Synthesis Report on the Implementation of the Madrid

VII Synthesis Report on the Implementation of the Madrid International Plan of Action on Ageing in the UNECE Region SeĐond Revieǁ and Appraisal oĨ the Regional ImplementaƟon StrategǇ oĨ the Madrid InternaƟonal Plan oĨ AĐƟon on Ageing ;MIPAAͬRISͿ

EyECUTIVE SUMMARY >ŝĨĞĞǆƉĞĐƚĂŶĐǇƌŝƐĞƐĂŶĚůŽǁĨĞƌƟůŝƚǇƌĂƚĞƐƉĞƌƐŝƐƚ The Đonteǆt oĨ the seĐond ĐǇĐle oĨ MIPAAͬRIS The extent and pace of populaƟon ageing depend on implementaƟon trends in life expectancy, ferƟlity and, to some degree, migraƟon. Kver the last ten years, increases in life Kver the last ten years, the ageing of the populaƟon was expectancy at birth and beyond age 65 were notable a dominant feature across all UNECE countries. And in across the region, adding on average three years and the coming decades, the extent and pace of ageing in the nearly a year and a half, respecƟvely. ,owever, in some region is not expected to abate: people 65 years old and countries in the Eastern and South-Eastern part of the above are set to account for more than a ĮŌh of the total region, recent gains in longevity have not yet fully oīset populaƟon by 2030, while those 80 years old and above the signiĮcant losses in life expectancy of their ciƟǌens, will make up more than 5 per cent. The median age of parƟcularly men, during the 1990s. the region’s populaƟon will move up from 37.6 years presently to 41.8 years by 2030. The dispariƟes in life expectancy among UNECE countries and between men and women ;among and within The Dadrid InternaƟonal Plan of AcƟon on Ageing countriesͿ remain large: at birth, for instance, for men ;DIPAAͿ and its Regional ImplementaƟon Strategy they vary from 80.2 years in Switǌerland to 62.8 years in ;RISͿ, both adopted in 2002, provide the main policy the Russian FederaƟon͖ for women, from 85.3 years in framework to direct the response to populaƟon ageing France and Spain to 73 years in

45 ŶƐƵƌŝŶŐĂ^ŽĐŝĞƚǇĨŽƌůůŐĞƐ͗WƌŽŵŽƟŶŐƋƵĂůŝƚǇŽĨůŝĨĞĂŶĚĂĐƟǀĞĂŐĞŝŶŐ

Įscal austerity measures that also aīected pensions and private pension systems. In addiƟon to redesigning various social beneĮts. pension systems, several countries have engaged in comprehensive reforms of their social security and Although many countries in the region now seem welfare systems. to be on the path of economic recovery, important challenges remain in ensuring the sustainability of >ĂďŽƵƌŵĂƌŬĞƚƐ social security systems, strengthening intergeneraƟonal In many countries, developing strategic frameworks relaƟonships, tackling rising ineƋualiƟes and managing to address populaƟon ageing dynamics from a labour the conseƋuences of migraƟon Ňows. market perspecƟve has become a high priority. Special Main Įndings Ĩrom the seĐond revieǁ and appraisal oĨ aƩenƟon is given to measures directed toward extending MIPAAͬRIS implementaƟon acƟve working lives. Legal frameworks prescribe eƋual treatment and non-discriminaƟon based on age or In the second review and appraisal of DIPAAͬRIS, most disability. The pension legislaƟon in some countries is UNECE Dember States reported maũor progress in policy being adũusted to facilitate working beyond reƟrement areas such as mainstreaming ageing, reforming social age. AcƟve labour market measures have been directed at protecƟon systems, and further developing health and employers who can, for example, beneĮt from subsidies if care systems. ,owever, they also indicated that the they employ older unemployed workers. Employees may main challenges remain in these areas, especially in receive support in the form of ũob placement services implemenƟng reforms on social protecƟon systems and and training. AdũusƟng the setup of the workplace and further developing health and care systems, as well as allowing for more Ňexible work Ɵme arrangements may adũusƟng labour markets. be eƋually important to accommodaƟng the special DĂŝŶƐƚƌĞĂŵŝŶŐĂŐĞŝŶŐ needs of older workers. Countries have supported A number of countries have developed ageing-related entrepreneurship opportuniƟes for older persons, some strategic frameworks to streamline policy-making in of them especially targeƟng older women. the future. oth Armenia and the Republic of Doldova ŶƐƵƌŝŶŐ ƋƵĂůŝƚǇ ŽĨ ůŝĨĞ Ăƚ Ăůů ĂŐĞƐ ĂŶĚ ŵĂŝŶƚĂŝŶŝŶŐ have beneĮted from UNECE assistance in developing ŝŶĚĞƉĞŶĚĞŶƚůŝǀŝŶŐ͕ŚĞĂůƚŚĂŶĚǁĞůůͲďĞŝŶŐ RŽĂĚ DĂƉƐ ĨŽƌ DĂŝŶƐƚƌĞĂŵŝŶŐ ŐĞŝŶŐ, providing concrete guidance based on a thorough analysis of the Several countries have developed integrated ageing- country situaƟon. Several countries have established related strategies or plans with relevance for the health naƟonal-level mulƟ-stakeholder bodies with government and care sectors, with the aim of making service provision advisory funcƟons that also include older persons or more sustainable and enhancing access to aīordable their representaƟves. Some countries have speciĮcally health and care services. Dedical insurance coverage strengthened the role of decentraliǌed levels of ensures access to health care in many countries within government in policy implementaƟon. AnƟ-discriminaƟon the region. legislaƟon prohibits age-based discriminaƟon in most To reduce ineƋualiƟes in access to health and social UNECE countries. services, some countries provide a range of services free of ^ŽĐŝĂůƉƌŽƚĞĐƟŽŶƐǇƐƚĞŵƐ charge or at reduced prices for older persons with special needs. Dost countries provide a conƟnuum of care, Social security expenditures take a large share of public aiming to privilege individual choice and independent budgets, and they are the focus of a maũority of UNECE living, oīering home-based care, making eīorts to Dember States’ policymaking. Finding ways to sustain further develop long-term care systems, geriatric and social protecƟon systems has been one of the prioriƟes in palliaƟve care, as well as insƟtuƟonal care for those in Dember States. Realiǌing a need to adũust to populaƟon need. ,owever, providing access to aīordable services ageing and faced with the current economic downturn, conƟnues to be a challenge. Countries have expanded a number of countries have taken steps to reform their their acƟviƟes to address challenges around Alǌheimer’s pension systems, for example by increasing reƋuired disease and other forms of demenƟa. PracƟcally all contributory periods, limiƟng early reƟrement opƟons countries agree to the need for health promoƟon and and increasing the reƟrement age. In general, funded disease prevenƟon programmes. obligatory employment pension schemes Įnanced by contribuƟons of both employers and employees are Across the region, work has been done on enhancing complemented by social pension schemes based on Ƌuality of care and capaciƟes among care staī. social security contribuƟons. KŌen, the mandatory Increasingly, Dember States acknowledge abuse and pension insurance system exists alongside voluntary violence against older persons as a challenge and have opƟons so that more and more people are covered by strengthened their legal frameworks, raised awareness, supplementary pension schemes. Challenges remain improved monitoring and provided support. CoordinaƟon in the area of pension reform implementaƟon. Some of services of older persons remains a maũor challenge countries have had diĸculƟes in developing funcƟoning and countries have been conscious of the need to

46 Synthesis Report promote integrated health care and social services. To ͻ Countries will conƟnue working on lifelong expand service provision, more and more countries have learning to keep the ageing workforce well-adũusted to improved frameworks for the non-proĮt and the private changing realiƟes in the workplace and also empowering sectors to play a stronger role. older persons to live acƟve and fulĮlling lives. Tasks ahead Ĩor the third ĐǇĐle oĨ MIPAAͬRIS ͻ 'ender aspects are given more and more implementaƟon importance when formulaƟng and analysing policies, using for example gender impact assessments or UNECE countries will be entering into the third cycle of performing gender budgeƟng. AddiƟonal eīorts will implementaƟon of DIPAAͬRIS ;2013-2017Ϳ with disƟnct be reƋuired to facilitate the reconciliaƟon of work with awareness of the enduring demographic change and family and care responsibiliƟes. with an increasing recogniƟon of both challenges and opportuniƟes that populaƟon ageing generates in the ImplemenƟng DIPAAͬRIS in the region has been about region. The recent economic downturn in many parts of using opportuniƟes and addressing challenges related to the UNECE region is likely to have a lasƟng impact on the populaƟon ageing. The second review and appraisal of social and economic environment in which the DIPAAͬ the DIPAAͬRIS culminated in the Dinisterial Conference RIS commitments will be carried out. which took place on 19-20 September 2012 in Vienna, Austria, under the theme ͞Ensuring a Society for All tithin the overall framework of a mainstreamed and Ages: PromoƟng Ƌuality of life and acƟve ageing͟. integrated approach towards ageing, UNECE Dember The outcome document aims to guide acƟviƟes in the States will conƟnue to focus on a number of speciĮc next cycle of implementaƟon. The torking 'roup on policy-areas set out in the DIPAAͬRIS framework: Ageing provides the insƟtuƟonal framework to facilitate ͻ Issues around health and care will remain high on intergovernmental collaboraƟon in this area, providing the agenda, in parƟcular with regards to beƩer integraƟon the structure to exchange experiences and ũointly work and coordinaƟon of social and health services, Įnancial towards a ^ŽĐŝĞƚǇĨŽƌĂůůŐĞƐ in the countries and across sustainability, the promoƟon of independent living and the region. ageing at home, developing integrated models of long- term care, supporƟng informal and family care givers and prevenƟng violence and abuse. 1. INTRODUCTION ͻ Changes in labour market policies have aimed The MIPAAͬRIS proĐess to allow persons to conƟnue working if they wish by Dadrid Plan of AcƟon on Ageing ;DIPAAͿ, adopted increasing the reƟrement age and abolishing incenƟves at the Second torld Assembly on Ageing in Dadrid in for early reƟrement. Such reforms need to be further 2002, provides the global policy framework to guide the implemented. They need to go hand in hand with pension eīorts of countries in response to populaƟon ageing. and social protecƟon system reforms that aim to ensure In the UNECE region, Dember States have devised a sustainability while safeguarding minimum subsistence more targeted Regional ImplementaƟon Strategy ;RISͿ, levels and countering poverty among older persons. adopted in 2002 in erlin. The Strategy highlights ten commitments that Dember States agreed to focus on when implemenƟng the Dadrid Plan.

The 1Ϭ Commitments oĨ the Regional ImplementaƟon StrategǇ Ĩor the Madrid InternaƟonal Plan oĨ AĐƟon on Ageing ;MIPAAͬRISͿ 2ϬϬ2 1. To mainstream ageing in all policy Įelds with the aim of bringing socieƟes and economies into harmony with demographic change to achieve a society for all ages 2. To ensure full integraƟon and parƟcipaƟon of older persons in society 3. To promote eƋuitable and sustainable economic growth in response to populaƟon ageing 4. To adũust social protecƟon systems in response to demographic changes and their social and economic conseƋuences 5. To enable labour markets to respond to the economic and social conseƋuences of populaƟon ageing 6. To promote lifelong learning and adapt the educaƟonal system in order to meet changing economic, social and demographic condiƟons 7. To strive to ensure Ƌuality of life at all ages and maintain independent living, including health and well-being 8. To mainstream a gender approach in an ageing society 9. To support families that provide care for older persons and to promote intergeneraƟonal and intrageneraƟonal solidarity among their members 10. To promote the implementaƟon and follow-up of the Regional ImplementaƟon Strategy through regional cooperaƟon.

47 ŶƐƵƌŝŶŐĂ^ŽĐŝĞƚǇĨŽƌůůŐĞƐ͗WƌŽŵŽƟŶŐƋƵĂůŝƚǇŽĨůŝĨĞĂŶĚĂĐƟǀĞĂŐĞŝŶŐ

Countries were asked to report on progress made in Comprehensiveness implemenƟng DIPAAͬRIS for the Įrst Ɵme aŌer Įve years, Reports were on average 30 pages long, not counƟng in 2007. ased on common guidelines, country reports annexes. Some countries provided addiƟonal material in were collected and compiled into a regional report that annexes, such as naƟonal ageing plans, informaƟon about was published together with the proceedings of the laws and regulaƟons, programmes and insƟtuƟonal set Dinisterial Conference ^ŽĐŝĞƚǇĨŽƌĂůůŐĞƐ͗ŚĂůůĞŶŐĞƐ ups, descripƟons of good pracƟce examples or indicators ĂŶĚ ŽƉƉŽƌƚƵŶŝƟĞƐ which took place in Leſn, Spain, in ;AUT, EL, CE, ESP, FRA, 'R, IRL, LTU, LVA, DA, DLT, 2007. tith the outcome document of the Conference, NL, PKL, RKU, SR, T:<, U

ϰϴ Synthesis Report recently concluded public consultaƟon exercise to allow of maũor challenges as a combined result of populaƟon stakeholders to express their opinions about policies and ageing and the conseƋuences of the global crisis, both service provision. Another report made special reference of which threaten the sustainability of social protecƟon to having consulted with young people as well ;DLTͿ. systems. ConƟnued aƩenƟon will have to be paid to AddiƟonal N'K comments on the oĸcially submiƩed implemenƟng recently adopted reforms ;'R, CE, N<, naƟonal report were received from the Netherlands. ESP, FIN, FRA, LTU, DA, DLT, NL, PKL, RKU, RUS, SV<, They were taken into consideraƟon for the synthesis SVN, T:<, TURͿ. Commitment 7 on health and well-being report. Several countries reported consultaƟons with has received similar aƩenƟon and generaƟng maũor experts from academia, private sector or internaƟonal achievements in this area ;ARD AUT, 'R, CAN, C,E, organiǌaƟons ;ARD, AUT, CAN, CE, LTU, DA, SR, StEͿ. N<, ESP, FIN, FRA, IRL, ISL, LTU, LUy, D<, DLT, PKL, A few countries have used informaƟon from focus group StE, T:<, TUR, USAͿ. InteresƟngly, even more countries discussions, public hearings or consultaƟon processes to idenƟfy this area as also one where maũor challenges take into account stakeholder views ;ARD, CE, IRL, SR, remain, making it the commitment most oŌen reported StEͿ. as a main challenge ;AUT, EL, CAN, CzP, CE, N<, ESP, Kverall, countries have found very individual ways of FIN, FRA, ISL, ITA, D<, NL, NKR, PKL, RKU, SR, SV<, reporƟng, choosing to provide more details on selected SVN, StE, U

