Ageing policy in the Czech Republic Politique du vieillissement en Rpublique Tcheque

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Ageing policy in the Czech RepublicPolitique du
vieillissement en République Tcheque
CEFRES, December 18, 2008
Petr Wija Ministery of Labour and Social
Affairs of the Czech Republic
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Discourse, perspectives

• Demographic ageing, competing and confusing
  perspectives
• Concern with ageing, life expectancy,
  longevity, concern about older people
• Concern over (Lowest) low fertility, concern
  about family/children
• Ageing policy social integration and human
  rights of older persons?

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Discourse, perspectives

• Public health success x fiscal (pension, health)
  time bomb

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Discourse, perspectives

• Older people - Burden x resource (active ageing,
  silver economy)
• Quantity x quality (work, health, education)

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Discourse, perspectives
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Discourse, perspectives

• Generations
• Gender
• Life course approach

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Demographic ageing in the Czech Republic

• The Velvet Revolution brought about the economic
  and social changes which lead to decrease in
  mortality and fertility and accelerated
  demographic ageing

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Fertility (1992-2007)
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Life Expectancy (1992-2007)
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Age structure 2010 (population projection)
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Age structure 2050(population projection)
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Key Figures on Demography (2007)

• Population 10.381.130
• Total fertility rate 1,44 (1,33 in 2006)
• Life expectancy at birth 73,7 (men) and 79,9
  (women) (72,4 men, 78,8 women in 2006)
• Natural increase 10.000
• Net migration 83.900
• Foreigners 3,8

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Age Structure (2007)

• Children 0-14 (14,2 , 1.476.923)
• Persons 50 (35,8 , 3.718.586)
• Persons 65 (14,6 , 1.512.834)
• Persons 85 (1,2 , 124.937)
• Persons 100 (0,01 , 544)

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Population Projection (2050, median variant,
CZSO)

• Total population 9.438.334
• 50 (51,3 , 4.841.412)
• 65 almost 3 million (31,3 )
• 85 about a half million (5,3 )
• Life expectancy at birth 78,9 men and 84,5 women
• Total fertility rate 1,62

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Demographic figuresin 2050 (population
projection)
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Policy Framework

• National Programme of Preparation for Ageing for
  20082012

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Kvalita ivota (WHO)

• Quality of life is an individuals perception of
  his or her position in life in the context of the
  culture and value system where they live, and in
  relation to their goals, expectations, standards
  and concerns. It is a broad ranging concept,
  incorporating in a complex way a persons
  physical health, psychological state, level of
  independence, social relationships, personal
  beliefs and relationship to salient features in
  the environment. (WHO, 1994).

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Institutional Framework

• Government Council for Older Persons and
  Population Ageing

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Government Council for Older Persons and
Population Ageing

• Set up in March 2006 by Goverment as permanent
  advisory and working body
• Consists of 28 members
• Chair of the Council is the Minister of Labour
  and Social Affairs
• The Council meets at least three times a year

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Members of the Council

• Deputy ministers
• Social partners (unions of employers and trade
  unions)
• Committees on health and social policy of the
  Senate and the Chamber of Deputies
• Health insurace companies
• Non-governmental organizations
• Government Commissioner for Human Rights
• Czech Statistical Office
• Experts

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Mission of the Council

• The Councils mission is to promote conditions
  for healthy and active ageing, dignity in old
  age, and active participation of older persons in
  economic and social development in the context of
  demographic ageing. It aims to ensure equal
  rights for older persons in all areas of life, to
  protect their human rights and support
  development of intergenerational relationships in
  family and society

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National Programme of Preparation for Ageing for
20082012 (NPPA)

• Approved by the Government in January 2008
• All relevant ministries included
• Monitored by the Governement Council for Older
  Persons and Population Ageing

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Strategic long-term priorities

• Active ageing
• Age-friendly environment and community
• Improving health of older persons and health and
  social services
• Supporting family and carers
• Supporting participation of older persons in
  society and protecting their human rights

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Employment rate of older workers in selected EU
countries (2007)
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Employment situation older workers (2007)

