Action area I:
Change how we think, feel and act towards age and aging
Despite all the contributions and actions older adults have made to their communities and family members, there is still a lot of stereotyping (how we think), prejudice (how we feel) and discrimination (how we act) toward people based on their age. Ageism affects people of all ages, but has particularly deleterious effects on the health and well-being of older people.
With the support of the PAHO/WHO, the Inter-American Convention on Protecting the Human Rights of Older Persons was adopted at the General Assembly of the Organization of the American States (OAS) in June 2015. The Convention specifically advocates for the importance in ensuring that older adults receive:
- independence and autonomy
- informed consent on health matters
- equal recognition before the law
- social security, accessibility and personal mobility
- and many other fundamental human rights
The value in these liberties were decided by experts from multiple regions and several countries have ratified this Convention including Argentina, Bolivia, Chile, Colombia, Costa Rica, Ecuador, El Salvador, Mexico, Peru, Suriname and Uruguay.
Adopting this Convention promotes the economic, social, political, educational, and cultural engagement of older persons. For example, Costa Rica has successfully implemented multiple laws to further enforce these ideals. The “Integral Law for older adults in Costa Rica” guarantees that older people have “equality of opportunities and a dignified life.” The “San Jose Charter on the Rights of Older Adults in Latin America and the Caribbean” asserts the improvement and development of the social protection systems to meet the needs of older adults, and the “Law on Penalization of Abandonment of Older Adults” ensures that persons who abandon and neglect older adults will receive felony charges. It is important for legal frameworks around the world to further advocate and protect this vulnerable and rapidly expanding older adult population in their respective countries.
Resources related to the area
Related documents:
- Global report on ageism
- Global report on ageism - Executive Summary
- Ageism in artificial intelligence for health
- Older Persons: A Human Rights-based Approach
- Global Campaign to Combat Ageism - Toolkit
- Initiating a conversation about ageism
- Nature ageing: Creating an anti-ageist healthcare system to improve care for our current and future selves
Inter-American Convention on Protecting the Human Rights of Older Persons
Action area II:
Ensure that communities foster the abilities of older people
Physical, social and economic environments, both rural and urban, are important determinants of healthy aging and powerful influences on the experience of aging and the opportunities that aging offers. Age-friendly environments are better places in which to grow, live, work, play and age, which means an age-friendly community is a better place for all age groups.
The WHO Global Network for Age-friendly Cities and Communities
In turn, the WHO Secretariat and other UN agencies were called to extend the WHO Global Network for Age-Friendly Cities and Communities and other work to foster healthy aging to ensure providing:
- evidence and technical assistance to countries for building age-friendly environments and ensuring that the most vulnerable are being served;
- opportunities to connect cities and communities, exchange information and experiences and facilitate learning by leaders in countries, cities and communities on what works to foster healthy aging in different contexts;
- tools and support to countries, cities and communities to monitor and evaluate progress in creating age-friendly environments; and
- identifying priorities and opportunities for collaborative action and exchange among networks and constituencies.
The WHO Global Network for Age-friendly Cities and Communities currently includes 1,500 cities and communities in 51 countries, covering over 300 million people worldwide.
Just in 2019, 186 communities from the Americas were added to the WHO Global Network of Age Friendly Cities and Communities. The Americas now has the most approved communities of any region and represents more than half of all member communities worldwide, with over 800 certified cities. At the moment, the approved countries include Argentina, Bolivia, Brazil, Canada, Chile, Colombia, Costa Rica, Cuba, Mexico, Paraguay, Peru, Puerto Rico, U.S.A., and Uruguay.
Membership to the Network is not an accreditation for age-friendliness. Rather, it reflects cities’ commitment to listen to the needs of their aging population, assess and monitor their age-friendliness and work collaboratively with older people and across sectors to create age-friendly physical and social environments. Membership is also a commitment to share experience, achievements and lessons learnt with other cities and communities.
Visit the PAHO’s web page of the Network to learn more about this initiative in the region.
Resources related to the area
To join the Network and find out more about what actions communities are taking, refer to the following links:
- Apply for Membership
- Browse the Network
- Consult the Age-Friendly Practices Database
- Age-friendly cities and communities in the Americas
For further guidance on the step-by-step Membership process, guides and methodology, please refer below to the list of resources and guiding tools.
Related documents:
- The Sociodemographic Situation of Indigenous Peoples in Latin America and the Caribbean. Analysis in the Context of Aging and COVID-19
- The Influence of Environments on Healthy Aging. World Health Organization Global Network for Age-friendly Cities and Communities
- Age-friendly Environments: Baseline Assessment in Latin America with reference to Costa Rica
- Closing The Gap: The Health Disparities of Older LGBTI People in the Americas
- The Role of Digital Technologies on Aging and Health
- National programmes for age-friendly cities and communities: a guide
- Checklist of Essential Features of Age-friendly Cities-WHO
- Let's go! Steps for engaging older people and improve communities for all age: Toolkit
- Snapshot of Age-friendly Cities and Communities in the Americas during the COVID-19 Pandemic: Lessons Learned
- Step Safely: Strategies for preventing and managing falls across the life-course
- Global Age-friendly Cities: A Guide
- Measuring the age-friendliness of cities
- The Global Network for Age-friendly Cities and Communities: Looking back over the last decade, looking forward to the next
Action area III:
Deliver person-centered integrated care and primary health services responsive to older people
Health systems need to be prepared to deliver high quality health care for older people that is integrated among providers and settings and one that is linked to the sustainable provision of long-term care. Integrating health and social sectors in a person-centered approach is key to achieve better care for older adults. In addition, the vision of implementing services driven by maintaining and improving the functional ability of older individuals is essential to achieve healthy aging.
