SOCRATES PROGRAMME: ADULT EDUCATION ACTION
"SALOMON: AN INTEGRATED EUROPEAN PROGRAMME
FOR ELDERLY PEOPLE LIVING IN A RESIDENTIAL ENVIRONMENT"
71150-CP-1-1999-1-ES-ADULT-EDUC-ADU
TRANSNATIONAL REPORT ON ELDERLY PEOPLE CARE POLICIES
Written by: Raúl de Prado Elisenda Giner Milagros García Angela Vargas From the (*) national reports written by:
DENMARK: Henning Salling Olesen and Helle Krogh Hansen. GERMANY: Carmen Stadelhofer, Astrid Ühlein and Gabriela Körting. SPAIN: Rosa López, Xoan Manuel González, Asunción Gimeno, Raúl de Prado, Angela Hernando GREAT BRITAIN: Peter Shanahan and Evelyn Brett. (*) (Note: this is the order in which participant countries are mentioned on this report. This order is the one stipulated by the European Union in its official documents, which is also mentioned on the Socrates application form.)
TRANSNATIONAL REPORT ON ELDERLY PEOPLE CARE POLICIES
INDEX
SALOMON project: An European integrated programme for elder people
living in rest homes comes from progressive ageing of the European Union
population and from the assessment of the social consideration that elderly
people have about it.
The population ageing phenomena is common to all European Union countries. The statistical service Eurostat (1994) said that in the first quarter XXI century more than 20% of the European population will be over 65 years elderly. This trend was confirmed in the four countries involved in Socrates project "SALOMON: AN INTEGRATED EUROPEAN PROGRAMME FOR ELDERLY PEOPLE LIVING IN A RESIDENTIAL ENVIRONMENT", as shown by the following data (KROGH & SALLING, 2000, 1; STADELHOFER & ÜHLEIN, 2000,1; PRADO 2000,13-16; BRETT & SHANAHAN, 2000,11):- Denmark: in 1996 the 20% of the population was over 60 and it was foreseen that in 2030 the 50% of the population will be over 60. (according to figures corresponding to the group of people who are 20-59 and they are in active labour situation)
- Germany: in 1995 the 21% of the population was over 60.
- Spain: in 1996 the population over 65 was the 15%.
- Great Britain: in 1995 approximately the 18% of the population was over 65 and the expectation is that in 2010 it will be 19%.
In all the mentioned countries there is a population between 75-90 sharp growing and the women proportion is as well higher than men proportion.
Social reality about elder people in Europe is that that society seems obliged to maintain, every day more, these protected people but not included in the social activity. European citizenship wants to characterise itself as inclusive, supportive, equal and with a high life quality. But reality reflects that this group is outside "productive life" and has to face up exclusion situations owing to three reasons:
As they are not in the labour activity it is not considered, in general, the necessity of maintaining and developing their capacities.
There is a social prejudice that adult people's capacities are limited when it comes to learning so their possibilities are reduced. This fact is more relevant with elderly people.
Social participation opportunities are closed when they have to live in an institution, owing to its characteristics and possibilities.The general situation, in the eighties and nineties, high rate of unemployment and low growing of the production, oriented the concentration of the resources in the youngest and more productive social sectors. This option has caused the following consequences:
The development of a process of early retirement, which has been common in the different countries and which has contributed to increase the number of people considered "elderly". (At the moment some opposed policies are being applied in order to make a more flexible retirement, although they haven´t got a generalized implantation.)
The support decrease in the public protection systems has brought about the necessity to make an individual planning during the labour life period so as to have the necessary resource which ensure acceptable levels of life quality after its ending.
