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The realization of the right to health of older persons 2011, para. 70
- Paragraph text
- In a report of this length, it is impossible to address all of the important issues, but the Special Rapporteur notes with urgency the present demographic changes leading to a rapidly increasing number of older persons. Society should move beyond seeking simply healthy ageing for its citizens, and begin working towards active and dignified ageing, which should be planned and supported just like any other stage of the individual's life course. Planning for old age implies putting in place diagnostic and prevention services at the primary healthcare level long before ageing sets in. The pursuit of active and dignified ageing for older persons requires re-framing society's concept of ageing to focus on the continued participation of older persons in social, economic, cultural and civic affairs, as well as their continuous contributions to society longer into their lives. The promotion and protection of the human rights of older persons should be of concern to everyone because ageing is a process which everyone will undergo. Older persons are especially vulnerable as a group because of stereotyped perceptions of the group as a "lapsed" segment of society. However, as life expectancy increases and medicine improves, older persons stay active longer than ever before, both in terms of occupational and non-occupational activities. Encouraging older persons to remain physically, politically, socially and economically active for as long as possible will benefit not only the individual, but also the society as a whole.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Person(s) affected
- Older persons
- Year
- 2011
- Paragraph type
- Conclusion / Recommendation
Paragraph
The realization of the right to health of older persons 2011, para. 71f
- Paragraph text
- [The Special Rapporteur recommends:] Putting in place policies and procedures for reporting, addressing and preventing abuse of older persons;
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Health
- Person(s) affected
- Older persons
- Year
- 2011
- Paragraph type
- Conclusion / Recommendation
Paragraph
The realization of the right to health of older persons 2011, para. 71c
- Paragraph text
- [The Special Rapporteur recommends:] Implementing the right-to-health framework to ensure shifting the discourse surrounding older persons from a needs-based perspective to a rights-based approach, which enables greater realization of the right to health of older persons;
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Person(s) affected
- Older persons
- Year
- 2011
- Paragraph type
- Conclusion / Recommendation
Paragraph
The realization of the right to health of older persons 2011, para. 71d
- Paragraph text
- [The Special Rapporteur recommends:] Encouraging the establishment and support of networks of older persons in order to ensure their participation in the development and improvement of social protection and health care, which recognizes and ensures the enjoyment of the right to health;
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Person(s) affected
- Older persons
- Year
- 2011
- Paragraph type
- Conclusion / Recommendation
Paragraph
The realization of the right to health of older persons 2011, para. 71e
- Paragraph text
- [The Special Rapporteur recommends:] Establishing a system of social protection that affords older persons access to long-term care, whether institutional or home-based, which ensures that abuse or violations of rights do not take place;
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Person(s) affected
- Older persons
- Year
- 2011
- Paragraph type
- Conclusion / Recommendation
Paragraph
The realization of the right to health of older persons 2011, para. 71h
- Paragraph text
- [The Special Rapporteur recommends:] Developing international guidelines and national systems to regulate and monitor hospice-care practices to ensure that the elderly are supported in making informed health-care decisions, and that their human dignity and autonomy are not neglected due to their vulnerability
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Person(s) affected
- Older persons
- Year
- 2011
- Paragraph type
- Conclusion / Recommendation
Paragraph
The realization of the right to health of older persons 2011, para. 71g
- Paragraph text
- [The Special Rapporteur recommends:] Instituting mechanisms to raise awareness and train medical professionals, non-medical carers and the wider community on the treatment of older person, and to prevent and address their abuse;
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Person(s) affected
- Older persons
- Year
- 2011
- Paragraph type
- Conclusion / Recommendation
Paragraph
The realization of the right to health of older persons 2011, para. 71a
- Paragraph text
- [The Special Rapporteur recommends:] Recognizing ageing as a lifelong process, a reality which State policy, legislation and resource allocation should reflect so that health-care services, including diagnostic and prevention services, are available and accessible to a person before becoming old to allow for healthy ageing;
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Person(s) affected
- Older persons
- Year
- 2011
- Paragraph type
- Conclusion / Recommendation
Paragraph
The realization of the right to health of older persons 2011, para. 71j
- Paragraph text
- [The Special Rapporteur recommends:] Developing and implementing mechanisms to protect the rights of older persons if/when they are deemed incapable of providing informed consent to any treatment and/or other medical intervention due to injury, disease or chronic conditions such as dementia.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Person(s) affected
- Older persons
- Year
- 2011
- Paragraph type
- Conclusion / Recommendation
Paragraph
The realization of the right to health of older persons 2011, para. 71b
- Paragraph text
- [The Special Rapporteur recommends:] Ensuring that the right to the highest attainable standard of health shapes, and is integrated into, relevant national and international policies concerning ageing and older persons. Health facilities, goods and services should be made available, accessible, affordable and acceptable to older persons, and be of good quality;
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Person(s) affected
- Older persons
- Year
- 2011
- Paragraph type
- Conclusion / Recommendation