• Employment rate (15-64) 66.1 (57.3 men, 46
  women) (EU27 65.4)
• Employment rate for persons aged 55-64 is
  increasing. It was 46,0 (men 59.6 , women 33.5
  ) in Czech Rep. (EU27 44.7 )
• Increase is influenced by rising retirement age
  and ageing of strong post-war cohorts

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Employment situation older workers (2007)

• As labour force is ageing the share of 50 is
  rising as well. Nearly one third of all
  job-seekers were aged 50 and over (i.e. 30,6 -
  108.000) in 2007
• Risk of unemployment esp. for older workers at
  pre-retirement age, esp. for those with lower
  education (with rising retirement age the age of
  older unemployed persons is increasing as well)

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Average exit age from the labour force (2006,
Eurostat)
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Aktivní a zdravé stárnutí (WHO)

• the process of optimizing opportunities for
  health, participation and security in order to
  enhance quality of life as people age.

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Family and ageing-in-place

• During the communist era social services were
  biased towards institutionalization
• Paternalistic approach undermined family
  solidarity

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Family and ageing-in-place

• After the fall of the communist regime, thousands
  of NGOs were established in various areas of
  society
• Nowadays, NGOs are key providers of social
  services and play important role in promoting
  development of new services

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Providers of social services
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Family and ageing-in-place

• Respite care and services for carers and families
  are developing
• During 1990s home health care rapidly developed,
  but remains regionally unequally distributed
• Acute model of health care prevails and may not
  often respond to the needs of older frail patients

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Social Services Act

• New Social Services Act came into force from
  January 2007
• Act introduced care allowance
• Care allowance is based on medical assessment of
  self-care capabilities (ADL and IADL)
• Amount of care allowance depends on the degree
  of dependency on care
• 81 of all recepients of the allowance are aged
  50

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Social Services Act

• The care allowance empowered users to choose the
  type of care they prefere
• The seniors homes are motivated to accept
  preferably people with higher need of care and
  thus higher amount of care allowance
• The Act introduced a system of registration of
  providers of social services and quality
  inspection

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ICT and ageing-in-place

• The Ministry of Labour and Social Affairs
  co-operates with the foremost Czech NGO Life
  90 (ivot 90), which is progressively involved
  in the area of ageing and ICT
• The project on the use of modern ICT in the
  development of integrated services supporting
  ageing-in-place

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ICT and ageing-in-place
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ICT and ageing-in-place

• Availability and sharing of information
• Integration of services and care
• Emergency services and safety
• Information, support and guidance
• Identifying and intervening against abuse
• Keeping in touch with seniors
• Participation in events and activities
• Representing the clients in official proceedings

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The view of ageing

• The foremost Czech gerontologist Zdenek Kalvach
• In our approach to ageing and old age we are
  conservative and short-sighted, similarly as we
  used to be to our life style and diet some time
  ago. It is pointless and brings us harm.

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Challenges

• Reduce chronic diseases and other factors leading
  to decrease in functional health status
• Increase availability of rehabilitation and
  geriatric services
• Introduce community health care (e.g. community
  nurses)
• Mainstream geriatric education and develop human
  resources in care services

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Challenges

• Deinstitutionalize social services
• Support development of community centers
  providing educational, cultural, spiritual,
  opportunities and advocacy
• Increase the availability of home health care
  (palliative and hospice care)
• Imrove integration of social and health care at
  all levels and settings

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Challenges

• Promote the concept of lifelong homes to
  support mobility and social connectedness
• Adopt standards of barrier-free and age-friendly
  housing and design
• Promote education and research into age-friendly
  design

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European Conference on Dignity and Hazard in
the Elderly
Prague, May 25-26, 2009
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European Conference on Dignity and Hazard in the
Elderly

• Protection of dignity and human rights, EDAN
  (Elder Dignity, Abuse and Neglect)
• Promotion of the geriatric frailty in medicine
  and health care
• Deinstitutionalization, long-term care and
  community care

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Thank you for your attention
Contact Petr Wija, Ph.D. Ministry of Labour and
Social Affairs of the Czech Republic Department
for Social Services and Social Inclusion Social
Inclusion Policy Unit Na Poricnim pravu 1, 128 01
Praha 2 Czech Republic Phone [phone] Fax
420.22192.2306 E-mail petr.wija_at_mpsv.cz Web
http//www.mpsv.cz/en