A change in the social perception of workers of this age-group, who now are required to revise and update their knowledge and skills.Based on Vygostski`s contributions (1995) it is taken into account the meaning of the social interactions in which a person participates, so that the perspective that conceives the learning as a especially social process is developed. From this point the transcultural perspective is developed which confirms how adult people and, by extension, elder people are able to resolve great complexity problems related to their every day life using equally complex strategies (SCRIBNER, 1998). Besides these perspectives about learning conception there must be added longitudinal studies (SCHAIE, 1983) which consider people cognitive evolution along their lives, and the difference between (CATTEL,1971):
- Fluent intelligence (joined to physiological base and receives more influence from hereditary factors than environmental so that is deteriorated and decreases along the time)
- Crystallized intelligence (joined to experience in the own socio-cultural environment and includes all reached activities, through experience along life, and which are considered important socially to maintain a determined culture)
- Serious pathologies will probably appear in advanced age (elderly than 80) owing to life hope growing and health assistance improvement, and an increasing number of elder people will spend this stage, between the end of their labour life and ageing, in good conditions of health and maintaining a high level of activity.
- This possibility implants new challenges about what the most suitable ways of accommodation are, taking into account that elder people must have requiredattention but not to affect their possibilities of social participation. A great number of these people want to stay in their own homes while their health is fine, when it is not like this, elder people live with their sons/daughters or in rest homes.
These different situations must develop possibilities of continuing education, which deal with educational intervention for social participation development from the opposition to the ideas and practices of segregation, and of the integration, from elder people perspective in an environment of concrete and determined interrelation (MOODY, 1976).
It must be taken into account that in the globalized society, the generation of new knowledge comes from processes of generation and information and knowledge processing, so that its control decide who has more power (CASTELLS,1997). It must not be neglected social dimension of Information Society to achieve it is really for everybody. In this sense, it should not be forgotten that elder people belong to generations for which is difficult to assume technological challenge that is meaning this new kind of society, that is why it is necessary stress in this matter from educational approaches so that a new factor of exclusion, which may deteriorate their life quality, do not be constituted.
The response will come from the setting up of new ways of horizontal relation through nets that reach and maintain a democratic and dialoguing potential which benefits everybody.
From the elderly people care international dimension, as well as from the national plans/schemes; it can be stated that there has been a general change in attitudes towards the elderly.
This change is also seen in national and community policies, which are designed to improve social protection systems and an effort to increase economical support through pensions, specialised medical assistance and a wide range of social services. Despite policy purposes and targets it is clearly seen that the trend is to keep the elderly protected but not included in the social life.
This report proposes to analyse how the European Citizenship idea is far from the elderly, despite the different national policies try to develop inclusion, equality, solidarity values as well as quality of life. Even if different educational and leisure offers were collected, the educational en and cultural dimension is less considered and developed than the economical, medical and attendant one.It is made an analysis of elderly people care policies to confirm the reality and to implant as an educational programme for these people who live in rest homes, influences decisively on overcoming of social and cultural exclusion contributing to the life quality improvement.
Later on "An Integrated European Programme for Elderly People Living in a residential environment" and its respective plan of evaluation will be elaborated, starting from their necessities and expressed assessments through life stories and gatherings together to characteristics analysis of some rest homes and the programmes carried out in them.1. ELDERLY PEOPLE CARE INTERNATIONAL DIMENSION.
The international context of elderly people care has its source at 1948 Human Rights Universal Declaration. From that moment the elderly rights and their in the society had a specific consideration. After that United, Nations decided to set up the Elderly World Assembly. This specific consideration about elderly people is seen as the "elderly problem".
The international view changes in 1982 with Elderly Rights Declaration, in its International Action Plan about ageing, proposes that the role which elderly people are going to play, will oblige society to adopt a positive, active concept of ageing and directed towards development. Besides, it generates a series of measures in the following ambits: education, employment, income, home, environment, health and hygiene, social welfare and family.
The different assessments made reflect that developed countries have politics and specific programmes which respond to this population necessities, while developing countries are slowly establishing elderly people support programmes and the presence of non-governmental organisations is increasing in the development of services and actions to assist this population needs: centres, clubs, food programmes and home help.