ϰϵ ŶƐƵƌŝŶŐĂ^ŽĐŝĞƚǇĨŽƌůůŐĞƐ͗WƌŽŵŽƟŶŐƋƵĂůŝƚǇŽĨůŝĨĞĂŶĚĂĐƟǀĞĂŐĞŝŶŐ

Table 1͗ Major aĐhievements and Đhallenges as reported bǇ ĐoƵntries in the naƟonal MIPAAͬRIS implementaƟon reports COUNTRIES C 1 C 2 C 3 C 4 C 5 C ϲ C 7 C ϴ C ϵ C 10 Armenia ;ARDͿ ✓ × ✓ ××✓ Austria ;AUTͿ ✓ × ✓ × ✓ × Aǌerbaiũan ;AEͿ ✓✓✓ elarus ;LRͿ ✓✓ ✓ elgium ;ELͿ ✓ × ✓✓× ulgaria ;'RͿ ✓ × ✓✓×× Canada ;CANͿ ✓ × ✓ × ✓ × Cyprus ;CzPͿ ✓ × ✓ × ✓ Cǌech Republic ;CEͿ ✓✓ ×× × enmark ;N<Ϳ ✓ ×× ✓ × Finland ;FINͿ ✓ × ✓ × ✓ × France ;FRAͿ ✓✓ × ✓ × 'ermany ;EUͿ ✓✓ × ✓ Iceland ;ISLͿ ✓ × ✓✓ ×× Ireland ;IRLͿ ✓ ×× × ✓✓ Israel ;ISRͿ Italy ;ITAͿ ✓✓✓×× × Latvia ;LVAͿ ××✓✓× Lithuania ;LTUͿ × ✓ × ✓ × ✓ Luxembourg ;LUyͿ ✓✓✓ Dalta ;DLTͿ ✓ × ✓ × ✓✓ × Netherlands ;NLͿ ✓ ✓ ✓ ×× × Norway ;NKRͿ ✓ ✓ ✓ ××× Poland ;PKLͿ ✓✓ × ✓ × Portugal ;PRTͿ ✓ × ✓ × ✓ × Republic of Doldova ;DAͿ ××✓✓ × ✓ Romania ;RKUͿ ✓✓ × ✓ ×× Russian FederaƟon ;RUSͿ ✓ ✓ ✓ ×× Serbia ;SRͿ ✓✓××✓ × Slovakia ;SV<Ϳ ✓✓ × ✓ × Slovenia ;SVNͿ ✓ × ✓✓ ×× Spain ;ESPͿ ✓ × ✓ × ✓ × Sweden ;StEͿ ✓ × ✓✓ × Switǌerland ;C,EͿ ✓✓ ✓ The former zugoslav Republic ✓ × ✓ × ✓ × of Dacedonia ;D<Ϳ Taũikistan ;T:<Ϳ × ✓ × ✓ × ✓ Turkey ;TURͿ ✓ ×× ✓ × ✓ Ukraine ;U

^ŽƵƌĐĞ͗Country Reports ✓ : Achievements - ×: Challenges ϱϬ Synthesis Report tith an obvious poliƟcal focus on remodelling social the main ministry in charge, other ministries also work security systems, improving health care provision, on ageing-related aspects, for example the Dinistry of mainstreaming ageing and adũusƟng labour markets ,ealth. Israel has set up a Dinistry for Senior CiƟǌens to ;commitments 4, 7, 1, 5Ϳ, some of the remaining highlight the issue of older person within government. commitments on lifelong learning, mainstreaming Iceland has aƩempted to streamline diīerent issues by gender, intergeneraƟonal solidarity and regional merging the previously separate Dinistry of Social Aīairs cooperaƟon ;commitments 6, 8, 9, 10Ϳ have received and Social Security with the Dinistry of ,eath into a new comparaƟvely less prominence in the discussion of Dinistry of telfare. In Ireland an Kĸce for Klder People maũor achievements and challenges. Nevertheless, many was established within the then epartment of ,ealth relevant iniƟaƟves can be found with regards to those and Children ;2008Ϳ. At the same Ɵme, the Dinister commitments too, making them important elements of State for Klder People assumed responsibiliƟes of an integrated response, as outlined in the chapters for older persons’ issues across three government relaƟng to the individual commitments below. departments. ,owever, coordinaƟon between ministries and departments remains a challenge. Serbia speciĮcally 2.2 Commitment 1͗ To mainstream ageing in all raised the issue of lack of cooperaƟon between ministries poliĐǇ Įelds ǁith the aim oĨ bringing soĐieƟes and as well as between departments within ministries. The eĐonomies into harmonǇ ǁith demographiĐ Đhange to United

51 ŶƐƵƌŝŶŐĂ^ŽĐŝĞƚǇĨŽƌůůŐĞƐ͗WƌŽŵŽƟŶŐƋƵĂůŝƚǇŽĨůŝĨĞĂŶĚĂĐƟǀĞĂŐĞŝŶŐ for veterans and disabled persons have a special legal reduced mobility ;PKL, RUSͿ. In addiƟon, Poland targets status that enƟtles them to parƟcipate in governmental older persons in its road safety informaƟon campaigns decision-making bodies. and, towards the end of 2011, was preparing a dƌĂŶƐƉŽƌƚ ĞǀĞůŽƉŵĞŶƚ ^ƚƌĂƚĞŐǇ ƵŶƟů ϮϬϮϬ that addresses the In terms of insƟtuƟonal locaƟon of responsibility, needs of older persons. Austria has conducted several several countries have been undergoing decentraliǌaƟon research proũects focusing on the speciĮc mobility iniƟaƟves, transferring more responsibiliƟes to the paƩerns and needs of older ciƟǌens. ased on the local levels ;municipaliƟesͿ to handle service provision results, a guide for barrier-free public transport was directly where needs arise ;N<, ISL, D<Ϳ. In Israel, every local authority must appoint a consultant for developed. The research and innovaƟon promoƟon sub- senior ciƟǌen aīairs to assist and advise the head of the programme ǁĂǇƐϮŐŽ has been geared to the speciĮc authority on promoƟng programmes for older persons. mobility reƋuirements and mobility behaviours of older Several countries have local level bodies consisƟng of persons. In the United States, the Federal CoordinaƟng older persons with advisory funcƟons pertaining to Council on Access and Dobility brings together 11 policymaking in the municipality andͬor monitoring federal departments for the hŶŝƚĞĚ tĞ ZŝĚĞ iniƟaƟve͖ funcƟons for service provision ;EL, N<, IRL, ISLͿ. it also produced a naƟonal dialogue consisƟng of key stakeholders in more than 1,200 ciƟes to discuss how to Dany countries have adopted anƟ-discriminaƟon improve access to aīordable and reliable transportaƟon legislaƟon or have relevant arƟcles prohibiƟng age- for people with disabiliƟes, older adults and people with based discriminaƟon in their consƟtuƟon ;AUT, AE, limited income. Nevertheless, connecƟng more remote CAN, CE, FIN, IRL, ISL, LTU, D<, NL, NKR, SR, SV<, areas with public transport remains a challenge in some StE, USAͿ. Some have created addiƟonal insƟtuƟons countries ;e.g. SVNͿ. for oversight such as an ombudsperson ;LTU, NKR, SR, StEͿ and the Norwegian EƋuality Tribunal. N'Ks have ,ousing has been idenƟĮed as an important area to played an important role in raising awareness about enhance inclusion of older persons. Several countries issues of older people’s discriminaƟon and abuse ;e.g. maintain schemes to ensure access to appropriate SRͿ. In 'ermany, the Federal AnƟ-discriminaƟon Kĸce housing either by subsidiǌing rent for apartments on the supports individuals facing disadvantages including open market or by providing social housing ;e.g. ARD, those due to age. It made 2012 the zĞĂƌ ŐĂŝŶƐƚ KůĚͲ CAN, ESP, IRL, ISR, NKR, SRͿ. The Armenian government ŐĞŝƐĐƌŝŵŝŶĂƟŽŶunder the moƩo ͞In your best age. approved the ŽŶĐĞƉƚ WĂƉĞƌ ŽŶ ƌĞĂƟŶŐ Ă ŽŵƉůĞǆ ŽĨ Always͟. In addiƟon to awareness raising acƟviƟes, an ^ŽĐŝĂůǁĞůůŝŶŐƐĨŽƌ,ŽŵĞůĞƐƐ>ŽŶĞůǇKůĚĞƌWĞƌƐŽŶƐĂŶĚ expert commission was put in place which will develop WĞƌƐŽŶƐ ĞůŽŶŐŝŶŐ ƚŽ KƚŚĞƌ ^ŽĐŝĂů 'ƌŽƵƉƐ ǁŚŽ ZĞƋƵŝƌĞ recommendaƟons to reduce age-based discriminaƟon by ĂǁĞůůŝŶŐ in 2010. Proũects to create social dwellings in the end of the year. Armenia have been implemented since 2008. y the end of 2011, addiƟonal social dwellings were inaugurated 2.3 Commitment 2͗ To ensƵre ĨƵll integraƟon and in the city of Daralik. Similarly, the Cǌech Republic is parƟĐipaƟon oĨ older persons in soĐietǇ construcƟng ĐĂƌĞŇĂƚƐ for persons whose movement and In general, ensuring integraƟon and parƟcipaƟon of older orientaƟon ability is reduced due to old age or ill health. persons in society is an important moƟvaƟon for many Canada has a mulƟ-pronged housing approach, providing governments, and this becomes evident in the reporƟng substanƟal amounts of funding to support almost across all commitments. Dany countries use occasions 615,000 low- and moderate-income households residing like the /ŶƚĞƌŶĂƟŽŶĂůĂǇŽĨKůĚĞƌWĞƌƐŽŶƐ on 1 Kctober, in exisƟng social housing, one third of which is occupied the /ŶƚĞƌŶĂƟŽŶĂů&ĂŵŝůǇĂǇ on 15 Day, 'ƌĂŶĚŵŽƚŚĞƌƐ by seniors. The United

52 Synthesis Report exisƟng buildings have reportedly slowed down since States, such as New zork City and Portland, Kregon, have 2008. Lithuania is providing concessions for older become part of the torld ,ealth KrganiǌaƟon’s 'ůŽďĂů persons for house renovaƟons to improve their thermal ŐĞͲ&ƌŝĞŶĚůǇ ŝƟĞƐ WƌŽŐƌĂŵŵĞ. The WƌŽũĞĐƚŽ Đ/^ insulaƟon. In Ireland, the ^ĞŶŝŽƌůĞƌƚƐscheme provides ;ciƟes proũectͿ in Portugal also aims to create age-friendly funds to local community and voluntary organiǌaƟons ciƟes following the t,K approach, promoƟng non-slip to install alarms and home security items. 'rants can sidewalks, good home support services and an eĸcient be made to provide security measures for people aged public transport network, among others. Canada has 65 and above who are living alone. A sociological survey an ŐĞͲ&ƌŝĞŶĚůǇŽŵŵƵŶŝƟĞƐ/ŶŝƟĂƟǀĞ. A 'ƵŝĚĞƚŽŐĞͲ in Ukraine also showed that pensioners have taken self- ĨƌŝĞŶĚůǇZƵƌĂůĂŶĚZĞŵŽƚĞŽŵŵƵŶŝƟĞƐwas developed governance responsibiliƟes to address problems in the in 2007 to help communiƟes create supporƟve and housing environment where they live: buildings, streets, enabling environments for older persons. neighbourhoods, or districts. In addiƟon to the mulƟ-stakeholder bodies menƟoned Culture is an important means to facilitate integraƟon earlier, almost all countries have organiǌaƟons and and parƟcipaƟon. In Finland, as per a reƋuest of the associaƟons providing a voice to older persons ;e.g. EL, Dinistry of EducaƟon and Culture, a working group made C,E, EU, FIN, ISL, SVN, USAͿ. It has become common proposals for future policies and measures to increase pracƟce to establish mechanisms that take into account access to art and culture. Some countries menƟoned older persons’ views in service provision ;e.g. FINͿ. In discounts available for older persons to aƩend cultural Armenia there are councils of older persons that can events or visit museums and other cultural heritage sites raise problems with the management of an insƟtuƟon ;CzP, ESP, FIN, ISL, RUSͿ. Since the beginning of 2010, and suggest soluƟons. In Slovenia, reƟred experts of elgrade’s ciƟǌens who are 65 years and older can use all the FederaƟon of Pensioner’s AssociaƟons are involved libraries free of charge ;SRͿ. The cultural sphere oīers in supervising the work in older people’s homes some leeway to create intergeneraƟonal communiƟes. and social work centres. Several countries have user In a folk culture programme in Poland, for example, saƟsfacƟon surveys in place ;N<, ESP, ISL, PRT, SRͿ. older persons pass on skills and knowledge of regional User-friendliness in service provision is also enhanced tradiƟons to the younger generaƟon. torkshops, by providing good access to informaƟon about available courses, training programmes and folk culture fesƟvals services via Internet portals and hotlines or informaƟon raise awareness among the young generaƟon about the centres ;e.g. ISR, RUSͿ. valuable elements of folk culture that need preserving. The Įeld of volunteering has been developing rather In the United States the NaƟonal Endowment for the dynamically, also inspired by the ƵƌŽƉĞĂŶ zĞĂƌ ŽĨ Arts, together with the epartment of ,ealth and sŽůƵŶƚĞĞƌŝŶŐŝŶϮϬϭϭ, which has contributed to addiƟonal ,uman Services, held a forum on dŚĞƌƚƐĂŶĚ,ƵŵĂŶ focus on acƟviƟes in this area. The Įrst ƵƐƚƌŝĂŶZĞƉŽƌƚ ĞǀĞůŽƉŵĞŶƚ͗&ƌĂŵŝŶŐĂEĂƟŽŶĂůZĞƐĞĂƌĐŚŐĞŶĚĂĨŽƌ ŽŶ sŽůƵŶƚĞĞƌŝŶŐ ;&ƌĞŝǁŝůůŝŐĞŶďĞƌŝĐŚƚͿ of 2009 showed ƚŚĞ ƌƚƐ͕ >ŝĨĞůŽŶŐ >ĞĂƌŶŝŶŐ͕ ĂŶĚ /ŶĚŝǀŝĚƵĂů tĞůůͲĞŝŶŐ͘ that this was an important way for older persons The resulƟng white-paper proposes a framework to build to remain acƟve. According to the report, the most capacity for future research and evidence-sharing about important Įelds of acƟvity of the 50 to 64 year age group the role of the arts in human development. – besides informal volunteering – were religion, culture, CommunicaƟon connecƟvity is seen as an important disaster relief and sports. enmark issued a EĂƟŽŶĂůŝǀŝů opportunity for older persons in many countries. ^ŽĐŝĞƚǇ^ƚƌĂƚĞŐǇ in 2010, with the aim of strengthening AcƟviƟes abound to enhance computer literacy and reap the involvement of civil society and voluntary the beneĮts of modern communicaƟons technology, for organiǌaƟons in the Įeld of socially vulnerable people. example by providing computer courses or enhancing the The AdministraƟon on Ageing in United States funded access of older persons to the Internet ;e.g. 'R, LTU, a NaƟonal Resource Center for Engaging Volunteers in DLT, PKL, RUSͿ. In Lithuania, public libraries have been the Aging Network, a network of State Units on Aging, Area Agencies on Aging, tribal organiǌaƟons, and naƟve eƋuipped with Internet access and courses have been ,awaiian organiǌaƟons. The Center is developing and organiǌed that have generated a good response among tesƟng strategies for eīecƟve, replicable volunteer persons aged 55 years and above. Findings indicate that acƟviƟes to increase the capacity of the NaƟonal Ageing older adults use those Internet connecƟons for health, Network and to beƩer address community needs. employment or e-government informaƟon. Furthermore, the United States government created To enhance the eĸciency of service provision at the local the United te Serve website at www.serve.gov to make level, the Irish ŐĞ&ƌŝĞŶĚůǇŽƵŶƟĞƐWƌŽŐƌĂŵŵĞ stands volunteering opportuniƟes easier to Įnd through the out. IniƟated in 2008, the programme aims to align and Internet. 'ermany Įnancially supports its sŽůƵŶƚĞĞƌŝŶŐ mutually reinforce services provided to older persons at ^ĞƌǀŝĐĞƐ ĨŽƌ ůů 'ĞŶĞƌĂƟŽŶƐ with the aim of sensiƟǌing the local level. Examples involved health providers liaising children and youth to volunteering, to draw on the with transport providers to ensure that there are bus stops experiences of older persons and to engage people with outside health centres and hospitals. CiƟes in the United an immigrant background. Volunteers have to engage at

