Friday, June 22, 2018

Elderly Care Time "bank"



The share of Swiss residents 65 or older rose to 17 per cent in 2010
(Keystone)

St Gallen may become the first Swiss city to introduce a novel banking scheme in which retired care volunteers “deposit” hours worked looking after elderly people.
 
In return they can use any time saved up for their own care provision later in life. The St Gallen government hopes the pilot project will lower social service costs and encourage local solidarity as it copes with a steadily ageing population.

Switzerland’s demographic time bomb continues to tick louder and louder. Whereas only one in ten residents were over 65 in 1960, five decades later the ratio is one in six.

The state pension system is also suffering from underdevelopment. According to the Federal Statistics Office, four actively employed people fund the state pension of one retired person. Forty years from now this share will fall to two employees.

The ageing population, especially those in need of special care, represents a major challenge for local authorities.
“We need to bring the village mentality to the city and return to the days when people took more care of those around them, whether they are family, friends or neighbours,” Katja Meierhans, who is leading the pilot project devised by St Gallen and the Federal Social Insurance Office, told swissinfo.ch.

Under the proposed scheme, a retired person in good health who has time on their hands can provide care and support for elderly locals in need. Every hour worked is recorded as a “deposit” on a special personal account, which can later be used to pay for care workers’ time when the volunteer in turn needs assistance.
The idea for the project emerged as a result of the new situation facing many local authorities.

“We haven’t noticed a reduction of solidarity in Switzerland. But it’s more about greater individual mobility and new family structures; family ties and networks are not as resistant as in the past. It’s therefore important to look for help from outside the family circle,” explained Ludwig Gartner, deputy director of the insurance office.

Demographic change means that more and more people need help even if it appears that older people remain healthy longer.

Experience
 
St Gallen is located in northeastern Switzerland, close to the German border. With a population of 72,522, the city was chosen by the federal authorities for the pilot project due to its previous experience of voluntary schemes.

Since 2008 the canton has been offering a similar time scheme run by the local branch of the Swiss Red Cross in which people can exchange assistance.

The new project is not intended to create competition with existing activities for the elderly like nursing homes or mobile services, however.

“The biggest need for the elderly is help with day-to-day things like shopping, administrative tasks and cleaning,” said Meierhans.

Independence
 
The main goal is to help elderly people live longer independently in their own homes.

“After all, a job in a nursing home is a lot more expensive for the social services and less satisfactory for an elderly person,” she added. “The scheme can also combat loneliness and bring people together, strengthening solidarity.”

Some 12,000 people over 65 live in St Gallen and the programme’s success will ultimately depend on their level of participation.
The organisers hope that 300 people will sign up to provide 2-3 hours of care per week over a 42-week period, adding up to a total of 25,000 hours of work.

“If this is reached we will be delighted,” said Meierhans. The maximum amount that can be “deposited” by each volunteer will be 750 hours.

Restoring structure
 
Although it is a voluntary project, it will not be cost free. The St Gallen authorities have proposed creating a foundation with a SFr150,000 annual budget to finance an internet site to allow volunteers to contact those needing help, as well as to cover administrative and training costs.

The money will also serve as a guarantee if the project fails, to compensate volunteers for any hours they have accumulated.
The St Gallen city authorities still need to give the final rubberstamp this spring. All being well the project will then begin in summer.

“We believe it’s a very good proposal. It’s a way of using available resources in society and restoring social structures that have weakened over time,” said Thomas Diener, director of Pro Senectute, the largest professional organisation for the elderly.

“Retired people increasingly realise that they don’t want to waste time, even on themselves, but prefer to do something that gives meaning to their lives. These are people who are financially secure, but who are seeking to be active. It's not just altruism, but the pursuit of happiness through helping others.”

Care home statistics

More than 75% of elderly people in Swiss care homes have health problems, with almost two out of five suffering from dementia.

The Federal Statistics Office found that 67% had great difficulty in performing daily tasks such as eating and getting dressed. The results were part of a 2010 report on the state of health and living conditions of old people living in institutions.