In the published information about the evaluation of the Plan it is stated (UNITED NATIONS, 1999c): "In the present exam and evaluation only between a third and a half of the countries informed that they offered educational opportunities to elderly people. A great number of countries informed that they employed elderly people as teachers in cultural heritage documents structured programmes, in intergenerational projects and in art an crafts lessons.United Nations adopted on 16th December 1991, in favour of elderly people, the following principles (UNITED NATIONS, 1999b):
Independence, not only to cover basic necessities, food, home, dress, health and income, but also to have educational and training programmes.
Participation as members of society, through intergenerational exchange, service to community and promotion of their own associations.
Access to family or community protection and health, social and juridical services, which make sure their autonomy, protection and attention.
Self-fulfilment , which means to develop completely their capacities and to have access to educational and cultural resources.
Dignity, that requires social assessment of these people to enjoy a good life quality.On 16th October 1992 General Assembly passes the Proclamation about Ageing, which highlights the increasing contribution that elderly people bring to economical, social and cultural development. Besides, it implants the development of a practical strategy for the decade 1992-2001, which affects as taking of measures by the international community as national initiatives support about ageing. It is noticed among the proposals: the development of elderly people cultural dimension, their contribution to maintenance the balance between tradition and innovation and the promotion of their participation in the community.
The year 1999 was the International Year of Elderly People, which reflects the international importance of the ageing phenomena and the need to develop a different perspective and social assessment. From this fact it is expected to advance towards the construction of a society for all ages. It is going to be changed elderly people concept, proposing the perspective that people's development takes place along different stages of biological cycle. It would be necessary to combine their independence with their participation and contribution to the society, achieving their self-fulfilment through continuing education, the increase of their knowledge and the development of a healthy life. The actions during this International Year tried to incorporate the problems of ageing in the social reflection making aware: to reach the society for all ages, to implant a perspective which defines essential processes and priorities long term, to encourage support activities for non-traditional actors and to establish interactions and exchanges of information and investigations inside setting up world-wide nets (UNITED NATIONS, 1999a).This necessity for a change in elderly people´s consideration and treatment in our society has been noticed in the last decade, as well as a recognition at different levels, which is guaranteed by several initiatives (such as Elderly People Rights Declaration) elaborated by different institutions and which are gradually appearing in some states.
Elderly people are considered a priority group in the new perspectives of Adult Education, as it is revealed at different international meetings about Life-long Learning. In this sense, the 5th World Conference in Adult Education organised by UNESCO and celebrated in Hamburg July 1997, includes in its declaration and its action plan for the future a commitment to reinforce elderly people's learning opportunities, in this way (UNESCO,1997):"21. Elderly people. Nowadays the percentage of elderly people in the world is higher than ever before, and it is increasing. These people can contribute a lot to the development of society. Therefore, it is important that they have the possibility to learn on terms of equality and suitableness. Their skills and competence must be acknowledged, valued and used"
The number of Adult Education projects destined to elderly people is increasing. This fact means the beginning of a new dimension in cultural and educational activity, whose aim is to guarantee a real life-long learning.
Elderly people's cultural and educational initiative is an unquestionable sign of their active participation in society. Besides, the different proposals and institutional compromises are pointing at this direction. It can also be observed how different kinds of professionals working with this age-group agree to consider cultural and educational aspects as essential factors in the improvement of their life quality. This is a possibility which is being taken into account by different Adult Education approaches.
The context which is being configured opens doors and ways for an interdisciplinary and co-ordinated work, in which, from different ambits of intervention, has to be worked to carry out a common action and to achieve life quality improvement and elderly people participation in the development of a more plural and equal society.
2. ELDERLY PEOPLE CARE NATIONAL POLICIES PLANS.
The same international dimension is noticed in every studied country in terms of social consideration and governments' worries.