53 ŶƐƵƌŝŶŐĂ^ŽĐŝĞƚǇĨŽƌůůŐĞƐ͗WƌŽŵŽƟŶŐƋƵĂůŝƚǇŽĨůŝĨĞĂŶĚĂĐƟǀĞĂŐĞŝŶŐ least eight hours per week for at least six months and a In elgium, speciĮc acƟviƟes have taken place to wriƩen agreement has to be signed between volunteers enhance the inclusion of older migrants. StaƟsƟcal data and the service providers that engage them. oth Austria were collected about the situaƟon of older immigrants in and the Former zugoslav Republic of Dacedonia have service provision and in insƟtuƟons. A pilot proũect was passed naƟonal laws on volunteering. In Slovenia, N'Ks carried out in a nursing home and training was provided have demanded more support from government to to staī on maƩers of intercultural communicaƟon. improve the status of volunteers. The federal government Portugal adopted a WůĂŶ ĨŽƌ /ŵŵŝŐƌĂŶƚ /ŶƚĞŐƌĂƟŽŶ in Canada reimburses reasonable out-of-pocket expenses ϮϬϭϬͲϮϬϭϯ which menƟons older immigrants as a new of volunteers. A special Prime Dinister’s Volunteer Award intervenƟon area. The United States oīer programmes was also created. The Russian FederaƟon provides tax and services in support of indigenous populaƟons, exempƟons to support the volunteer sector. In elgium, such as American Indians, Alaska NaƟves and NaƟve the Commission Communautaire Franĕaise issued a call ,awaiians, taking into account the respecƟve cultures for proposals to support volunteer iniƟaƟves by older and tradiƟons ;c.f. also CANͿ. The country also established persons for older persons and other age groups. its Įrst naƟonal resource centre to assist communiƟes in providing services and support to lesbian, gay, bisexual A number of acƟviƟes have focused on ĮghƟng loneliness and transgender ;L'TͿ older individuals. and isolaƟon. In Dalta, Caritas has encouraged the creaƟon of social clubs, each of them run by a team of Some countries menƟoned acƟviƟes to address the trained voluntary workers, the maũority of them older needs of older persons as consumers. The Austrian persons themselves. In addiƟon, self-help groups can proũect &ƵƚƵƌĞDĂƌŬĞƚƐĂŶĚ'ĞŶĞƌĂƟŽŶƐ;ƵŬƵŶŌƐŵćƌŬƚĞ play a role in enhancing older persons’ parƟcipaƟon in ƵŶĚ 'ĞŶĞƌĂƟŽŶĞŶͿ of the Federal Austrian Chamber society. Serbia reported about its ŝĂůŽŐƵĞŽĨŝǀŝů^ŽĐŝĞƚǇ of Economy won recogniƟon as a European 'ood KƌŐĂŶŝǌĂƟŽŶƐ ŽŶ WƌŽďůĞŵƐ ŽĨ ƚŚĞ ůĚĞƌůǇ ŝŶ tĞƐƚĞƌŶ PracƟce in 2011. 'ermany advocates for the needs of ĂůŬĂŶƐunder which self-help groups where developed older consumers, for example through the introducƟon to empower older persons to resolve their own problems. of the 'ĞŶĞƌĂƟŽŶͲĨƌŝĞŶĚůǇ ƐŚŽƉƉŝŶŐ Ƌuality label. In In the Former zugoslav Republic of Dacedonia, ĂƌĞĨŽƌ Switǌerland, the N'K Pro Senectute partnered with ƚŚĞůĚĞƌůǇĂƚ,ŽŵĞworks with six professional nurses the second-largest retail group in Switǌerland, Coop, to and 60 volunteers. The nurses provide advice on health improve the consideraƟon of needs of older consumers. and diet͖ they measure blood sugar levels and blood In 2008, magnifying glasses were installed at a large scale pressure, while volunteers provide food and medicine, on shopping trolleys. Serbia reported that the private perform administraƟve tasks for the older persons and sector is discovering older persons as a speciĮc target give them company. group, for example as clients in tourism. Countries are also looking more consciously for ways to Knly a few countries have shared informaƟon about the Įght stereotypes and promote posiƟve images of ageing parƟcipaƟon of older persons in the poliƟcal sphere, a ;e.g. EL, CzP, CE, FIN, IRL, ISL, DAͿ. Ireland has an notable example being Serbia where the Party of United annual ^ĂǇEŽdŽŐĞŝƐŵ awareness iniƟaƟve, the aims of Pensioners of Serbia obtained a eputy Prime Dinister which are to raise public awareness about stereotyping post in 2008. In Slovenia, the emocraƟc Party of of older people and to promote and support pracƟcal Pensioners of Slovenia brings together representaƟves of acƟon for age-friendly service provision in key sectors. A the older populaƟon – in 2011, the party won 6.97 per speciĮc theme is selected annually. The elgian campaign cent of the vote. In Dalta, the two maũor poliƟcal parƟes KƵďůŝĞ ůĂ ĚĠŵĞŶĐĞ͕ ƐŽƵǀŝĞŶƐͲƚŽŝ ĚĞ ůĂ ƉĞƌƐŽŶŶĞ ;&ŽƌŐĞƚ both have their own respecƟve associaƟons of pensioners ĚĞŵĞŶƟĂͲƌĞŵĞŵďĞƌƚŚĞƉĞƌƐŽŶͿaddresses images and and older persons which have a role in formulaƟng and stereotypes of persons with demenƟa. Several countries implemenƟng poliƟcal party programmes. have taken steps to encourage media to transmit more 2.4 Commitment 3͗ To promote eƋƵitable posiƟve images of ageing and older persons ;EL, CEͿ. and sƵstainable eĐonomiĐ groǁth in response to In elgium, in connecƟon with a WůĂŶ ϮϬϭϬͲϮϬϭϯ ƉŽƵƌ popƵlaƟon ageing ů͛ĠŐĂůŝƚĠĞƚůĂĚŝǀĞƌƐŝƚĠĚĂŶƐůĞƐŵĞĚŝĂƐĂƵĚŝŽǀŝƐƵĞůƐĚĞůĂ ĐŽŵŵƵŶĂƵƚĠĨƌĂŶĕĂŝƐĞ, an annual barometer measures It is clear that the economic situaƟon of UNECE Dember the presence of older persons in television broadcasƟng. States has been severely aīected by the conseƋuences In Taũikistan, the weekly newspaper ǀĞŶŝŶŐ ƵƐŚĂŶďĞ of the economic and Įnancial crisis since 2008. Ukraine dedicates one page to older people’s concerns. A brochure reported diĸculƟes in meeƟng its social commitments – dŚĞǁŽƌůĚŽĨƚŚĞŽůĚĞƌŐĞŶĞƌĂƟŽŶ– is published six Ɵmes declared in the budget during 2008 to 2009. oƩlenecks a year by authors and ũournalists who are themselves have necessitated short-term measures, such as freeǌing older persons. In Canada, the EĞǁ,ŽƌŝǌŽŶƐĨŽƌ^ĞŶŝŽƌƐ pension increases in Serbia or reducing monthly pension WƌŽŐƌĂŵ conƟnues to promote posiƟve images of older payments for periods of Ɵme in Iceland. In 2008, Lithuania persons by supporƟng senior-led or inspired community- had to fully exhaust the reserve fund to compensate based proũects that encourage volunteerism, mentoring for a serious deĮcit of its Social Insurance Fund. At the and social parƟcipaƟon. same Ɵme, many countries report that governments

54 Synthesis Report have made it an explicit priority to uphold social welfare (e.g. EU, MK, NOR, SRB). In 2010, Canada’s federal programmes that are relevant for older persons (e.g. ISL, and provincial/territorial governments agreed on a RUS). framework for a deĮned-contribuƟon Pooled Registered Pension Plan that will provide a low-cost private pension Strategies in response to the crisis should not be to the and assist Canadians meet their reƟrement obũecƟves. detriment of vulnerable older persons (AUT). Economic development strategies are designed to bring countries In some countries the private pension system is not yet onto a path of sustainable growth, thus providing funcƟoning well. In the Republic of Moldova, for example, opportuniƟes for all generaƟons and segments of two private pension funds are registered but reportedly society, promoƟng social inclusion and combaƟng do not operate. poverty (ARM, BLR, CAN, CYP, ESP, FIN, GBR, ITA, NOR, ue to populaƟon ageing and in light of the economic StE, U

55 ŶƐƵƌŝŶŐĂ^ŽĐŝĞƚǇĨŽƌůůŐĞƐ͗WƌŽŵŽƟŶŐƋƵĂůŝƚǇŽĨůŝĨĞĂŶĚĂĐƟǀĞĂŐĞŝŶŐ

PRT, SRB). Aǌerbaiũan adopted a government programme discriminaƟon on the grounds of age in the labour market to strengthen social welfare for older ciƟǌens for 2006 to in place was idenƟĮed as a shortcoming by the Ukrainian 2008 and was working on social care legislaƟon to deĮne report. the basis for government policies in the area of social Pension legislaƟon may create important incenƟves service provision of older persons. The United Kingdom of to work beyond reƟrement age. Some countries allow Great Britain and Northern Ireland introduced a tĞůĨĂƌĞ pensioners to receive an income from work and the full ZĞĨŽƌŵŝůů in 2011, revising maũor elements such as the pension at the same Ɵme (e.g. MLT, RUS). In Sweden, disability living allowance, housing beneĮts, beneĮt caps income-based pensions and premium pensions can be and local welfare assistance. Serbia also introduced a new drawn from the age of 61, and the amount increases >ĂǁŽŶ^ŽĐŝĂůtĞůĨĂƌĞ in 2011, harmoniǌed with modern European standards – improving protecƟon of the the later the person decides to reƟre. If the individual poorest groups, including poor older people in rural areas conƟnues to work aŌer beginning to draw the pension and developing community services. Local government is or a parƟal pension, new pensions rights are earned responsible for social services in communiƟes. irrespecƟve of age. In Serbia, the >ĂďŽƵƌ >Ăǁ foresees reƟrement at age 65 with a minimum of 15 years of The maũority of municipaliƟes provide services to older paid contribuƟon, with the possibility of arranging with persons and their families, including short-term Įnancial the employer to prolong work or make arrangements aid, aid in-kind, home assistance and clubs for older for gradual reƟrement. In Belgium, the ŽŶƵƐ WĞŶƐŝŽŶ persons. One third of Serbian municipaliƟes oīer day foresees addiƟonal pension rights for persons staying in care centres, meals in soup kitchens, uƟliƟes, transport employment aŌer age 62 or aŌer 44 years in employment or medicaƟon. Belarus adopted the ŽŵƉƌĞŚĞŶƐŝǀĞ respecƟvely. In Finland, the reform of the income-related WƌŽŐƌĂŵŽĨ^ŽĐŝĂů^ĞƌǀŝĐĞƐŝŶϮϬϭϭͲϮϬϭϱ aiming to seƩle pension scheme allowed for more Ňexible reƟrement. At condiƟons for sustainable improvement in access to the same Ɵme, countries have limited opƟons available social protecƟon. The main aims of social transfer system to reƟre early, for example by elevaƟng the age threshold reform in Slovenia were to improve the transparency, for taking early reƟrement (BEL, NK, UKR). In France, eĸciency and user-friendliness of the distribuƟon of disincenƟves for taking up early reƟrement are created means-tested social transfers and subsidies and the by limiƟng beneĮts and increasing taxaƟon. In 2009, harmoniǌaƟon of the criteria for granƟng such transfers Canada announced support for a change in federal rules and subsidies while encouraging people to search more to prohibit federally regulated private sector employers acƟvely for soluƟons to their problems. Overall, achieving from seƫng a mandatory reƟrement age to give older beƩer means-tesƟng and targeƟng of assistance has workers the opƟon of remaining in the workforce if they been found challenging when reforming social protecƟon wish to do so. system (MLT, UKR). Austria has implemented a large-scale /ŶǀĂůŝĚŝƚǇ ŝŶ dƌĂŶƐŝƟŽŶ ;/ŶǀĂůŝĚŝƚćƚ ŝŵ tĂŶĚĞůͿ proũect Governments have tried to work directly with social which has pursued several goals since 2007, including partners. In Norway, the dƌŝƉĂƌƟƚĞ ŽŽƉĞƌĂƟŽŶ ŽŶ the harmoniǌaƟon of regulaƟons, puƫng in place /ŶĐůƵƐŝǀĞtŽƌŬƉůĂĐĞƐrepresents an agreement between invalidity prevenƟon iniƟaƟves and improved interface government and the social partners aimed at reducing management between the diīerent stakeholders sick leave, increasing employment of persons with involved in health promoƟon. disabiliƟes and raising the real average reƟrement age (c.f. also PRT). In Belgium, the Flemish authoriƟes have 2.ϲ Commitment 5͗ To enable labour markets to concluded agreements with economic sectors to develop respond to the economic and social consequences oĨ acƟviƟes around the topic of ageing and vulnerable populaƟon ageing groups among the unemployed, including due to age or Labour market measures have had a high priority low educaƟon. in many countries. Where countries have adopted Countries have also taken an array of acƟve labour integrated ageing strategies, labour market measures market measures directed at employers. In some feature prominently (e.g. ARM). At the same Ɵme, where countries, they can beneĮt from subsidies if they employ countries have adopted labour market strategies, they older workers, especially those previously registered tend to take into account challenges such as demographic as unemployed (AUT, BEL, MK, PRT, SRB, SVK, SVN). changes (e.g. ESP, MK, SRB). In France, a speciĮc acƟon Labour market reforms in Austria have been designed plan for the employment of older persons was adopted with older persons in mind, for example to the eīect of for 2006-2010 ;WůĂŶ ŶĂƟŽŶĂů Ě͛ĂĐƟŽŶ ĐŽŶĐĞƌƚĠ ƉŽƵƌ a decrease in non-wage labour costs for older workers. ů͛ĞŵƉůŽŝĚĞƐƐĞŶŝŽƌƐƐƵƌůĂƉĠƌŝŽĚĞϮϬϬϲͲϮϬϭϬͿ͘ In Poland, employers hiring an unemployed person A Įrst step towards ensuring eƋual opportuniƟes usually aged 50 years or older do not contribute to the Labour is to prescribe eƋual treatment and non-discriminaƟon Fund and the Guaranteed Employee BeneĮts Fund for a based on age or disability into the labour legislaƟon 12-month period. In Sweden, employers are exempt from (AZE, GBR, IRL, MA, POL, RUS). Not having a regulatory employers’ contribuƟons when they employ persons legal framework on prevenƟon and prohibiƟon of aged 65 and over. In some countries, employers invesƟng