It found that 77% had a health problem of more than six months’ duration, with 39% suffering from dementia and 26% from depression. Other health issues included heart and blood pressure problems, diabetes and rheumatism. The average age of those surveyed was 83 years old.

The report also found that care home residents had fairly regular calls or visits from friends and family. Some 55% were visited at least once a week, with 12% having daily visits. Only 2% had no contact with the outside world at all.
end of infobox

Swiss population

The ageing of the Swiss populationcontinues from year to year. On the one hand, the share of people 65 or older rose to 16.9% in 2010 – or 1.3 million people out of the total population of 7.9 million.
On the other, the share of the population under age 20 continued to fall (from 21.2% to 21.0%).

In 1900, there were 76 young people (under age 20) and 10 people 65 or older for every 100 people of working age (ages 20–64). This ratio has changed significantly: in 2010, there were only 34 young people and 27 people 65 or older for every 100 of working age.
Thus, the old-age dependency ratio has almost tripled while the youth dependency ratio has halved. This link between generations is especially influenced by the ageing of the population; this trend is caused by falling birth rates coupled with a steadily increasing life expectancy.

As a result of the higher life expectancy, the number of elderly people is rising. For women life expectancy rose from 48.9 years in 1900 to 84.5 in 2010 and for men it rose from 46.2 to 80.1.

But the number of people under age 20 is decreasing: 1,636,125 in 2009 against 1,703,750 in 1960.

Worried about growing older? About your place in society when you're 60, 70 or 80?

There is a lot to life after 60 — and society is coming increasingly to appreciate the contribution older people can make. That’s what active ageing is about — getting more out of life as you grow older, not less, whether at work, at home or in the community.

And this can help not just you as an individual but society as a whole.

About the year

2012 - European Year for Active Ageing and Solidarity between Generations

The year is intended to raise awareness of the contribution that older people make to society. It seeks to encourage policymakers and relevant stakeholders at all levels to take action with the aim of creating better opportunities for active ageing and strengthening solidarity between generations.

What is active ageing?

Active ageing means growing old in good health and as a full member of society, feeling more fulfilled in our jobs, more independent in our daily lives and more involved as citizens. No matter how old we are, we can still play our part in society and enjoy a better quality of life. The challenge is to make the most of the enormous potential that we harbour even at a more advanced age. The European Year 2012 seeks to promote active ageing in three areas:

Employment – as life expectancy increases across Europe, pension ages are rising, but many fear that they will not be able to stay in their current jobs or to find another job until they can retire on a decent pension. We must give older workers better chances in the labour market.

Participation in society – retiring from one's job does not mean becoming idle. The contribution of older people to society as carers for others, typically their own parents or spouses and their grandchildren is often overlooked and so is their role as volunteers. The European Year seeks to ensure greater recognition of what older people bring to society and create more supportive conditions for them.

Independent living – our health declines as we grow old, but a lot can be done to cope with this decline. And quite small changes in our environment can make a big difference to people suffering from various health impairments and disabilities. Active ageing also means empowering us as we age so that we can remain in charge of our own lives as long as possible.

Foreword by Commissioner Andor
 
 
We tend to forget that population ageing is a major achievement – the result of healthier living conditions and medical breakthroughs that reduce premature mortality. Additionally, people now have more freedom to choose whether and when to have children.

Yet it is undoubtedly true that the rapid ageing of Europe’s population over the coming decades and the upcoming retirement of the ‘baby-boom’ generation presents real challenges. Many people fear that life will be harder in the much older societies in which we will be living and that tensions or even open conflict between the generations will be unavoidable.

The European Year for Active Ageing and Solidarity between Generations 2012 has sought to forestall any such negative developments. The key is to support active ageing across all aspects of life, from professional, community and familial activities to the capacity to age healthily and independently. This will be the basis for solidarity between generations in the years to come. It means that, as we age, we retain control over our own lives rather than having to depend on the younger generations.

Active ageing starts in the workplace. A third of Europeans said recently in a Eurobarometer survey that they would like to stay in work after they have reached the age at which they are entitled to a pension, though not necessarily full time. But not many Europeans currently get the chance to do so.

