Services access in old age Hugary

1. Services access in old age Hugary László Patyán University of Debrecen Faculty of Health Institut for Social Studies Hungarian Scientific Research Fund (OTKA) 81667. Changes – Crises – Reactions (Adaptation of local organizations of social services in peripheral countries in Europe)

2. Promotion of population aged 65 and over % of total population of selected countries(Yearbook of Welfare Statictics, 2010)

3. Europe is getting older…Old age dependency ratio compareing the going rate in selected years(Yearbook of Welfare Statictics, 2010)

4. General informations • Social services are provided by the state (redistribution) • Health services provided by the state (insurance) • LTC belongs to the social care area • The main responsibility organising services: Local Government

5. Income, pension, allovance 2010 (Yearbook of Welfare Statictics, 2010) • Average income: 135.000 HuFt (450 €) • Average pension: 86.361 HuFt (288 €) • Minimum pension guaranteed: 28.500 HuFt (95 €) • Old age allovance: 27.421 HuFt (91 €) • Nursing allowance: 28.567 HuFt (95 €)

6. Service providers in the personal social care(2010)(%)

7. Present movements - ideologies • Re-paternalisation of the welfare area • The state wants to get back the direction, organisation, financing, controlling, and service providing (culture, education, employing area, health, social services) • Church organised services still in the highlited positions (94,5% extra finance)

8. Problems with the service providing area • Service path-dependency (focus on the institutional services, especially LTC) • Non determined social risks (ADL-type scales from 2008) and service users • General aims, governmental startegies, and short term plans (changes rapidly) (1993, 2004, 2008, 2009, 2011)

9. Problems with the service providing area • Methods of care giving focused to the physical care • Service users: paternalistic attitudes, and way of thinking • Low number of provided services compareing to the European trends • The provided services has special caracteristic, it depends the size of the settlement

10. Datas about services2010…(Yearbook of Welfare Statictics, 2010) • Every 145-th elders relative can have nursing allowance • Every 30-th elder had domestic care (organised by Local Governments) • Every 16-th elder used catering • Every 90-th elder had alarm system based home assistance • Every 60-th was a member of the day center for elderly • Every 2.128-th could use the special day service for elder people with dementia • Every 47-th lived in long term residential care for old people

11. Main discussions • Active aging • Sustainable services (in the growing number of elderly) • Quality • Ecual access • Focus on the family care, and self responsibility • Modern technologies (ICT) for reduceing costs, and developing access

12. Main components of access (used research methods, and results) • Life Quality Research of Nyíregyháza 2008-2010 (reprezentative sample, N=286; N=196) • Services located and served in a small area (strenghten the physical access) • Services cumulated in some area and weak access in other areas • The older age, the less services (benefits) • Main caracteristic of the service providers. User selecting methods, practices (interview, and test shopping) 25 service provider (Local Government, County, Subregion, Church, Non-Govermental Firms) Szabó Judit 2009. • The service providers select the users (care giving, financial status) • The selection methods are not specialised for one kind of provider

13. POSKE Service Accessability test-research University of Oulu, Northern Finnland Excelence on Social Welfare, MTA PTI, Debreceni Egyetem • Simply random method (Random walking) • 22 settlements (Esztergomtól Biharkeresztesig) • 200 answerer (over 65 years old) • Almost a half of the sample lived alone

14. The size of the settlements (%)

15. Age groups of the answerers (%)

16. Education

17. Who can help you doing the housework? (%)

18. Who provide you a financial help? (%)

19. Are you satisfied with the services organised by the local government? (%)

20. Are you satisfied with the health services? (%)

21. How can you get informations about services? (%)

22. Which are the worst services to access? (%)

23. No experience…(%)

24. Correlations with the size of the settlement and unsatisfied services (%) P=0,066

25. Correlations between the size of the settlement and the number of the family (%) P=0,063

26. Membership (%)

27. Reasons of the participation (%)

28. Do you use info-communication technologies? • 79,7% has a mobile phone • 26% has PC • 26,8% has Internet access

29. Summary • Develop the method of the family support: The family takes important part of careing elderly, but they do not have specialised supportive services. • How can we give more informations about the services: Family doctors, home care nurses, and the social professionals of the home help are the most popular persons for elderly. They need to konw about all the accessable services. • Active aging 2012? Elderly people wants to have more physical activity, free entertainments, and cultural programs. • The infocommunication techniologies are quite new for the elder people. They prefer the mobile phone, so it can be the further way developing ICT-based services. • More centralisation of services means less services to reach for old people

30. More information about the service access • Peer Review in Social Protection and Social Inclusion and Assessment in Social Inclusion(Hungarian Country Report by Balazs Krémer) http://www.peer-review-social-inclusion.eu/peer-reviews/2009/combining-choice-quality-and-equity-in-social-services

31. Kiitos Köszönöm a figyelmet!