56 Synthesis Report in training for older workers can be parƟally reimbursed which came into force in 2008. A number of countries (e.g. POL). Campaigns using print, audio and visual media allow for more Ňexible work Ɵme arrangements, such have targeted employers, adverƟsing the ƋualiƟes of as Lithuania where employers set more Ňexible work older workers (EU, MLT). The Ƌuality seal EĞƐƚŽƌͲ'ŽůĚ schedules for older women to support their reconciliaƟon is granted to enterprises and organiǌaƟons oīering of family and work life. Austrian reforms have included age(ing)-appropriate condiƟons in Austria. the part-Ɵme working scheme for older workers. In addiƟon, the ϮϬϬϵ ŵƉůŽǇŵĞŶƚ WƌŽŵŽƟŽŶ Đƚ A diversity of measures is also directed towards ;ĞƐĐŚćŌŝŐƵŶŐƐĨƂƌĚĞƌƵŶŐƐŐĞƐĞƚǌͿ has made it possible employees to enhance the employment of older workers. to combine short-Ɵme working with skills development. In Italy, through the ϮϬϭϬ&ŝŶĂŶĐĞĐƚ, it is now possible The main beneĮciaries are employees aged 45 years and to Įnance the pension contribuƟon for employees with above. In Sweden, the tŽƌŬŶǀŝƌŽŶŵĞŶƚĐƚ states that 35 years of contribuƟon who receive income support employers shall make an allowance for the employees’ and accept an oīer of work at a lower salary. In Canada, special apƟtudes for the work by adapƟng working the dĂƌŐĞƚĞĚ /ŶŝƟĂƟǀĞ ĨŽƌ KůĚĞƌ tŽƌŬĞƌƐ ensures that condiƟons. displaced older workers in tradiƟonal sectors, such as forestry, Įshing and mining, have access to the training A number of countries support entrepreneurship and employment programmes they need to secure opportuniƟes for older persons (LTU, MA, SVN), some new employment. A 2010 evaluaƟon shows that 75 per of them especially targeƟng older women (CYP, LTU, cent of parƟcipants found employment during or aŌer MA, PRT, SRB). In the Republic of Moldova where older parƟcipaƟon in the programme. Moreover, Canada, persons are oŌen not in a posiƟon to obtain employment, established an Expert Panel on Older Workers in 2007 ,elpAge oīers income-generaƟng acƟviƟes. At the same to examine the labour market condiƟons aīecƟng older Ɵme, a new trend is showing that pre-pension persons workers and to idenƟfy ways to enhance their labour are emigraƟng because of the limited capaciƟes of the market perspecƟves. Several countries have integrated naƟonal labour market. Agreements were concluded funcƟons into their public employment agencies to in 2010-2011 between the Republic of Moldova and support persons with special needs, including older Bulgaria, Romania, Luxembourg and Portugal to ensure persons, to provide ũob placement services, training or social security for those migrants. Other countries have otherwise improve access to the labour market (CYP, also concluded internaƟonal social security agreements MA, POL, SVK, SVN, SWE). In Malta, the Employment to validate pension credits accumulated elsewhere (e.g. and Training CorporaƟon, the enƟty responsible for CAN). providing public employment services, maintains an KǀĞƌ 2.7 Commitment ϲ͗ To promote liĨelong learning ϰϬƐ^ĐŚĞŵĞ with the aim of helping persons of this age and adapt the educaƟonal system in order to meet the group Įnd employment. Some countries oīer a service changing economic͕ social and demographic condiƟons to develop individual acƟon plans for non-employed persons (CZE, POL, SVK). In Austria, temporary ũobs are Lifelong learning has become more and more accepted made available in social enterprises to promote the long- as a model to allow people to remain employable term integraƟon into the labour market of persons hard throughout their lives and to stay integrated in society. to place, including people 50 years and older. In addiƟon, Several countries have integrated lifelong learning into countries oīer ũob fairs or ũob market websites that also their ageing strategies (ARM, LTU, MA, SRB) or have beneĮt older persons (e.g. MA). In Belgium, the ĞŶƚƌĞƐ even developed separate strategies or acƟon plans on Ě͛ĂĐĐŽŵƉĂŐŶĞŵĞŶƚ ĚĞ ĐĂƌƌŝğƌĞ provide professional lifelong learning and age-integrated educaƟon (ARM, support with regards to career development. Maintaining ESP, POL, PRT, SVN, UKR). Austria, for example, adopted the moƟvaƟon of employees towards the end of their a strategy for lifelong learning in 2011 which commits career is an important aim of this service. In Lithuania, to making a country-wide basic supply of Ƌuality, low- the employer-accessible database ^ĞŶũŽƌƿ ďĂŶŬĂƐ threshold educaƟon services available to older persons in ;^ĞŶŝŽƌƐďĂŶŬͿ stores informaƟon about reƟrement-age the close vicinity of their place of residence. At the same ũob seekers. uring 2007-2011, 5,000 ũob seekers of Ɵme, some countries have found it diĸcult to uphold reƟrement age registered on this database. Providing implementaƟon of their lifelong learning goals in view of such services through public employment services is not other compeƟng prioriƟes (ARM, UKR). a given͖ this is illustrated by Taũikistan, where the public In many countries educaƟon is tradiƟonally very focused employment service at the Ministry of Labour and Social on receiving an iniƟal educaƟon and Ƌualifying for a Welfare explicitly does not provide services to older profession. Later, ongoing educaƟon is largely targeted people looking for employment. towards very speciĮc labour market needs, for example A range of measures to facilitate longer working lives is retraining or on-the-ũob training on some new uƟliƟes or also directed at adũusƟng the setup of the workplace to speciĮc technologies (CZE, SWE, UKR). Several countries beƩer accommodate the needs of older workers. In Italy, have put in place programmes to validate skills acƋuired for example, eīorts have concentrated on implemenƟng on the ũob according to some external tests based on new legislaƟon on health and safety in the workplace, which candidates can be granted a cerƟĮcate (BEL, ESP,

57 ŶƐƵƌŝŶŐĂ^ŽĐŝĞƚǇĨŽƌůůŐĞƐ͗WƌŽŵŽƟŶŐƋƵĂůŝƚǇŽĨůŝĨĞĂŶĚĂĐƟǀĞĂŐĞŝŶŐ

ISL, PRT). In the United Kingdom, the government’s ^Ŭŝůů of parƟcipants have dropped since 2007 in connecƟon ^ƚƌĂƚĞŐǇ is largely focused on unemployed people. Serbia with the economic crisis. In the Russian FederaƟon, has worker’s universiƟes in 18 towns, oīering informal universiƟes for the third age oīer courses in creaƟve educaƟon to help adults and older persons to return to arts, sports, health promoƟon and disease prevenƟon, the labour market. Several countries have made eīorts to as well as training in use of computers and mobile establish closer links between educaƟonal insƟtuƟons and phones, cameras and modern appliances. In fact, IT and employers, for example through employers’ federaƟons computer courses for older persons are oīered in many and enterprises (GBR, ISL, POL, SRB, SWE). Some countries in diīerent seƫngs (BEL, ESP, ISR, LTU, MK, countries also oīer training speciĮcally targeted towards MLT). The Irish naƟonal Ğ/ŶĐůƵƐŝŽŶ^ƚƌĂƚĞŐǇ&ƌĂŵĞǁŽƌŬ reintegraƟon into the labour market of those who leŌ the has prioriƟǌed acƟon to increase access to informaƟon formal educaƟonal system early, the United Kingdom’s and communicaƟon technology (ICT) and increase ICT programme on literacy and basic numerical skills being a skills, including awareness of potenƟal informaƟon and case in point (cf. also ESP, IRL, PRT). The Former Yugoslav communicaƟon technology and how they can be used Republic of Macedonia has held a number of campaigns to assist older persons in their social or work life or at since 2006 to moƟvate Roma parents to involve their home to facilitate independent living. Partnerships in this children in primary and secondary educaƟon. Finding area have involved academic insƟtuƟons, locally based IT courses for conƟnued educaƟon may be diĸcult, the mulƟnaƟonals and older persons’ organiǌaƟons. Several available opƟons being too costly or of ƋuesƟonable countries oīer pre-reƟrement training (e.g. FIN, ISR, MLT, Ƌuality. Building up the necessary infrastructure is a SRB). Canada has made special eīorts to provide training cumbersome process and aƫtudes towards educaƟon on Įnancial literacy to prepare for reƟrement for the next may change only slowly. Therefore, Poland has held generaƟon of seniors through the integraƟon of Įnancial naƟonal campaigns to promote lifelong learning. In planning for reƟrement in the high school educaƟon Slovenia a >ŝĨĞůŽŶŐ>ĞĂƌŶŝŶŐtĞĞŬ is organiǌed every year curriculum. to draw aƩenƟon to the importance of learning at all 2.ϴ Commitment 7͗ To strive to ensure quality oĨ liĨe stages of life. at all ages and maintain independent living͕ including In some countries, ongoing educaƟon is already more health and ǁellͲbeing established (ISL, MLT, NOR). In Iceland for example, the ConƟnuing EducaƟon InsƟtute at the University of Iceland In addiƟon to those instances where overall strategies on is the biggest provider of conƟnuing educaƟon, oīering ageing were adopted, several countries have developed 400 short courses with 12,000 parƟcipants. In Malta, the integrated strategies or plans with relevance for the two maũor poliƟcal parƟes have established insƟtutes health and care sectors and ageing (AZE, BEL, CYP, NK, aimed at the conƟnuing educaƟon of their members. FRA, ISL, MK, SRB, UKR) or they have adopted new Maũor NGOs have developed their own package of non- health care laws and acts (FIN, ISL, NOR, POL, SRB). In the formal and informal learning opportuniƟes for parƟcular United Kingdom, research has been done into ineƋualiƟes categories of ciƟǌens at both central and community in health, results of which were published under the levels. AddiƟonal training centres are available through Ɵtle &Ăŝƌ^ŽĐŝĞƚǇ͕,ĞĂůƚŚǇ>ŝǀĞƐ (February 2010). This has the private sector. In Aǌerbaiũan, more than 30 training served as a basis for discussion and policy-making. modules are available for older ũob seekers in educaƟonal To strengthen policy development, the Serbian Ministry centres of the Ministry of Labour and Social ProtecƟon, of ,ealth established a Commission for the Improvement as well as in specialiǌed educaƟonal insƟtuƟons of the of Aged Persons’ ,ealth in 2008. The Republic of Moldova Ministry of EducaƟon. Moreover, Aǌerbaiũan is currently has created a Working Group at the Ministry of ,ealth elaboraƟng a distance learning programme. With the with the parƟcipaƟon of civil society organiǌaƟons and help of Įnancial support received from the European foreign experts to develop a normaƟve framework for Social Fund, some 1,300 distance learning centres were facilitaƟng access to adeƋuate services to those with established in villages in Poland during 2007-2008. The incurable diseases. centres have helped overcome diĸculƟes associated Medical insurance coverage ensures good access to with the low computer skill levels of older persons. Some health care in many countries within the region. Some countries have especially invested in training teachers for countries have compulsory medical insurance. The adult educaƟon (POL). Russian FederaƟon passed a federal law to this eīect in More and more countries oīer learning opportuniƟes to 2010. To reduce ineƋualiƟes in access to health and social older persons in ͞universiƟes of the third age͟ (BLR, CZE, services, some countries provide a range of health care ESP, FIN, IRL, LTU, MK, MLT, POL, RUS, SRB, SVN, UKR) services free of charge (ARM, MLT). Many countries have or ͞colleges for the elderly͟ as they are called in Israel. In also made provisions to make reduced-price medicines the Cǌech Republic these are linked to public universiƟes. available to older persons, especially those suīering Funding is shared between student fees and government from chronic diseases (e.g. MLT). In the United States, the support. At the Third Age University in Belgrade, īŽƌĚĂďůĞĂƌĞĐƚ was signed into law in 2010, calling parƟcipants have to cover their own fees and numbers for comprehensive health reform to make health care