At the same time, it means changing our attitudes to what it means to be older, shifting upwards the borderline between ‘young’ and ‘old’ as our life expectancy increases and increasing our appreciation of the support and experience older people can and do offer in all areas of life. Active ageing also means offering better support to older people who need it so that health impairments do not automatically lead to exclusion and excessive dependence on the help of others, ensuring a life of dignity.

It is a vast agenda to which all levels of government, businesses, trade unions and civil society must contribute. The main policy instruments are in the hands of policymakers in the Member States. However, the European Union (EU) has a role to play in this regard. It can mobilise a wide range of policy instruments to support Member States and other stakeholders in their efforts.

The European Year provides an opportunity for all of us to think about what we can do to make active ageing a reality and to commit to new initiatives in the years to come. This brochure presents the EU’s contribution to the active ageing agenda and shows that the EU is a strong partner in this regard.

I hope this brochure will help strengthen the resolve to work together at European level and inspire more determined efforts in all Member States to promote active ageing, thereby ensuring that solidarity between generations can withstand the test of population ageing.
 
László ANDOR
 

Generations 2012 seeks to incentivise stakeholders at all levels to set ambitious goals and to take action that will enable our societies to cope with demographic ageing by strengthening the contribution that older people make to society and enhancing their independence.

This is a timely initiative, since the large cohorts born in the late 1940s and the 1950s are now reaching retirement age. Thus, demographic change is happening now in the EU, with massive social, economic, budgetary and political consequences.

Two trends are particularly noticeable. Firstly, the total working-age population (15-64 year-olds) is set to fall by 20.8 million from 2005 to 2030 as the baby-boom cohorts retire. This has tremendous implications for the future of jobs and growth in the EU, as well as for the sustainability of social protection and health systems, which face a widening gap between spending needs and revenues from taxes and contributions.

Secondly, the number of elderly people is increasing rapidly. The number of people aged 80+ is set to increase by 57.1 % between 2010 and 2030 (1). This will mean 12.6 million more people aged 80+ in Europe, with significant implications for health and care services.


Demographic change can be successfully tackled through a positive approach that focuses on the potentials of the older age groups. The concept of active ageing is at the heart of this positive response to demographic change, which is essential to preserve solidarity between generations. Active ageing principally means three things:
1. Enabling both women and men to remain in employment longer – by overcoming structural barriers (including a lack of support for informal carers) and offering appropriate incentives, many older people can be helped to remain active in the labour market, with systemic and individual benefits.
2. Facilitating active citizenship through enabling environments that harness the contribution that older women and men can make to society.
3. Enabling both women and men to keep in good health and to live independently as they grow older, thanks to a life-course approach to healthy ageing combined with adapted housing and local environments that allow elderly people to remain in their own homes as long as possible.

Europe can only meet the challenges of demographic change through active ageing; its future prosperity and social cohesion depend on it.
(1) Eurostat base scenario.
The EU’s Europe 2020 strategy aims to deliver smart, sustainable and inclusive growth with high levels of employment, productivity and social cohesion. It has set five specific targets for the EU to meet by 2020, including an employment rate of 75 % for all 20-64 year-olds and at least 20 million fewer people in or at risk of poverty and social exclusion (2).


Active ageing is an essential part of the Europe 2020 strategy, the success of which depends to a large extent on enabling older people to contribute fully within and outside the labour market. Older people have to be empowered to remain active as workers, consumers, carers, volunteers and citizens.


Eurobarometer Survey on Active Ageing According to a 2012 Eurobarometer survey, the majo-rity of Europeans (60 %) reject the need for higher reti-rement ages. Rejection is strongest in Romania (87 %), Latvia (86 %) and Slovakia (83 %). Only in Denmark (58 %), the Netherlands (55 %), Ireland (53 %), the UK (51 %) and Austria (49 %) the majority of respondents agrees on the need for the official retirement age to rise. This rejection does not, however, mean that Europeans are not ready or willing to consider working longer. Some 61 % support the idea that people should be al-lowed to continue working once they have reached the official retirement age, and 53 % reject the idea of com-pulsory retirement age.