Paragraph
The realization of the right to health of older persons 2011, para. 12
- Paragraph text
- The Special Rapporteur concedes that in order to be fully successful the right-to-health approach to older persons should be accompanied by a paradigm shift with respect to how society perceives ageing and older persons. The World Health Organization defines ageing as the "process of progressive change in the biological, psychological and social structure of individuals". Throughout the course of one's life, the human body's functional capacity declines from early adulthood to old age. However, increases in longevity also mean that older persons may stay active for a longer part of their lives than ever before, both in terms of occupational and non-occupational activities. Encouraging older persons to remain physically, socially and economically active for as long as possible will have benefits not only for the individual, but for society as a whole.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Person(s) affected
- Older persons
- Year
- 2011
- Paragraph type
- Other
Paragraph
The realization of the right to health of older persons 2011, para. 44
- Paragraph text
- Long-term care includes a variety of services (medical or otherwise) that help meet both the medical and non-medical needs of people with a chronic illness or disability who cannot care for themselves for long periods of time. Long-term care is manifested in the provision of help with daily tasks such as bathing, dressing up, cooking and so on. According to the Organization for Economic Cooperation and Development (OECD), long-term care can be defined as "a range of services for people who depend on ongoing help with the activities of daily living caused by chronic conditions of physical or mental disability". In the context of the right to health, long-term care must also be understood as the intervention of skilled practitioners to provide assistance in dealing with syndromes associated with chronic diseases or disabilities impeding personal capacities. They are, nonetheless, medical conditions affecting older persons disproportionately.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Person(s) affected
- Older persons
- Persons with disabilities
- Year
- 2011
- Paragraph type
- Other
Paragraph
The realization of the right to health of older persons 2011, para. 59
- Paragraph text
- The Special Rapporteur is of the view that a holistic approach to health should also address the process of dying. While this report does not consider issues of patient autonomy in respect of deciding to end life, it is nonetheless necessary to ensure that patients be able to make autonomous, informed decisions regarding the quality of health during the process of dying. That includes choices about access to adequate pain relief and other necessary interventions, location of death, and the ability to refuse treatment designed to prolong life when it is not desired by the patient. This requires clear, candid and non-judgmental discussion with medical practitioners, who should be adequately trained to deal with these delicate issues in order to enable older persons to "die with dignity", as required from a human rights prospective.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Person(s) affected
- Older persons
- Year
- 2011
- Paragraph type
- Other
Paragraph
The realization of the right to health of older persons 2011, para. 60
- Paragraph text
- The Special Rapporteur believes that the end of life of persons forms an integral part of their life. Consequently, he stresses that older persons must be treated with as much dignity during the process of dying as they should have been in the earlier phases of their life course. Palliative care requires important funding and mobilisation of numerous actors and stakeholders within the medical sector, and it is absolutely crucial in order to prolong the lives of older persons affected by life-threatening diseases and to ensure their death in dignity.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Person(s) affected
- Older persons
- Year
- 2011
- Paragraph type
- Other
Paragraph
The realization of the right to health of older persons 2011, para. 62
- Paragraph text
- Health information needs to be of the highest quality, freely available on a non-discriminatory basis, accessible to the individual's particular communication needs (including special physical or cultural circumstances), and presented in a manner culturally and otherwise acceptable to the person consenting (ibid., para. 23). Informed consent requires that communication is cognizant of varying levels of comprehension and not be too technical, complex, hasty, or in a language, manner or context that the patient does not understand. This is particularly true and necessary for vulnerable populations, such as older persons, who may require additional attention, explanation, or assistance in receiving and adequately understanding the health information that is imparted by the caregiver to the patient prior to treatment.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Person(s) affected
- Older persons
- Year
- 2011
- Paragraph type
- Other
Paragraph
The realization of the right to health of older persons 2011, para. 63
- Paragraph text
- Evaluations have consistently found a deficit in the information provided to older persons to help them make an informed decision, in particular those with less formal education. Some healthcare workers can be dismissive of the particular vulnerabilities of older persons, failing to adequately obtain informed consent because it may be more complex than usual to do so. A one-size-fits-all approach is often inappropriate with respect to older persons, A more customized, individualized, age-friendly approach is required to better address the needs of this group. This will imply moving beyond basic health literacy, which does not adequately secure the right to health, into greater health information awareness and education, possibly through peer networks.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Education
- Equality & Inclusion
- Health
- Person(s) affected
- Older persons
- Year
- 2011
- Paragraph type
- Other
Paragraph
The realization of the right to health of older persons 2011, para. 50
- Paragraph text