- In Denmark from the beginning of the 80s the elderly people population has been gaining greater influence on (and responsibility for) their own situation. The desintitutionalization national plan expects to maintain elderly people in their homes as long as possible, but when it is not possible, it looks for accommodations where elderly people have the same responsibilities, possibilities and rights as people living in their own homes. This policy is due to the consideration of human rights and the economic problems generated by the growing number of elderly people in the Danish society (KROGH & SALLING, 2000,2).
- In Germany the 4th family report, of 1986, shows how the image of the elderly people in social changes and gaining social importance of the "third age". This trend is confirmed in 1991 by founding the Ministry for the family and seniors. In 1995 comes into effect attention care insurance, which recognises for the first time the right to have attention, the patient can reclaim the expenses generated by attention care into the family. In this way it is expected encourage elderly people responsibility and self-attention and attention from the family (STADELHOFER & ÜHLEIN, 2000,5).
- In Spain, from the end of the 80s to the 90s there is a progress in the social attitude and care towards elderly people, which leads to the social action system and social services development. The Gerontologic National Plan of the Social Services National Institution proposes an intervention in these items: pensions, medical attendance, social services and culture and spare time. The attention to these matters is directed towards personal autonomy, staying in their home, living in their usual environment and the access to cultural assets (INSERSO, 1993).
- In Great Britain, In the 70s there was a change in the social services conception and during the 80s there was a change in the social policy which consisted in changing the attention from an Institution to their own home. This change meant a wide range of accessible and flexible services, attention in the familiar environment, promotion of independence, study of elderly people necessities, evaluation of person necessities and work done by person who attends, use of the Institution only in necessity case, purchasing power maintenance through plurality of offers of attendant services and the implication boost of the public and private services and volunteers in the attention to this collective (BRETT & SHANAHAN, 2000, 4).
In every country, elderly people care plans were found and they all share the main part of the elements:
- economic (pension scheme)
- medical (social security)
- attendance (social service)
- educational, cultural and leisure (community and educational services).The main aims of the national plans are: develop and improve pensions, promote health from prevention, primary care and suitable medical assistance; co-ordinate administrative and resources structures; to match social service offer with population needs; reinforce elderly people access to education, cultural wealth and a creative use of the leisure time; and extend elderly people democratic participation through social organisations at every life activity.
As specific elements this report should highlight the following:
- In Spain the gerontologic national plan includes, among its priorities, the promotion of the ageing phenomena research as well as the social knowledge about elderly people.
- In Germany these plans include actions to help people during the transition to retirement. It has also been found a general trend to offer the best service as possible from all care structures and it is also possible only if steps towards participation, expressing opinion and involvement in decision-making processes, are done.
The national policy purposes show, from the global view to specific regulations, the concern about these aspects: economical, medical and attendance.
It seems that educational, cultural and leisure areas are considered as playing a second role.
The situation of national and regional levels to face elderly people living conditions, as well as the joint local efforts to improve them, do not allow to foresee an easy solution, mainly due to two kind of problems:
- A group of problems that can only be approached from the provision and qualified resources, such as diseases, physical disability, mobility problems, economical resources scarcity and scrape living.
- Another group is related to own life and environment perception, which is not transformable by the provision and qualified resources. This talks about loneliness, social undervaluing, abandonment feeling and psychic diseases. The best way to avoid these problems is the prevention of them through the development of educational programmes that will be carried out by social services professionals and social education, trained and specialised in taking care of elderly people.
3. THE PENSION SYSTEMS OR SCHEMES.
Social Security systems are the central part of the social welfare policies at European level. These policies are mainly designed to support and improve people's quality of life and two different models can be described:
- The continental one, which is on professional bases as well as on contributor entitlement (this includes illness situations, inability, elderly age and death). This model has been noticed in Germany, Spain and Great Britain.
- The Universal one, which takes care of every citizen basic needs and it is not dependent on previous contributions. This second one is observed in Denmark.
Both of them pretend to contribute to avoid need situations and exclusion. The difference between them consists of a different political conception, which is defined by the way this question is answered: What is the intervention of the State, (in which measure) in people's every day life?