Active ageing is the basis for solidarity between generations – a goal of the EU enshrined in Article 3 of the Lisbon Treaty. It means that older people can take charge of their own lives and contribute to society – and allows more to be done for those elderly people who depend most on the support of others.

The European Year for Active Ageing and Solidarity between Generations 2012 aims to create new momentum to achieve the goals set, including the wider economic and societal goals, by raising awareness of these crucial issues, by changing attitudes and by engaging all levels of society in an effort to offer better opportunities to older people to remain active and to participate as full members of society alongside the younger generations.

The European Commission hopes that the Year will produce new actions and new commitments on the part of Member States, local and regional authorities, social partners and civil society organisations to promote active ageing and thus strengthen solidarity between generations. Each of these

(2) Other targets cover Education, Climate Change and Energy, and Research and Development spending. http://ec.europa.eu/europe2020/ reaching-the-goals/targets/index_en.htm


providing policy expertise on living and working conditions The European Foundation for the Improvement of Living and Working Conditions in Dublin provides information, advice and expertise – on living and working conditions, industrial relations and managing change in Europe – to the key actors in the field of EU social policy, including governments, EU institutions and the social partners. It has developed a resource pack on active ageing that looks in particular at what needs to change at the work-place to keep older workers in employment, and at labour force participation of people above the official retirement age.





The Open Method of Coordination in Social Inclusion and Social Protection
 
 
 
Active ageing in the labour market, active ageing in the community and healthy ageing are all affected by social protection systems and issues around poverty and social exclusion. Social protection systems and employment policies need to support each other to encourage and enable people to work longer, while social transfer schemes as well as health and social services ensure that older people can actively participate in society and live independently.
 
As with employment, social protection and social inclusion policies are a matter of Member State responsibility. Nevertheless, the EU makes an important contribution by supporting reforms through the definition of common goals and a process of mutual learning. This process is known as the Open Method of Coordination on social protection and social inclusion (OMC) (10). The OMC covers pensions, healthcare and long-term care, and social inclusion. It provides Member States with:
1. common objectives;
2. shared indicators to measure success;
3. a framework for reporting;
4. benchmarking to compare performance and identify best practice.



Reporting in the context of the Social Protection Committee helps to assess progress and identify key challenges and future priorities. Peer review seminars provide for the dissemination and discussion of good practice between Member States.
 Making a decisive impact on poverty and social inclusion
 
 
 
Achieving the Europe 2020 target of lifting at least 20 million people out of poverty and social exclusion will require, in many countries, looking also at the situation of older people and older women in particular.
 
 
(10) Open Method of Coordination: http://europa.eu/legislation_summaries/ glossary/open_method_coordination_en.htm


The OMC on Social Protection and Social Inclusion supports Member States in promoting access for all to the resources, rights and services needed for participation in society, combating exclusion and its causes, and enabling access to the labour market.

As well as supporting mutual learning and exchange through the OMC process, the European Commission has established the European Platform Against Poverty and Social Exclusion as one of the seven flagship initiatives of the Europe 2020 agenda. It aims to strengthen work at all levels to reach the EU headline poverty reduction target. Notably, it seeks to promote new partnerships and social innovation and to make best use of all EU funds towards social inclusion objectives.

The Platform was created as an outcome of the European Year for Combating Poverty and Social Exclusion 2010.

A priority of the European focus on combating poverty is to overcome discrimination and increase the integration of people with disabilities, ethnic minorities, immigrants and other vulnerable groups. This is directly relevant to the situation of vulnerable older people. The Platform against Poverty and Social exclusion also contains a special focus on the social risks of elderly migrants within this context, including consideration of the specific cultural and linguistic needs they may have and the particular risks of poverty and isolation they face.
 
A comprehensive strategy for adequate, sustainable and safe pensions
 
 
 
The future sustainability of adequate pension systems is a key requirement for active ageing in the coming decades. Many older people have no other source of income than their retirement pension, and without sufficient income, people are restricted in their ability to take part in society fully.
 

