Swedish European Presidency Conference
Dementia was highlighted during the Swedish Presidency at the onference on healthy and dignified ageing (September 2009). The motto of the Presidency was 'Taking on the challenge'.
The Swedish Presidency Conference on healthy and dignified ageing took place in Stockholm from 15 to 16 September 2009 and brought together representatives of ministries and civil society from 27 European countries. Jean Georges, Executive Director of Alzheimer Europe, reports on the two-day Conference.
Promoting dignity across Europe
A key goal of the Swedish Presidency of the European Union was to promote the dignity and quality of life for elderly persons in Europe and a conference was dedicated to this subject in order to explore how to enhance the cooperation and coordination between the health and social sectors at EU, national and regional level.
Maria Larsson, Swedish Minister for Elderly Care and Public Health, opened the conference by stressing how our perceptions of age had undergone profound changes over time and that the ageing of European populations would lead to an increased demand for social care. All European healthcare systems, said Ms Larsson, are therefore faced with the challenges of how best to promote health, whilst at the same time providing high quality services respecting the dignity and individual wishes of people in poor health. She stressed that “Europe can deal with the challenges of an ageing population”.
Jérôme Vignon, Director, DG Employment, Social Affairs and Equal Opportunities, European Commission, welcomed the Presidency initiative to dedicate a conference to healthy and dignified ageing and reminded the audience of previous EU Presidencies which had highlighted similar themes, such as the Luxembourg Presidency’s focus on the economic, social and ethical aspects of long term care, the Slovenian Presidency Conference on intergenerational solidarity or the French Presidency initiatives in the field of Alzheimer’s disease and related disorders.
Having been commissioned by the Swedish Presidency to prepare a discussion paper for the conference, Mr Bernd Marin, the Executive Director of the European Centre for Social Welfare Policy and Research presented the key findings of the “Who cares?” report. His first observation was that elderly care or long term care are relatively new areas of interest that are only now emerging. It has unclear boundaries and a high degree of fragmentation between the health care sector and social care. There are also huge differences between Member States as to the scope and quality of services.
Within the EU, only 3.3 percent of elderly persons live in residential housing, whereas the US has a much higher percentage of people in institutions. Europe also has a very high degree invested in home help and home health care. The coverage of institutional care is not increasing in any European country. At the same time, the 3.3 percent of persons living in residential care take up more than half of available resources and Bernd Marin questioned the sustainability of this allocation of resources in the long term.
Another topic that he dealt with in his presentation was about carers, both formal and informal. To an increasing extent there is a shortage of skilled care workers. Without the important work that family members and friends are doing, he stressed that systems could break down. He also highlighted the growing black market in social care, with hundreds of thousands of migratory workers travelling from the eastern regions of Europe working in families as carers and this in many cases without working permit, regulated working hours or pension rights.
Despite these disparities between European countries, he concluded that “it is obvious that countries could learn a lot from each other – and also from other parts of the world. Even comparatively poor countries may devote a lot of resources and have innovative ideas for the elderly care sector.”
Focus on dementia
Quoting the recently released prevalence figures of the “European Collaboration on Dementia – EuroCoDe” project, Prof. Bengt Winblad, Director of the Alzheimer’s Disease Research Center of the Karolinska Institutet highlighted the need to include the 7.3 million Europeans living with a form of dementia in our discussions on dignified ageing.
In particular, he felt that the recently adopted national guideline for good dementia care in Sweden provided some important pointers on how to develop a “caring philosophy” which is person-centred and where staff competencies and staff conditions are key to promote diagnostic and prognostic thinking in order to avoid future complications. Presenting some of the latest research with regard to prevention and treatment of Alzheimer’s disease and other dementias, he concluded by calling for more European investments in dementia research and the need to reducing the gap and time between research and clinical practice.
A number of parallel workshops were organised during the conference with one focusing specifically on Alzheimer’s disease. This workshop was chaired by Florence Lustman, the coordinator of the French Alzheimer’s Plan who reminded the audience that the true number of people affected by dementia in the European Union was 19 million people, when you included the carers and family members of people with dementia.
During the workshop, Nick Fahy, Head of Unit for Health Information at the European Commission, presented the four pillars of future European action on dementia which will focus on prevention and early diagnosis, better coordination of European research, exchange of good and best practices in the field of care and collaboration on ethics and fundamental rights of people with dementia. A more detailed presentation of the Commission initiative can be found on pages XX to XX of this edition of the Dementia in Europe Magazine.
