1 report services provided of the elderly 09 01 2014

Grundtvig Learning Partnership 2012 – 2014

Report: Active Ageing

REBOOT: Retired But nOt Tired

Belgium Italy Poland Turkey UK

Content

Introduction ............................................................................. 2 I. Older adults and the labour market ..................................... 9 II. Social inclusion and participation ...................................... 21 III. Healthy Ageing ................................................................. 29 IV. Independent living ............................................................ 37 V. Intergenerational solidarity ............................................... 44 VI. In conclusive ..................................................................... 49

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Introduction

The overarching target of the European Innovation Partnership on Active Ageing, discussed at the EU top level policy dialogues and launched in 2011, is to increase the healthy life span of European citizens by two years by 2020. Active ageing is promoted by the European Commission and it evokes the idea of longer activity, with a higher retirement age and working practices adapted to the age of the employee.

Europe is the fastest ageing region in the world and life expectancy in healthy ageing differ greatly between countries. This fact gives us some challenges we have to deal with.

Firstly, this rapid change will cause labour policies to have to adapt themselves to the older workers.

The second problem that arises is the health costs of both older workers and pensioners due to rising life expectancies. A third challenge will be the urban services that will also require adaptions to the ageing citizens.

On the other hand, the ageing populations will also be the engine of the suffering economies. That age group can also be seen as a A-­‐classe consumer/ customer group. The social inclusion of older adults is an important topic as well as this age group has a lot of skills and knowledge, a potential which is very often underestimated.

In this report the partner institutions of the REBOOT-­‐project will present the policies and services for the ageing populations and pensioners in their countries, will learn their demands and compare the partner countries in terms of active ageing policies. The partner institutions will also work on the term of total social inclusion. The outcome of the project will be suggesting standards for the concept and a pilot implementation of a chosen good practice in partner countries.

Active lifestyles, at all ages, are a precondition for social cohesion, requiring solidarity between generations. As there are barriers in many different sectors like education or employment only thinking at the governmental level is too fragmented: a change of attitude is needed by bringing down barriers between policy approaches to social, health, education and employment sectors.

The population of Europe is getting older year by year. This leads to both threats and opportunities for the economies and social and daily lives of European countries. This project will help us understand the ageing groups better and in this manner we will be able to provide them with what they actually need and demand.

In the first place we will do a desktop research about the situation of older adults in the different partner countries. That will give us some guidance to put on a questionnaire. With the questionnaire we would like to get insights in the situation of older adults and their perception of active ageing and the needs they have concerning this topic.

(Grundtvig Learning Partnership application REBOOT)

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A European project: An ageing population: issues and challenges

In 2012 the European Commission published a statistical portrait of ‘Active ageing and solidarity between generations in the European Union’ (Eurostat, 2012). In what follows we give a short summary of the issues and graphics discussed in this report which can give us more insights and background for the reboot project.

The European Union’s (EU’s) population structure is changing profoundly. The proportion of older adults in our European society is significantly increasing. Table 1, derived from the report, shows the current status of the proportion of older adults in the EU-­‐countries. In the tables we highlighted the five countries of the partners. The increasing life expectancy and falling fertility, lead to several challenges for families and individuals. Comparing the five partner countries, the proportion of older adults in each country is quite similar, except for Turkey where the proportion of older adults is significantly lower (Eurostat, 2012).

Table 1: Population on 1 January 2010

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Table 2: Comparison healthy life expectancy at birth between the different countries, Healthy Life expectancy (HALE) at birth (years) source WHO data Country

Gender

Value

YEAR

Belgium

Male

70

2007

Belgium

Female

74

2007

Belgium

Both

72

2007

Italy

Male

73

2007

Italy

Female

76

2007

Italy

Both

74

2007

Poland

Male

64

2007

Poland

Female

70

2007

Poland

Both

67

2007

Turkey

Male

64

2007

Turkey

Female

67

2007

Turkey

Both

66

2007

UK

Male

71

2007

UK

Female

73

2007

UK

Both

72

2007

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The next table clearly shows the expected increase of older adults in our society as indicated by the increase in the old-­‐age dependency ratio.

Table 3: Projected old-­‐age dependency ratio’s EU-­‐27

Many of the challenges that arise from population ageing are universal and include according to the European Commission (Eurostat, 2012):

• pressure on public budgets and fiscal systems; • strains on pension and social security systems; • adjusting the economy and in particular workplaces to an ageing labour force; • possible labour market shortages as the number of working age persons decreases; • the likely need for increased numbers of trained healthcare professionals; • higher demand for healthcare services and long-­‐term (institutionalized) care; • potential conflict between generations over the distribution of resources.

László Andor, Commissioner for Employment, Social Affairs and Inclusion has noted that ”the key to tackling the challenges of an increasing proportion of older people in our societies is “active ageing”: encouraging older people to remain active by working longer and retiring later, by engaging in

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volunteer work after retirement, and by leading healthy and autonomous lives.” Within the ReBoot project we would like to have more insights in these different areas of active ageing in the different participating countries.

According to the World Health Organization (WHO) active ageing can be defined as ‘the process of optimizing opportunities for health, participation and security in order to enhance quality of life as people age’ (WHO, 2002). The definition therefore includes the notion of extending the activity of older persons, both: • within the labour force, through delaying their retirement, and; • within society, through participation in a range of social, economic, civic or cultural activities.

Building on these theoretical perspective, we distinguish several topics in this report: 1) older adults and the labour market, 2) social inclusion and participation, 3) healthy ageing, 4) independent living and 5) intergenerational solidarity. But first we address the situation in each partner country.

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The situation of older adults in Belgium

The population of Belgium, like the one of other European countries, is ageing rapidly. Between 2008 and 2010, the share in the population of those aged 55-­‐59 years increased by 1 percentage point and the share of those aged 60-­‐64 years increased by 3 percentage points. The share of those over the age of 65 years reached 17.2 % in 2010, only slightly below the European average of 17.3 %. There are demographic differences between the regions1. The population of Brussels is younger: in 2010, the share of those aged 55-­‐59 is 5.2 % , the one of those aged 60-­‐64 is 4.5 % and the share of the people older than 65 is 14.0 %. These shares are respectively 6.5 %, 6.0 % and 16.4 % in Wallonia.

Flanders has the oldest population with shares of respectively 6.6 %, 6.0 % and 18.2 % (Plasman et al., 2012).

Figure 1: % aged 65+ by region

The situation of older adults in the Italy Older people in Europe are constantly increasing: in the next 25 years over 60 will grow by about 2 million a year while in a quarter of a century the over 65 will be one quarter of the entire population of the European Union.

In Italy, at 1st January 2010, the population was 60,340,328 (60,397,400 to Eurostat) and 12,206,470 were over 65. Of these, 6,741,444 in the age group 65-­‐75; 4,158,300 in the range 76-­‐85; 1,306,666 from 86 to over 100 years. In particular, there were 14,974 people from 100 years of age compared to 12,588 in 2008 (when the population reached a height 59,619,290).

In the Marche region, on a population of 1,559,542 at 1st January 2010 there were 350,016 people over 65 years. In the age group between 65 and 75 there were 182,847 people, 124,570 between 76 and 85, 42,599 from 86 to over 100. Centenarians or over-­‐centenarians in the region were 394, against 306 in 2008 (with a population of 1,553,063 units) In 2000, in the 15 countries that formed the EU, over 65 were 15.6% of the population. This is a number that continues to grow, so that, in the 27 EU countries, the forecasts say that over 65 will

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pass from 17.1% in 2008 to 30% in 2060. In addition, to take the example of our country, according to estimates, in 2050 34.6% of the Italian population will be over 65 years, and now we are at 20%.

Also the over-­‐75 will increase (in Italy, in 2030, will be the 14%).

Moreover, according to the National Report 2009 on the conditions and the thought of the older people, 18.8% of those over 65 are disabled and the main consumers of care are over 75.

The situation of older adults in Poland According to the Central Statistical Office (CSO) within a few years there will be a rapid process of ageing. The CSO projections to the year 2035 demonstrate that as a result of low birth rates decline, the percentage of working age population will be 16%, there will be a sharp decline in the population of working age (only 57%), and significant increase in the percentage of working age population amounting to 27%. In view of the above situation, the population of working age will be charged much more with work for the benefit of other generations.

In demographic terms, the share of older persons in the total population in Poland at the end of 2010 was 38.2 million people. In this number the population of person in pre-­‐working age (0-­‐17) was 19%, persons in working age (18-­‐59/64) was 64 % and those of post-­‐working age (60 + / 65 +) was 17%.

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vista 17/10/13 17:12 Comment [1]: To be added: Turkey and UK

I. Older adults and the labour market

1.1.

Europe

One of the main challenges regarding active ageing is the labour market participation of older adults and more specifically of the baby-­‐boom-­‐generation. As shown in the next figure, the labour market participation has increased slightly on the European level.

Figure 2: Employment rates by gender and by age group, EU27 (%)

Source: AGE Platform Europe, 2011

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Table 4: Main labour force indicators for those aged 50-­‐64

Source: AGE Platform Europe, 2011

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Table 5: Main reason for inactive persons not seeking employment, persons aged 50-­‐64, 2010 (%)

Source: AGE Platform Europe, 2011 The main reason for inactivity in all partner countries is retirement, except for Turkey where almost half the people state that “other family or personal responsibilities” are the main reason for inactivity. Illness or disability is also an often stated reason, specifically in the UK and Poland.

In addition, retired persons were asked whether they already or planned to seek a job for extra income. Most people are not. Comparing the countries, some differences appear: in the UK and

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Belgium significantly less people are planning are actually seeking a job compared to Poland and Italy. For Turkey no information is available (AGE Platform Europe, 2011).

Figure 3: Since you retired, have you already or are you planning to seek a job for extra income, September 2008 (%)

Source: AGE Platform Europe, 2011 When retired, older adults are generally more at risk of poverty. The next figure gives an indication of the individual perception of the financial well being of retired persons in Europe.

Figure 4: How would you judge the current situation for the provision of pensions, May-­‐June 2009 (%)

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Source: AGE Platform Europe, 2011 In general, almost half of the Europeans judge the provision of pension as very bad or rather bad.

Comparing the five countries again significant differences appear. Whereas in Belgium and the UK approximately 3 out of 10 judge their pensions as insufficient, this is about 6 out of 10 and 7 out of ten for Italy and Poland and Turkey.

Therefore, as stated by the AGE platform: “Mobilizing the potential of older workers is a key response to addressing the problem of the shrinking labour force”. By doing so older people can also benefit financially through better current incomes and higher pensions in the future.

At the local and regional level, education and training initiatives, as developed by this learning partnership, can be an important contribution to active ageing (AGE platform Europe, 2011).

1.2.

The situation of older adults and the labour market in Belgium

Employment The employment rates for the older workers in Belgium are far under the EU-­‐15 average: only 30% of the 55+ are working. Especially for women the employment rates are very low. The tradition of early withdrawal in Belgium began before the policy of the 1970’s to tackle unemployment.

Transition labour market retirement When people reach an age of 65 year or older, they will probably stop with paid work and leave the labour market. This transition is often seen as a process of disengagement, not only in the labour market, but also as a withdrawal from other important civil rolls and functions. That older people have to be inactive is often the dominant image in the society (De Donder et al. ,2011).