- The Special Rapporteur is particularly concerned about unreported violence directed against older persons in care. As with other vulnerable and marginalized groups, special attention is needed to protect older persons from abuse and to ensure that their rights are not violated in settings where they might be especially prone to violations. Abuse of older persons is defined as a single or repeated act, or lack of appropriate action, occurring within any relationship where there is an expectation of trust which causes harm or distress to an older person. It is important to note that abuse is often insidious, limiting the autonomy of older persons in subtle ways. It can take various forms, including physical, psychological, emotional, sexual or financial abuse, or be affected by neglect.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Violence
- Person(s) affected
- Older persons
- Year
- 2011
- Paragraph type
- Other
Paragraph
The realization of the right to health of older persons 2011, para. 15
- Paragraph text
- Treating older persons as a homogenous group is incorrect and needs to be rectified. In developing a more comprehensive approach to the enjoyment of the right to health of older persons, it is important to both collect and analyse disaggregated data and develop appropriate strategies for diverse groups.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Person(s) affected
- Older persons
- Year
- 2011
- Paragraph type
- Other
Paragraph
The realization of the right to health of older persons 2011, para. 28
- Paragraph text
- International human rights law proscribes discrimination and ensures equality on a number of grounds and for a variety of groups, including older persons. Older persons are further identified by general comment No. 14 as a group especially vulnerable to violations. Treaty bodies, including CESCR, have identified older persons as a vulnerable or marginalized group, one that is potentially more susceptible to discrimination and violence. According to general comment No. 14, it is important to ensure the functionality and autonomy of older persons (E/C.12/2000/4, para. 25). This implies promotion of individual choice with respect to models of care, insofar as this is possible.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Person(s) affected
- Older persons
- Year
- 2011
- Paragraph type
- Other
Paragraph
The realization of the right to health of older persons 2011, para. 29
- Paragraph text
- Older women are often more disadvantaged because they may suffer from a combination of both gender and age discrimination. Ageing women make up a significant proportion of the world's population, with the majority of older women living in developing countries. A number of life-course events adversely affect the health of women in older age, including discrimination against infant girls in the provision of food and care, barriers to education, low incomes and poorer access to decent work, care-giving responsibilities as mothers and wives, domestic violence (during childhood, adulthood and elder abuse), widowhood, and cultural traditions and attitudes towards health care. Lower incomes, disruptions to work due to family responsibilities, and discrimination in access to the labour force during women's working life mean that women often have less retirement savings and are therefore more financially vulnerable in older age.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Economic Rights
- Equality & Inclusion
- Gender
- Health
- Person(s) affected
- Girls
- Older persons
- Women
- Year
- 2011
- Paragraph type
- Other
Paragraph
The realization of the right to health of older persons 2011, para. 36
- Paragraph text
- Chronic illnesses and disability increase in prevalence with advancing age. Around half of deaths due to non-communicable diseases occur in persons aged over 70. It is estimated that 35.6 million people lived with dementia worldwide in 2010, which will increase to 65.7 million by 2030 and to 115.4 million by 2050. In light of the increasing proportion of the population who are elderly, it becomes vital that these conditions are managed in an equitable and resource-effective manner. Health systems throughout the world are generally designed to deal with acute medical conditions. They have struggled to re-model and adapt to prevent or manage the increasing number of chronic illnesses. One should also note the importance of the use of evidence-based guidelines and establishment of minimum standards of health care for common chronic conditions, and integration of their management into primary health care.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Person(s) affected
- Older persons
- Year
- 2011
- Paragraph type
- Other
Paragraph
The realization of the right to health of older persons 2011, para. 20
- Paragraph text
- Internationally recognized human rights standards and principles as contained in core international human rights treaties cover and protect older persons. Despite this tacit protection, it has increasingly been argued that there is a gap in the international human rights system because there is currently no specific universal human rights instrument on the rights of older persons. Specific provisions focusing on older persons, such as those which exist for some other categories of vulnerable persons such as women, children, persons with disabilities, and migrant workers, are also lacking.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Governance & Rule of Law
- Health
- Person(s) affected
- Children
- Older persons
- Persons on the move
- Persons with disabilities
- Women
- Year
- 2011
- Paragraph type
- Other
Paragraph
The realization of the right to health of older persons 2011, para. 23
- Paragraph text
- General comment No.14 describes legal obligations of States. The three primary obligations are to respect, protect and fulfil the right to health. The obligation to respect refers to the States' duty to refrain from interfering directly or indirectly with the right to health. In many cases, older persons are the object of State policies which may infringe upon their right to health. Examples include restrictions on the autonomy of older persons in terms of definitions of capacity without an individual determination. The obligation to protect deals with States' duty to prevent third parties, such as corporations, from interfering directly or indirectly with the right to health. This may be relevant, for example, where there is systematic abuse of the elderly in private long-term care facilities. Finally, the obligation to fulfil requires States to adopt appropriate legislative, administrative, budgetary, judicial, promotional and other measures to fully realize the right to health.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Governance & Rule of Law