There has been found a fundamental similar social cover, funding and distribution in the four analysed countries. Besides, the social pension system is as well complemented by private systems.
The most significant aspects in these countries are:
- In Denmark for the last twenty years, the income average available for pensioner family has increased by about 20%, and statistics show that each new generation of pensioners has a larger average income in addition to the state pension. It is promoting the stay at work over 60. The legal age of retirement has changed from 67 to 65 and people who work until that age are rewarded. (KROGH & SALLING, 2000,4)
- In Germany the situation of the West and East parts is not balanced. In the West part 90% of the population contributes to the compulsory pension system. This system is based on the principle of long-term uninterrupted working biography. For women it is difficult to qualify for a pension. The counting of the time spend in growing up children is not equal to the time spent in gainful employment. The result is that today there are more elderly women living in poverty than men of the same age. The 60,7% of people over 50 receiving social assistance are women. A politics that promotes the individual responsibility and the responsibility towards the rest of people is developing in this country. There is a considerable increase of pension private systems. (STADELHOFER & ÜHLEIN, 2000,4)
- In Spain there has been an increase of tax-paying period to receive the pension and has enlarged the period which serves as base for its calculation to balance the contribution with the receipt. (PRADO ET AL., 2000, 4-8). Receipts are divided into two different groups: contributory pensions (which include incapacity, retirement, orphanhood) and non-contributory aids (which include disabled people social integration, illness, and elderly age).
- In Great Britain the age of retirement for men is 65 and for women 60, although it seems it is going to be equal for both. Besides the universal pension, there are others such as: private occupational pension (financed by workers and businessmen) and support pension, among others. (BRETT & SHANAHAN, 2000,21)
The Spanish and Danish reports reflect the social debate about elderly people welfare, pensions and the governments' worries about the financial problems. However, different possibilities to handle the issue are showing different ways to work it out. In Denmark by increasing the amount of the pensions and asking the elderly to pay for some of the services and in Spain increasing wealth production and active population.
The health systems are changing from a traditional model based on cure towards another one intended to offer an integral care. The sanitary care is changing as well to a more multi-professional and rehabilitative approach. The key issue is being currently analysed and is the one related to distribution, regulation and organisation of the services. This issue worries professionals involved and trying to unify the offer connecting the medical and the social care.
- In Denmark the system of cover is universal, this means that everybody has free health assistance, independently from their income or social position. During the last years, owing to a conservative politics, private systems of health assistance are being offered although only people with high income can accede them. (KROGH & SALLING, 2000, 5)
- In Germany, for instance, the 90% of the population is covered by a compulsory illness insurance. (STADELHOFER & ÜHLEIN,2000, 5)
- In Spain in 1977 the percentage of the population covered was 77% and nowadays it is 97% and the other 2,6% is covered by other kind of systems.(GERIATRICS AND GERONTOLOGY SPANISH SOCIETY, 1999). It is fundamental to preserve people´s autonomy with regard to health assistance through the whole required information so that people can decide about any action which can have important consequences for their health (PRADO ET AL., 2000, 9). There is an important increase of private systems of health assistance. Different proposals of organisation and running about health system are being planned towards privatisation. These proposals are causing a social answer and a lot of discussion.
- In Great Britain primary attention, nursery and medical, is the one which has more resources. However, secondary attention, psychological and socio-emotional, has been somehow neglected in spite of the fact that this could be carried out by a variety of educational programmes. Since 1992 Social and Health Service of Northern Ireland, organised in local Trusts in which a Health Board works supplying Sanitary Service, began to consider that a difference must be made between the user and the supplying entity. In this way, a market of sales and purchases of services to the private sector and among the different trusts has been generated (BRETT & SHANAHAN, 2000,23).