The EU has set a common framework for Member States to share ideas, approaches, knowledge and experiences with regard to pensions. This process (10) has the following common objectives:
1. Adequate retirement incomes for all in the spirit of solidarity and fairness between and within generations;
2. Financial sustainability of public and private pension schemes, notably by supporting longer working lives and active ageing;
3. Pension systems that are transparent and well adapted to individual and societal needs.

Pensions Peer Review Examples In 2011, nine EU countries peer reviewed the Dutch approach to Balancing the security and affordability of funded pension schemes. In 2011, 10 EU countries peer reviewed German work on the Effects of life courses on women’s pensions.EU support to national policymakers: coordinated strategies and mutual learning 15



The 2010 Joint Report on Pensions highlighted that more reform is needed, particularly around achieving active ageing in employment – particularly for older female workers. The EU facilitates national reform efforts notably through peer reviews.

On 16 February 2012, the Commission adopted a White Paper on Pensions setting out how the EU and Member States can best work towards ensuring adequate incomes in retirement, notably through active ageing. It proposed measures to promote a better balance between years spent working and years spent in retirement and to enhance the opportunities for making additional retirement savings.
 
Cooperation in the area of healthcare and long-term care
 
 
 
Systems of healthcare and long-term care play a major role in enabling healthy ageing and independent living. However, these systems are under tremendous pressure at a time of demographic ageing and strained public budgets.
 

Organising these systems is down to national and often regional policymaking. However, an EU process (10) is supporting mutual exchange and learning in identifying solutions to achieve:
1. Access – to a mix of home, community and institutional services, including through affordability or insurance coverage and shorter waiting times;
2. Quality – including through better coordination between levels of care and priority on rehabilitation and helping people remain in their own home;
3. Sustainability – including through an appropriate mix of public and private finance and better coordination between services, as well as health promotion.



The EU facilitates reform processes in the Member States through peer reviews and by funding projects aimed at giving better access to international experiences to national policymakers.
 
Healthcare and long-term care peer review examples In 2011, seven EU countries peer reviewed the Swedish approach to Dealing with expanding care needs and limited resources. In 2009, eight EU countries peer reviewed French work on Alzheimer’s and other related diseases: coping with behavioural disorders in the patient’s home.



The EU supports active and healthy ageing also by promoting a better quality of care for frail older people, both in institutional settings and in the home. It has focused in particular on preventing elder abuse. A Special Eurobarometer report on health and long-term care of 2007 found that 55 % of Europeans believed that many dependent older people are victims of abuse from people who are supposed to look after them.

In March 2008, the European Commission organised a major conference on Protecting the dignity of older persons – the prevention of elder abuse and neglect to help develop a better understanding of the phenomenon and how it can be tackled effectively across Europe.

Following this the European Parliament requested a pilot action, which the European Commission implemented through a Call for Proposals for projects focused on monitoring elder abuse through public health and long-term care systems and identifying good practice for its prevention.
 

A pilot initiative against elder abuse: three projects funded by the EU EuROPEAN – European reference framework for the prevention of elder abuse and neglect http://www.preventelderabuse.eu MILCEA – Monitoring elder abuse across the European Union through public health and long-term care systems http://www.milcea.eu WeDO – European Partnership for the Wellbeing and Dignity of Elder People http://www.wedo-partnership.eu/



The Commission has also funded an action called ABUEL, which provides a multinational prevalence survey of elder abuse under the Public Health Action Programme.

The EU’s Daphne programme fights against all forms of violence against children, young people and women and protects victims and groups at risk. It has also funded actions to tackle elder abuse. These have covered better ways for detecting, monitoring, tackling and preventing elder abuse, including physical and financial abuse. The Daphne project Eustacea created a European Charter of rights and responsibilities of older people in need of long-term care and assistance.
 
The DAPHNE programme: tackling abuse within families Breaking the Taboo 2 is working to empower health and social service professionals to combat violence against older women within families. It follows up a first project which resulted in the publication of the report CLICK HERE TO CONTINUE READING


 

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