ϱϴ Synthesis Report more aīordable, expand health coverage, make health homes and community care housing. In Ireland, the insurers more accountable and make the health system Working Group on Long-Term Care reported in 2008 on more sustainable. It is designed to help individuals make the policy opƟons for a Įnancially sustainable system of informed decisions about care opƟons, plan for long- long-term care and on measures to raƟonaliǌe the range term services and streamline access to publicly supported of beneĮts, services and grants currently in place. &Ăŝƌ programmes through single point of entry approaches. ĞĂů, a nursing home support scheme, introduced in In the care sector, there is a complementary mix between October 2009, was founded on the core principles that diīerent forms of care, from home care to assisted living long-term care should be aīordable and that a person in age-friendly housing or day-care services in most should receive the same level of State support whether countries. Even though services of all kinds co-exist in they choose a public, voluntary or private nursing home. most countries, in many places they do not cover all in The scheme is the sole funded means of accessing long- need. Overall, there is support among governments to term nursing home care for all new entrants. enable seniors to conƟnue to live as long as possible in Several countries have made eīorts to develop their their places of choice. Countries have a broad range of geriatrics care systems (BLR, MA, POL, SVN, T:K, UKR). home-based care services in place to allow older persons Slovenia reported on preparaƟons for a ^ƚƌĂƚĞŐǇĨŽƌƚŚĞ to live independently for as long as possible, such as ĞǀĞůŽƉŵĞŶƚŽĨ'ĞƌŝĂƚƌŝĐƐĂŶĚ'ĞƌŽŶƚŽůŽŐǇ which would domiciliary nursing, telecare, home care or meals on assess the populaƟon’s needs for geriatric treatment and wheels (CAN, CYP, FRA, ESP, GBR, IRL, ISL, LTU, MA, propose methods to restructure the health care system MLT, T:K). In enmark, all ciƟǌens are enƟtled to home accordingly. In Poland in 2007, the Ministry of ,ealth nursing free of charge when prescribed by a pracƟƟoner. appointed a Team for Gerontology and developed a enmark has carried out research to integrate ambient strategy for the development of the geriatric health care assisted living tools in care homes and at home. In Serbia, system. In Taũikistan, thanks to the iniƟaƟve of a civil home-based care is currently only available in the capital, society organiǌaƟon and in partnership with the staī but there is a plan to broaden coverage to all maũor of the department of internal medicine, gerontologists ciƟes. To address the current gap, the Serbian Red Cross have been trained and from 2010 onwards lectures on implemented a programme for independent living by gerontology have been introduced at all faculƟes at providing home assistance through a network of around the Taũik Governmental Medical University. Ukraine, 1,000 volunteers, of which 70 per cent are themselves which already has a tradiƟon of geriatrics, has invested older persons. In the United States, a ŽŵŵƵŶŝƚǇ>ŝǀŝŶŐ more in the pre- and post-graduate geriatric training of /ŶŝƟĂƟǀĞ was implemented to work across government to medical and social workers, volunteers and the general remove barriers and to enhance the ability of individuals public. In Belarus, the epartment of Gerontology and of all ages with disabiliƟes to live independently in Geriatrics EducaƟon at the Belarusian Medical Academy their communiƟes. The iniƟaƟve is a conƟnuaƟon of of Postgraduate EducaƟon trained more than 1,300 the ϮϬϬϵ zĞĂƌ ŽĨ ŽŵŵƵŶŝƚǇ >ŝǀŝŶŐ. Israel’s ^ƵƉƉŽƌƟǀĞ doctors in geriatrics. A NaƟonal Gerontological Centre ŽŵŵƵŶŝƟĞƐ provide older persons living in their homes is dedicated to scienƟĮc and methodological issues with a panic buƩon to summon help around the clock. concerning the medical care of older persons. The programme also includes a community mother or father, a doctor and ambulances for a small fee, as well Several countries have introduced or enhanced as social and cultural acƟviƟes. For older persons who are available palliaƟve care services (C,E, LTU, MA, SRB). no longer in a posiƟon to live independently, countries In Switǌerland, the EĂƟŽŶĂů^ƚƌĂƚĞŐǇĨŽƌWĂůůŝĂƟǀĞĂƌĞ oīer insƟtuƟonal care. In several countries there is sƟll ϮϬϭϬͲϮϬϭϮ was adopted to enhance the availability a tendency towards excessive hospitaliǌaƟon due to lack of palliaƟve care. In Serbia, a concept on developing of or imperfecƟon in primary care or other services (e.g. palliaƟve and hospice care was developed for the period UKR). Increasingly, however, countries are Įnding opƟons 2010 to 2014. In addiƟon, an InsƟtute of PalliaƟve and to provide alternaƟves to insƟtuƟonaliǌaƟon. ,ospice Medicine was established and the naƟonal branch of the Red Cross trained 88 educators from civil eveloping long-term care systems has received special society organiǌaƟons to provide services in palliaƟve aƩenƟon in a number of countries (CZE, ESP, IRL, POL, care. The Canadian InsƟtutes of ,ealth Research, with SVK, SVN). Austria has a well-developed system of funding from the federal government, conducts research beneĮts and services relaƟng to long-term and nursing on palliaƟve end of life care, including care transiƟons, care and the highest rate of long-term care beneĮt caregiving, pain management and care for vulnerable recipients globally. Recent system reforms have been populaƟons. aimed at increasing long-term care beneĮts and shortening procedures for determining the care level. Alǌheimer’s disease and other forms of demenƟa remain The government of Norway has compiled a ĂƌĞ WůĂŶ of special concern across the region. Several countries with deĮniƟve measures in long-term care up to 2015, have adopted or have been working on developing such as increasing the number of health personnel, naƟonal mental health, demenƟa or Alǌheimer strategies strengthening their competence, invesƟng in nursing and plans (BEL, CAN, C,E, CZE, NK, FIN, FRA, GBR, USA).

ϱϵ ŶƐƵƌŝŶŐĂ^ŽĐŝĞƚǇĨŽƌůůŐĞƐ͗WƌŽŵŽƟŶŐƋƵĂůŝƚǇŽĨůŝĨĞĂŶĚĂĐƟǀĞĂŐĞŝŶŐ

In Slovenia, the Ministry of ,ealth appointed a working scheme enables groups to purchase new eƋuipment. In group to deal with the medical treatment of demenƟa enmark, the &ƌĞĚĞƌŝĐŝĂ ƉƌŽũĞĐƚ, under the moƩo ͞In paƟents, with the aim of developing clinical guidelines. your own life as long as possible͟, has been successfully The ƌŝƟƐŚ EĂƟŽŶĂů ĞŵĞŶƟĂ ^ƚƌĂƚĞŐǇ, published in pursuing an approach whereby older persons in need of 2009, sets out a vision for transforming demenƟa services, care are trained to become more self-reliant. improving awareness of demenƟa, early diagnosis and More and more countries consciously build on technology high-Ƌuality treatment. In Finland, the NaƟonal InsƟtute to improve their service provision, for example by for ,ealth and Welfare published guidelines for high- supporƟng research into ICT-based products and services Ƌuality demenƟa care in 2008. A number of memory clinics (e.g. AUT). focussing on diagnosing cogniƟve disorders in the ageing populaƟon are available. Israel has day care centres and CoordinaƟon of services for older persons remains a programmes that aim to preserve the cogniƟve funcƟons maũor challenge (e.g. LTU). Conscious of the need to of paƟents and to prevent deterioraƟon. In Cyprus, promote integrated health care and social services for training programmes for formal and informal carers of dependent persons, the government of Portugal has paƟents with Alǌheimer’s and other forms of demenƟa set up the NaƟonal Network for ConƟnued Integrated were carried out. Germany oīers sports acƟviƟes to Care under the ũoint responsibility of the ,ealth, and people with demenƟa as part of the WŚǇƐŝĐĂů ĐƟǀŝƚǇ Labour and Social Solidarity Ministries. enmark has ŶĞƚǁŽƌŬϱϬƉůƵƐ proũect. The /ŶŝƟĂƟǀĞŽŶ<ŶŽǁůĞĚŐĞĂŶĚ made eīorts to enhance cross-sectoral cooperaƟon, ^ƵƉƉŽƌƚ EĞƚǁŽƌŬƐ ŝŶ ĞĂůŝŶŐ ǁŝƚŚ ĞŵĞŶƟĂ, started in especially between primary health care and general 2009, includes an Internet portal providing informaƟon pracƟƟoners. Norway implemented a maũor ,ĞĂůƚŚ about the diseases and available support and contact ^ĞƌǀŝĐĞƐŽŽƌĚŝŶĂƟŽŶZĞĨŽƌŵ to improve organiǌaƟonal persons. Countries have also scaled up their research development of services and encourage the professions eīorts (CAN, C,E, NK, SRB), notably in the anish to cooperate beƩer. A new health and care plan will emenƟa Research Centre, established in 2007, in the prepare the implementaƟon of the ŽŽƌĚŝŶĂƟŽŶZĞĨŽƌŵ. Serbian Center for emenƟa at the Faculty of Medicine Increasing older people’s access to and awareness of Belgrade University, opened in 2010, and through of government programmes is a challenge for many the InternaƟonal CollaboraƟve Research Strategy for countries. In Canada, the federal Government provides Alǌheimer’s isease with contribuƟons from Canada and Canadians with a single point of access to a range of other countries. In Spain, a naƟonal centre of reference informaƟon through service centres located across the for Alǌheimer’s disease pursues a mulƟdisciplinary country, phone and online channels, as well as specialiǌed approach and specialiǌes in research assessment and outreach services for seniors. disseminaƟon of data and knowledge regarding the best Budgetary constraints remain maũor obstacles to forms of socio-sanitary care. The centre also works to developing diīerent forms of care (e.g. POL). Therefore, raise awareness to the needs of people suīering from more and more countries count on the private sector Alǌheimer’s disease and their families. to take on roles in service provision (e.g. BLR, NK). Programmes for health promoƟon and disease Several countries have menƟoned using public-private prevenƟon are in place in many countries (BLR, CAN, partnerships to construct and operate such insƟtuƟons C,E, CYP, CZE, LTU, MA, MLT, POL, SWE). AcƟviƟes (MLT, RUS). In Malta, the ĞƉĂƌƚŵĞŶƚĨŽƌƚŚĞůĚĞƌůǇĂŶĚ include vaccinaƟon programmes for older people, cancer ŽŵŵƵŶŝƚǇ ^ĞƌǀŝĐĞƐ subcontracted the administraƟon screening, prevenƟon of cardiovascular disease and for two government-owned homes to CareMalta Ltd., a diabetes, programmes to encourage healthy eaƟng and private organiǌaƟon. In another instance, the contractor physical acƟvity, as well as programmes on prevenƟng builds and operates the home, while government pays falls and on promoƟng road safety (e.g. CAN, FIN, MLT, for the service given once the home starts operaƟng. POL). A prevenƟon package for older persons was Countries have taken steps to ensure Ƌuality of care by launched in 2009 by the epartment of ,ealth in the seƫng standards and introducing monitoring mechanisms United Kingdom. enmark has a system of prevenƟve for insƟtuƟons, and also for non-residenƟal services house calls for persons of 75 years and above where (ARM, BEL, ESP, MLT). Austria has a EĂƟŽŶĂů YƵĂůŝƚǇ older persons are contacted at least once a year to ĞƌƟĮĐĂƚĞ ;EĂƟŽŶĂůĞƐ YƵĂůŝƚćƚƐǌĞƌƟĮŬĂƚͿ for nursing provide them with advice and guidance. In Austria, the homes, a countrywide uniform external procedure. City of Vienna conducted the >Ğƚ͛Ɛ ŐŽ ŽƵƚƐŝĚĞ͗ ,ĞĂůƚŚͲ With its ŚĂƌƚĞƌŽŶƌŝŐŚƚƐĨŽƌƉĞŽƉůĞŝŶŶĞĞĚŽĨĐĂƌĞĂŶĚ ƉƌŽŵŽƟŶŐ ũŽŝŶͲŝŶ ĐĂŵƉĂŝŐŶ ĨŽƌ ŽůĚĞƌ ǁŽŵĞŶ ĂŶĚ ŵĞŶ ƐƵƉƉŽƌƚ, Germany has created an instrument to ensure ŝŶ ǁŽƌŬŽƵƚ ƉĂƌŬƐ ;'ĞŵŵĂ ƌĂƵƐ͊ 'ĞƐƵŶĚŚĞŝƚƐĨƂƌĚĞƌŶĚĞ Ƌuality in service provision. Among the accompanying DŝƚŵĂĐŚĂŬƟŽŶĞŶ Ĩƺƌ ćůƚĞƌĞ &ƌĂƵĞŶ ƵŶĚ DćŶŶĞƌ ŝŶ measures are telephone and Internet-based consultaƟon ĞǁĞŐƵŶŐƐƉĂƌŬƐͿ proũect between 2009 and 2011. 'Ž services. In enmark, strengthening Ƌuality of health ĨŽƌ >ŝĨĞ is the naƟonal Irish programme for sports and care has been found to be especially challenging in rural physical acƟvity for older people. Physical acƟvity leaders and remote areas. The government is analysing the need are trained to run sports sessions and a small grant for addiƟonal medical ambulances and acute vehicles.

