Maria irene carvalho 29.05.2012

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  • 1. IFA International Federation of AgingPragha, 28 May 1 June - 2012 29 May 2012Aging, poverty and policy intervention in PortugalMaria Irene Carvalho ULHT LisbonIsabella Paoletti CLUN UN - Lisbon

2. Aims and metodologyAims 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 socialinclusion.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 olderpeoples 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 3. Increasing Aging Population - Demografic trends )] 15%19,1% Censo, 2011 4. Increasing Dependency - racioGrfico 1960-2060 Dependency 5. Poverty amongst older people in Portugal (limiar: 60% do rendimento mediano por adulto equivalente aps transferncias sociais)Fonte: Eurostat [SILC: At-risk-of-poverty rates by age and gender (ilc_li02); actual. 15-06-2011]Link: Eurostat (com dados actualizados) 6. Inequalities Income distribution, 2011 7. 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; 8. Road map of social policies in Portugal (social inclusion exemple)Social Security System 1 - National Ministry of Labour andSocial Solidarity - Law onSocial Security 2007 levelSocial Security andLabour)Pensions and other Centralaccessories Institute ofSocial Security IPSocial benefits andsupplementsFunding for Social Action National Local services Social services Inclusion Plan Local Services of the Institute of National Action Social Security IP Plan for Inclusion2 - LocalLocal authoritiesSocial network MunicipalitieslevelPlatform above district MunicipalitiesMunicipal Assemblycouncil Parish Councils Parish AssemblyParish Social Committee Civil Society non-profit organizations3- Civil Society - Law 1983PSS - relationship with the state, Social facilities and other financing and protection:Nursing homes, Home care day centersCommunitySCM, Associations, Community and night, living, home support services, Centers, Social Solidarity integrated responses. Cooperatives Projects to combat poverty. Universitylevel senior, senior tourism.Call center, food bank, senior citizenOngsonline, social emergency, otherFoundations, other 9. In the last 15 years social policiesPolicy 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, specificprograms on housing, Development a variety of specific services (day centres, home careassistance, residential/nursing care etc.), Promote integrated care facilities with health and social services -Integrated continuing health and social care; 10. Some strategic programs have been developedIn 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. 11. PAII - configurationPAII 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 - Servio de Apoio Domiciliriointegrado (SADI); Temporary centres for disabled older people -Centro de ApoioDependentes (CAD); Training activities for voluntary helpers and for professionals - Formaode Recursos Humanos (FORHUM); Help line, leisure and reduced pay schemes for public transport. 12. 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 13. Current financial crises have put an end to these two programmes PAII and PNAI, and the following cuts have also been put inplace: 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; 14. 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. 15. Evidences Despite all the above policy measures, poverty remains widespreadamong older people in Portugal. Such measures address only basic needs of older people (food, housing,health, etc), but underestimated the importance of their involvement indecision making processes - taking into account the rights of olderpeople; Measures that aim to bring people out of poverty have to look at thespecific conditions that maintain the person in that situation. There is aneed for the development of integrated and individualized care planssupported by well coordinated interventions; It is necessary to look not only to what extent services are provided, buthow they are provided in practical terms. 16. 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, promotetheir empowerment and participation in decision making; Develop legal mechanisms and social protection for older people with dementiaand chronic illnesses; Promote the adaptation of the new technologies to improve the quality of life ofolder people - Assistant Living Conditions; Value the work of formal and informal carers for older people and developappropriate training and information processes; Provide adequate training to all the professionals that work with older people interms of values, theories and methodologies. Thanks