Functional ability is defined as the “health-related attributes that enable people to be and to do what they have reason to value,” and consists of the intrinsic capacity of the individual, - the “composite of all the physical and mental capacities that an individual can draw on” - the environment of the individual, and the interactions between them. These definitions are important to point out the relationship between the components of the Decade of Healthy Aging and the relevance of developing intersectoral activities, built upon a life course approach.
In particular, PAHO has developed a virtual course, titled the “International Accreditation of Competencies in Health Care for Older Persons (ACAPEM),” specifically for primary care health professionals. It consists of three progressive levels. This course is divided into three levels, from most minor to most complex: ACAPEM-Basic, ACAPEM-Intermediate, and ACAPEM-Advanced. The primary and intermediate levels are available on PAHO’s Virtual Campus for Public Health.
Registration to ACAPEM-Intermediate (currently only available in Spanish)
Resources related to the area
The virtual course on the Development of Competencies in Health Care for the Older Persons: ACAPEM – is part of the training itinerary to improve capacities in attending to the needs of older persons. This course is divided into three levels: ACAPEM-Basic, ACAPEM-Intermediate and ACAPEM-Advanced. The basic and intermediate levels are available on PAHO’s Virtual Campus for Public Health.
Registration to ACAPEM-Intermediate (currently only available in Spanish)
Related documents:
- The Sociodemographic and Economic Context of Aging in Latin America
- Life Expectancy and Disease Burden in Older People in the Region of the Americas
- Visual and Hearing Health of Older People in the Region of the Americas
- Oral Health Status of Older Adults in the Americas
- Fostering Health Systems' Monitoring to Better Serve Older Populations
- Health Service Access Barriers for Older People in the Region of the Americas
- Taking the pulse of the health system’s response of the needs of older persons. Situational analysis: Mexico | Brazil | Chile
- Inclusion of Older People in Emergency Planning: Perspectives During and Beyond the COVID-19 Pandemic
- Physical activity and sedentary behaviour: a brief to support older people
- Portfolio: Evidence-based Programs for a Person-centered, Integrated Care for Older People at the Primary Health-care Level
- Integrated care for older people (ICOPE): Guidelines on community-level interventions to manage declines in intrinsic capacity
- Integrated care for older people (ICOPE): guidance for person-centered assessment and pathways in primary care
- Integrated care for older people (ICOPE) implementation framework: guidance for systems and services
- Integrated care for older people (ICOPE) implementation pilot programme: Findings from the 'ready' phase (WHO)
- ICOPE brochure
- ICOPE handbook (mobile application for implementation)
- Mitigating the Indirect Impacts of COVID-19 on Maternal, Newborn, Child and Adolescent, and Ageing Health Services: Lessons Learned from the Experience of Brazil
- Building Health Throughout the Life Course. Concepts, Implications, and Application in Public Health (PAHO)
- Other programs:
- Chronic Disease Self-Management Small group - SMRC - Self-Management Resource Center (selfmanagementresource.com)
- Vivifrail: Program on physical exercise for the prevention of frailty and falls in the elderly
- Diabfrail LatAm: Program on exercise and education in the functional capacity of older persons with diabetes
Action area IV:
Provide access to long-term care for older people who need it
Declines in physical and mental capacities can limit older people’s ability to care for themselves and to participate in society.
The majority of people in need of such care is older adults, most of who live in the community and receive care from informal caregivers like family members and friends. Access to good-quality long-term care is essential to maintain functional ability, enjoy basic human rights and live with dignity.
In addition, it is essential to support caregivers, so they can deliver proper care and also take care of their own health.
Resources related to the area
Policy on Long-term Care
The Policy on Long-term Care, covering the period 2025–2034, provides the Member States of the Pan American Health Organization (PAHO) with strategic and technical guidance for the development, strengthening, and expansion of LTC capacities in the Region was adopted by the 61st Directing Council.
- Health ministers agree on new policy to strengthen long-term care in the Region
- CD61/8 - Policy on Long-term Care
Resources and Guiding Tools
- Long-term Care in Latin America and the Caribbean
- Institutional care in four Latin American countries: the importance of fostering public information and evaluation strategies
- Long-term care for older people: package for universal health coverage
- Framework for countries to achieve an integrated continuum of long-term care
- The urgency of fostering long-term care systems in aging societies
- The Challenges and Opportunities in Fostering a Long-Term Care System in the Americas
- Policy brief: access to assistive technology
- iSupport for dementia: training and support manual for carers of people with dementia
- Integrating palliative care and symptom relief into primary health care: a WHO guide for planners, implementers and managers
- Preventing and managing COVID-19 across long-term care services: policy brief
- Implementing long-term care systems in the Americas: a regional strategy | Pan American Journal of Public Health
Other resources related to the Decade
- PAHO Healthy Aging website
- WHO Decade of Healthy Ageing (2021-2030)
- Decade of Healthy Ageing 2020–2030 (Final Proposal)
- Madrid International Plan Action on Ageing 2002
- 2030 Agenda for Sustainable Development
- World report on ageing and health (2015)
- La Estrategia Global y el Plan de Acción sobre el Envejecimiento y la Salud
- Decade of Healthy Ageing 2020–2030 (EB1 146/23, 11 dic 2019)