ϲϬ Synthesis Report

In other countries shortages of staī have contributed to that also cover aspects of ageing and intergeneraƟonal diĸculƟes in providing access to health and care in rural relaƟonships (ARM, CYP, ESP, FIN, IRL, LTU, MA, SRB). areas (MA, SVN). The Republic of Moldova, for example, has adopted a EĂƟŽŶĂů WƌŽŐƌĂŵŵĞ ŽŶ ŶƐƵƌŝŶŐ 'ĞŶĚĞƌ ƋƵĂůŝƚǇ ĨŽƌ Capacity building among staī is recogniǌed as a maũor ϮϬϭϬͲϮϬϭϱ which provides for acƟons to prevent gender factor in improving Ƌuality, eĸciency and the humanity discriminaƟon, domesƟc violence, and reconciliaƟon of services delivered to older persons. Several countries of family and professional lives. In Norway, a Public report that work with older persons is part of the iniƟal CommiƩee on the Future of Gender EƋuality Policies has educaƟon of health and care professionals (FRA, POL, been mandated to deliver a report on the organiǌaƟonal SRB). Several countries also report about vocaƟonal and framework of the gender eƋuality policy. Based on this, in-service training opportuniƟes in this regard (CZE, GBR, the Ministry of Children, EƋuality and Social Inclusion ESP, MA, MK, MLT, SVK). The Canadian &ĂůůƐWƌĞǀĞŶƟŽŶ will iniƟate work on a government ǁŚŝƚĞƉĂƉĞƌ for the ƵƌƌŝĐƵůƵŵWƌŽũĞĐƚprovides an opportunity for health care Parliament on the Norwegian gender eƋuality policy. providers and community leaders to learn how to design, implement and evaluate fall prevenƟon programmes for A number of countries have adopted acts on gender older persons. Special degrees have been introduced in eƋuality and laws prohibiƟng discriminaƟon based on some countries, such as Poland where there is now the gender (ESP, ISL, LTU, NOR, SRB). In some countries, possibility in post-secondary educaƟon to train for the gender eƋuality is even included in the consƟtuƟon profession of an older person’s guardian. Members of (AUT, BLR, ESP, FRA, ISL, MLT, RUS). In Serbia, all the Ministry of Labour and Social Security in Aǌerbaiũan regulaƟons pertaining to social welfare were reviewed have visited Germany to familiariǌe themselves with the from a gender eƋuality standpoint. Ukraine has also German system of professional schools training social taken steps to improve the legal framework for gender workers. Nevertheless, the availability of ƋualiĮed staī eƋuality, including the reƋuirement of reviewing current remains a challenge in a number of countries (e.g. ARM, legislaƟon from the gender point of view. ,owever, MA). no mechanism for implementaƟon of the Įndings or sancƟoning mechanisms in case of failure to comply Several countries have addressed the issue of abuse and with the recommendaƟons of the review have been put violence against older persons (BEL, CAN, EU, IRL, POL, in place. The Portuguese Commission for CiƟǌenship PRT, SVN). In Poland, a naƟonwide survey on violence and Gender EƋuality promotes a 'ĞŶĚĞƌ ĂŶĚ ŐĞŝŶŐ͗ against older people and persons with disabiliƟes was WůĂŶŶŝŶŐ ƚŚĞ ĨƵƚƵƌĞ ŵƵƐƚ ďĞŐŝŶ ƚŽĚĂǇ͊ proũect which conducted and a naƟonal campaign to counteract aims to improve knowledge about ageing populaƟons domesƟc violence and to prevent violence against older from a gender perspecƟve and make recommendaƟons persons and persons with disabiliƟes was carried out in to policies and programmes to ensure mainstreaming 2009. In Belgium contact points have been created to gender from an age perspecƟve. report cases of maltreatment. The Irish Elder Abuse Service has staī dispersed across the country. AcƟviƟes include In the United Kingdom, a speciĮc Ministry for Women data collecƟon, oversight mechanisms and awareness has insƟtuƟonal competence to develop policies relaƟng training programmes. Through the &ĞĚĞƌĂů ůĚĞƌ ďƵƐĞ to gender eƋuality. In Norway, the EƋuality and AnƟ- /ŶŝƟĂƟǀĞ, Canada launched a naƟonal awareness discriminaƟon Ombudsman is in charge of enforcing the campaign in 2009 enƟtled ůĚĞƌďƵƐĞʹ/ƚ͛ƐdŝŵĞƚŽ&ĂĐĞ exisƟng 'ĞŶĚĞƌ ƋƵĂůŝƚǇ Đƚ. The Ministry of Children, ƚŚĞZĞĂůŝƚǇto help seniors and others recogniǌe the signs EƋuality and Social Inclusion coordinates gender and symptoms of elder abuse and provide informaƟon mainstreaming at the government level, but each ministry on available support. The United States has a programme has to implement gender eƋuality measures in its own to train law enforcement oĸcers, health care providers area of responsibility. At local and regional levels, county and other professionals on how to recogniǌe and respond governors are mandated to follow up with municipaliƟes to elder abuse and to support outreach and educaƟon on their work to promote eƋuality, but governors campaigns to increase public awareness of elder abuse have not given it high priority. In Malta, the NaƟonal and how to prevent it. The ůĚĞƌ:ƵƐƟĐĞĐƚ was signed Commission for the PromoƟon of EƋuality represents into law in 2010, creaƟng an Elder :usƟce CoordinaƟng the government machinery for mainstreaming gender Council to foster coordinaƟon throughout the federal eƋuality. Eīorts are made to mainstream gender when government on elder abuse issues. Countries have also formulaƟng and analysing policies, and methodologies strengthened their provisions to protect older persons for gender impact assessments have been developed from Įnancial abuse (e.g. CAN, EU, IRL). (cf. also FIN). In Canada, the federal government has improved accountability mechanisms for the integraƟon 2.ϵ Commitment ϴ͗ To mainstream a gender of gender-based analysis in government reporƟng approach in an ageing society instruments. In parƟcular, Status of Women Canada Many countries have in recent years developed leads the process of implemenƟng gender-based and adopted strategies or plans to advance gender analysis by developing and delivering training tools and mainstreaming and eƋuality between men and women public awareness materials. In Iceland, the government

61 ŶƐƵƌŝŶŐĂ^ŽĐŝĞƚǇĨŽƌůůŐĞƐ͗WƌŽŵŽƟŶŐƋƵĂůŝƚǇŽĨůŝĨĞĂŶĚĂĐƟǀĞĂŐĞŝŶŐ approved a three-year programme for the introducƟon women, women of colour, and women with limited of gender consideraƟons in economic management English-speaking proĮciency. Through WISER’s one-stop and budgeƟng. Related training programmes have been gateway, women have access to comprehensive, easily provided to government oĸcials and employers, and understood informaƟon that promotes opportuniƟes gender budgeƟng is regularly applied in all government to plan for income during reƟrement and for long-term programmes. In Austria, gender budgeƟng has been care. Services include an interacƟve website and a series enshrined in the consƟtuƟon since 2009, according to of naƟonwide webinars. which the federal provinces and the municipaliƟes have Several countries report about available age- a mandate to achieve de facto eƋuality between women disaggregated data and gender-sensiƟve indicators (CAN, and men in budgeƟng. From :anuary 2013, an impact- CYP, FRA, GBR, MA, MK, PRT, RUS, SRB). ,owever, oriented budgeƟng has been introduced. In the budget a lack of data on the social situaƟon of older women preparaƟon process each ministry will have to formulate remains a challenge. This may also be due to the fact a maximum of Įve impact goals, including one eƋuality that in surveys the 65 year and above age group, albeit goal. diverse, is oŌen not further subdivided (AUT). Several countries refer to the importance of a labour 2.10 Commitment ϵ ͗ To support Ĩamilies that legislaƟon that ensures eƋual opportuniƟes for provide care Ĩor older persons and to promote employment, training and promoƟon as well as eƋual pay for eƋual work (AUT, FIN, ISL, LTU, MK). In Italy intergeneraƟonal and intrageneraƟonal solidarity the NaƟonal CommiƩee for EƋual OpportuniƟes in among their members Employment of the Ministry of Labour and Social Policies Families are at the core of providing care. Countries take formulated a programme in 2011 aimed at increasing this into account and have strengthened their social women’s employment and ƋualiĮcaƟons, eliminaƟng welfare services with respect to assisƟng families in wage and career dispariƟes, fostering the creaƟon and performing their care responsibiliƟes while also being consolidaƟon of businesses run by women, and creaƟng able to reconcile these with other responsibiliƟes such networking opportuniƟes. AcƟviƟes also aim to facilitate as work, and to avoid puƫng them at a disadvantage, the reconciliaƟon of work and family duƟes: in 2011 for example in the pension system. Within its four- The Fund for Family Policies Įnanced proũects from year 'ĞŶĚĞƌ ƋƵĂůŝƚǇ WƌŽŐƌĂŵŵĞ (2011) Iceland has companies and social partners aimed at the introducƟon entrusted a special commiƩee with examining how of new Ňexible working Ɵme systems and arrangements family life and working commitments can be harmoniǌed such as teleworking, programmes and acƟviƟes for the and how people in employment can be enabled to meet reintegraƟon of workers coming back from periods of care reƋuirements. Austria has invested in research parental leave of at least 60 days, as well as networks on the reconciliaƟon of work and care-giving duƟes. between local authoriƟes, enterprises and social partners Several countries have adopted policies to facilitate the for the promoƟon of innovaƟve services for reconciling combinaƟon of work and family life and care obligaƟons, work and family life. Under the 'ĞŶĚĞƌ ƋƵĂůŝƚǇ Đƚ such as Ňexible work Ɵme arrangements or teleworking in Iceland, employers and trade unions are obliged to (CZE, EU, ESP, GBR, MLT, NOR, POL). Employees in take measures bring greater gender eƋuality in the Norway have a right to leave with income compensaƟon labour market. Since the amendment of the ƵƐƚƌŝĂŶ to care for close relaƟves at home in a terminal stage for ƋƵĂůdƌĞĂƚŵĞŶƚĐƚ in 2011, larger enterprises are now up to 60 days. There is also an opƟon of unpaid leave for reƋuired to draw up a gender pay report. In Iceland up to ten days to care for parents or spouses. Pension employers have to take measures to enable women rights can be obtained during periods of unpaid care and men to balance family responsibiliƟes, allowing for for children and sick family members in the NaƟonal Ňexibility in working hours and facilitaƟng the return Insurance System (c.f. also BEL). In Germany, the law to the workplace following periods of parental leave. on reconciling care and work came into force in 2012, Germany has a programme to support women seeking allowing employees in acute need to take up to ten to reũoin the labour market following family-related working days of leave to organiǌe and provide appropriate interrupƟons, counselling the women, and in a second care to a family member. Employees also have the opƟon phase, also approaching their partners to take over family of working part-Ɵme for up to 24 months and be parƟally responsibiliƟes. Raising employer awareness of gender compensated for the income lost. In Spain, respite care issues is ongoing in many countries (AUT, CYP, CZE, FRA, is made available in centres under the ^ǇƐƚĞŵ ĨŽƌ ƚŚĞ GBR). ƵƚŽŶŽŵǇĂŶĚĂƌĞŽĨƚŚĞĞƉĞŶĚĞŶƚ. In Belgium respite The AdministraƟon on Aging in the United States care is oīered in so-called ,ƀƚĞůƐĚĞƐŽŝŶƐ (care hotels) conƟnues to collaborate with the NaƟonal EducaƟon and or by providing aƩendance and care at night (c.f. also Resource Center on Women and ReƟrement Planning, MLT). Since 2007 in Austria, the costs of subsƟtute carers maintained by the Women’s InsƟtute for a Secure replacing care-giving family members can be Įnanced ReƟrement (WISER) to provide user-friendly Įnancial from a Support Fund for Care-Giving Family Members. educaƟon and reƟrement planning tools for low-income In Portugal, it is possible to temporarily hospitaliǌe a

62 Synthesis Report dependent person to allow the caregiver to rest. Israel of the working-age populaƟon, addiƟonal steps will be has development programmes to free up caregivers for necessary to address the gaps that are created due to part of the day or certain periods during the year to migraƟon. enable them to work, study or take holidays. In 2009, the In other countries, the working age generaƟon with their United States began implemenƟng the >ŝĨĞƐƉĂŶZĞƐƉŝƚĞ children is more likely to live separately from grandparents, ĂƌĞWƌŽŐƌĂŵ. This programme brings together Federal, nevertheless maintaining close relaƟonships (e.g. C,E). State and local resources and funding streams to help In such a context, Switǌerland has focused eīorts on support, expand and streamline the delivery of planned developing solidarity in neighbourhoods. The NGO Pro and emergency respite services for persons of any age Senectute, in partnership with a private foundaƟon, while also providing for the recruitment and training of developed a proũect in the canton of Vaud were respite workers. older volunteers are encouraged to assist children in Some countries have also started to assist family carers doing their homework. The award-winning naƟonal by providing them with training (CYP, CZE, ESP, FRA, MLT). programme ǆƉĞƌŝĞŶĐĞ ŽƌƉƐ in the United States has In the Cǌech Republic, the Ministry of ,ealth provided engaged people aged 55 years and older in mentoring, Įnancial resources for the operaƟon of ĂƌŝŶŐ KŶůŝŶĞ͕ providing literacy coaching, homework help and care. an Internet portal that assists family members in caring Independent research has shown that the ǆƉĞƌŝĞŶĐĞ for dependent older persons at home. It is a source of ŽƌƉƐ has boosted student’s academic performance and informaƟon on health and social care, and carers can has helped schools and youth organiǌaƟons operate more consult with professionals regarding speciĮc ƋuesƟons. successfully while also beneĮƟng the well-being of the This proũect was chosen as a good pracƟce example by adults involved. In Portugal, the ƌƌĂŶĚƐ ĂŶĚ ŽŵƉĂŶǇ the EU. Similar proũects exist in Spain and in Germany, proũect aims to create an intergeneraƟonal social support where Internet-based psychological counselling is network through the establishment of local networks of oīered to family carers of older persons. In some young volunteers to support older people living alone in countries family carers may also be eligible to receive their daily acƟviƟes. cash beneĮts (NK, ESP, IRL, ISL, MLT, RUS, UKR) or tax CommuniƟes are playing an increasingly important role. deducƟons (CAN, RUS). Poland, in its Đƚ ŽŶ &ĂŵŝůǇ The Austrian ƵĚŝƚ ŽĨ &ĂŵŝůǇͲĨƌŝĞŶĚůǇ DƵŶŝĐŝƉĂůŝƟĞƐ ĞŶĞĮƚƐ, allows a nursing beneĮt for family members supports processes to develop family-friendly measures who resign from gainful acƟviƟes. In enmark, persons in municipaliƟes and formally recogniǌes their successful in the labour market caring for a person severely in need implementaƟon. In Serbia, the naƟonal branch of the of care can be employed by local authoriƟes to do home Red Cross has a proũect to care for older persons in local care for that relaƟve. Since 2008, Austria pays 100 per communiƟes. The Serbian government also established a cent of the pension insurance contribuƟons of family ^ŽĐŝĂů/ŶŶŽǀĂƟŽŶƐ&ƵŶĚ which in 2007 to 2010 supported members no longer covered by pension insurance due 117 proũects in the area of home assistance, day care to the provision of domesƟc care services to a long- centres and clubs for older persons. Even though the term care beneĮt recipient. Other countries also take community care sector has received increasing aƩenƟon, into account periods of unpaid care for children and old this seems to be an area that needs to be further family members for the calculaƟon of the pension (e.g. developed, with more solid informaƟon needed about NOR). In France, a 2010 reform contains elements to funcƟoning models that could be replicated across the beƩer take into account part-Ɵme work, maternity leave, region. family solidarity leave and family support and care for the calculaƟon of the pension. 2.11 Commitment 10 ͗ To promote the implementaƟon and ĨolloǁͲup oĨ the Regional Organiǌing care for older persons within the ImplementaƟon Strategy through regional cooperaƟon mulƟgeneraƟonal family is a strong value in some countries (ARM, MA, UKR). ,owever, in Ukraine, Many UNECE Member States have been acƟve supporters mulƟgeneraƟonal households bearing a double of the MIPAA/RIS process from the beginning. They have burden of caring for children and older persons also parƟcipated in the Įrst review and appraisal of MIPAA/ bear an increased risk of poverty. The situaƟon of RIS, which culminated in the adopƟon of the >ĞſŶ mulƟgeneraƟonal households living in rural areas is ĞĐůĂƌĂƟŽŶ at the Ministerial Conference in Leſn, Spain especially dire. In addiƟon, high levels of migraƟon in 2007. Since the creaƟon of the UNECE Working Group strain capaciƟes to provide within-family care. This is on Ageing in 2008, Member States have been regularly especially obvious in the Republic of Moldova where parƟcipaƟng in its meeƟngs and have been commiƩed high levels of work emigraƟon have modiĮed tradiƟonal to making contribuƟons towards implemenƟng its capaciƟes of families to oīer primary assistance. programme of work. Many countries have provided good FreƋuently, grandparents become the primary care givers pracƟce examples for the policy briefs, and Armenia and to grandchildren, neglecƟng their own need for care. the Republic of Moldova have engaged in developing ZŽĂĚ In response, the country has tried to reinvigorate the DĂƉƐ ŽŶ DĂŝŶƐƚƌĞĂŵŝŶŐ ŐĞŝŶŐ. Special commitment role of the family. ,owever, given the economic needs was shown by the members of the Bureau of the Working