The employment rate of older people in Belgium increased between 2008 and 2010, but remains below the European average. While the employment rate of those aged 25-­‐54 is better in Belgium (80.0 %) than in Europe in general (77.6 %), our employment rate is below the European average for all older age groups: 53.1 % versus 60.9 % within the group aged 55-­‐ 59, 20.2 % versus 30.5 % within the group aged 60-­‐64 and 4.1 % versus 10.2 % within the group aged 65-­‐69. According to Eurostat, the unemployment rate of older people in Belgium is relatively low (4.4 % on average for those aged 55-­‐64 years). This is the unemployment rate according to the ILO definition, which includes the requirement of active job search. However, in Belgium, we have measures which, under certain conditions, exempt the older unemployed from actively seeking employment (for reasons such as training). If we look at the statistics of the National Employment Office, the ratio of unemployed people older than 50 years to the population aged 50-­‐64 years reaches 11.9 % in 2010 (EEO Review, 2012).

The inactivity rate of older people in Belgium is very important. While the inactivity rate is lower in Belgium than in Europe, in general among those aged 25-­‐54, it is higher than the European average among all older age groups: 44.1 % versus 34.3 % among those aged 55-­‐ 59, 79.0 % versus 67.6 % among those aged 60-­‐64 and 97.9 % versus 95.2 % for people older than 65 years.

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While in Europe more than half of the inactive aged 55-­‐64 are pensioners, in Belgium this share is only one third. It is also important to note that inactivity rates are higher among women than men and that this gap has very slightly reduced since 2008.

1.3.

The situation of older adults and the labour market in Italy

The working conditions and pensions Job Although it represents only 10% of the income of the older adults, the work can be considered, on a symbolic level, an important part of life of older people for several reasons. In the first place for the long-­‐term trend of improved health and increased life expectancy will increase the chances of older people in the future to continue with the work beyond the present age, and secondly work activities post-­‐retirement age can become an opportunity to avert situations of isolation.

With regard to the situation of the labor force over-­‐65 in Italy in 2010 (all those older people who are employed or seeking employment), it denotes that in all regions the female labor force is about one third of the male one, with a tendency to increase towards the south. Paying attention to the aggregate data, can see the small size of the phenomenon work in old age: in Italy there are 380,000 older people who are employed or seeking employment, accounting for 3.2% of the older population.

An interesting study is provided in relation to the number of employees by gender, region and qualification. Of about 12 million over-­‐65, over 65% have only primary school (58% among men and 73% of women), while graduates are 5% (70% of men and 30% of women). It is also interesting to note that the region with the highest rate of male employment over-­‐65 is Trentino Alto Adige, followed by Lazio and Valle d'Aosta, with at the last places Basilicata, Calabria and Sicily. As for the female, however, the highest rate is in Valle d'Aosta, Trentino and Emilia Romagna, while at the bottom of the list there is Molise, Campania and Puglia.

Pensions The main element through which to view the economic situation of the older, however, remains that of pensions. It is therefore looking at the amount received by the elders that you can understand the trend of the income share of this growing population.

For what concern the monthly average amount received according to the category and the region, the highest is found in Lombardy (914 €), followed by Piedmont (862 €), the last places in Molise (487 €) and Calabria (€ 516). Looking at the different categories, then, we can see that the biggest gap relates to old-­‐age pensions and disability benefits, while the gap between social allowances and civil disability is minimal.

The ISTAT also recalls that pensions up to € 915.52 represent on average 27.3% of the total income of households with pensioners. In 2011, according to the INPS data, a total of 5,269,493 old-­‐age pensions (the figure refers to the number of performances), about 52% have an amount of less than € 500 per month and as much as 78% does not exceed € 750. Relatively at old age pensions, more than 30% of the services does not exceed the threshold of € 900.

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Another interesting study is related to gender difference: the gap between men and women is particularly high at the level of the average amount received, especially with regard to old-­‐age pensions, a sign that older women have not been very active on the labor market, but also for those of disability. Spouse's pension, as expected, are biased in favor of women. In geographical terms the differences are substantial: a woman perceives in the south an average € 477 per month compared with € 1,183 of a man in the north.

In addition to the geographical distribution is important to note that by class of age. This is to avoid falling in the parallel: pension = older population. The segment that interest us most, namely those over-­‐65, show that higher is the age the lower the average amount of the retirement pension, from € 1072 of 65-­‐69 to € 729 of the over-­‐80.

1.4.

The situation of older adults and the labour market in Poland

Anna Kaźmierska, Joanna Unterschütz, Ph.D. Employment Situation of older adults on the labour market Figures presented above have of course an important impact on the situation of older persons in the labour market.

Statistical data (Central Statistical Office) show, that economic activity of workers in the age 55+ is comparable to general indicators for the person sin production age (18-­‐59/64). It is much lower though for young persons of 20-­‐24. At the same time activity of person sin post-­‐production age 60+/65+ is very low. It is also interesting to note that unemployment rate for persons aged 55-­‐64 is lower than the average, while again unemployment rates of young workers are outstandingly high.

ECONOMIC ACTIVITY OF THE POPULATION 2010-­‐2012

Age

Year

2010

2011

2012

Total

55,7

55,8

56,2

Working age (18-­‐59/64

72,2

72,5

73,3

20-­‐24

60,1

57,6

55,8

55-­‐64

71,5

71,5

72,2

60/65+

6,5

6,7

6,8

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UNEMPLOYMENT

Age

Year

2010

2011

2012

Working age (18-­‐59/64

9,3

9,5

10

20-­‐24

22,5

24

24,4

55-­‐64

6,5

6,5

9,7

60/65+

2,2

1,4

3,3

It should be noted, however, that the activity rate of people over 50 years of age increased in the last three years, amounting to, respectively, in 2007 -­‐ 30.2%, in 2008 -­‐ 31.1%, in 2009 -­‐ 31.8%. The level of activity was higher for men over 50 age than women (in 2010 amounted to respectively 43.0% and 25.6%) and was higher among urban residents than rural areas (in 2010, respectively, 33.6% and 32.4%).

People over 50 years, working mostly as employees, in total 68.9% of people over 50 year old worked as paid employees, 26.6% were working on their own account, and 4.4% helped in the family business. Among the employed persons were mostly urban dwellers (75.5%) and men (54.8%). Self-­‐ employed men worked more (65.7) than women, and according to the criterion of residence -­‐ there was a higher proportion of self-­‐employed in rural areas (55.1% share).

In the social legislation older adults as a separate category do not exist, however, in various legal acts there are some references to age as a criterion for adherence (or less frequently loss) of certain rights and responsibilities. Age is not usually a discriminatory factor, therefore, (i.e. associated with different treatment in comparison to other groups), but primarily as an indicator of belonging to a certain target groups of social policy -­‐ or in this particular case of labour market policy. At the same time often entering a specific target group is conditioned not only with the fulfilment of age criterion, but also the other ones such as length of service (in this case, we must remember that the differentiation of the legal situation of workers because of seniority is not considered as discrimination).

An exception to this is in the category of persons aged 50 years and more, who in case of unemployment are regarded by the Act on employment promotion and labour market institutions, as "persons in a particular situation on the labour market", just as the unemployed under 25 years of age, long-­‐term unemployed, unemployed with no qualifications, the unemployed and those with disabilities, persons raising a child to 7 years of age. This lack of discrimination (i.e. special treatment) was reinforced in 2004, when with the accession to the EU, the Labour Code has been extended to refer to "anti-­‐discrimination" on grounds of age as well as gender, disability, race, ethnicity, nationality, sexual orientation, political or religious belief.

In practice, discrimination on grounds of age during the period of employment occurs in the form of a different intensity of investment in human capital of workers. That capital is the knowledge, skills, health, and the hierarchy of values, and these investments usually take the form of a variety of training. Discrimination based on age is manifested in this case, on the one hand by much rarer delegation of senior staff on trainings to improve skills, and on the other hand in choosing for them

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trainings that are shorter, cheaper, more often resulting in the need to adjust to market requirements or the law rather than developing employee’s creativity and innovation.

Transition labour market-­‐retirement In Poland, there are cases of dismissal of workers when they reach retirement age. In this regard, the Supreme Court in 2009 ruled that the termination of the employment contract concluded for an indefinite period solely because the worker has attained the age of retirement constitutes direct discrimination on grounds of age. Termination of contract of woman employee for the reason that she has reached earlier retirement age and acquired pension rights (if the retirement age is lower for women than for men) constitutes indirect discrimination on grounds of sex.

Many entrepreneurs suggest that one of the barrier to the employment of older people is also a 4-­‐ year period of protection, i.e. the situation when the employer cannot terminate the contract of employment with workers who will reach retirement age in four years or less. The period of protection was introduced in order to enhance the protection of older workers against dismissal, but according to experts, this solution brings counterproductive effects -­‐ employers are afraid to hire people at the age of retirement for fear that they cannot be released.

According to the results of a survey (2011) among Polish men and women in the age up to 13% are retired . The first major outflow of workers to retirement and pension starts at age 43 years (especially in men). At the age of 50 percentage of working women and men is equal. At the age of 60 only 37% of men are still professionally active . With age, the average time of looking for a job increases -­‐ in the age group of 55-­‐64 years -­‐ it is as long as 57 months. However, in this age group, more than half of respondents (52%) expressed a willingness to undergo professional training in case they were not able to find a job.

People working at the age of 50+ are not often willing to look for a new job -­‐ in the group of 50-­‐54 years only 6% of people admitted they were trying to do it, the 55-­‐59 group only 4% in the group and in the group of 60-­‐64 years only 2% .16% of respondents believe that their age is a barrier to finding a job -­‐ this factor was often mentioned by older people (50% of people over 50 years of age).

The problem with finding a job and keeping it is closely linked to the level of competence of employees and the desire to improve their skills, so in order to change the situation on the labor market should carefully look into the issue of education.

1.5. The situation of older adults and the labour market in Turkey

Employment In Turkey, older workers are in general defined as 55-­‐64 years-­‐olds. On the other hand the labour force participation rate drops significantly after the age of 59 especially for women and in practice it is 55-­‐59 years olds who are old workers. In 2010, there were 3 million individuals in 55-­‐59 years age group, 2.3 million individuals in 60-­‐64 year age group and 5 million individuals were aged 65 and above. Individuals over 55 years old constituted 14.5% of the total population of 71.3 million. The same figure is 29.6% in the EU, hence Turkey has the lowest proportion within the EU and candidate countries.

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Table 6 Employment and inactivity rates of older adults by gender in year 2010

Employment ratios Age group 55-­‐59 60-­‐64 65+

TR

EU

Inactivity rates Male Female Male Female 46.3 18.8 69.5 52.8

37.7 14.8 38.2 23.4

29.0 10.6 13.2 7.6

TR Male 50.0 60.3 80.2

EU Female 80.9 85.0 94.1

Male 24.7 59.1 93.1

Female 43.4 75.4 96.8

The employment rates are the lowest within the EU and candidate countries. For 25-­‐54 years olds the employment rate is 55.4% (The EU average is 77.6%) and for 55-­‐59 years olds the employment rate is 32.4% (the EU average is 60.9%). the employment rate for 60-­‐64 year olds is 25.8%(for the EU it is 30.5%) and for people aged over 65 it is 18.9 (for the EU it is 10.2%). In the EU the 55-­‐59 employment ratio falls by half for 60-­‐64 years old and drops further for people aged over 65 (hence the need for the active ageing policy agenda). In Turkey, where the employment ratio is 22 points lower for the prime age group than the EU average, the significant drop falls after the age of 54, by 23 points amongst 55-­‐59 years old, but the decline is gradual afterwards. In fact in the retirement age group, the proportion of the employed is close to twice the EU average. The most Europeans retire at the age of 60, whereas most Turks retire at 55. The key issue is agricultural employment, which is still close to 30% in Turkey and explains the above patterns. Therefore the urban employment ratio is even worse in Turkey in the prime age group and people continue to work in the family agricualtural plot into their old age. Gender differences in older age groups are shown in Table 6. In the EU, where the most employment is non-­‐agricultural occupations and women’s employment ratios are much higher than they are for Turkey, the women’s employment ratio is 53% for 55-­‐59 years olds falls sharply by almost 30 percentage points at the age of 60 and becomes very low at the age of 65.