Sylvie Legrain , Professor of geriatrics at Hôpital Bretonneau, provided a report on the peer-review organised by the European Commission and hosted by France on the subject of how best to deal with behavioural problems at home. The key recommendations resulting from this exchange between Member States concerned the role of general practitioners and the need for better training of health care professional, better information to informal carers and campaigns to address the stigma perceived by society. A fuller presentation of the peer review process can be found on pages XX to XX of this magazine.
I outlined some of the findings of Alzheimer Europe’s Lawnet and Eurocode projects which had highlighted differences between European countries in social support systems or the legal protection of people with dementia and had identified some existing best practices in this field. To improve the autonomy and self determination of people with dementia, I highlighted the clear need for closer collaboration between Member States on care approaches and social support systems, as well as on the legal and ethical aspects of dementia. Thanks to the support of the German Ministry of Health, Alzheimer Europe was able to start with the development of a European Ethics Network which is presented in more detail on pages XX to XX of this magazine.
Dementia knows no borders
The second day of the conference was opened by a highly personal testimony of H.M. Queen Silvia of Sweden who recounted how her mother, diagnosed with Alzheimer’s disease, turned to her complaining “I forgot my life”. She stressed that at the time of diagnosis 15 years ago, little training was provided for professional carers which gave her the vision of creating “Silviahemmet”, a foundation which provides training programmes for nurses and assistant nurses in dementia care. The guiding philosophy of any care, she said, should be the best quality of life for the person with dementia and the family throughout the whole disease. According to H.M Queen Silvia, dignity is not just about treatment, but about attitudes and she concluded that “informal carers also require recognition and support for their own health and quality of life, which I appreciate from my own experience”.
During the high-level round table discussion at the close of the conference, Maria Larsson thanked the Queen for sharing her personal experience and convictions. With elderly care already representing over 50% of healthcare budgets, all European societies are faced with the challenge of how to expand this sector whilst improving the quality of care at the same time. The Swedish Minister underlined that this would only be possible by adopting a preventive approach aimed at promoting health, by enhancing the collaboration between the health and social sectors and through a stronger focus on the individual by increasing free choice and finding ways for older people to influence their own lives. Her aspiration was to “put elderly issues permanently on the EU agenda”.
Further challenges and opportunities were identified by the other participants in the round table. Mr. Marian Hosek, Deputy Minister of Labour and Social Affairs of the Czech Republic, focused on the growth of the labour market in the social care field with an increasing demand for skilled staff and the need to review existing education systems to promote possibilities for requalifications and life-log learning. He believed that particular attention should also be paid to the use of new technologies as an important part of comprehensive solutions for care of the elderly.
Ms. Melinda Medgyaszai, Hungarian Secretary of State for Health, emphasised the lack of communication between health and social sectors and called for social care knowledge to be included in medical education, to find ways of better valuing social care professions and a better recognition of geriatrics as an important medical specialty.
Reiterating the fact that an ageing society represents an economic opportunity, Ms. Lenia Samuel, Deputy Director-General of DG Employment, social affairs and equal opportunities of the European Commission described the care sector as an important growth factor for employment with 82% of new jobs in this sector having been taken by women and jobs being less dependent on the fluctuations of the economy. At the same time, she recognised that access for all to high quality care, with a preference for home care or care in the community, remains problematic.
Speaking on behalf of the forthcoming Spanish EU Presidency, Ms. Pilar Rodríguez, Director General of the Institute for the Elderly and Social Services (IMSERSO), promised a continuation of the focus on elderly issues at a European level during the next year. She highlighted some of the recent initiatives of the Spanish government to promote the dignity of elderly in her country, such as the introduction of a law on personal autonomy and a long-term care dependency system, a campaign to break social isoltation of the elderly and an outreach programme for rural areas. She informed us of a White Paper on the elderly which is currently under preparation and will be presented during a Spanish Presidency Conference.
Mr. Fabrice Heyriès, Director General at the French Ministry of Health, presented some of the key innovations introduced through the French Alzheimer’s Plan and highlighted the development of a common European research agenda on Alzheimer’s and the use of the open method of coordination and peer reviews as key elements for the definition of a common European basis for standards and principles in the field of elderly and dementia care.
Thanking her colleagues, Maria Larsson expressed her great satisfaction with the fruitful discussions of the previous two days and concluded the conference with the statement that “there is a need for strengthened collaboration on ageing”.
Last Updated: vendredi 14 décembre 2012