Are Poland's private nursing homes better alternatives to state-run homes?
24.2.2006 - Bogdan Zaryn, Michal Kubicki

As in all of Central Europe the average age in Poland is on the rise. At the same time many young people are holding down two jobs and trying to get ahead in the world. This leaves little time for taking care of the elderly. As Radio Polonia found out, some Poles are breaking away from the traditional extended family and placing their parents in western style private nursing homes.

'Palac', or Palace in English, is an 18th century royal former aristocratic residence in the Warsaw suburb of Marki. At the turn of the millennium the chateau was given a facelift and a new lease on life. A group of private investors decided to make it into a luxury nursing home. Daniel Balla a twenty-six-year-old economics major says that he invested his time and money for one simple reason.

'Right now we can observe there is a gap in the market, because now state-run residence homes are overbooked and there is a need for private residential homes'

In the rehabilitation centre, a group of senior citizens are exercising. One lady's on a bike, and there's another lady who's doing some pushups. Daniel Balla makes sure that the needs of the residents are taken care of.

'Since I was young I always tried to help people. I was doing shopping for older people. The first time when I saw a nursing home, I saw that the residents lived in poorly run homes, and the smell of urine was everywhere. It wasn't a very nice place. When I decided to open a residential home, it was seven years ago. Owners don't need special qualifications. The residents have 24-hour medical care. We provide exercise for everyone, musical entertainment, and tea-time at 4pm every day'

The Palace in Marki may be high on health care, but as I strolled the grounds I couldn't help feeling a sense of loneliness within it. It's estimated that Warsaw and the districts around the capital have 140 private and public homes.

Nursing home resident Barbara is an 81 year old woman with a warm smile and thoughtful eyes, the daughter of a pre-war Polish diplomat:

'I am not very sure why I am here and I am very home sick. I read books, I read newspapers, I write letters and that's about it. I try to persuade my son that it is time to go home....... I feed ducks...they know I am coming, I miss my cat and my neighbors'.

On average it costs close to 2500 zlotys or 600 euros a month to stay in an above average private home. This is three times the average state pension. Insiders argue that the price depends largely on turn-over and competition is fierce.

Wanda is also 81 years old. Her room has a picturesque view of the forest. She says that she managed to jump the long queue by offering a "gift".

"I understand that there is a waiting list to stay in a newer part that is more luxurious. What I did was to sell my apartment and offer the money as a gift to the people here, in order to speed things up"

Wanda, a sensitive woman with beautiful blue eyes, says that she spends her time constructively, despite the fact that she feels like a stranger and out of place most of the times:

'I read a lot. There are times when we meet - on Tuesdays we meet and sing, and on Thursdays we do all kinds of handy work. When you come as a new person, it is not so easy to get included because you have different views on different things.'

But compared to the shabby, understaffed state-run nursing homes with waiting lists too long to contemplate, Wanda and Barbara may count themselves lucky to be able to afford an alternative. For the majority of elderly Poles, though, the prospects remain bleak.

Better days ahead for the Czech Republic's home care service for the elderly
24.2.2006 - Jarka Hálková

Statistics show that twelve percent of Czechs are now over sixty-five years old. Nothing exceptional about this, but the number will rise significantly when a big group of Czechs who are now in their fifties reaches retirement age, putting a bigger strain on the state budget and on relatives.

The state is obliged by law to look after its older citizens and to provide them with affordable care. But the answer is not for every body to be crammed into old people's homes. With a bit of help, most old people can - and want to - stay at home.

Helena Celisova is director of a welfare organisation for the elderly in Prague 13, the newest and smallest in the Czech capital.

"It is better when there are fewer hospices and hospitals. It is easy to place an old parent in a hospice if they are very sick, but an elderly person should stay at home as long as possible. We can meet all his needs in his own environment. He doesn't have to go anywhere, doesn't have to get dressed and after all we all feel most comfortable at home. Home nurses wash, do shopping, tidy the flat or prepare food for everyone who needs it. Moreover clients like to have a closer relationship with home nurses who very often become like part of a family."