According to Turkish Health Survey 2008 findings, 51,8 % of the older male population declared that they were retirees while it was 7 % among the older female population. While 20,5 % of the older men is still working, only 5,4 % of the older women is working. On the other hand, 24,5 % of the older men are unable to work while 39,7 % of the older women stated they are unable to work.

1.6.

The situation of older adults and the labour market in UK

•

The number of people of state pension age and above in employment has nearly doubled over the past two decades, from 753,000 in 1993 to 1.4 million in 2011.

•

Older workers are far more likely to be self-­‐employed than their younger counterparts: 32 per cent compared with 13 per cent.

•

Around two-­‐thirds of the older workers are part-­‐time but they are generally doing this shorter roles with the same employer. Eight in every 10 of older workers have been with their employer for five years or more.

•

Men working later in life tend to stay on in higher skill roles while women tend to stay on in lower skill roles.

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•

Just over a half (51 per cent) of older workers are in small organisations of fewer than 25 employees

•

Across the country, London and the South East have the highest percentages of people aged above state pension age in employment and the North East has the lowest.

http://www.youtube.com/watch?v=nXoBhAB3BCY

Number working beyond State Pension Age doubles over past two decades The number of older workers, defined here as those working beyond State Pension Age (SPA), has almost doubled from 753 thousand in 1993 to 1.4 million in 2011. Over the period, the number remained relatively flat between 1993 and 2000 but quickly rose to a peak of 1.45 million in 2010.

Over the period with an ageing population and with the post World War II ‘baby boom’ generation reaching SPA the population of older people has increased. Likewise, looking at the percentage of the older population in employment this too has increased from 7.6 per cent in 1993 to 12.0 per cent in 2011. This shows that the number of workers above SPA has risen at a faster rate than the population.

There may be many factors influencing the decision for more people to work past SPA such as the improved health and well-­‐being of this group, financial pressures, people living longer and wanting to remain active in society and others.

Employment levels and rates for older workers, annual averages 1993-­‐2011, UK Now focusing on the final quarter of 2011, workers over SPA were more likely to be self-­‐employed than their younger counterparts . Also, workers over SPA were twice This shows that when working over the State Pension Age, those remaining in the labour market work fewer hours, possibly helped by the financial support of their state pension and other pension arrangements, which allows them to fit their work around other engagements.

Older workers more likely to stay on in smaller firms As well as being more likely to work part-­‐time, older workers are remaining with their same employer. 62 per cent had worked with their same employer for ten years or more and a further There may be many factors for these differences such as the fact that smaller firms are less likely to offer a workplace pension than larger firms. This may result in individuals having to work longer in smaller firms for financial reasons.

Older workers by duration with employer, skill level and firm size, Q4 2011, UK Men do higher skilled roles while women do lower skilled Of the 1.4 million older workers above SPA in the UK in the final quarter of 2011 around 39 per cent were men and 61 per cent were women. However, there is a difference between men and women when looking at the types of jobs that these workers carry out. Around two-­‐thirds of men above SPA work in jobs classed as higher skilled but almost two thirds of women above SPA work in jobs classed as lower skilled.

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Of all the jobs carried out by men, the two most common were farmers and taxi drivers. Looking at women, the most common job was cleaners, followed by administration assistants, care workers and retail assistants.

Many of these roles for both men and women are characterised by their adaptability to flexible working patterns that allow workers to remain engaged in the labour market.

Transition labour market-­‐retirement The transition from work to retirement involves a move towards part-­‐time employment. In April-­‐June 2011, 7.3 per cent of men of SPA and over worked part time, while 4.6 per cent worked full time; 8.9 per cent of women of SPA and over worked part time, while 3.6 per cent worked full time.

A larger proportion of men than of women take early retirement: 8.2 per cent of women in the 55 to SPA group were classified as retired in April-­‐June 2011, compared with 20.4 per cent of men aged 60 to SPA .

The average age at which men leave the labour market rose from 63.8 years in 2004 to 64.6 years in 2010. For women, it rose from 61.2 years in 2004 to 62.3 years in 2010 (Figure 4.8).

In 2010, men had higher working life expectancy and lower non-­‐working life expectancy than women at every age between 51 and 75 years.

With the UK still mired in economic troubles and unemployment high, it is perhaps obvious that the country needs to get more people into work.

Among older people, who find it harder than any other age group in the UK to move into work, this needs to be a real priority, in particular when looking at how poorly Britain fares compared with the Uk’s international competitors. Getting more people aged 50+ into work can be done.

The UK lags well behind the best performing countries from around the world.

While the average of the 5 best performers is about 72%, the UK falls well short with only 57% in work. This is a huge gap and shows that globally, when the opportunities are there and the incentives are right, people in their late 50s and above are often keen to keep working.

Older workers are less likely than equally-­‐qualified youngsters to be offered jobs because of widespread ageism in the British labour market. Therefore, older workers are more likely to suffer long-­‐term unemployment.

Greater levels of support must be put in place to help unemployed older workers back into the labour market, and to support individuals’ opportunities later in life.

Since 1 October 2011, it is illegal for an employer to force someone to retire, signalling an end to the Default Retirement Age.

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II. Social inclusion and participation

2.1. Europe

Europe’s increasing numbers of older people have much to contribute to society. Social participation can include many activities: being a member of an organizations, sport, culture, .. but also volunteering, informal care and political participation. Several studies indicated a positive correlation between social participation and individual wellbeing at old age. Therefore, improving the social participation of older people is an important goal regarding ‘active ageing’.

As indicated social participation not only means participating in clubs, culture, … but can also encompass informal care and volunteering. Informal care and volunteering are often undervalued resources which contribute to the prosperity of a country . More and more policymakers notice the importance to support and encourage informal caregivers and volunteers. This support is needed, specifically for older informal caregivers as well as for older volunteers. Volunteering represents one of the few formal activities that older adults can perform after leaving the labour market (Morrow-­‐ Howell, 2010), allowing them to stay active and continue to pay a meaningful and valuable contribution to society. It has been shown that older adults attach more importance to volunteering than younger adults (Musick & Wilson, 2008), experience it as a key source of satisfaction, engagement in meaningful activities, and self-­‐validation. Furthermore, the benefits of volunteering amplify in later life (Morrow-­‐Howell, 2010). Volunteering by older people is associated with positive outcomes such as improved health and reduced risk of mortality, higher levels of quality of life, greater well-­‐being, a sense of purpose, feeling less lonely, and having more social resources than their non-­‐volunteering peers (Fraser et al., 2009).

2.2. Social inclusion and participation in Belgium

The Belgian Ageing Studies (BAS) demonstrates that the biggest part (namely 2/3rd) of the Flemish older population is a member of one or more formal association(s). 23,2% of the older people are a member of one organization, 15,8% of two and 25,5% is a member of three or more formal association. The rest (35,2%) is not a member of such an association. Many older people are involved on an active manner to the society through different forms of active ageing. The most popular is being a member of one or more formal associations. Nearly two out of three older people are affiliated to such an association. A second widespread type of active ageing form is going to theatre, movies or sport events. It is important to mention that the greater part of the older people participates, although not very frequently. Third, older people execute informal care quite regularly.

About 30% takes care for little children and over 40% takes care for sick, disabled and older people.

Fourth, neighborhood involvement is a following form of active ageing to which many older people participate. Fifth, following education/training or a course and using Internet and the computer are two forms of active ageing that are about even popular. Finally, about on out of six older people are volunteers (Dedonder et al., 2011).

A recent study on social isolation and loneliness showed that 46% of the Belgian older adults (65+) are being confronted with minor to strong feelings of loneliness. Taking into account the fact that the number of older adults will increase significantly in the future, this would result in more than a

21

million lonely older adults in 2020 (Vandenbroecke et al., 2012). Loneliness not only increases the risk on depression, alcohol and drugs abuse or suicide, but, as a recent meta-­‐analysis showed, increases mortality risks as well (Holt-­‐Lunstad et al., 2010). Fostering social participation among older adults therefore not only adds to the individual wellbeing, but has positive effects on the societal level as well. Health costs diminish and more older adults participate and contribute to the society as a low level of social isolation and activities such as volunteering and informal caregiving go hand in hand.

2.3. Social inclusion and participation in Italy

One last interesting element used to assess the situation of the older adults in Italy is on their participation and on other elements of their social life. In the following paragraphs we will divide this topic in some indicators, such as sport and physical activity, interest and political participation and the use of technology.

As for the people who play sports in Italy by age group we can see that, compared to the older population, show a clear decrease the class of 65-­‐74 years and the next age group over 74, who sees a very low percentage. It is evident also a marked difference between men and women, with the latter having a much lower level of physical activity compared with men, in all age groups. Trying to locate a historical evolution of the phenomenon between 2001 and 2010, the percentage of older people between 65 and 74 who said they were involved in physical activity is continuously increased from 4.4% to 9, 8%, with an increase of 5.4 percentage points. Moving in the older age group, it is possible to note that the over 75 performing physical activity on an ongoing basis have gone from 1.4% to 3.5%, with an increase of 2.1%.

This type of indicator is important as it gives directions, albeit very partial, of at least two basic dimensions for the older adults. It is possible to say that the increase in the number of older people engaged in some sort of physical activity has positive effects both from the point of view of health and sociality.

Another indicator finalized to focus attention on the conditions of sociability and participation of older populations is related to political participation, understood in the strict sense as a desire to learn in relation to policy issues. Men between 65 and 74 years are informed and involved much more than women of the same age and older men.

Compared to the time period can be seen that, between 2001 and 2010, the differential between men and women has decreased slightly, a sign of increased interest on the part of older women to the facts of politics, a very positive fact as it goes groped to undermine a cultural stereotype that sees in the adult male the individual who has to take care of public affairs.

Another selected indicator is related to the use of technology, in this case intended as the use of computers and the Internet by the older adults. These data are particularly interesting because the use of these technologies by the older adults can allow a greater social inclusion, greater ability to learn and better conditions of life.

With regard to the use of computer emerges that the older adults who use computers have increased considerably over the period, an increase of about 10 percentage points for the years 65-­‐ 74, but only by 2 points for the over-­‐75, against an increase of 14% of the total population. Even in

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this case, men use the computer a lot more than women. With regard to the use of the internet, it is possible to identify a trend very similar to that for the use of the computer.

It is still very clear the distinction between the use of internet / pc for the older adults and the rest of the population, a sign of a strong "digital divide" at generational level, against which should increase our effort to improve the knowledge and ability to access technologies by older adults.

2.4. Social inclusion and participation in Poland

Active participation in society Social policy in Poland is faced with new challenges and needs of the ageing of the Polish population.

