productive activities to improve social usefulness and physical health.

Temporary social rehabilitation programmes provide day care, medical assistance and hygiene support, while cultural and recreational activities such as arts and crafts and clubs encourage older people to participate in social life. These initiatives, which are often organised by non-governmental organisations or local neighbourhood meetings, aim to restore a sense of purpose to the elderly and improve their quality of life.

To sustain and expand these efforts, it is crucial that:

Develop tailored social and medical rehabilitation programmes that address the specific needs of older people.

Train social service centre staff in culturally sensitive approaches to ageing and improve their ability to identify and meet individual needs.

Increase the accessibility of social services in remote areas through mobile and decentralised programmes.

Establish structured co-operation between families and social workers to ensure comprehensive care for older people.

Increase public awareness of the benefits of active ageing and social engagement for seniors.

These measures will enable older people to maintain their physical and mental health, actively participate in society and experience a dignified and fulfilling ageing process.

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