This welfare organisation is, like others of its kind, financed from the city's budget. Though the money is only just enough to get by on, any other ways of raising funds, such as sponsorship or grants, are out of the question. But by the end of the year, the parliament is expected to pass a new law that will allow these organisations to find additional sources of cash. This would enable home care services to provide wider and better care to their clients. Also, under current rules, home care social workers are unable to provide basic services like changing bandages and giving injections, simply because they are not covered by health insurance companies.

The welfare organisation in Prague 13 takes care of four hundred clients. About a hundred of them use 'meals on wheels'. Warm food, cooked in a local school is delivered to their door and comes as a blessing to those not able to cook and lacking a relative's helping hand.

"We cook three different meals each day, including one meal for people with special food needs. We make sure that it is suitable for diabetics. All meals are put into special dishes that keep the food warm for longer. Lunch usually arrives at about 11.30. Our crew delivers food to the clients' doors. If our client is not able to heat his food or feed himself we can do it for him. It all depends on what we agree with the client or his or her family."

To start with each client is interviewed by a nurse who finds out about his or her preferences and health needs.

Bela Masova is one of the clients. At 83 she needs daily special care, even with the regular help of her four children. She has been suffering from asthma and can't do any housework or go out. I visited her in her flat.

"I was given a microwave for Christmas so I can heat my meals easily now. I don't cook I only make coffee. Of course I do like that. I am very satisfied. Home nurses do anything I ask for. I don't think I could ask for any more. I don't have to cook, do shopping, clean the flat, they even wash me."

The welfare organisation has been helping Bela Masova for about ten years now adding "meals on wheels" service to a list of tasks last September. Bela has just one criticism.

"The food was great when I signed up for it. I even recommended it to my neighbour I told her, 'Milada, it's not worth cooking! You can get the same food as me for 40 crowns. It will be enough for you and your husband.' So she did follow my advice but after two months the food got worse and she got very dissatisfied. It is not as tasty and not very varied. I have been taking notes of the menu to make sure I remember. In one week we had chicken four times. So I called in to complain and talked to the cook. Although they promised a change, nothing has happened yet. It costs 40 crowns and it is waste of money if food is not tasty."

According to Helena Celisova it is difficult to please everybody and it would be even harder to cook a different meal for every client.

"We do have regular feedback from our clients. They do not beat about the bush and simply say if they do or don't like a meal. Of course it is impossible to please everyone especially the hundred or so people we serve, but if they complain we try to offer them some sort of compensation. Their feelings are important to us."

If the new law is passed it will not just make things easier for welfare organisations. It will also create a more competitive environment, as it will be possible to set up new welfare organisations in competition with existing services. The bill's authors say it will enable clients and their families to make their own choices. Welfare workers do agree but warn that it might be tricky for lonely seniors recognise good and bad services.

Demographic shift in Slovenia influences political landscape
24.2.2006 - Michael Manske

We've been hearing how Central Europe's aging population is expected to put a strain on budgets and care facilities in Poland and the Czech Republic. But in Slovenia, there's a new twist to this old story. Slovenia has the lowest fertility rate in the entire European Union according to the European Statistics Office. And although the population is slowly increasing due to immigration, the country is undergoing a very noticeable demographic shift. And, this "greying" of Slovenia is expected to bring major changes to the political landscape.

A case in point is the Slovenian pensioner's party, the Demokraticna stranka upokojencev Slovenije. Known commonly by their acronym DeSUS, the small party has already begun exerting considerable influence over the political process, something that is expected to grow. In Slovenia's last election, DeSUS won nearly 40,000 votes and four seats in parliament. Since the election was very close, every seat became crucial for the center-right coalition. DeSUS, which had previously been allied with the left, swung over to the center-right coalition, but only after it had secured some of its demands.

