Independent Living:  Giving Meaning to Home Professor Eamon O’Shea Irish Centre for Social Gerontology National University...
Older Population: Ireland and EU Year Ireland % of Population EU25 % of Population 1950 10.7 8.2 1975 10.7 11.4 2002 11.1 ...
Life Expectancy at 65 and 75 Year 65M 65F 75M 75F 2001/03 15.4 18.7 8.9 11.2 2005/07 16.6 19.8 9.8 12.1
Disability <ul><li>323,707 people with disabilities (8%) </li></ul><ul><li>136,696 >65 years </li></ul><ul><li>Incidence o...
Care and Caring <ul><li>149,000 carers (CSO) </li></ul><ul><li>97,500 households contain carer of older person either with...
Social Spending on Age <ul><li>Ireland overall ranked lowest of EU15 in terms of social spending per older person </li></u...
Welfare Regimes <ul><li>Universalist- Social Democratic - Nordic countries </li></ul><ul><li>Conservative – state corporat...
Welfare Paradigms <ul><li>Statist- state has extensive responsibility </li></ul><ul><li>Familialist/Individualist – Indivi...
Community Care in Ireland <ul><li>4.2% of older people in long-stay care account for 60% of overall public budget of about...
UN Principles <ul><li>Independence </li></ul><ul><li>Participation </li></ul><ul><li>Care </li></ul><ul><li>Self-fulfillme...
WHO Active Ageing <ul><li>Participation </li></ul><ul><li>Health </li></ul><ul><li>Security </li></ul>
Active Ageing: Six Determinants <ul><li>Economic </li></ul><ul><li>Health and Social Services </li></ul><ul><li>Behaviour ...
OECD Healthy Ageing <ul><li>Improved integration into the economy and society- social capital </li></ul><ul><li>Better lif...
Challenge of Ageism <ul><li>Value of older person in changing world </li></ul><ul><li>Healthy, active, successful ageing i...
Older Person Centred Approach   Co-ordination and inte-gration Income Environ-ment Housing  Support for carers Health Soci...
HOME <ul><li>Where we are </li></ul><ul><li>matters to who </li></ul><ul><li>we are </li></ul>
Home <ul><li>Past </li></ul><ul><li>Self </li></ul><ul><li>Housing type </li></ul><ul><li>Living arrangements </li></ul><u...
Wrong Place <ul><li>Heidegger’s existential homelessnes -belonging nowhere </li></ul><ul><li>Choosing between nomadism and...
Home as Identity <ul><li>Person and home intertwined </li></ul><ul><li>Home is within us as we are in it </li></ul><ul><li...
Technology and Home Living <ul><li>Information and Communication (ICT) technologies offer opportunities to make independen...
Technology Solutions   <ul><li>Sensors, hand-held devices, communication networks, data processing servers can enhance ind...
Barriers to use of technology among older people  <ul><li>Readiness, acceptance and accessibility </li></ul><ul><li>Income...
Future Attitudes and Expectations <ul><li>Today’s “computer generation” has a friendly attitude to technology and is likel...
Public Policy for Independent Living at Home <ul><li>Maintaining the self  </li></ul><ul><li>Maintaining communities </li>...
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Prof Eamon O’Shea – “Overview of international approaches to enabling older people live in their own homes – Challenges in Ireland

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Prof Eamon O’Shea – “Overview of international approaches to enabling older people live in their own homes – Challenges in Ireland