The most frequent illnesses which this sector of population suffers from are: osteoarthritis, heart failure, high blood pressure; lung illnesses such as bronchitis; neurological illnesses such as Parkinson, senile dementia and cancer. There are also a series of problems which frequently appear, as a result of different causes and which determine a high death rate, functional deterioration and a increase of incapacity and dependence.
These are, for instance, falls, incontinence, sensorial problems, sleep disorders, medicament abuse, immovability syndrome and confusing syndrome among others.
The sanitary schemes addressed to elderly people focus their services on appliances and technologies, movement difficulties, non-age-related disease, age-related grave or chronic pathologies, psychiatric disorder and terminal illnesses.
5. SOCIAL ACTION AND SOCIAL SERVICES.
This care area is developed from the regional and local dimension. This responsibility distribution is oriented by general principles, which have been noticed as common among the studied countries, and they are: universality, globally, planning, prevention, integration, autonomy, participation and initiative promotion.
Social action regulations and social services understand that elderly people must remain at their social environment, help them to develop social and cultural needs, and if necessary, move them to a suitable residence.
Elderly people care is implemented through basic services and specialised services.
Social services work usually focus on this areas: a follow-up of familiar situation derived from residence admittance, keeping familiar and community relations, emergency in hospitalising elderly people when special need arise, prevent our overcome personal exclusion situations, integration of person in his/her community, participation schemes implementation, cultural development, creativity and leisure; enhance associative processes among elderly people.
There is a common philosophy in all the studied countries in relation with resources and services offer: stay at home as long as you can, with a good quality of life, keeping family and community connections, having independence and privacy and these services will support and assist the elderly person.
Services more often offered to elderly people in the four countries:
- Home help and home care, depending on the service consisting of care, house, accompaniment, or support.
- Tele-assistance, consisting of a technological appliance to contact emergency and social services, if needed.
- Day centres, offering basic care, integral services and it can refer the person to specific services for care. There can be found general medical assistance, occupational therapy, leisure and cultural activities, etc.
- Associations are organisations designed to facilitate participation and social interchange by activities.
- Rest homes, accommodation for elderly people with very different personalities, mobility and cognitive abilities. This accommodation largely varies from one country to another.
- Sheltered dwellings/apartments, are forms of alternative accommodation for elderly people, which offer higher independence degree.
- Intergenerational schemes/programmes designed to provide interchange, communication about views, life experiences among young and elderly people.
A quantitative data can show an overview on population living in rest homes in the studied countries:
- In Denmark in 1994 a study over 1000 elderly people, between 67 and 80 or over, confirmed that 92% lived in own house, 5% in rest homes and 3% in other kind of accommodation.
- In Germany in 1994, 93% of population aged 65 lived in own house, 5,3% in rest homes and the difference lived in other kind of accommodation.
- In Spain in 1996 elderly people living in rest homes were 3`2 %.
From the studied reports it is reasonable to conclude that there is a different conception of elderly people accommodation in the four countries:
- Denmark has made a big effort to desinstitutionalise offer for elderly people, which meant that in addition to closing nursing homes, many measures were taken to ensure that daily life for people living in nursing or homes sheltered accommodation, should resemble life in ordinary Danish homes. Besides and under the idea of "care continuity" other measures have been taken. It was highlighted the local administration follow-up of elderly people over 75, being this administration responsible for the compulsory visits, at least, once a year. It is, therefore, a priority to maintain elderly people at home as long as possible, and to achieve this aim, the same administration provides home help and care, but when it is not possible, the elderly people or their family can move to alternative accommodation. Depending on the elderly people income/pension, they are asked to pay for some of the services provided or not, meanwhile, administration supplies care. In addition, care for people dying in their own home is supported by a "care allowance" for family or friends wishing to look after ill people. Several family members or friends can share this allowance. Since 1998 it is laid down that all municipalities should draw up quality standards for personal care a practical assistance at least once a year (KROGH & SALLING, 2000, 6)
- In Germany, three different welfare supports can be found, which are regulated through a subsidisation principle: public services (community, district and state), non-profit and private organisations. The setting up of attention social insurance, which provided a financial aid between 200 and 650 EUROS, involved an immediate increase in elderly people attention inside the family environment. Therefore, the entry in a rest home is generally limited to some specific cases. The accommodation location is decided by a previous three-stage assessment. According to care needs accommodation can be: supervised (independent small apartments and common areas), elderly people homes for elderly people with mobility problems, nursing care homes and home foundations (higher standard). The most vulnerable elderly people are cared in residential environments (STADELHOFER & ÜHLEIN, 2000,7).