Priority issues for the older adults should be to create conditions for further personal and professional development, active role in society by fulfilling various social roles and maintaining of the overall fitness. Essential to this is the right attitude and the elimination of negative stereotypes about the role and place of the older adults in society and the economy. In the social aspect there was a big change in the attitude to older people who once were recognized authorities at least because of their age and life experience. Currently, there is a perception that older people are often incompetent, they cannot take care of themselves, and may be a burden for others. One of the causes of such unfavourable change is undoubtedly a very rapid advancement in technology coupled by the inability to adapt to the new senior living, as well as less overall resistance.

In Poland, a wide range of activities for older people at the central, regional and local level is undertaken, taking into account the important role of non-­‐governmental organizations. These tasks are carried out in terms of the labor market, the tax system, education system, infrastructure solutions, as well as the activities of the State in the field of tourism, culture, sports and volunteering.

At the level of infrastructure a large variation in the level of development of the digital society is characteristic for Poland. Strengthening of digital literacy of older people can reduce their exclusion.

To this end, in addition to the reform of education, it will be necessary to overcome the fears and changing habits of the older adults, as well as reduce the cost of access to digital services.

Political engagement The participation of older people in the wider public sphere is unsatisfactory. This concerns different dimensions of participation: activity in political structures and the structures of civil society, openness to other people's problems, and a willingness to take on behalf of some activities, presence in the media, being in a public space.

Those in the oldest age group (65 years and more) to a limited extent participate in forms of activity of civil society -­‐ particularly in their engagement for the sake of their closest environment and people in need. The level of involvement of seniors in the life of local communities is law. The reason for this is lack of interest, and the lack of power. It seems, therefore, that older people are on the margin of the social life of the neighbourhood , very often due to auto marginalization.

Moreover, the older generation is poorly represented in representative bodies -­‐ the Sejm, the Senate and local government at all levels.

Too little space is devoted to the older adults in information, communications and mass culture. Even if old people and their affairs are present in the information or in journalism, they are assigned some stereotypical roles: the poor, the sick, in need of care, ones making use of public funds, reflecting

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negative image of old age as a phase in the cycle of human life. More positive image of an old persons can be found (in very few advertising messages, though, here the authors also refer to the stereotype: this time the robust old lady (or old man), for whom there are only two relevant fields of activity: the family and recreation. Cognitive activity or activities of other older people do not appear as part of the social image of old age.

Volunteering Ministry of Labour and Social Policy has taken a number of actions to promote the idea of volunteering among both mature and already existing seniors -­‐ volunteers. In Poland, about 16% of people are involved in volunteering, including a small proportion of older people. Measures should be taken to encourage seniors to engage in such actions, especially in terms of exchange of experience between the generations.

Informal care Older people are a group, which requires very different approach to social support at various stages of ageing. Taking into account their specific activity and the age range, they should encourage and assisted to ensure that they remain active as long as possible on professional, social and personal basis, while supporting those who are no longer independent and providing them with care.

In Poland, despite the disintegration of the structure of the extended family main institution representing caring support and assistance to the older person is still their family. Reluctance to place an older person in a nursing home is clearly marked not only by older people themselves, but also for their carers. In Poland, the largest group of carers of older people are their children (51.1%).

More than 85% of caregivers live in the same household or in a different one located very near.

However, to carry out functions of care and family care, the right housing conditions are needed, the lack of which may cause that the family does not meet the expectations o folder people they take care of.

It is foreseen that the family will not be able to bear the burden of care for the older person themselves, and therefore the demand for care services will increase. Regardless of whether older people are dependent or independent, they will wish to live in their own homes as long as possible.

Polish families expect the government to focus on the organization of social life and the expansion of social services in order to support the family in carrying out its care functions not only in the area of care itself, but also health, education and recreation.

2.5. Social inclusion and participation in Turkey

Social participation In Turkey, as in most of the developing countries, young individuals in rural areas migrate to cities for educational and occupational purposes, while the older individuals continue with their lives in villages either through traditional family support or being deprived of sufficient financial means. In this case, older men and women become dependent on others and suffer the most from economic problems, as no payment is made to them for their roles in the family and against their efforts in the family business. Older people living in rural areas whose children work abroad receive economic support in the form of some compensation from their children, which also make considerable contributions to the society and the national economy. In Turkey, the situation of active or passive older people or those with no relatives who migrate from rural areas to cities seems to be more

24

advantageous compared to those living in rural areas, in terms of maintaining their traditional family structures and the communication between individuals. In particular, considerable support is provided by local governments and non-­‐governmental institutions, within the limits of their means, to homeless and deprived older people or those who are sick or disabled.

There are no support services or policies for informal caregivers in Turkey. However, there are certain obligations for family members to look after dependants in their families. According to TURKSTAT, 6.8% of the total population was aged 65 or over in 2008. When the number of available places in rest homes is considered (total capacity of 20 970), there was only 1 bed per 232 people in the 65+ age group in 2008. Ministry of Family and Social Policies (MoFSP) operates three bodies: care and rehabilitation centres, which produce inpatient care and provide disabled persons with services; family counselling and rehabilitation centres, which provide day services; and the provincial social services directorates, which represent the general directorate in provinces and which ensure coordination among institutions. As of August 2009, MoFSP offered service to 192419 disabled persons, 186457 of whom received home care by their families; 4039 received care in the official care and rehabilitation centres, 417 in family counselling and rehabilitation centres and 1506 in private care centres. Given the lack of institutional capacity overall, one can easily estimate that a considerable amount of services are provided by informal carers.

The economic growth and social change occurring in our country do not affect women, men and older people equally, and the influences of development in the household are not divided equally either. Women who are adversely influenced from gender discrimination provide the circulation of information inside their village by forming various social networks in rural areas and play significant roles in the keep up of daily life, even as they fail to be cognizant of and/or utilize the adequate means and tools that would enable them to live a better life, thus remain marginal in the modernization process. Indeed, women’s participation in management and decision making processes is less compared to men, they benefit from principal healthcare and educational services at a lesser level, have difficulty in accessing income sources and fail to profit from technology. As such, the contributions of individuals in all age groups, and especially women, in all sectors including non-­‐remunerated work are neglected. In this connection, awareness levels of individuals need to be improved through provision of solidarity between generations in social, economic, cultural, etc. spheres so as to eliminate all kinds of discrimination and exclusion against disadvantages groups and older people.

In Turkey, efforts to include older people in personal or organizational endeavours in economic, political, cultural and social spheres and ensure their active participations in this respect fall short. In both rural and urban life, no structuring other than village headman and village authorities is observed in the political sphere in this sense. While a number of sincere efforts are observed in providing for active participation of older people in rural or urban living in economic, social and cultural spheres, these efforts remain very limited.

2.6. Social inclusion and participation in the UK

Social participation Older people are less likely to feel integrated into society. Feeling part of society usually involves participating in certain activities such as sports, the arts, volunteering or social networking, research shows that older people face particular barriers to participating in such activities.

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The Government promotes work as the best route to personal well-­‐being, with worklessness going hand in hand with low income and social exclusion and can also have implications for people’s opportunities to engage and feel integrated in society.

Older people face barriers to participatory activities. Over one million older people experience poor social relations and social exclusion.

Spending time with friends is an important way of building social networks and support. They can be crucial for older people dealing with life-­‐changing events such as retirement, bereavement or illness – each of which can pose an increased risk of social isolation. Spending time with people outside the household can also provide the older with a sense of independence.

Older people who live alone spend a lot of time with friends and acquaintances, but on average, they can also spend eleven hours alone on a week day and ten and a half hours alone at weekends (excluding sleep).

Over a third of the time that older people spend with their friends is devoted to participatory activities -­‐ most often social networking such as visiting or receiving visitors, celebrating birthdays and catching up over the phone. Religious activity and doing acts of kindness involving friends are also important participatory activities.

The research also showed that women are more likely than men to spend time with friends on social networking activities. Their ability to participate, however, is limited by housework, caring for others and personal care.

It is clear that social participation is important for an improved quality of life. Improving the accessibility of public transport and other facilities and services would go a long way towards increasing social inclusion in Britain.

Local government and charities need to recognise that social participation is important to improve people’s quality of life. Local governments can encourage public leisure complexes and public transport services to operate wider hours or 24/7. Charities could be more aware of these groups when arranging social clubs targeting shift workers and older people. 1

Political engagement; Young people are less interested and knowledgeable about politics and Parliament than older age groups. There is a similar degree of satisfaction about how things work locally across all age groups, however interest in and knowledge about how things work in the local area peaks at the 35-­‐54 age group and decreases after the age of 75. Interest in and knowledge of politics increases with age, but dips slightly in the over 75 age bracket. 50% of those aged over 55 who could correctly name their local MP. Those aged over 55 are the most likely to vote (72%), as well as being the most likely to have voted in the last council election; 70% in comparison to 39% of 18-­‐34 year olds. Those over 75 are markedly less likely to have taken part in the political activities.

Interest in and knowledge about how things work in the local area is high between the ages of 35-­‐74, but decreases after this point; almost three quarters (72%) of 45-­‐54 year olds are interested compared to 56% of those over 75, and over half (57%) of 65-­‐74 year olds know at least a fair

1

ESRC: Social exclusion among shift workers and older people M. Barnes 2011

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amount compared to 46% of respondents over 75. Perceptions across the age groups about how things work in the local area are more or less identical; 48% of 18-­‐34 year olds and 50% of 35-­‐54 year olds and 49% of those over 55 feel things work well. Over half of the 55 plus group feel that people getting involved in their local community can change the way that their area is run (52%). The 35-­‐44 age group are the most enthusiastic about getting involved in decision-­‐making in the local area, over half (56%) would like to be involved, and the 75 plus age group is the least enthusiastic, only a quarter (24%) would like to be involved Satisfaction with the way that Parliament works increases with age with 31% of those 55 years and over slowing satisfaction. However, the oldest and youngest age groups are less positive about the current system of governing Britain; 29% of those over 55 say it works well in comparison to 36% of the 35-­‐54 age group. Those aged 55 or over are the most likely to agree that the UK Parliament holds the government to account, with a high percentage of those in the older age brackets (55 plus) see Parliament as having an impact on people’s everyday lives.2 Volunteering; In terms of the voluntary activities just 10% of those aged 55 and above would be likely to be involved. Propensity to volunteer is low in the oldest age bracket (75 plus) except for volunteering with a church or religious groups, where a quarter (24%) would volunteer.

There has always been a tradition of volunteering in the UK in all sectors. Older volunteers are a great asset to their communities. Older people possess the experience, expertise and time that can greatly benefit any organisation or cause. The kind of volunteering help varies from helping to deliver a hot meal to a homebound older person, reading to primary school children or helping out at their church. Moreover, older people realise meaningful improvements in their own mental and physical health.

In addition to giving older people meaning and purpose to their lives, volunteering also offers specific benefits including keeping active and agile, learning new skills and increasing cognitive and mental well-­‐being. Engaging in mentally challenging tasks is one of the best ways to stave off Alzheimers and dementia!. Volunteering increases social interaction and studies show that older people who stay busy with a lot of social interaction were the happiest and healthiest.

In the UK there are community organisations keen to utilise the skills and abilities of mature volunteers and also networks and bodies set up to support volunteering by older people.

Informal care Informal care, particularly by the family, is the most important source of care for most older people.

Older people rely far more on informal than on formal care. 80% of people aged 65 and over who had help with domestic tasks relied exclusively on informal help (spouse, other household members, relatives outside the household, neighbors and friends), 10% relied on both informal and formal help and only 10% relied exclusively on formal services (National Health Service, personal social services, and paid and voluntary services).

