Transcript Maria Irene Carvalho_ 29.05.2012

IFA – International Federation of Aging
Pragha, 28 May 1 June - 2012
29 May 2012
“Aging, poverty and policy intervention in Portugal”
Maria Irene Carvalho – ULHT – Lisbon
Isabella Paoletti – CLUN – UN - Lisbon
Aims and metodology
Aims
• Discuss critically policy intervention to facing poverty among the elderly in Portugal;
•
Present the road map of elderly policies and discuss some good practices in relation to social
inclusion.
Methodology
• This paper is part of an ongoing research project: Aging, poverty and social exclusion: a
interdisciplinary study on innovative social services.
•
It aims at providing evidence of the efforts done at policy level and of good practices in
services provision in order to address inequalities and social exclusion, in relation to older
people living in poverty.
•
•
•
•
The data collected so far include:
1) 50 semi-structured interviews to social workers, services coordinators, presidents of older
people´s associations, coordinators of civil societies initiatives;
2) Ethnographic documentation of social intervention involving older people;
3) Relevant documents and legislation – This presentation is about this policies analyses
Increasing Aging Population - Demografic trends
)]
15%
Censo, 2011
19,1%
Increasing Dependency - racio
Gráfico –1960-2060 Dependency
Poverty amongst older people in Portugal
(limiar: 60% do rendimento mediano por adulto equivalente após transferências sociais)
Fonte: Eurostat [SILC: At-risk-of-poverty rates by age and gender (ilc_li02); actual. 15-06-2011]
Link: Eurostat (com dados actualizados)
Inequalities – Income distribution, 2011
Multidimension of aging poverty
Desengagement;
Decrease in economic resources, poverty
Increased loneliness, isolation;
Chronic diseases, dependency;
Need for social and health care specialized services;
Need for formal and informal caregivers;
Risk of violence and discrimination;
 Difficulties in accessing services and social benefits;
Risk of violation of human rights and dignity;
Road map of social policies in Portugal (social inclusion exemple)
1 - National
level
Social Security System
Ministry of Labour and
Social Solidarity - Law on
Social Security 2007
Social Security and
Labour)
Central
Institute
National
Inclusion Plan
National
Action
Plan for Inclusion
2 - Local
of
Social
Security
Local services
Local Services of the Institute of
Social Security IP
Local authorities
Municipalities
IP
Pensions and other
accessories
Social benefits and
supplements
Funding for Social Action
Social services
Social network
level
Municipalities
Parish Councils
3Community
level
Civil Society
Civil Society - Law 1983
and other
Municipal Assembly
Parish Assembly
non-profit organizations
PSS - relationship with the state,
financing and protection:
SCM, Associations, Community
Centers, Social Solidarity
Cooperatives
Ongs
Foundations, other
Platform above district
council
Parish Social Committee
Social facilities
Nursing homes, Home care day centers
and night, living, home support services,
integrated responses.
Projects to combat poverty. University
senior, senior tourism.
Call center, food bank, senior citizen
online, social emergency, other
In the last 15 years social policies
Policy interventions in Portugal have been focused on:
 Increasing the minimum pensions, (solidarity supplement for the elderly),
 Improvement and promotion of quality of live for older people, specific
programs on housing,
 Development a variety of specific services (day centres, home care
assistance, residential/nursing care etc.),
 Promote integrated care facilities with health and social services Integrated continuing health and social care;
Some strategic programs have been developed…
In order to create safety social nets, participation and effective health care,
programs such as:
 PAII (Plan for Integrated support services for the elderly, 1994, 1998 –
until 2006 – Continuing Care Act – 101/2006)
 PNAI (National Plan of Action for Social Inclusion- 2001, 2003, 2005, 2006,
2008-2010),
These programs involved several stakeholders at national, local and
community level.
PAII - configuration
PAII includes a financial scheme and the main technical procedures for the
creation of support services for older people. The main areas of
intervention of PAII are:
• Integrated Home care support services - “Serviço de Apoio Domiciliário
integrado” (SADI);
• Temporary centres for disabled older people -“Centro de Apoio
Dependentes” (CAD);
• Training activities for voluntary helpers and for professionals - Formação
de Recursos Humanos (FORHUM);
• Help line, leisure and reduced pay schemes for public transport.
PNAI- configuration
Several measures relating to income, housing, social integration,
consolidating network of services have been developed, for example:
• Solidarity supplement for the elderly (MTSS) ;
• Programme for housing comfort for the elderly (MTSS) (PCHI);
• Improving home conditions for older people;
• Reinforcing facilities for the elderly:
– Social services and equipment network programme (PARES)
– Re-qualification and safety programme for social facilities
• National network for integrated long term care (RNCCI) MTSS/MS
Current financial crises have put an end to these two programmes
– PAII and PNAI, and the following cuts have also been put in
place:
 Cuts pensions and allowances;
 Reduction of tax exemptions for medicines and transport;
 Rationing access to social and health services ;
 Increased health fees – medical appointments and medical exams;
Policies intervention are now focused:
1- Reconfiguration on welfare services - restricting access to the
social security and health system;
2 – Ideia of “commissioning” to promote health and well-being–
the state contracts these services to private and third sector
organizations;
3 - Individual responsibility - Every individual has to plan for the
risk of old age and illnesses through private schemes, such as
PPR and Health Insurance;
4 – The state intervenes only in the most problematic cases – like
ex cumulative issues: poverty, dependency, isolation.
Evidences
• Despite all the above policy measures, poverty remains widespread
among older people in Portugal.
• Such measures address only basic needs of older people (food, housing,
health, etc), but underestimated the importance of their involvement in
decision making processes - taking into account the rights of older
people;
• Measures that aim to bring people out of poverty have to look at the
specific conditions that maintain the person in that situation. There is a
need for the development of integrated and individualized care plans
supported by well coordinated interventions;
• It is necessary to look not only to what extent services are provided, but
how they are provided in practical terms.
Concluding, to face poverty in financial crises…
 Develop policies that are geared to the needs of people –oriented by multiservice partnerships and intervention in networks;
 Consider the expectations and needs of older people in the intervention, promote
their empowerment and participation in decision making;
 Develop legal mechanisms and social protection for older people with dementia
and chronic illnesses;
 Promote the adaptation of the new technologies to improve the quality of life of
older people - Assistant Living Conditions;
 Value the work of formal and informal carers for older people and develop
appropriate training and information processes;
 Provide adequate training to all the professionals that work with older people in
terms of values​​, theories and methodologies.
Thanks