63 ŶƐƵƌŝŶŐĂ^ŽĐŝĞƚǇĨŽƌůůŐĞƐ͗WƌŽŵŽƟŶŐƋƵĂůŝƚǇŽĨůŝĨĞĂŶĚĂĐƟǀĞĂŐĞŝŶŐ

Group on Ageing, under the leadership of the chairs and experiences into internaƟonal policy-making forums. from Slovakia and, later, Austria and the co-chair from The NaƟonal FederaƟon of Senior CiƟǌens in Iceland is Armenia. AŌer the government of Spain, which hosted a case in point. It serves as an umbrella body for more the Ministerial Conference on Ageing in 2007, now the than 52 socieƟes operaƟng within the country. The government of Austria has oīered to host the Ministerial FederaƟon is a member of the European federaƟon Conference in Vienna, in September 2012. Several AGE that comments on European Commission and member governments have invited the Bureau of the European Parliament iniƟaƟves. Civil society views Working Group to meet in their countries (BEL, ESP, MLT). play a prominent role during Ministerial Conference Several countries have supported MIPAA/RIS acƟviƟes in Vienna, which is preceded by an NGO forum that by giving extra-budgetary funds to the trust fund of the culminates in the adopƟon of an outcome document. UNECE Working Group on Ageing, and Germany made This document is taken into account when negoƟaƟng a special commitment, Įnancing a ũunior professional the outcome document of the UNECE Ministerial oĸcer post during three years. UNECE Member States Conference. ScienƟsts have been eƋually important have parƟcipated in capacity building seminars organiǌed partners in providing inputs into the internaƟonal in collaboraƟon with the governments of the Cǌech policy discourse. Some countries have beneĮted from Republic and Israel. internaƟonal support in collecƟng data (e.g. ARM, MA). Overall the Working Group on Ageing has established Several countries have been acƟve parƟcipants of the itself as a much-valued mechanism in facilitaƟng 'ĞŶĞƌĂƟŽŶƐ ĂŶĚ 'ĞŶĚĞƌ WƌŽŐƌĂŵŵĞ (GGP), consisƟng implementaƟon of MIPAA/RIS. It has provided the of a panel survey on relaƟonships between parents and framework for the present second review and appraisal. It children (i.e. generaƟons) and partners (i.e. gender) and is therefore well posiƟoned to facilitate implementaƟon of a context database collecƟng informaƟon about the MIPAA/RIS in the follow-up to the Ministerial Conference policy environment within a country (AUT, BEL, BGR, EST, ͞Ensuring a Society for All Ages: PromoƟng Ƌuality of life EU, FRA, GEO, LTU, ,UN, ITA, NL, NOR, ROU, RUS). and acƟve ageing͟ in Vienna, Austria (September 2012). The importance of data collecƟon and research was acknowledged with the Research Forum that preceded Beyond the integraƟon into the UNECE framework, the Ministerial Conference. Its outcome document was countries are engaged in a mulƟtude of internaƟonal taken into account for the discussion of the Ministerial collaboraƟon. Some countries have taken part in the Conference. Open ended Working Group on Ageing, established by the General Assembly with resoluƟon 65/182 in 2010 3. CONCLUSIONS AND THE WAY (CAN, NK, LUy , NL, USA). For Member States and FORWARD those wishing to accede, the European Union is an Countries have reported progress on MIPAA/RIS important framework of reference. Countries in Eastern implementaƟon since 2007 in many areas across all Europe and Central Asia have beneĮted from assistance commitments. There have been visible eīorts to improve received through UN oĸces such as UNFPA, UNP or UN the normaƟve framework to promote mainstreaming ESA. The InternaƟonal InsƟtute on Ageing in Malta, a ageing. The challenge now is to implement this policy UN aĸliate, has provided capacity building on MIPAA/ framework (ARM, IRL, MA, MK, SVN, UKR). Some RIS topics. Countries have also collaborated with the countries plan to further work on mainstreaming ageing- European Centre for Social Welfare Policy and Research related policymaking and on revising and improving in Vienna, which has a Memorandum of Understanding naƟonal legislaƟon to be more sensiƟve to maƩers with the UNECE. related to ageing (e.g. UKR, T:K). A maũority of countries Some of the more economically advanced countries has a well-developed civil society infrastructure in place in the region have reached out to its other members, to represent the interest of older persons – even though oīering capacity-building. Austria, for example, has available Įnancial means to support civil society may be organiǌed know-how transfer events with expert perceived as too liƩle (e.g. SVN). Several countries have seminars taking place in Vienna for delegaƟons from enhanced insƟtuƟonal capaciƟes by creaƟng relevant the Russian FederaƟon, CroaƟa, Turkey and the Republic structures, such as commissions or councils that discuss of Moldova. Austria has also posted AƩachĠs for Social ageing from a cross-cuƫng perspecƟve. ,ere again, Aīairs in CroaƟa, Serbia, Bosnia and ,erǌegovina, the the challenge is to achieve a coordinated approach that Former Yugoslav Republic of Macedonia and the Republic sustainably drives and directs policy acƟon and takes of Moldova with the aim of sharing knowledge. into account the views of all stakeholders, including civil society and older persons themselves (ARM, MA). Across the region, there is a vibrant civil society comprising organiǌaƟons that provide services at the Another challenge is to maintain the sustainability of grass-roots level and NGOs directed towards represenƟng public Įnances to uphold commitments made. Overall, interests and inŇuencing policy-making. Many of the the economic and Įnancial crisis has had serious impacts organiǌaƟons operaƟng naƟonally are also acƟvely on ageing-related policymaking in the region. Countries engaged in internaƟonal networks, feeding their opinions have struggled to uphold their ongoing obligaƟons in

64 Synthesis Report social and pension payments but have generally made it example with regards to longer working lives. ,owever, a priority not to cut measures that are meant to protect percepƟons do not change from one day to another the most vulnerable from the conseƋuences of the and so this will remain an important challenge for the crisis. Economic strategies have aimed at stabiliǌing the countries in the region (AUT, CZE, IRL, MA, MLT). economic situaƟon in general, to create sustainable and To create incenƟves to stay in work longer, several eƋuitable growth, and to reduce poverty (ARM, BEL, CAN, countries have increased their reƟrement age and CYP, ISR, LTU, MA, MK, NOR, SRB, T:K, UKR). Overall, abolished incenƟves for early reƟrement. Reforms to towards the end of the reporƟng period, the economic create pension and social protecƟon systems that are outlook across the region seems already slightly more sustainable and eƋuitable for all generaƟons and that opƟmisƟc. ,owever, for a number of countries migraƟon ensure minimum subsistence levels and avoid poverty remains a maũor ongoing challenge (ARM, LTU, MA). in old age have been key areas of acƟvity. Carrying Some areas are of parƟcular concern to Member States. through and implemenƟng reforms iniƟated during the For example they freƋuently prioriƟǌe health and care reporƟng period to ensure adeƋuate and secure income provisions for their future acƟviƟes (BLR, CAN, FIN, in reƟrement featured prominently among the future MK, POL, SRB). Member States will conƟnue to strive tasks listed (BLR, CAN, CZE, ESP, FIN, GBR, LTU, MA, towards beƩer integraƟon and coordinaƟon of health MK, NL, SRB, T:K, UKR). and social services (CYP, CZE, MA, SVN, UKR, USA). Closely related is the focus on developing labour market Providing access to aīordable and Ƌuality health and and employment strategies that reŇect the new realiƟes social services is an important challenge. Therefore, the of ageing socieƟes (AUT, BLR, GBR, ISR, LTU, MA, MK, Įnancial sustainability of the health and social care sector NL, NOR, PRT, SRB, SWE). Among the priority areas is of utmost importance to uphold service provision. are measures encouraging employees to work longer – In addiƟon, countries aim to further build up targeted including measures to increase the reƟrement age – as care services and to reĮne them so they correspond to well as providing incenƟves, including Įnancial ones, for individuals’ needs, building upon the principles of self- employers to keep older persons employed or to newly determinaƟon and self-management of older paƟents employ older people who are seeking ũobs. Countries (AUT, CZE, NK, SWE, UKR, USA). Enabling older persons have reported eīorts towards adapƟng workplaces to to live independently for as long as they can has been the needs of older persons (CZE) or to adopt Ňexible a priority declared by many. IllustraƟng broad support work schedules that allow for the combining of work with for concepts such as ageing in place, home-based care training and conƟnued educaƟon (BEL). and domiciliary services will be further strengthened as will be informaƟon accessibility with regards to available Several countries have worked on strategies for lifelong services (BEL, CAN, ISL, ISR, SWE, USA). Challenges are learning to keep the ageing workforce well-adũusted found parƟcularly with regards to supporƟng informal to changing realiƟes in the workplace, although care givers, especially in the family (AUT, ISL, MLT). Eīorts implemenƟng such strategies remains a challenge in have to be made to achieve inclusion and parƟcipaƟon some places where it has been diĸcult to uphold this area of older persons with reduced mobility, to allow them to against other prioriƟes. ,owever, many of the reports maintain social Ɵes and to address the issue of loneliness agreed that improving the computer literacy of older (MLT, NOR, POL). Member States are planning to expand persons should be a priority to enhance connecƟvity and community-based services, both in terms of making them provide access to the advantages of modern informaƟon available in more regions, including remote areas, and in and communicaƟons technologies (BEL, GBR, MLT, SRB). terms of extending hours and scope of services (e.g. ISR, Some countries have paid special aƩenƟon to gender- MA, SRB, SVN, USA). Several countries intend to further related acƟviƟes to achieve more eƋuality in addressing develop and diversify the volunteer sector (BEL, CZE) to the speciĮc situaƟon of women oŌen living longer than enhance social inclusion. men and performing a considerable part of the care An area of special aƩenƟon will be to design integrated responsibiliƟes. Further work on Įnding soluƟons to models of long-term care (IRL). At the same Ɵme, countries reconcile work and family responsibiliƟes, including care agree that strategies to further explore the opportuniƟes for older family members, is recogniǌed as important of e,ealth and use of modern technology are important (BEL, SVK). (AUT, CZE, NK, GBR, IRL, SWE). Countries subscribe to Several countries have seen a need to further enhance the need for health promoƟon and disease prevenƟon monitoring and evaluaƟon of MIPAA/RIS and ageing programmes, improving the social determinants of policies in their countries. They point to a need for health (BEL, IRL, LTU, MA, POL, USA). beƩer indicators and would like to improve policymaking A few countries have menƟoned measures to avoid based on evidence. Overall, the most professional way violence and abuse (CAN, SWE). Several countries will to develop targeted programmes is to base them on invest more in awareness raising, in combaƟng ageism scienƟĮc insight. More work is certainly needed to and old age stereotypes and in changing aƫtudes, for enhance the collecƟon of gender and age-disaggregated

65 ŶƐƵƌŝŶŐĂ^ŽĐŝĞƚǇĨŽƌůůŐĞƐ͗WƌŽŵŽƟŶŐƋƵĂůŝƚǇŽĨůŝĨĞĂŶĚĂĐƟǀĞĂŐĞŝŶŐ data and to increase the evidence base for pracƟcal as the coordinaƟon of acƟviƟes within the framework proũects in diīerent areas (ARM, IRL, MA, MK, NOR, of internaƟonal organiǌaƟons. Considerable exchange is RUS, SRB). Slovenia concretely outlined a scienƟĮc taking place within the European Union. The UNECE, in agenda which includes establishing a database for the turn, remains an important forum for the cooperaƟon monitoring of long-term care services and expenditures, of EU Member States and other countries in the region analysing home-based care provided by public services, as emphasiǌed by some countries (ARM, LTU, MA). The and studying the acƟve inclusion of older persons in need for further capacity building in some areas relaƟng the framework of the ƵƌŽƉĞĂŶ zĞĂƌ ĨŽƌ ĐƟǀĞ ŐĞŝŶŐ to strategy development and the implementaƟon of ĂŶĚ ^ŽůŝĚĂƌŝƚǇ ďĞƚǁĞĞŶ 'ĞŶĞƌĂƟŽŶƐ in 2012. Several exisƟng programmes and acƟon plans is stressed (e.g. other countries have menƟoned their focus on acƟve ARM, MK). Overall, countries are commiƩed to further ageing, reŇecƟng the current emphasis on the topic in implemenƟng MIPAA/RIS. Acknowledging the challenges the framework of the ƵƌŽƉĞĂŶzĞĂƌ (AUT, ESP, GBR, PRT, within their countries, they express strong support for SVN). the regionally coordinated MIPAA/RIS process, the next In general, countries acknowledge the importance phase of which will be shaped by the decisions made at of conƟnuous cooperaƟon between countries in the the UNECE Ministerial Conference ͞Ensuring a Society for region in sharing experience and best pracƟces, as well All Ages: PromoƟng Ƌuality of life and acƟve ageing͟.