  1. 1. Independent Living: Giving Meaning to Home Professor Eamon O’Shea Irish Centre for Social Gerontology National University of Ireland, Galway
  2. 2. Older Population: Ireland and EU Year Ireland % of Population EU25 % of Population 1950 10.7 8.2 1975 10.7 11.4 2002 11.1 16.4 2021 14.8 19.1 2050 25.9 29.9
  3. 3. Life Expectancy at 65 and 75 Year 65M 65F 75M 75F 2001/03 15.4 18.7 8.9 11.2 2005/07 16.6 19.8 9.8 12.1
  4. 4. Disability <ul><li>323,707 people with disabilities (8%) </li></ul><ul><li>136,696 >65 years </li></ul><ul><li>Incidence of disability increases with age </li></ul><ul><li>65 year old 9 times more likely to develop disability than person aged 15-24 </li></ul><ul><li>Multiple disabilities </li></ul><ul><li>Of disabled people aged 65 years or over two thirds experience multiple disabilities </li></ul>
  5. 5. Care and Caring <ul><li>149,000 carers (CSO) </li></ul><ul><li>97,500 households contain carer of older person either within or without (ESRI/O’Shea) </li></ul><ul><li>89,000 older people require care in the community (Fahey and Murray) </li></ul><ul><li>13,000 of these estimated to be in very highest dependency category (O’Shea) </li></ul><ul><li>31,000 needing high or continuous care (Mercer) </li></ul><ul><li>20,000 in long-stay care </li></ul>
  6. 6. Social Spending on Age <ul><li>Ireland overall ranked lowest of EU15 in terms of social spending per older person </li></ul><ul><li>Ireland spends one third of what Denmark spends per person aged 65+; 40% of what UK spends </li></ul><ul><li>Total expenditure on long-term care in OECD ranges from 0.2 to around 3% GDP; Ireland 0.62% </li></ul><ul><li>Much but not all of this difference is explained by demography- particularly pensions payments </li></ul>
  7. 7. Welfare Regimes <ul><li>Universalist- Social Democratic - Nordic countries </li></ul><ul><li>Conservative – state corporatist – Germany, Netherlands </li></ul><ul><li>Liberal welfare -Anglo-Saxon – UK </li></ul><ul><li>Southern European - Italy, Greece, Spain </li></ul>
  8. 8. Welfare Paradigms <ul><li>Statist- state has extensive responsibility </li></ul><ul><li>Familialist/Individualist – Individuals responsible for finance and provision- extensive use of means testing </li></ul><ul><li>State pays- others provide – state main funder- multiple providers </li></ul>
  9. 9. Community Care in Ireland <ul><li>4.2% of older people in long-stay care account for 60% of overall public budget of about 1 billion </li></ul><ul><li>Community care is under-resourced </li></ul><ul><li>Provider/bureaucrat-driven </li></ul><ul><li>Poor support for carers </li></ul><ul><li>Poor co-ordination </li></ul><ul><li>Care not embedded in local communities </li></ul>
  10. 10. UN Principles <ul><li>Independence </li></ul><ul><li>Participation </li></ul><ul><li>Care </li></ul><ul><li>Self-fulfillment </li></ul><ul><li>Dignity </li></ul>
  11. 11. WHO Active Ageing <ul><li>Participation </li></ul><ul><li>Health </li></ul><ul><li>Security </li></ul>
  12. 12. Active Ageing: Six Determinants <ul><li>Economic </li></ul><ul><li>Health and Social Services </li></ul><ul><li>Behaviour </li></ul><ul><li>Personal </li></ul><ul><li>Physical Environment </li></ul><ul><li>Social </li></ul>
  13. 13. OECD Healthy Ageing <ul><li>Improved integration into the economy and society- social capital </li></ul><ul><li>Better lifestyles- physical activity, nutrition </li></ul><ul><li>Adapting health systems to the needs of the elderly- prevention, self care, mental health, home visits, co-ordination </li></ul><ul><li>Environmental factors; transport, housing </li></ul>
  14. 14. Challenge of Ageism <ul><li>Value of older person in changing world </li></ul><ul><li>Healthy, active, successful ageing is ethically and politically problematic </li></ul><ul><li>Emphasis on functional capacity can polarize older people into functioning and non-functioning </li></ul><ul><li>Agich (2003) challenges very idea of independent living – relational view- inter-dependence is the norm </li></ul>
  15. 15. Older Person Centred Approach Co-ordination and inte-gration Income Environ-ment Housing Support for carers Health Social networks and activities Transport Technol- ogy Older Person
  16. 16. HOME <ul><li>Where we are </li></ul><ul><li>matters to who </li></ul><ul><li>we are </li></ul>
  17. 17. Home <ul><li>Past </li></ul><ul><li>Self </li></ul><ul><li>Housing type </li></ul><ul><li>Living arrangements </li></ul><ul><li>Staying indoors </li></ul><ul><li>Getting out and about </li></ul><ul><li>Neighbourhood </li></ul>
  18. 18. Wrong Place <ul><li>Heidegger’s existential homelessnes -belonging nowhere </li></ul><ul><li>Choosing between nomadism and sedentariness </li></ul><ul><li>Choosing between digital interfaces and the human touch </li></ul><ul><li>Choosing between disjuncture and connectedness </li></ul>
  19. 19. Home as Identity <ul><li>Person and home intertwined </li></ul><ul><li>Home is within us as we are in it </li></ul><ul><li>Home as belonging – displaced long-stay residents </li></ul><ul><li>Home fosters meaningful relationships </li></ul><ul><li>Home as boundless – Bachelard (1994) – a tool for analysis of the human soul </li></ul>
  20. 20. Technology and Home Living <ul><li>Information and Communication (ICT) technologies offer opportunities to make independent living a reality </li></ul><ul><li>Technologies can help in prevention, management of chronic conditions, as well as enhance quality of life </li></ul><ul><li>New technologies can alleviate caring pressures within families </li></ul><ul><li>Effective use of technologies offers an alternative to institutional care </li></ul>
  21. 21. Technology Solutions <ul><li>Sensors, hand-held devices, communication networks, data processing servers can enhance independent living </li></ul><ul><li>Technology can help identify and monitor fallers, cognitive decline and social isolates </li></ul><ul><li>Telemetric monitoring systems that transmit health data directly to the physicians. </li></ul><ul><li>Technology can enhance social connection and participation </li></ul><ul><li>Technology can help foster inter-generational relationships </li></ul>
  22. 22. Barriers to use of technology among older people <ul><li>Readiness, acceptance and accessibility </li></ul><ul><li>Income and education barriers </li></ul><ul><li>Health and social care sectors have been relatively slow in offering technology-based tools </li></ul><ul><li>Mismatch between needs and technology devices which leads to lack of acceptance, lack of usability or even lack of usefulness. Need to move from high-tech to appropriate-tech </li></ul><ul><li>ICT services sometimes seen as a threat to human contact, privacy or personal control </li></ul>
  23. 23. Future Attitudes and Expectations <ul><li>Today’s “computer generation” has a friendly attitude to technology and is likely to demand increased technology-supported services in their old age </li></ul><ul><li>Ongoing socio-economic and socio-cultural dynamics lead us to expect that the next generation of ICT users will have somewhat different expectations and attitudes towards technology </li></ul>
  24. 24. Public Policy for Independent Living at Home <ul><li>Maintaining the self </li></ul><ul><li>Maintaining communities </li></ul><ul><li>Supporting families and connectivity </li></ul><ul><li>Creating and meeting expectations </li></ul><ul><li>Integrated solutions for home care </li></ul><ul><li>Maintaining built environment and public infrastructure </li></ul><ul><li>Ensuring equity </li></ul>

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