Prof Eamon O’Shea – “Overview of international approaches to enabling older people live in...
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Independent Living: Giving Meaning to Home
Professor Eamon O’Shea
Irish Centre for Social Gerontology
National University of Ireland, Galway
Older Population: Ireland and EU
Year Ireland
% of Population
EU25
% of Population
1950 10.7 8.2
1975 10.7 11.4
2002 11.1 16.4
2021 14.8 19.1
2050 25.9 29.9
Life Expectancy at 65 and 75
Year 65M 65F 75M 75F
2001/03 15.4 18.7 8.9 11.2
2005/07 16.6 19.8 9.8 12.1
Disability
323,707 people with disabilities (8%) 136,696 >65 years Incidence of disability increases with age 65 year old 9 times more likely to develop
disability than person aged 15-24 Multiple disabilities Of disabled people aged 65 years or over
two thirds experience multiple disabilities
Care and Caring
149,000 carers (CSO) 97,500 households contain carer of older person
either within or without (ESRI/O’Shea) 89,000 older people require care in the community
(Fahey and Murray) 13,000 of these estimated to be in very highest
dependency category (O’Shea) 31,000 needing high or continuous care (Mercer) 20,000 in long-stay care
Social Spending on Age
Ireland overall ranked lowest of EU15 in terms of social spending per older person
Ireland spends one third of what Denmark spends per person aged 65+; 40% of what UK spends
Total expenditure on long-term care in OECD ranges from 0.2 to around 3% GDP; Ireland 0.62%
Much but not all of this difference is explained by demography- particularly pensions payments
Welfare Regimes
Universalist- Social Democratic - Nordic countries
Conservative – state corporatist – Germany, Netherlands
Liberal welfare -Anglo-Saxon – UK Southern European - Italy, Greece, Spain
Welfare Paradigms
Statist- state has extensive responsibility Familialist/Individualist – Individuals
responsible for finance and provision- extensive use of means testing
State pays- others provide – state main funder- multiple providers
Community Care in Ireland
4.2% of older people in long-stay care account for 60% of overall public budget of about 1 billion
Community care is under-resourced Provider/bureaucrat-driven Poor support for carers Poor co-ordination Care not embedded in local communities
Active Ageing: Six Determinants
Economic Health and Social Services Behaviour Personal Physical Environment Social
OECD Healthy Ageing
Improved integration into the economy and society- social capital
Better lifestyles- physical activity, nutrition Adapting health systems to the needs of the
elderly- prevention, self care, mental health, home visits, co-ordination
Environmental factors; transport, housing
Challenge of Ageism
Value of older person in changing world Healthy, active, successful ageing is ethically and
politically problematic Emphasis on functional capacity can polarize older
people into functioning and non-functioning Agich (2003) challenges very idea of independent
living – relational view- inter-dependence is the norm
Older Person Centred Approach
Co-ordination and inte-gration
Income
Environ-ment
Housing Support
for carers
Health
Social networks
and activities
Transport
Technol-ogy
Older Person
Wrong Place
Heidegger’s existential homelessnes -belonging nowhere
Choosing between nomadism and sedentariness
Choosing between digital interfaces and the human touch
Choosing between disjuncture and connectedness
Home as Identity
Person and home intertwined Home is within us as we are in it Home as belonging – displaced long-stay
residents Home fosters meaningful relationships Home as boundless – Bachelard (1994) – a
tool for analysis of the human soul
Technology and Home Living
Information and Communication (ICT) technologies offer opportunities to make independent living a reality
Technologies can help in prevention, management of
chronic conditions, as well as enhance quality of life
New technologies can alleviate caring pressures within families
Effective use of technologies offers an alternative to institutional care
Technology Solutions
Sensors, hand-held devices, communication networks, data processing servers can enhance independent living
Technology can help identify and monitor fallers, cognitive decline and social isolates
Telemetric monitoring systems that transmit health data directly to the physicians.
Technology can enhance social connection and participation
Technology can help foster inter-generational relationships
Barriers to use of technology among older people
Readiness, acceptance and accessibility Income and education barriers Health and social care sectors have been
relatively slow in offering technology-based tools Mismatch between needs and technology devices
which leads to lack of acceptance, lack of usability or even lack of usefulness. Need to move from high-tech to appropriate-tech
ICT services sometimes seen as a threat to human contact, privacy or personal control
Future Attitudes and Expectations
Today’s “computer generation” has a friendly attitude to technology and is likely to demand increased technology-supported services in their old age
Ongoing socio-economic and socio-cultural dynamics lead us to expect that the next generation of ICT users will have somewhat different expectations and attitudes towards technology