66 Synthesis Report

Table 2͗ NaƟonal reports considered in the Synthesis Report on the implementaƟon of the Madrid InternaƟonal Plan of AcƟon on Ageing in the UNECE Region COUNTRIES Language of report AddiƟonal material provided Armenia (ARM) English No Austria (AUT) English, German AcƟvity examples Azerbaijan (AZE) Russian No Belarus (BLR) Russian No Belgium (BEL) French Indicators Bulgaria (BGR) Bulgarian, English No Canada (CAN) English No Cyprus (CYP) English No Czech Republic (CZE) English Good pracƟce examples, EĂƟŽŶĂůWƌŽŐƌĂŵŵĞŽĨWƌĞƉĂƌĂƟŽŶĨŽƌ ŐĞŝŶŐĨŽƌϮϬϬϴʹϮϬϭϮ Denmark (DNK) English No Finland (FIN) English No France (FRA) French Good pracƟce examples Germany (DEU) German No Iceland (ISL) English No Ireland (IRL) English Indicators, acƟvity examples Israel (ISR) English No Italy (ITA) English Indicators Latvia (LVA)Ύ English Indicators Lithuania (LTU) English Indicators Luxembourg (LUy)Ύ French No Malta (MLT) English Indicators Netherlands (NDL) English AcƟvity examples, elaboraƟon of policies Norway (NOR) English EŽƌǁĞŐŝĂŶ^ŽĐŝĂů^ĞĐƵƌŝƚǇĂŶĚ>ĂďŽƵƌDĂƌŬĞƚ/ŶĐůƵƐŝŽŶWŽůŝĐŝĞƐ Poland (POL) English AddiƟonal explanaƟon of insƟtuƟonal seƫng Portugal (PRT) English Indicators Republic of Moldova MDA) English Indicators, informaƟon on laws and policies Romania (ROU)Ύ English Indicators Russian FederaƟon (RUS) English, Russian No Serbia (SRB) English Indicators, EĂƟŽŶĂů ^ƚƌĂƚĞŐǇ ŽĨ ŐĞŝŶŐ ŝŶ ^ĞƌďŝĂ͕ ŶƟͲ ĚŝƐĐƌŝŵŝŶĂƟŽŶ >Ăǁ͕ ^ŽĐŝĂů tĞůĨĂƌĞ >Ăǁ, informaƟon on ageing- related research, ĐƟǀĞĂŐĞŝŶŐĨƌĂŵĞǁŽƌŬĨŽƌ^ĞƌďŝĂ Slovakia (SVK) English No Slovenia (SVN) English No Spain (ESP) English Indicators Sweden (SWE) English No Switzerland (CHE) English No Tajikistan (TJK) Russian List of laws The former Yugoslav Republic of English No Macedonia (MKD) Turkey (TUR)Ύ English No Ukraine (UKR) English, Russian Indicators United Kingdom of Great Britain English No and Northern Ireland (GBR) United States of America (USA) English No (Ύ) Not included in the text of the ^ǇŶƚŚĞƐŝƐZĞƉŽƌƚdue to late submission. Main challenges and achievements included in Table 1, page 50.

67 ŶƐƵƌŝŶŐĂ^ŽĐŝĞƚǇĨŽƌůůŐĞƐ͗WƌŽŵŽƟŶŐƋƵĂůŝƚǇŽĨůŝĨĞĂŶĚĂĐƟǀĞĂŐĞŝŶŐ

STATISTICAL ANNEX UNECE COUNTRIES͗ POPULATION AGEING IN FIGURES

In their review and appraisal of developments since Some observaƟons on the current status and changes the Madrid InternaƟonal Plan of AcƟon on Ageing and since 2000 its Regional ImplementaƟon Strategy (MIPAA/RIS) were ĞŵŽŐƌĂƉŚŝĐĚĞǀĞůŽƉŵĞŶƚƐ adopted in 2002, and in parƟcular during its second implementaƟon cycle (2007-2012), countries marked ͻ In 2012, the number of people aged 65 years or the posiƟve changes, determined areas for improvement above reached 174.5 million and presently accounts and idenƟĮed emerging issues that must be addressed in for 14.1 per cent of the region’s total populaƟon. This an intergeneraƟonally balanced way in the coming years. proporƟon is expected to exceed 20 per cent by 2030 Overall, the reports showed that UNECE Member States (table A1). In Germany and Italy, a ĮŌh of populaƟon was will be entering into the third cycle of implementaƟon 65 years old or above already in 2010, and is projected of MIPAA/RIS with a disƟnct awareness of the enduring to reach over a Ƌuarter by 2030. This will also be the demographic change and with an increasing recogniƟon case in Austria, Finland and Portugal. Out of eight UNECE of both challenges and opportuniƟes that populaƟon countries where presently the proporƟon of people ageing generates in the region. aged 65 years or above is below 10 per cent, only four are projected not to breach this threshold by 2030 Many countries supplemented their naƟonal reports (Kyrgyzstan, Tajikistan, Turkmenistan and Uzbekistan). on MIPAA/RIS implementaƟon with some factual informaƟon and staƟsƟcs on demographic change, labour ͻ The proporƟons of older olds о 80 years or above о market developments, health and social care services, are also set to rise: this age group will account for more and volunteering by older people. Such informaƟon is than 5 per cent of UNECE populaƟon by 2030, and in a valuable complement, but due to diīerences in the Austria, Finland, France, Germany, Italy, Sweden and coverage and non-comparability of the data provided, Switzerland it will exceed 7 per cent. it was not possible to refer to it in a consistent manner ͻ The median age of populaƟon in the UNECE region in the Synthesis of the naƟonal reports. At the fourth increased from 35.4 years in 2000 to 37.6 years in 2010 meeƟng of the Working Group on Ageing, the UNECE and is projected to reach 41.8 years by 2030. If in 2000 secretariat’s iniƟaƟve to provide a more consistent the median age was slightly above 40 years only in Italy, staƟsƟcal annex on selected indicators to the Synthesis nowadays this is the case in more than twenty UNECE Report was endorsed. countries, while it remains at or below 30 years in only Apart from the main demographic staƟsƟcs (tables eight countries. A1-A4), this annex includes data on indicators broadly ͻ In 2000-2010, some slowdown in the pace of reŇecƟng certain aspects of the three main topics of the populaƟon ageing was characterisƟc for countries with 2012 Ministerial Conference on Ageing: WƌŽŵŽƟŶŐůŽŶŐĞƌ older populaƟon structures, while it sped up markedly in ǁŽƌŬŝŶŐůŝĨĞĂŶĚŵĂŝŶƚĂŝŶŝŶŐǁŽƌŬĂďŝůŝƚǇ(tables A5-A7), ͞younger͟ countries (Azerbaijan, Turkey and Uzbekistan). WĂƌƟĐŝƉĂƟŽŶ͕ ŶŽŶͲĚŝƐĐƌŝŵŝŶĂƟŽŶ ĂŶĚ ƐŽĐŝĂů ŝŶĐůƵƐŝŽŶ ͻ The average total ferƟlity rate in the UNECE region ŽĨ ŽůĚĞƌ ƉĞƌƐŽŶƐ (tables A8-A10), ƌĞĂƟŶŐ ĂŶ ĞŶĂďůŝŶŐ dropped to a low of 1.7 children per woman in 2000 ĞŶǀŝƌŽŶŵĞŶƚ ĨŽƌ ŚĞĂůƚŚ͕ ŝŶĚĞƉĞŶĚĞŶĐĞ ĂŶĚ ĂŐĞŝŶŐ ŝŶ (table A2). In the last ten years, ferƟlity rates marginally ĚŝŐŶŝƚǇ(tables A11-A12). The annex is mainly based on recovered in a number of countries, the average for the data available from UN and other internaƟonal databases region reaching just below 1.8 children per women by (UNDESA PopulaƟon Division, UNECE gender database, 2010. InternaƟonal Labour OrganizaƟon, World Bank, World Health OrganizaƟon, and Eurostat). To illustrate changes ͻ Presently, the total ferƟlity rate is below the over the two cycles of MIPAA/RIS implementaƟon, replacement level (2.1 children) in 45 UNECE countries. In staƟsƟcal data are provided for the years 2000, 2005 18 of those countries the rate remains under 1.5 children and 2010 whenever possible. The coverage of countries per woman. The ferƟlity rates are projected to increase for individual indicators varies, depending on data slightly by 2030, but in most countries they will remain availability and comparability. For a number of indicators well below replacement levels and, with the cohort of the lack of data and/or data disaggregaƟon by gender childbearing women declining in numbers, the impact on and relevant age groups, in parƟcular for countries in the the pace of populaƟon ageing will be rather moderate. Eastern part of the UNECE region, points to a need for ͻ Mortality rates for adults (15-60 years old) beƩer staƟsƟcal coverage of populaƟon ageing at both declined markedly across the region. In 2005-2010, in naƟonal and regional levels. many UNECE countries the mortality rates declined faster

ϲϴ Synthesis Report for adult men, but sƟll remain more than twice as high as was raised and steps were taken to gradually close the the rates for adult women (table A2). gap between men and women in several countries of the ͻ Increases in life expectancy at birth and at the age region (some EU countries, the majority of countries in beyond 65 have been notable across the region in the last the Caucasus and South-Eastern Europe). On the other decade, adding on average three years and nearly a year hand, no changes in reƟrement age were introduced and a half, respecƟvely. The strongest gains in longevity in Belarus, Russian FederaƟon, Ukraine and Uzbekistan for both men and women were reported in Turkey (table since the break-up of the Soviet Union. A3). ͻ In 2009, the statutory reƟrement age of 65 years ͻ The dispariƟes in life expectancy among UNECE or above was in force in 25 UNECE countries for men and countries and between men and women (among and in 14 countries for women. In 21 countries the reƟrement within countries) remain large: at birth, for instance, for age for women was sƟll Įve years lower than that for men they vary from 80.2 years in Switzerland to 62.8 men. years in the Russian FederaƟon, for women, from 85.3 ͻ The eīecƟve reƟrement age, although gradually years in France and Spain to 73 years in Kyrgyzstan. The rising over the last decade, was generally lower than the divide between countries slightly narrowed from that of statutory reƟrement age. However, in a few cases it was 2000, but the recent gains in longevity in many countries a year or two higher for men and two to Įve years higher in the Eastern and South-Eastern part of the region have for women (Bulgaria, Romania). not yet fully oīset the signiĮcant losses in life expectancy, parƟcularly for men, during the 1990s. >ŝĨĞůŽŶŐ ůĞĂƌŶŝŶŐ͕ ǀŽůƵŶƚĞĞƌŝŶŐ ĂŶĚ ƐŽĐŝĂů ŝŶĐůƵƐŝŽŶ ŽĨ ŽůĚĞƌƉŽƉƵůĂƟŽŶ >ĂďŽƵƌŵĂƌŬĞƚƉĂƌƟĐŝƉĂƟŽŶ ͻ Data on lifelong learning and volunteering are ͻ In 2000-2010, labour force parƟcipaƟon rates of scarce and oŌen non-comparable across the region. the older populaƟon increased steadily for the region as whole: in the 55-59 year age group, the rates went up ͻ InformaƟon from EU labour force surveys on by 4.4 percentage points for men and 10.5 percentage formal and informal training shows that in the last points for women, and among those 60 to 64 years old, decade an increasing share of the EU’s older populaƟon by 6.9 and 8.8 percentage points, respecƟvely (table A5). was undertaking training. In general, women were more Slight increases were also observed among men and acƟve in training: in 2010, nearly a third of women in women aged 65 years and older. High gains in labour age group of 55-74 years old parƟcipated in training force parƟcipaƟon among women, in parƟcular in the in Denmark, and between 15-20 per cent in Iceland, 55-59 year age group, in many countries of the region Sweden and Switzerland. Among men in the same age were due to the rise in statutory reƟrement age. In a few group, the highest proporƟon was in Switzerland (18.8 UNECE countries, however, the labour parƟcipaƟon rates per cent), followed by Denmark and Iceland (table A8). of the older populaƟon declined, in some cases markedly ͻ The Ɵme-use surveys conducted in a number of (Republic of Moldova, Romania, Turkey). UNECE countries indicate that men 65-74 years old spent ͻ Unemployment dynamics contrasted sharply up to 35 minutes per week on unpaid acƟviƟes outside between 2000-2005 and 2005-2010 in the majority their households while women in that age group spent of UNECE countries (table A6). In the Įrst part of the up to 51 minutes a week (Poland, table A9). Data from decade, six out of ten countries for which data are other data sources point to a higher freƋuency of older presented reported declines in unemployment among women’s parƟcipaƟon in volunteering acƟviƟes across prime and older age groups. By 2010, however, the the regions. tendency was the opposite: seven out of ten countries reported higher unemployment rates for all age groups ͻ During 2005-2010, a slight decline in the share of in 2010 as compared to 2005. Poland and Germany were older populaƟons facing poverty or social exclusion (in striking exempƟons to the laƩer trend. relaƟve terms, as deĮned by individual countries) was observed in the UNECE region. However, about two in ͻ In 2010, in a number of UNECE countries ten countries reported rises in the share for those aged unemployment rates for those 55-59 years old reached 75 years and above. The incidence of poverty and social double digits and oŌen were markedly higher for men exclusion was more freƋuent among older women than than women. Unemployment rates of those 60 years and older men in all three age groups referred to in table A10. older were in general below those of younger groups in 2010, even though they were double the level of 2005 in ,ĞĂůƚŚ͕ŝŶĚĞƉĞŶĚĞŶƚůŝǀŝŶŐĂŶĚĂŐĞͲƌĞůĂƚĞĚĞǆƉĞŶĚŝƚƵƌĞ a number of countries. ͻ More people in the UNECE region not only live ͻ Changes in labour force parƟcipaƟon among older longer, they also remain in relaƟvely good health. Health- populaƟon groups and to a certain degree unemployment adjusted life expectancy at age 65 and beyond accounts rates among them reŇect changes in labour market for more than a half of total life expectancy for men and policies. During 2000-2010, the statutory reƟrement age is slightly below 50 per cent for women.

ϲϵ ŶƐƵƌŝŶŐĂ^ŽĐŝĞƚǇĨŽƌůůŐĞƐ͗WƌŽŵŽƟŶŐƋƵĂůŝƚǇŽĨůŝĨĞĂŶĚĂĐƟǀĞĂŐĞŝŶŐ

ͻ The diīerence in healthy life expectancy between ͻ The proporƟon of older populaƟon beneĮƫng men and women is much less pronounced than for life from home care is on average at least twice as high as that expectancy in general. In fact, in a number of EU countries of persons in insƟtuƟonal care. In Denmark, a Ƌuarter of health-adjusted life expectancy is slightly higher for men 65-79 years old persons were provided with home care than for women, while in the Eastern and South-Eastern services while about 5 per cent were in insƟtuƟonal care. part of the region men’s health-adjusted life expectancy In Iceland, Netherlands and Norway, home care services is markedly shorter than that of women (i.e. Russian were provided for a ĮŌh of the populaƟon in that age FederaƟon, Belarus, Ukraine, see table A4). group in 2005-2007. Home care was less available in most countries in the East and South-Eastern parts of ͻ About one in seven men and women at the age the UNECE region͖ it is also much less developed in many of 65-79 live in a single-person household in the UNECE Eastern EU countries. countries represented in table A5. The proporƟon is higher than 20 per cent for the older olds (80 plus years old). In ͻ Total old-age related expenditure as a proporƟon nearly one out of three countries the share of women of GDP has increased with a few excepƟons across 80 years and older living in a single-person household the region in recent years. In 2009, in four out of ten accounts for more than 25 per cent (in Norway, Denmark reporƟng countries total old-age expenditures accounted and Germany, more than 30 per cent, see table A11). for 10 per cent or more of GDP. Currently old-age related expenditure accounts for about a half of all social beneĮts in Italy, Poland and Romania and varies between 30 and 45 per cent in most EU countries (table A12).

ϳϬ