Informal care is a key factor infuencing the extent of formal services. The approach to informal care adopted by social services in the UK, certainly prior to the community care changes of the early

2 Audit of Political Engagement -­‐ The 2011 Report with a focus on coalition politics, civic involvement and the Big Society, Hansard Society 2011

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1990s, was characterized by a model that tended to treat carers as resources and to assume that the social care system need only step in when informal support was unavailable. Local authorities varied greatly in this and, during the late 1980s and early 1990s, new emphasis was placed in government policy on providing positive support for carers. The extent to which older people continue to rely on informal care, however, suggests that any reduction in informal care could have a substantial influence on demand for formal care.

Yet there is considerable uncertainty about the future of informal care. A number of reasons have been cited for anticipating a potential decline in informal care. These include the changing age structure of the population; rises in divorce rates; a decline in family size; rising childlessness; rises in employment rates among married women; the changing household composition of older people, with fewer living with their children; the changing care preferences of older people and the nature of kinship obligations, especially in relation to filial responsibilities.

There is by no means universal agreement about the implications of current social trends for informal care, yet this is clearly an issue of great importance affecting future demand for formal care.

Underlying the uncertainty about the future availability of informal care, there is a wider social policy issue, concerned not so much with whether we can continue to rely on informal care but whether the UK should continue to rely on it. The emphasis in community care policies on informal care has been queried in recent years by those writing from the disability rights perspective. From this perspective, the emphasis on informal carers diverts attention and resources from the issue of the support of older people themselves.3 The importance of the informal network in providing care for older people cannot be underestimated, and successive studies have indicated that most older people can only continue to live in the community because of the care provided by informal carers

3

Relying on informal care in the new century?: informal care for elderly people in England to 2031 -­‐ Pickard, Linda et al LSE

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III. Healthy Ageing

3.1. Europe

Another specific challenge of the ageing population is the significant increase in the number of people requiring care and meeting the costs associated with this demand for care. Within this respect healthy ageing and more specifically health promotion and preventive health care are crucial to reduce the risk of dependency. Age friendly environments can play a key role within this respect (AGE Platform Europe, 2011).

3.2.

Healthy ageing in Belgium

Organisation of healthcare The system of health insurance is an important element in the debate about the future organization of Belgium. It is a focal point in the discussion about the limits of solidarity, the existence of different preferences in the North and the South of the country, and the possible increase (or decrease) in efficiency that may be realized through decentralization. At the same time, the organization of health care is one of the most important challenges facing all rich Western countries. How to accommodate the trend towards increasing expenditures as a result of technical progress, in a situation with growing doubts about the long-­‐run sustainability of government expenditures?

Preventive actions Fall prevention The Flemish Institute for health promotion and disease prevention (VIGeZ) and the Centre of Expertise for fall prevention Flanders (ETUC) developed, BOEBS (Keep on Own Legs), commissioned by the Flemish Government. BOEBS informs about all aspects around fall. They discuss not only the risk factors and the impact of falling but give also tips on how to prevent fall, both by the reorganisation of surroundings as by plenty of exercise. BOEBS gives handles to as many people as possible to inform in different ways. (www.valpreventie.be, www.boebs.be)

Cancer The Flemish League Against Cancer is a non-­‐governmental organization that has made reduction of cancer a priority. Focus is on prevention. Every two years they organise ' Kom op tegen Kanker ', a solidarity campaign to raise money to realize concrete projects. One of these projects puts breast cancer in the spotlight. This campaign allows every woman of 50 to 69 years to have every two years a free and high-­‐quality mammography (x-­‐ray of the breasts). In addition to breast cancer screening, they do many other things e.g. inform on how to reduce the risk of diseases: healthy eating, take plenty of exercise and avoid overweight. (www.tegenkanker.be)

Physical activity Also on local level many activities are organised on healthy ageing. The city of Turnhout organises every Monday FIT-­‐PLUS, support gym for seniors where the participants work on their overall condition. Dance, floor exercises, ball exercises, fitball, ... are programmed.www.turnhout.be

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The city of Geel organizes sports for seniors, 'Aan tafel' is a Do It Yourself project on our eating habits. Via a pass-­‐the-­‐buck system you will discover all groups of the food triangle. Gradually you will learn what healthy food is. (www.geel.be)

Facts and figures about health The older group is getting larger due to the medical progress and better living conditions. That’s why we have to deal with age-­‐related health problems. Therefore it’s important that we not only strive to live longer, but also to be healthy and age happily.

At political level this is a major challenge. Because of this ageing, there will be an increased demand for health care in future. It is therefore important for social security and other health systems to adapt so that they meet the needs of the ageing population. However, the systems must be sustainable for the shrinking active population (Vigez, 2013).

In Belgium, in 2007, approximately 22% of the population aged 65+ used formal care at home. Based on a recent European survey among adults aged 50+, analyses show that approximately 28% of the Belgian older adults aged 50 or more rate their health as poor (Borsch-­‐Supan et al., 2013).

On the regional level, people have been very actively engaged in mapping the needs of older adults and they try to provide appropriate answers.

In 2009, The regional Government formulated an action plan for nutrition, movement and sedentary behaviour. This plan contains a variety of recommendations around nutrition, movement and sedentary behaviour. They also provide tools so that patients/clients get correct information about these themes (Zorg en Gezondheid, 2012).

There are many more initiatives around healthy ageing. It is impossible to mention them all. The initiatives mentioned above are just some examples but they are nevertheless important handles for healthcare providers and others who are committed to the welfare of people who are very old.

3.3.

Healthy ageing in Italy

Another indicator to allow you to define the position of the older adults is related to health. In the following we refer to three categories of diseases typically associated with the older adults: diabetes, cardiovascular disease and osteoporosis; to this was added a report on the amount of smoking of the older adults, in order to give and also check out the potentially harmful behaviors; finally, changing perspective, it was moved to the perception of one's state of health by the older population, having been matched data on the consumption of drugs and their evolution over time.

With regard to the first section, diabetes affects women more frequently than men and tends to increase considerably in the range of over-­‐75, in which about 20% of the population is affected, compared to 12-­‐13% of the lower group age. Heart disease, however, most frequently affecting men, especially the older adults, who are serving a percentage of 18% of these diseases. A third disease typically linked to the condition of old age is osteoporosis, which in 2010 hit nearly 32% of the over-­‐ 75 and almost 20% of the 65-­‐74. However, net is the difference between males and females, with rates among women over-­‐75 which exceed the 45% and 31% between 65-­‐74.

In addition to the diseases mentioned above, it is important also to observe the behavior potentially harmful to the physical, in particular the percentage of smokers. Is particularly interesting to note

30

that in the last 15 years (1995 to 2010), compared to a decrease of the total number of smokers (-­‐ 2.5%, of which -­‐4.7% among males and -­‐0.3% among females), for some of the groups smoking is increased: we refer to women over-­‐75 and especially to 65-­‐74, which recorded an increase in the number of smokers (respectively +0.5% and +2, 9%).

In addition to the "objective" situation on the health of the older adults, we have to consider the perception of it by the people we consider. Concerning Istat data on health status declared by the population, it is interesting to note that, between 2009 and 2010, are witnessing an increase of more than one percent of seniors who say they are in good health (for the 65-­‐74 group from 36.9 to 38.8% -­‐ for the over-­‐75 from 20.9 to 22.2), indicating an improvement at least in the perception of their own health. This is also evident from the decrease of the older adults who claim to be very bad (respectively for the group 65-­‐74 and over -­‐75 : 2.3% and 4.8% in 2009, 1.8% and 4.6% in 2010).

A final important factor to track the health status of the older people regards the assumption of medicines. From 1995 to 2010, we can see the sharp increase in consumption, both for the over-­‐75 (77.2% in the 1995 -­‐ 86% in the 2010) and for the group 64-­‐75 (from 62.1 to 73%). This figure is particularly interesting, especially considering that the life expectancy has increased significantly in the meantime, a sign that greater access to medicines (not only economic, but also cultural) has improved the situation of the older adults.

3.4.

Healthy ageing in Poland

Organisation of healthcare The healthcare system in Poland is based on the insurance model i.e. on universal health insurance.

Regardless of the financial situation each insured person has in principle the right to health care. The range of services provided and the conditions thereof are defined in the relevant law (Law on provision of health services and the law on healthcare services financed from public funds).

The National Health Fund (NHF) is the only institution in the Polish health care system, which is responsible for funding health services and reimbursement of medicines. Mandatory health care contribution of 9% is discharged to the NHF of the personal income by the Social Insurance Institution. NHF is a state owned central institution in possession of the whole of the resources gathered in this way. The NHF does not provide services itself. Its role is only to manage the funds, and in particular to conclude agreements with health services providers (such as hospitals, medical co-­‐operatives, private doctors), who are then obliged to deliver free (or with a small charge) services to patients.

Some health insurance is tax-­‐financed by the state budget, particular funds, employment offices or social welfare centres and, to a small extent, by employers.

The basic element of the health care system in Poland is a primary care physician -­‐ a specialist in family medicine. This doctor is responsible for preventive health care and cure of patients in general disease cases and to direct the patient to a specialist clinic or hospital if necessary. Institutions providing health services are public or private health care, and on the complementary basis, fully paid for, private health care. Document authorizing the use of medical services is a health insurance document.

Preventive actions

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In Poland, preventive health including measures for disease prevention is addressed to people of all ages and in various states of health. The structure of mortality in Poland is characterized by a very high proportion of deaths due to cardiovascular disease (45.4%), cancer (24.6%) and injuries, accidents and poisoning (6.6%). Programs aimed at disease prevention or detection of the early stage of development, when the therapy is most effective are conducted each year , however, spending on preventive health care in Poland is lower than in most European countries and account for about 2% of the health expenditure.

Unfortunately the education of the public in dealing with diseases such as civilization ones is insufficient. Lack of basic knowledge about healthy eating, respect for the laws of nature, the impact of stress, lack of physical activity, or the abuse of alcohol and cigarettes on the body are reflected in increased health care costs.

Facts and figures about health; A very important demographic and health issue is also an ageing population, indicating the need for education of the older people in self-­‐care, or activities to live independently, and the public to prepare to take care of the older people on a non-­‐professional basis. In addition, the increase in the number of people with disabilities especially during the period of professional activity is an important concern. People with disabilities in Poland constitute 14.3% of the total population. Given the above, it would be an important challenge to the increase expenditure on health education

Health care in Poland is one of the biggest problems in the country. Even though that most of people living in Poland are covered by health insurance, in practice the access to free services within the system is very limited. Many people in order to get the right treatment on time must pay for services, which are not covered by the insurance. At the same time the system is very expensive, and in anticipation of the expert you can lose a lot of time and, unfortunately, health, and therefore it is necessary to reform health care. . Due to technological advances and the development of civilization carrying new diseases, as well as Poland's demographic changes it is foreseen that Poland will be challenged with huge financial health issues.

3.5. Healthy ageing in Turkey

Organisation of healthcare Health care for the older people is given under the general health care services (PHC). By regulations older people are considered as being in risky group and screening them is necessary in PHCs. The older people should be screened at least two times in a year and be referred to a hospital if needed.

In Turkey each individual has a family physician. Family physician is responsible for preparing programmes, screening and monitoring activities and to input the gathered data to the system.