DeSUS parliamentary representative Franc Znidarsic explains:

"DeSUS is aware of the aging population in Slovenia. This is why the party insisted, in its coalition contract, that the Ministry of Labour, Family and Social Affairs be obligated to prepare a care programme for the elderly. This programme should cover all levels: sufficient health care, appropriate capacities for homes for the elderly, home help, prolongation of the working period, jobs suitable for the elderly population, continuing education; taking care that that elderly are not pushed away from society, and that they have their rights and are given the opportunity to be included in every-day life at all levels."

DeSUS also secured a ministerial post: 45-year-old Karl Erjavec became the new Minister of Defense. And the current government, which has pursued a series of reforms, has been careful not to tread heavily on the pension system. As Slovenia's population gets older, and the ratio of workers to retirees evens out, the political power of the elderly is expected to rise. This will be to the advantage of DeSUS, or at the very least, the interests it represents.

Politics Professor Bogomil Ferfila of the University of Ljubljana's Faculty for Social Sciences:

"The political power of the older population in Slovenia will without any doubt grow, regardless of whether the elderly only vote for DeSUS as their own party, or vote for other parties. Either way, the other parties will have to consider the interests of the elderly: pensions, their economic, social and to a lesser extent their political situation. DeSUS has been trying to attract as many of these voters as possible. But it is worth noting that they started off as a party meant to attract the votes of other generations as well."

DeSUS has managed to carve a niche for itself in the Slovenian political landscape. The 15-year-old party boasts 36,000 members, with 143 local chapters. Its small size belies its influence, especially as "kingmaker" in the previous election. And as a party representing the interests of an age group that is rapidly increasing, it stands to gain ground in the future.

Throughout the 1980s, the number of people in Slovenia over the age of 65 remained flat at 10%. It has since risen to 15% -- and according to population projections by the Slovenian statistical office, this percentage will more than double by 2050, reaching a formidable 31.3%.

The percentage of people over the age of 80, meanwhile, is expected to more than treble in the next 50 years: from just 3% now, to 10% in 2050.

Whether DeSUS manages to harness these potential votes, or they are co-opted by the other large political parties, it's clear that the elderly will have an increasingly powerful say in the running of Slovenia.

Work up a sweat and postpone the ageing process!
24.2.2006 - Katarina Richterova

It was comedian Groucho Marx who said: "Anyone can get old. All you have to do is live long enough". But what Groucho didn't say but most doctors stress is that exercise is important if we want to live long enough and to have quality of life. In Slovakia, more and more women are finding that a good work-out in the gym can make them look and feel younger. Katarina Richterova put on her leotards and went to join them:

The fitness boom reached Slovakia 10-15 years ago. Staying fit and trim are the most common reasons why women come to sweat it out at classes like this one. And today it is not only young women that work out, says Zora Czoborova, a famous Slovak keep-fit icon:

"From the beginning when fitness came to Slovakia, only young women took care of themselves. But we have reached a time now when middle aged women between 30 and 50 years have come to understand that without movement and doing something for their body and also for their mind, it will not work. Whether young or old, when you work out you feel happier, healthier, you will have more energy, and you won't be so stressed."

I asked a few women over the age of 45 what makes them work out:

"This is how I relax. It gives me certain rewards, I feel healthier, and get the feeling that I have done something for myself."

Through the exercise, do you feel that you are postponing the aging process and that you are younger?

"You must feel young. If you don't feel young, you can exercise as much as you want, but it won't help you. But of course it might support the idea that I don't feel so old [laughs]."

20 years ago there were not as many women in their 50s looking as good and young as there are today. Certainly they have taken inspiration from the TV, where everybody has to look good, but also:

"Nowadays there is a trend for people to want to stay young as long as possible. And in society in general there is a cult of beauty, attractiveness."

... says psychologist Barbora Mesarosova from the Commenius University. Specialists agree on the fact that today's older people are in many ways different from earlier generations.

"Older people nowadays cannot enjoy retirement as it was before. Since the Velvet Revolution life has been faster and people live in more difficult conditions."