- Health
- Person(s) affected
- Older persons
- Year
- 2011
- Paragraph type
- Other
Paragraph
The realization of the right to health of older persons 2011, para. 24
- Paragraph text
- According to general comment No. 14, the right to health contains both freedoms and entitlements. The freedoms include the right to make independent decisions about one's health, which is to say freedom from State interference. For older persons, freedoms regard issues such as informed consent, autonomy and guardianship. Entitlements, which concern positive obligations of the State may, for example, include the provision of primary health care and social protection which recognizes and takes into account age-related elements, States should recognize that ageing is a lifelong process; State policy and legislation should reflect this reality. Investment in health services should be made at various stages of the life course, when risks to well-being and windows of opportunity are greatest.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Person(s) affected
- Older persons
- Year
- 2011
- Paragraph type
- Other
Paragraph
The realization of the right to health of older persons 2011, para. 69
- Paragraph text
- The Special Rapporteur points to the importance of increasing awareness and empowering of older persons in order to strengthen their participation in health policymaking and build networks of older persons through which health information can be more easily accessed. It is also important that older persons are in a position to fully understand health information and make voluntary and informed decisions based on that information. It is the duty of the State to find and implement new and innovative ways to reach out to older persons, identify age-friendly means to disseminate health-related information and encourage their participation.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Person(s) affected
- Older persons
- Year
- 2011
- Paragraph type
- Other
Paragraph
The realization of the right to health of older persons 2011, para. 8
- Paragraph text
- Developing countries will be predominantly affected by the resulting epidemiological transition, when non-communicable diseases amongst older persons increase. The broader population will however continue to struggle with communicable diseases, particularly infectious diseases and other illnesses related to poverty. Developing age-friendly services and settings, and promotion of health care and preventive medicine among older persons will strengthen the efforts of developing countries to deal with the complications of chronic and terminal non-communicable illnesses. In order to address the challenge adequately, it is essential for States to prepare themselves to meet the needs of older persons, train health professionals in old-age care, and formulate sustainable policies for long-term care.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Person(s) affected
- Older persons
- Year
- 2011
- Paragraph type
- Other
Paragraph
Right to health in conflict situations 2013, para. 37
- Paragraph text
- States should give particular attention to persons rendered vulnerable by conflict, such as women, children, older persons, people with disabilities and displaced communities. This requires States to address marginalization arising from social, political and economic exclusion; discrimination against persons belonging to or perceived to belong to a specific community; vulnerability due to ill-health; and conflict strategies that deliberately render certain communities vulnerable. These factors, individually or in combination, may expose certain groups to multiple vulnerabilities and an increased risk of violation of their right to health. Recognizing the diverse vulnerabilities in different communities and empowering them to participate in all decision-making processes that affect their health enable States to fulfil their obligation under the right to health during conflict and also promotes a sustainable recovery from conflict.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Humanitarian
- Person(s) affected
- Children
- Older persons
- Persons on the move
- Persons with disabilities
- Women
- Year
- 2013
- Paragraph type
- Other
Paragraph
The realization of the right to health of older persons 2011, para. 30
- Paragraph text
- The right-to-health requires active and informed participation in policy decisions by those populations that are affected by them (E/CN.4/2006/48, para. 25). Effective provision of health services can only be assured if the participation of affected populations is secured by States (E/C.12/2000/4, para. 54). It is notable that the United Nations Principles for Older Persons encourages the participation of older people in the formulation and implementation of policies which affect them.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Person(s) affected
- Older persons
- Year
- 2011
- Paragraph type
- Other
Paragraph
The realization of the right to health of older persons 2011, para. 31
- Paragraph text
- The Special Rapporteur notes the importance of monitoring progress in ensuring progressive realization of the right to health of older persons using indicators and benchmarks as part of the right to health framework. General comment No. 14 identifies the failure of States to monitor the realization of the right to health at the national level, as well as the resulting insufficient or misallocated expenditure, as examples of violations of the State's obligations (E/C.12/2000/4, para. 52).
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Person(s) affected
- Older persons
- Year
- 2011
- Paragraph type
- Other
Paragraph
The realization of the right to health of older persons 2011, para. 38
- Paragraph text
- Several obstacles have been identified in relation to older persons' access to primary health care and to the quality of health-care services provided. Discrimination against older persons on the basis of their age is a major barrier to access primary care and prevention of chronic illness. . There is a pernicious and deeply ingrained notion that once a person ages, he/she becomes incapable of contributing to society, chronically ill and/or frail. Such prejudices often lead to a conclusion that not much can be done to assist them.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Person(s) affected
- Older persons
- Year
- 2011
- Paragraph type
- Other
Paragraph