District health directorates are responsible for controlling the process. It is expected that every older adult should be screened at least 2 times in a year. Family physicians are expected to make weekly plans and visits to the older adults in their region. Status for healthy nutrition, physical activity, and chronic diseases should be assessed and individuals may be referred to secondary care units if necessary. The individuals with long term conditions are planned to be given priority in visiting plans.

Other than FCUs, elderly focused health care is being given by 1 Geriatric Care Center, 14 Geriatric Policlinic and 25 Geriatric Care Units in Community Health Centers.

32

Preventive actions Ministry of Health (MoH) prepares and distributes Guidelines for diagnosis and treatment for Older Patients in a regular basis. MoH also prepares education materials for the public. MoH prepared

National Plan of Action on services for Ageing and health care for the older adults in 2011 covering targets that can be achieved in short, medium or long term and fundamental actions to be taken in order to reach these targets in line with the international commitments. The three main area of interest are older people and development, enhancement of well being and health in old age and providing secured, facilitating and supportive environments. The Ministry of Health of Turkey, Public Health Institution, Department of Chronic Diseases, Elderly Health and Disability is responsible for creating and screening the programs for the elderly health. The scope of the department is as follows; to develop national plans, implement these plans and evaluate the outcomes, to collaborate with national and international institutions on ageing and elderly health services, to initiate activities on education, information and promotion to increase knowledge, attitude and behaviour on true healthy ageing by education.

Facts and figures about health The percentage of people over 65 years old in Turkey increased since 1970 as a result of decreased mortality and increased birth rates. In 1940 the older people formed 3.5% of the total population and increased to 4.4% in 1970, to 7.3% in 2011. By 2025 it is expected that these figure will increase over 10% and the dependency rate will be 14.5%.

According to a recent study using Turkish Health Survey in 2008 the data collected from total 1,540 respondents at 65 ages and over when the most common health problems of the older population in Turkey were reviewed, only 18,1 % of the population over 65 expressed that they did not have any health problems in the last 12 months. While the ratio of the older men who did not have any health problems in the last 12 months is 26,5 %, it falls to 11,6 % among the older women. The analyses asking participants and examining chronic diseases they suffered in the last 12 months found out that 36,2 % of the older women suffered from 4 diseases and more while 19,8 % of the older men suffered from 4 diseases and more in the last 12 months. In the same study the most common five chronic diseases are same for both gender and residency: hypertension, rheumatoid arthritis, arthritis, back musculoskeletal system disorders and diabetes. Being a female significantly increases the risk of all these diseases more than two times. On the other hand risk of suffering depression is almost 4.5 times higher in women than men. The difficulty in daily routines and physical activities of elder population was assessed in 5 main topics; nutrition, going to and getting out of bed, getting dressed and undressed, going to the restroom and taking bath/shower. The most difficult activity was found to be taking bath/shower for the older population (19,7 %).

Among all 5 daily routines and activities of interest, it’s seen that females have more difficulty than males. While more than 20% of women living in rural areas seem to have difficulties in performing daily physical activities like going to/getting out of bed, getting dressed and undressed, going to the restroom and taking bath/shower; corresponding percent ages for men living in urban areas are all below 15 and represents a statistically significant difference with older women living in rural areas.

Given daily routine activities by settlement areas, the older people living in rural areas seem to have bigger difficulties in performing daily physical activities than the older people living in urban areas.

33

The challenges in daily routine of the older population are remarkable, too. The fact that almost 20 % of the older population having difficulty in taking bath/shower and going to restroom indicates the existence of severe problems about hygiene and life quality, both of which have utmost importance to the older people’s health. Additionally, it’s seen that being a women and living in rural are serious factors increasing the possibility of facing difficulties in daily life. It’s obvious that women living in rural areas are more vulnerable to all the challenges of interest. For instance, 26 % of women living in rural areas states that they have difficulties taking bath/shower compared to 12.8 of men living in urban areas

3.6.

Healthy ageing in the UK

Organisation of healthcare.

Age UK This charity has the aim of improving the lives of older people. It helps more than five million older people a year with services, information and products.

British Association of Occupational Therapists and College of Occupational Therapists This is the professional body for occupational therapy professionals in the UK. Occupational therapists and support workers aim to help people engage as independently as possible in the activities which enhance their health and wellbeing. It has advice about how occupational therapy might be of benefit to you or people you know.

National Health Service National

service

framework

for

older

people,

http://

http://www.nhs.uk/nhsengland/nsf/pages/olderpeople.aspx

In the UK monitoring, maintaining and promoting health and well-­‐being with age is critical for older people, their families, communities and for wider economic and social planning.

Healthy ageing has been described as ‘the ideal situation in which people survive to an advanced age with their vigour and functional independence maintained, and morbidity and disability compressed into a relatively short period before death’ but there is still little understanding of the constituent components of healthy ageing and how these differ between social, cultural, economic and traditional contexts.

Preventive actions There are many initiatives in the UK based upon the theme of “Lifelong health and wellbeing” and within the area of ageing major concerns are quality of life, physical frailty and ageing brain.

The best way to prevent infectious and chronic diseases is to prevent them from occurring in the first place. Prevention programmes have been introduced that reduce the economic and social costs of poor health by promoting healthy ageing. Measures such as vaccination drives and educational

34

campaigns help prevent contagious diseases, while promoting healthy lifestyles helps battle chronic illnesses. Helping individuals avoid disease in this way is the most cost-­‐effective form of healthcare leading into old age.

It is predicted that by 2020 all the health gains of successful anti-­‐smoking policies will be wiped out by the effects of obesity.

Better food labelling may be an important way to improve poor diets. The UK's "traffic light" labelling scheme—using red, amber and green colour-­‐coding—as well as guideline daily amounts (GDAs) indicate the relative healthfulness of food products. Yet causes of obesity are complex, and no single campaign can address it effectively. "In the UK, we had a huge public health initiative and really reduced male smoking," says Sarah Harper, professor of gerontology at the University of Oxford and director of the Oxford Institute of Population Ageing. "But the lifestyle disease of the 21st century probably won't respond the same way."

Preventive programmes against smoking and obesity need to be supplemented by "secondary preventive" schemes that focus on identifying commonly occurring asymptomatic diseases such as diabetes, hypertension and breast cancer. Early detection and intervention of these conditions can reduce their severity, slow their course and prevent them from becoming life-­‐threatening.

Screening is vitally important but more research is needed to determine exactly which screenings are most successful in improving health outcomes and which provide the most value for money. For example, experts are still debating the relative benefits of prostate cancer screening for men and how frequently women should have mammograms.

Facts and figures about health4 There is an unprecedented demographic change underway in the UK with the proportion of young people declining whilst that of older people is increasing. There are considerable benefits to the UK of having an active and healthy older population with potential economic, social, and health gains associated with healthy ageing and reducing dependency in later life Average life expectancy -­‐ Total 78.2, Male 75.9, Female 80.5 Healthy life expectancy (HALE) in years at the age of 60 for males and females: Male 15.7, Females 18.1 Employment rate of those working full-­‐time in the 50–64 age group and average exit age from the labour market: Employment, Male 72.5%, female 56.5% Working full-­‐time Male 88%, Female 52% Average exit age: Male 64.2, Female 61.9

4

Healthy Aging – A Challenge for Europe, Swedish National Institute for Public Health 2007

35

36

IV. Independent living

1.1.

Europe

A particularly innovative means of promoting independent living is through the development of home-­‐based ICT support systems. Local and regional actors can access a range of European research programs to support such activities. ‘Intelligent’ homes, digital and web-­‐based services aim to support older people in living independently and increase the efficiency of service delivery by better identifying specific needs.

1.2.

Independent living In Belgium

Financial situation of older adults In 2011 20% of the Belgian older adults were at risk of poverty. The risk of becoming poor is in Belgium significantly higher than for other age groups. The average risk of poverty is 15%.

Looking at all age groups in Belgium and the evolution through time, we can notice that, despite the fact that the general risk on poverty has increased to 15% , the risk among older adults has diminished from 23% to 20%. Women are generally more at risk of poverty than men at old age (~2%).

Table 7: Evolution in risk of poverty in Belgium (2006-­‐2011)

Source: ADSEI Housing and older adults Because of the ageing of the population, places in residential care are getting scarce. The government strongly supports living independently as long as possible and focuses on supporting the informal care networks of older adults.

37

Support Growing older often means an increasing need for support (personal care, financial support, support in the household, …). In Belgium there are several official services for older adults among which care at home and financial support. As mentioned earlier, almost 22% of the adults aged 65+ uses formal care at home.

1.3.

Independent living In Italy

Financial situation of older adults The socio-­‐economic conditions of the older adults

In order to assess the social conditions and the impact of the crisis on older populations in the Italian territory is important, first of all, to know what are the sources of revenue of these person and how these have changed during the last years, pay particular attention to the poverty indicators which can allow to establish and become aware about the needs of the target group.

The older adults and poverty The social and economic conditions of the older adults in our country have worsen significantly. The economic crisis and the maneuvers carried out by governments in the 2010-­‐2012 period have weighed on the older people, worsening living conditions and growing phenomena of social exclusion. The confirmation comes from Eurispes report of 2012: in 2011, 81, 5% of the older people indicates a deterioration of their economic status compared to 74.8% last year.

On the basis of ISTAT statistics, in 2010 Italian households composed of only the older people are the 28,06% of the total, were 27% in 2007 and retired poor turn out to be 2.3 million, an amount likely to increase.

The point estimate of relative poverty on the older people provided by ISTAT, shows a substantial condition of stasis in the last three years 2008/2010, with approximately 13% of older people living in poverty in Italy. Signs of deterioration are observed among over 65 living in the north, where the index, though it remains the lowest among the geographical areas, rise from 6.4 to 7%. By contrast, in the regions of central Italy, the index shows a decline of almost 1 percentage point between 2009 and 2010, bringing the North and Central part of Italy on the same level as regards the relative poverty among the older people. However, strong is the geographical disparity with the south, where more than 26% of the older people live, according to Istat dates reported in 2010, in relative poverty.

In 2010, in Italy, 5.5% of the older people are in absolute poverty, about 0.2% more than in 2009. The incidence of absolute poverty among the older people is increasing in the years 2009/2010, in the North (+0.5%), confirming the results shown for the relative poverty, and in the Centre (+0.5 %), while, in contrast, was down in the South (-­‐0.5%). Is still confirmed the disadvantage of the South (7.2% of older people are living in absolute poverty) and the North (5.1%) than those in central Italy (3.7%).

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In addition to the indicators of relative and absolute poverty, of considerable interest is the index of "material deprivation" (intended how not being able to support unexpected expenses, have arrears in payment as mortgage, rent, bills, payables, not be able to afford in a year a week's holiday away from home, a proper meal at least once every two days, the proper heating of the house, buying a washing machine, a color television, etc.). The Istat report from 2011 shows that the deprivation of households in Italy does not vary significantly between 2009 and 2010. 15.7% of families (it was 15.2% in 2009) has three or more symptoms of deprivation, while 7.1 percent of households are in conditions of severe deprivation (6.8% in 2009). Thus, about 45% of families in the conditions of deprivation is severe.

Housing and older adults The consumptions of the older adults: house and energy in growth, but consumption is reduced for food, clothing and health services ISTAT statistics show that over the past eight years (2003-­‐2010) the average monthly expenditure of an older adults living alone grow exclusively for house and energy (+2.9%) and transportation (+0.7%) . On the contrary, during the period, the older adults living alone has reduced the cost of supply (-­‐ 1.7%), clothing and footwear (-­‐0.8%), in addition to those for furniture (-­‐0.8%) and those relating to health services (-­‐0.6%). Especially the latter area indicates a worsening of the situation of the older adults, forced to reduce a type of consumption considered essential. Overall, then, the fact that between 2003 and 2010, the average monthly expenditure has grown by about 284 euro is not a good sign, since the increase comes exclusively from expenses related to housing and transport.