As they get older people often want to devote more time to activities that they never previously had time for: travelling, hobbies and also keeping fit:

"In comparison to western countries I think that our people are more conservative and they don't live as actively as people in western countries, mainly when it comes to travelling, and their activities and interests."

...adds psychologist Mesarosova. A longer working life is another feature of today's society. Recently the retirement age of men and women went up. A woman with two children now retires at 62. Not long ago her retirement age would have been 55years. Although specialists say prolonging our active life is good, surveys show that women would rather not stay at work longer. Sociologist Zora Butorova from the Institute for Public Affairs looks for reasons to explain this:

"This group of women belongs to the so called sandwich generation. This means that there are expectations of these women from the older members of the family. But also they are expected to become very active grandmothers. So this means that those women stay very active, but the field of their activity shifts to their private life."

Butorova says it is mainly educated women, professionals in their field, who try to prolong their working life. Regardless of whether you are at home or at work, an active lifestyle is very important if you are to enjoy your old age.

"We can expect that we will have more and more retired women who will be active in the civic sector in their communities, who will try to do things they were not able to do when they were working. We will have for instance more and more women who will study at universities of the third age. So this age group will become much more diverse than it was some 30 years ago."

In Slovakia the topic of aging is neglected more than in many other countries. But this is bound to change and society will be much more sensitive to the issue, says sociologist Butorova. Also ageism, or discrimination at work because of age, should soon diminish and especially young managers will realize the advantages of having an age-diversified working group.

And maybe we shall see the number of more mature women working out continue to increase. After all, looking good is important at any age, and that goes especially for Slovak women, who are said to be among the most beautiful in the world.

Hungary's popular elderly-friendly local government award
24.2.2006 - Sandor Laczko

A couple of years ago Hungary's Interior Ministry and Ministry for Equal Opportunities set up what is known as the "Elderly-Friendly Local Government Award". It goes to towns and villages which do the best job of integrating the elderly into their local communities.

The prize does not just bring money, as ministry officials believe that mayors like the prestige of being able to display plaques stating "Elderly-Friendly Local Authority" in their offices.

What do the applicants have to do to win the award? Judit Szabo from the Ministry for Family, Social Affairs and Equal Opportunities, explains:

"You have to show that you really want to integrate people. So it is not about social policy and financial help and health issues, it is more about everyday life. We were very happy when we learned from the first 200 applications that communities which organise a very active cultural and sports life are also offering these possibilities to the elderly."

Sociologist Zsuzsa Kravalik is of the view that most money spent by the new member states of the European Union on the elderly is spent on co-financing EU programmes and thus fewer resources remain for other programmes in the given country. That is why she believes initiatives like this award are very useful. They mobilise local communities to come up with ideas. A special area is people who are just going into retirement.

"What to do with people, who leave the work place, leave employment - how can we stimulate this social group to do something? I think this is something, which is missing in the new member states in the Eastern part of Europe and which works very well in the western part of Europe - to have civil activities, and community and other activities. Elderly people, retired people, can go and do something for the community, to keep themselves active, to keep their mind working. I think it's very important. And they can feel that they do something for society."

The recipients of the 2005 "Elderly-Friendly Local Government Award" range from small villages to cities and also include the 13th district of Budapest, which has - by proportion - the largest elderly community in the Hungarian capital. Anita Toth is a member of the social committee in the local government:

"It's a really important achievement and we are really proud of the work behind it. It's an important thing that we are the first local authority in the capital to have received such acknowledgement. 'Elderly-friendly' means not only social services, it's also important that elderly people shall have a better quality of life - that they shall feel better where they live. So, it's important also to provide other services for them. We have international cooperation with local governments from the neighbouring countries: Osijek, Kosice, Floridsdorf in Vienna and Ostrava in the Czech Republic, and we regularly organise a so-called 'Senior Olympics' for the elderly - different sports competitions, swimming, chess and others."

The "Elderly-Friendly Local Government Award" competition continues and to help inspire future applicants a book has been compiled, outlining the best ideas of the first 200 participants.