On October 31st, took place the international conference on elderly population with the title: “The Elderly Condition in the Balkans and Eastern Europe: Challenges and Opportunities”, organized by the Roman Academy of Public Health (RAPH) and dedicated to an important topic for health and social policies in almost every country: "Global population ageing and implications for the development of models of health and social services that are efficient, sustainable and responsive to the needs of this segment of the population".
The 19th century saw the beginning of an epochal transformation first in Europe and then throughout the planet, which is the demographic transition. Its consequences - a substantial growth of populations and life expectancy - have finally manifested in the emergence of a real demographic continent, that of old age. From a residual minority, the third age has become a mass season, which can be reached and experienced by the most citizens. Because of this new phenomenon, there has been a lack of thought on the consequences of this transformation, certainly economic and social security consequences, but also social, welfare and anthropological ones. “Reintegration” of elderly is one of the great priorities of our time, so that this long period of our life is lived in the best possible way.
Unfortunately, the demographic situation in the Balkans and Eastern Europe presents critical characteristics, which cause great concern for the future of this European area. In fact, there is a real absolute and relative decrease, linked not only to the decline in birth rates and fertility but also and above all to migration that has reduced the young population. Furthermore, another phenomenon of aging without actual growth in life expectancy is accompanied by high mortality rates, especially among the male population, and a few years of disability-free life expectancy. Poverty issues make the elderly in these countries even more needy, and it is even more urgent to review the old model centered on hospitals and care institutions in favor of a community-based approach.
Therefore, the foundation of the first RAPH region outside Italy aims to take up this great challenge by creating a collaborative network between universities and European institutions to address the issue of an ageing of Eastern Europe and the Balkans in dignified and healthy conditions, with a sustainable, integrated and holistic approach. The long-term goal is to build a movement that protects and enhances the role of the elderly in society, developing an original approach that does not consider aging as a cost, but as a strategic resource for the progress of each nation.
The vision is inspired by a Charter of Rights and Duties of Older People, designed to promote active aging and support the inclusion of the elderly in a context of recognized rights, active participation and acceptance of community duties towards the generations that preceded us.
Participation, sharing and discussion of challenges and experiences from different Eastern European countries represent a fundamental initial contribution to promote progress towards common solutions and innovative strategies, aimed at improving the effectiveness and sustainability of health and social services dedicated to the elderly population. Below are some key points for further discussion and exploration from each country/presentation:
Albania
- Community-based support systems: Establishing strong community support networks is essential to address social isolation among the elderly population. Programs that promote social inclusion and help with daily activities can significantly improve the quality of life of the elderly.
- Integrating elderly care into national policies: It is essential to incorporate elderly care into national health and social policies. This includes ensuring that health systems are adequately equipped to respond to the specific needs of the elderly population, promoting prevention and improving access to geriatric services.
- Training for caregivers: Providing comprehensive training to professional and family caregivers is vitally important. This training should focus on geriatric care practices, communication skills, and understanding the unique challenges the elderly population face, to ensure they receive appropriate and compassionate care.
Armenia
- Importance of sustainable demographic policies: Armenia's strategy emphasizes the need for balanced and sustainable demographic policies to address the challenges posed by population ageing and declining birth rates. This highlights the need for proactive measures to ensure demographic stability and social well-being.
- Addressing the challenges of migration: The significant net population loss due to migration in Armenia makes evident the importance of creating conditions that incentivize population permanence and attract returning citizens. This aspect highlights the need for policies aimed at improving economic opportunities and quality of life to mitigate the negative effects of migration.
- Focus on mono-ethnic stability: The high and constant proportion of Armenians in the population suggests that maintaining cultural and ethnic identity is essential for social cohesion. This element highlights the importance of promoting a sense of belonging and community among the population to support demographic strategies.
Romania
- Integrated and coordinated care models: Romania has developed pilot projects integrating health services and social support at community level, which have proven effective in addressing the needs of the elderly. The aim is to expand these models to ensure greater national coverage, promoting collaboration between government and NGOs to provide integrated care (Romania).
- Strategies to prevent and reduce avoidable mortality: Another key lesson is the importance of strengthening preventive care for the elderly, with interventions aimed at managing chronic diseases and promoting healthy lifestyles. This approach has demonstrated significant potential to improve quality of life and reduce avoidable mortality in older population groups. (Romania).
- Importance of support for family caregivers: Romania recognizes the crucial role of family caregivers, especially in rural areas. To address the challenges they face, financial support, specialized training and respite services for caregivers have been proposed, with the aim of strengthening the support system for the elderly population and promoting ageing in place. (Romania).
Serbia
- Need for service integration: Serbia's elderly population requires integrated health and social support services, as the current system is fragmented across several ministries and agencies. A unified point of entry for long-term care, with coordinated information and services, would improve access and preserve the dignity and rights of the elderly population.
- Support for informal caregivers: Informal caregivers, often family members, are the main providers of care for older people in Serbia, but they lack adequate support. Serbia recommends investing in training, counselling and more flexible labor market policies to improve quality of care and reduce caregiver exhaustion. This approach would also improve the quality of life of both caregivers and care recipients.
North Macedonia
- Integrated care for the elderly: North Macedonia has discovered that integrating health and social care for the elderly is essential. A collaborative approach is promoted that combines medical, social and community support services, helping to reduce hospital admissions and improve the quality of life of the elderly.
- Promotion of active ageing programs: Recognizing the importance of prevention for health, North Macedonia invests in programs that promote active and healthy ageing. These initiatives encourage physical activity, social integration and mental health support, reducing healthcare costs and supporting the well-being of the elderly population.
- Welfare reforms and long-term financial sustainability: Pension system reforms are seen as a necessary step towards sustainability. By changing the retirement age and revising pension calculation formulas, North Macedonia aims to maintain a financially sustainable system, ensuring support for the elderly without overburdening the working-age population.
Kosovo
- Challenges in public services for the elderly: Services for the elderly are guaranteed by the public health system, but consequently present limitations and shortcomings that reflect the financial and organizational challenges of the system itself. The reduced access to these services is mainly due to the lack of nursing homes and long-term care facilities dedicated to this segment of the population.
- Health Overburden and Lack of Social Support for the Elderly: Although the elderly population need both health and social services, this responsibility falls entirely on the health system. The consequences are multiple: on the one hand, the availability of services for other segments of the population is reduced; on the other, a shortage of qualified professionals for social assistance emerges. Finally, the lack of coordination between health and social services generates additional costs for the public system.
- Solutions to improve community services for seniors: Solutions to be introduced into community services include: using technology to facilitate access; improving training, monitoring and supervision of health workers; integrating health and social services to reduce costs for families; investing in prevention programs and financing sustainable models for the provision of these services.
Slovakia
- Risk factors for the elderly: The main risk factors for the health of the elderly are mainly related to lifestyle, such as smoking, alcohol consumption, poor eating habits and lack of physical activity. Cardiovascular diseases are the leading cause of hospital admissions, but they also offer significant opportunities to introduce healthier and more effective management models of these diseases in a community setting.
- Elderly care: strengths and weaknesses: The country has good conditions for the health and social management of the elderly, through structures appropriate to specific pathologies, qualified professionals in the geriatric sector (doctors and nurses), as well as national strategies, programs and standards for the promotion of specific risk factors for this segment of the population. However, there is a lack of an overall assessment of elderly care and a defined area for improvement.