Also with regard to a childless couple headed by a over 65, only one item of expenditure is on the rise: one destined to housing and energy (+3.9%). Down are instead all other spending, even if in a smaller way than the category of older people over 65 alone.

1.4.

Independent living In Poland

Financial situation of older adults; With universal pension system older people in Poland are relatively economically self-­‐reliant, but the comfort of their life is much worse than in other European countries. Almost 90% of people live only with retirement benefits. Owning your own, though small income, can give older people a sense of independence, however, not being sure if they can support themselves only with their retirement benefits poses a threat to the living conditions of the older people. The amount of pension benefit is important, especially for single people. Currently in Poland lowest guaranteed old age pension and pension for total disability is 799.18 zł., While the lowest guaranteed pension for partial disability 613.38 zł.

Polish pension scheme is far from perfect and cash benefits guaranteed by the state are insufficient, therefore the older people are the poorest social stratum. Despite the efforts of the family is not always able to provide the necessary care and support for seniors. To prevent poverty and to support the older people various institutions are created to support this social group. One of them are the Social Welfare Centres, with the task of maximize their independence and their activation to improve the quality of their lives. Although Social Welfare Centre is not an institution dedicated uniquely to older persons, it collaborates with a number of other institutions that support older people in their

39

daily lives such as the Polish Red Cross, the Polish Committee for Social and religious institutions, nursing homes, guest houses, hospices, shelters, soup kitchens. Unfortunately, the network of these institutions is not able to secure all their needs, both in terms of quantity and quality of services.

In Poland, there is no social policy dedicated especially to the older people, they use a system of social assistance on general principles. Approach is designed to encourage the extension activity of the older people, thus postponing the time of retirement. Extending the working life can increase older people gathered on the individual account of the insured capital, and thus affect the growth of the pension.

Housing and older adults Housing conditions and living environment of the older persons is an important problem to be solved by architects and urban planners together with social care and medical services. Housing conditions to a large extent predetermines the possibility to function independently and safely of older citizens.

Statistical and social research carried out in the recent decade has shown that living conditions of the older people are worse than average living conditions in the country.

Most of older people live in houses and apartments own by themselves or close family members.

Only a small percentage of the older people live in caring institutions. Almost ¾ of senior does not accept the perspective to move from current home to carrying institution. The main source of this reluctance is the fact that the social background in the place of living, (social networks, well known space inside and outside home) are considered as an important asset. Only 1/10 considers the possibility to move to a caring institution. There the main source of fear are negative preconceptions about such houses including low standard of living and care provided, possibility of abuse and also the fact that the existing cultural paradigm makes the closest family members responsible for the older ones. Management, financing of the housing institutions for seniors could be improved, through facility management (e.g. paid access to some of the facilities such as swimming pools, training and rehabilitation facilities) in order to increase living standard.

Many of older people (about 50%) encounter architectonical barriers, such as high or steep steps, lack of elevator, and lack of driveway for wheelchairs, lack of reels or handles. Many flats and homes need adaptation in order to facilitate entrance.

It is also indicated that the provisions regulating construction of buildings (both public and private ones) should be amend in a way to facilitate access of disabled persons. Social institutions should be better involved in care of the older people.

Support of older people (services, premiums,…)

Social benefits in Poland are low, mostly below the average wage. Care benefits for older people include attendance allowance and care benefit. Attendance Allowance is a social security benefit available to people aged over 75 years, it is intended to cover part of the expenses arising from the need to provide care and assistance of another person in connection with the inability to live independently. Attendance allowance granted to a person with the right to a pension, who was qualified by authorised doctor as unable to work and live independently and also to all of those who have completed 75 years. Care benefit is one of the forms of social assistance, provided to persons who resign or do not undertake paid work in order to take care for a person who was qualified by the authorised doctor as severely disabled.

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Having fulfilled the conditions prescribed by the law, some older people may benefit from early retirement benefits and social pensions. In addition, various additives are provided to pensions, among other, for one for the war-­‐disabled, orphans , war veterans, compensation benefits, cash benefits for deportees and victims of war. Unfortunately, all of these extras are paid a symbolic amount.

In addition to basic benefits the state also offers other forms of support for the older people, such as reductions in payments for services, exemption from subscription fees for radio and television, discounts and exemptions for the use of means of communication.

1.5.

Independent living in Turkey

Financial situation of older people In Turkey, older people had one or more financial sources for sustaining them, and more men were entitled to such incomes compared to women. Whereas 24% of older people aged 60+ in Turkey were reported to be poor. 65,3 % of the older population lives in households with less than 750 TRL income per month. It is also remarkable that 8,2 % of the older population pay out of their own pockets for health expenditures. Out-­‐of-­‐pocket payment for health expenditures is 7,6 % among men and 8,7 % among women.

Housing and older people According to Law No.5434 on the Republic of Turkey Pension Fund for Civil Servants, practices of services for older people are conducted through Rest Homes and Nursing Homes. Individuals, who receive pension from the Fund with the statuses of retired, disabled, widower, orphan or those in the scope of the Service to Country Arrangement, and who: are 60 years old, are not alcohol or drug addicts, do not have any contagious diseases, are not convicted of infamous crimes, are able to conduct their daily activities by themselves shall benefit from these institutions. Nursing homes are ruled by Ministry of Family and Social Politics, Department of Disability and Elderly Services, other ministries, municipalities, private nursing homes and NGOs. These nursing homes serve for nutrition, hostelling and physic social support. Individuals older than 60 years can stay in nursing homes.

Table8 : Number, capacity, Occupancy rates of nursing homes in Turkey, 2012 Type Number

Capacity

Occupancy

NH belongs to Disability and Elderly Health 105 Department

1 1682

10688

Other Ministries

2

566

566

Municipalities

20

2 013

1409

Associations and foundations

33

2770

1930

NH for minorities

7

961

673

Private nursing homes

127

6254

4377

41

Total

294

24 246

19 652

Elderly Service Centers serve to individuals with normal mental properties, who do not need medical assistance and no disability however in need of daily activities. They also give home care service support for continuing daily activities of the older adults. In total there are 5 Elderly Service Center with 1076 members in Turkey.

A means-­‐tested pension scheme was introduced in 1976 (Law Number 2022) and includes the following pension provisions: a. Means-­‐tested old-­‐age pension: It provides old-­‐age pension for poor and older citizens above 65 years of age. The poverty threshold in November 2011 was TL 104.43 per person. In November 2011, the pension amount was TL 109.65 (SGK, 2011/c). b. Means-­‐tested old-­‐age pension for needy disabled persons: It provides old-­‐age pension for poor, needy, disabled and older citizens above 65 years of age. The poverty threshold in November 2011 was TL 104.43 per person. The pension amount in November 2011 was TL 328.94 per person for people who are disabled to a degree of 70% or more (SGK, 2010/c). c. Means-­‐tested disability pension for disabled people and their families: It provides a disability pension for poor disabled persons aged 18 to 64. The poverty threshold in November 2011 was TL 104.43 per person. The pension amount in November 2011 was TL 219.29 for disability degrees between 40% and 69%. For disability of 70% or more, the disability pension amounted to TL 328.94 (SGK, 2011/c). If a disabled person under the age of 18 is cared for by a relative who is in financial hardship, the carer is eligible for a disabled relative’s pension (currently TL 219.29) (SGK, 2011/c).

4.6.

Independent living in the UK

Financial situation of older people New and imaginative ways of caring for older people are springing up across England -­‐ with claims it is necessary because politicians are "scared" of raising taxes to pay for it. With people living longer, caring for them in their latter years is going to cost the state billions. But the political debate is about cuts and austerity -­‐ not caring for the old.

Responsibility falls on wider society, on communities, on neighbourhoods, on families -­‐ to fill that gap. Communities, neighbourhoods and families have been establishing projects that aim to enable pensioners to feel confident they will be cared for as they age -­‐ regardless of their financial situation.

The UK Government is providing £1 million to fund “Active at 60” a project to help older adults approaching retirement or who have retired to help improve their wellbeing and to enable them to become more active.

The scheme is only open to community groups in certain areas of England chosen by the level of deprivation, age structure and a balance of rural and urban areas.

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Housing and older adults There are several options available to older people in the UK if their home is no longer as suitable as it once was.

•

Staying put and adapting the home

Most older people wish to stay put, and the challenge is to do it well. Much can be done to make most houses or flats easier to use, and there are reliable services to help organise adaptations or repairs to make the home more suitable or comfortable. A range of support and help can be arranged and an emergency call system can also be installed.

•

Moving to a more suitable property

Some will consider moving to a new home without stairs, in a more convenient location, in better repair, easier to maintain or without a large garden. There are services to help older people find a suitable home and to help with all that’s involved – from packing, to finances to arranging the move itself.

•

Moving to a new home where help or care is at hand

There is a wide range of housing in the UK built specially for older people, from traditional sheltered accommodation to retirement villages. More and more ‘schemes’ have care staff discretely at hand to provide assistance, when needed, to frailer and more vulnerable old people.

•

Moving to a care home

For some older people, moving to a care home is a positive choice, for others it is a necessity.

Responsibilities become a thing of the past, and care and support is always at hand. Many care homes offer excellent service, and there is a wide range of sizes and types. However this is often seen as a last resort for older people and their families.

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V. Intergenerational solidarity

5.1. Europe

Intergenerational solidarity can we understood as the social connectedness between generations and this on the individual, micro level, bus on a societal macro level as well. Because of the ageing of the population increasing attention goes to the concept of intergenerational solidarity (i.e. European Year 2012). Recent demographic trends show a strong increase in the average life expectancy all over Europe. Despite this increasing proportion of older adults in our society, the general attitude towards old age tends to be negative: older adults are only a cost for society. Ageism, the discrimination of older people, often is not far away. The opportunities for young and old to meet each other and exchange are often scarce. Fostering intergenerational solidarity therefore is an important goal. Local communities can play a key role in this process by promoting initiatives which bring together several generations (AGE platform Europe, 2011). In this context, the guideline of “Age Friendly Cities” of the WHO (2007) can play a key role.

5.2. Intergenerational solidarity in Belgium

The Flemish council of older adults as well as the Flemish council of youth (2009) state that intergenerational solidarity is a priority. They are concerned with the affordability of the pensions and the decline in intergenerational contacts.

Research on informal care in Flanders (Belgium) however is more optimistic (Vanderleyden & Moons, 2012). Many people in Flanders provide care to each other. About 30% of the people aged 18 to 85 years old provides care or support on a daily or weekly basis. This research pleads for strengthening the social ties as a large social network leads to a greater potential of supporters of informal carers.

In Belgium, several governmental levels, organizations and social groups are committed to the theme. With respect to the European year of active ageing many initiatives have been taken to support the informal care network of older adults.

5.3. Intergenerational solidarity in Italy

5.4. Intergenerational solidarity in Poland

Dialogue between generations Mutual understanding and ability to listen attentively to each other as well as general communication skills are crucial partner relationships.

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Leen 31/10/13 14:18 Comment [2]: To be added?

Intergenerational cooperation, as an important element in promoting solidarity between generations, gives a chance to different age groups to win and provide experience and expertise very valuable for both sides . Intergenerational integration aims to encourage mutual learning of the older and the young. not just participation of the older people in the learning process is important, but also the identification and transfer of skills and experience to younger generations.

In accordance with the lifelong learning policy guidelines , one possibility is to use the potential of older people in the non-­‐formal education, which supports selected tasks of the early care and education of children. Such forms include short activities with children, individual work with children and their support, assistance to parents in terms of care and education, neighbourhood initiatives, integrating the local community around important issues for the education of young children, encouraging different forms of self-­‐organization of local environmental and lobby for actions aiming at the development of young children, participation in training of parents or educational advice boards at schools in matters concerning contact with their parents.

In Polish society active proportion of older people (not just professionally) is one of the lowest in Europe. It can lead to marginalization and social exclusion of the older adults, and thus the problems of intergenerational social dialogue. The most important task is to prevent a situation in which the daily life of the Poles will focus exclusively and adapt to the needs of young people in working age, with exception of a very important and large group of older people.

Rights and discrimination (ageism).

Discrimination on grounds of age in Poland is still a new and unrecognized subject, despite its extraordinary social importance. Analysis conducted by the Ombudsman in 2008 shows that in general in Poland, rights of the older people are well protected, and in most of the cases it is not in the normative but in the social and organisational sphere, where the changes are needed. Ageism is still not well recognised as an unfavourable social phenomenon both by older people and the rest of society. As mentioned in the other part of our report, older people are not sufficiently active and represented in the public sphere. Perception of this group in mass media is also to a certain extend limited and biased. The area of labour law is being discussed in the „Employment” chapter, however it can be mentioned here that apart from insufficient activity o folder people in the labour market, some manifestations of discrimination in grounds of age can also be noted.

The process of increasing participation of the older people in the labour market is a very important.

Since 2008 the program "Solidarity between generations. Measures to increase labour force participation of people aged 50 +” is carried out. The program has been implemented within the legislative and information competences of the Ministry of Labour and Social Policy. A number of exemptions for employers of persons 50 + were introduced to reduce labour costs. The concept of lifelong learning is promoted as a way to facilitate development of professional skills. The number of people eligible for early retirement was limited, and action taken to prevent the deactivation of the older people because of the need to care for their grandchildren by improving the system of care for children.

As to the changes in the tax system, flat rate of income tax rate for people over 60 years of age was reduced, and at the same time employers o folder workers were exempted from pension contributions or the rates were reduced.

In the education system availability of training services provided in various forms of formal or informal learning was increased. They are aimed at the development of key competencies, personal development and their own interests in various fields, as well as the practical application of learning

45

outcomes in everyday life of older people. In Poland, important roles in learning of the older people play Universities of the Third Age. The development of diagnostic and therapeutic procedures in case of violence against seniors taking into account the specificity of this group is needed. Existing procedures mainly include family violence against children and as adults (spouses, cohabitants). Greater attention should be devoted to the problem of violence and neglect against older people residing in various institutions.

In public places old people face different types of barriers. Architectural barriers impeding access to places important for the residents such as e.g. shops, public buildings is often discussed and remedied. Unfortunately this does not exhaust the problem of public space hostile to seniors. It can be observed that in Polish cities, for example, there is insufficient number of benches on the streets and commercial areas as well as and public transport stops. Not enough squares, plazas, where people of all ages -­‐ including the older adults -­‐ could safely rest and socialise.

Problems mentioned above cannot be solved only by legislative means. Changes in social attitude are crucial in this regard, as well as involvement of the older people themselves together with representatives of influential professions and social circles.

5.5. Intergenerational solidarity in Turkey

Life styles based on mutual support between parents and children in the Turkish society is very important in facilitating young people’s start in life at the beginning of their marriages and taking their lives under assurance. While the tradition of living together with parents, even if for a temporary period, is one of the most distinctive factors, the need of the older people for their children to look after them is another factor bringing about living together. Urbanization and increased education level are important determinants bringing about the transition from traditionalism to modernism. The chances of parents living with their children decrease as young people start to have their own children.

While through modernization, there has been an increase in the nuclear families and a decrease in crowded ones, preference of older people and their children in the same quarters indicate that the family relations are still strong. Due to the limited social security systems in developing countries such as Turkey, families along with the state and other institutions assume the responsibility of older people.

The family functions as an important support mechanism in our country. Surveys conducted indicate that older people in our country do not prefer to live with their children, but rather live an independent life through living in their own houses while sustaining their communication with their children by residing in the same quarters with them. Surveys conducted again indicate that older people living close to or far away from their children and families tend to see each other rather frequently, help one another and more often than not they are satisfied with their relationships with their close relatives. However, the difficulties of the family members who assume the responsibility of helping and supporting the older members of their families increase with age, on account of their responsibilities also towards their work and their own families, and they tend to feel guilty for not being able to fulfill their responsibilities adequately.

Therefore, formation of service models that would serve to support family members in caring for the older members of their families gains more and more significance. Both official authorities such as governments and unofficial ones such as family and friends are very important in the provision of

46

help and support to older people. Volunteer organizations will be expected to assume vital roles in the provision of a higher level of economic and social support to older people in the future.

5.6. Intergenerational solidarity in the UK

In response to the European Year for Active Ageing and Solidarity between Generations several initiatives across the UK have been set up5. They include: •

England(United Kingdom)

Dignity in Care -­‐ Stockport •

Scotland(United Kingdom)

A City for All Ages workshops in Edinburgh •

United Kingdom / England(United Kingdom)

Age Action Alliance •

Northern Ireland(United Kingdom)

Age Discrimination Legislation Recommendations •

Cill Chainnigh(Ireland) / Wales(United Kingdom)

Age Friendly Communities Ping into Sport •

England(United Kingdom)

An Active Ageing and Intergenerational Train Ride Treat •

England(United Kingdom)

Arts 4 Dementia •

United Kingdom

BBC tackles ageing in primetime •

England(United Kingdom)

Brighton & Hove council applies for WHO Age-­‐Friendly city status •

Wales(United Kingdom)

Caring Connections -­‐ A digital storytelling project in Wales

Dialogue between generations

5

For the database links – http://europa.eu/ey2012/ey2012main.jsp?catId=975&langId=en&country=22&mode=searchSubmit

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Intergenerational attitudes are changing. Older generations see some young people as a threat to their safety. This is driven by anti-­‐social behaviour (tolerance of which is in decline), negative press coverage of young people and public behaviour, usually in groups, which looks intimidating.

On the flip side, youth attitudes to older generations may also be hardening. The ageing population means that a larger share of national income will be required to pay for pensions and healthcare, potentially leading to increasing debates on whether welfare gains for one age-­‐group (i.e. the older) come at the expense of another (i.e. students). At the same time the economic downturn has reduced opportunities for young people (including high house prices (see housing market), university fees, and a more competitive job market), there is constrained public spending, and an increased understanding that climate change may limit future consumption. Taken together, these factors are contributing to a perception that the current generation will not be able to attain as high a standard of living as some older people today.

Within the categories of 'older generation' and 'youth generation' there is ample diversity -­‐ 60-­‐year-­‐ olds are very different to 80-­‐year-­‐olds and inequalities of income and educational attainment are particuarly striking in the young. The increasing diversity of older people means that the way older people are viewed is shifting, which may lead to a decrease in stereotypes and prejudice towards older people. As the older generation participates more online – increasingly using services such as Facebook perceived as being for 'young people' -­‐ the cultural gap between young and old may diminish.

What are the implications?

•

A need to stimulate dialogue which fosters understanding between generations.

•

If conditions of equity between generations no longer exist, and more responsibility is placed on individuals, potential conflicts and tensions could arise.

•

There could be the development of social and political activism of and by different generation groups.

Rights and discrimination (ageism) Although ageism is often seen as a workplace issue, it can occur in an old person’s everyday life, this could include: •

Losing a job because of their age.

•

Being refused interest-­‐free credit, a new credit card, car insurance or travel insurance because of their age.

•

Receiving a lower quality of service in a shop or restaurant because of the organisation’s attitude to older people.

•

Not being eligible for benefits such as Disability Living Allowance due to age limits.

•

Being refused a referral from a doctor to a consultant because they are ‘too old’.

•

Being refused membership to a club or trade association because of age.

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All of these situations are examples of ageism. In the UK older people are protected against some of these situations by law, but not all of them.

Under the Equality Act, they are protected from ageism in employment, training and education, and also in membership of clubs and associations. Unfortunately, there is no protection in some areas, including housing, as yet..

The Equality Act 2010 brought together existing regulations that already gave protection against ageism and other forms of discrimination, and extended them.

Since October 2010 this has been the main law relating to age discrimination, protecting you against ageism in employment, education and training.

The law maintains the right not to be disadvantaged or treated badly at work because of age. It also covers the way people are treated by further and higher education organisations such as universities, and by clubs, associations and trade bodies. The Equality Act gives new protection to ensure older people get fair treatment when they are receiving goods and services, although this part of the Act will not be introduced until April 2012.

Previously, an employer could refuse to consider candidates for jobs if they were over 65 (or the firm’s normal retirement age). Since the default retirement age was abolished under the Equality Act 2010 and started being phased out in April 2011, this can no longer be used as a justifiable reason.

In addition to age, under the Equality Act people cannot be discriminated against as a result of any of the other ‘protected characteristics’. These are: disability, gender reassignment, marriage and civil partnership, pregnancy and maternity, race, religion or belief, sex, and sexual orientation.

VI. In conclusive

The World Health Organization emphasizes that active ageing can enhance the quality of life. We notice that active ageing is more than keeping older adults active on the labour market. It covers a wide range of aspects of life: participation, security and health. We tried to get some insights in the situation concerning Regarding this report we can conclude that every country has its own specific policies. Nevertheless all of the countries face the same demographic evolutions and the challenges that come along with them.

This Learning Partnership gives us the opportunity to learn from each other and maybe come to new ideas and insights about ageing and more specific how to encourage active ageing (at all ages).

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References

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Raport syntetyczny z badań. (Labour market and unemployed persons aged 50+. Barriers and opportunities. Synthetic report.)http://www.rynekpracy.pl/pliki/pdf/1.pdf 5. Central Statistical Office, Quarterly information on the labour market, Warsaw November 2012.

6. Central Statistical Office, Quarterly information on the economic activity of the Polish populatuon, Warsaw June 2012 7. Statistical Office in Bydgoszcz, People over 50 on the labour market in 2010, Warszawa-­‐ Bydgoszcz 2012.

8. Przejscie z pracy na emeryturę (Transition from work into retirement, GUS (Central Statistical Office, Warszawa 2007 9. Rządowy Program na rzecz Aktywności Społecznej Osób Starszych na lata 2012–2013 (Government programme for the Social Activity of Elderly persons 2012-­‐2013) http://www.mpips.gov.pl/gfx/mpips/userfiles/_public/1_NOWA%20STRONA/Aktualnosci/se niorzy/Rzadowy%20Program%20ASOS_2012-­‐2013.pdf 10. Krajowy plan działania na rzecz europejskiego roku aktywności osób starszych i solidarności międzypokoleniowej 2012 w Polsce (National Action Plan for the activity of Elderly persons and solidarity of generations for 2012 in Poland)

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References: Turkey

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5. Yaşlı Sağlığı, Sorunlar ve Çözümler Raporu, Halk Sağlığı Uzmanları Derneği 2012 ISBN: 978-­‐ 975-­‐97836-­‐1-­‐7

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