- There is a basic service net in Spain, which is connected with specific services. The objectives are to maintain the person in his/her social environment, encourage his/her socio-cultural development and supply a suitable residential environment. Regulations guarantee democratic participation in social action system, in which local, provincial and private actions work together. As a peculiar aspect, it can be highlighted the voluntary work bulk and the development of a new service based on family shelter, which consist of an elderly person integration in a family house and daily life.
- In Great Britain some areas (counties) services are provided by a Trust, which reflects community development aim, especially in Northern Ireland. In these areas elderly people quality of life is understood as a community matter and responsibility, and therefore, the Trust supplies suitable social services, integrating community, residential and hospital services. It is also remarkable the attention paid to care and interdisciplinary treatment of age-related mental diseases. The evaluation done by social services teams (compound by a social worker, a doctor, a psychogeriatrician, a geriatric consultant, an occupational therapist and a psychotherapist) about someone´s attendance necessities, take into account in the assessment, not only the simpler necessities but also those more complex which require a more complicated administration ( BRETT & SHANAHAN, 2000,32).
In Germany and Denmark there has been an evolution towards a more independent accommodation so rest homes are decreasing.
There has been an increase in pensions, grants and financial aids with regard to different limitations and incapacities that people can have and as users should pay requires services or part of them. Among the most relevant grants it is the one destined to people who have to stop working to look after elderly people. This grant is new in Germany but in Denmark is more established (firmly rooted).
Proposals and actions towards this population improvement and welfare define two aspects: the first one, maintaining elderly people in their own environment and supporting them by necessary help and care; and the second one, accommodation and services provision for elderly people needing nursing care. Both aspects work together to improve economic autonomy of elderly people, enhance home help, house functional adaptation, disabled elderly people guardianship, intergenerational schemes development and participation of elderly people overcoming communication barriers.
6. EDUCATIONAL AND CULTURAL ATTENTION FOR ELDERLY PEOPLE.
This field is in a process of development because it became matter of concern, seen as important for elderly people quality of life, during that last decade. We shouldn't consider that at this life stage elderly people have plenty of spare time to be met with merely a wide leisure offer, it is also necessary to supply and enlarge the opportunities of life-long learning.
At the moment of writing this report the common view on this aspect is shared by all the studied national policies: it is playing a second role in the national and local policies.
The approaches which focus on the educational intervention from a negative perception of the elderly people, as antithesis of prevailing social values (such as beauty, productivity, profitability…) or as a sector with deficiencies or limitations to carry out a participative action, are going to generate segregation and exclusion processes that hinder every educational and cultural initiative, or at best, develop the idea of elderly people's necessity for entertainment (MOODY, 1976).
On the other hand, a lot of studies show the positive relation which exists between the connexion to life from 65 years onwards and its quality. This joining with life consists in physical and emotional interaction with the environment and the fulfilment of tasks and activities that exercise body and spirit. In the same way it is confirmed that elderly people that maintain their mind active and make efforts to learn new things and maintain updated, experience a better ageing (ROJAS,1999,10).
Other approaches are being developed from the point of view of elderly people's integration and updating, searching a normal life in which personal development is possible in a concrete social interaction environment. (MOODY, 1976). These perspectives try to develop social assessment of this collective as source of Knowledge, transmitter of cultural traditions and bearer of experiences. Therefore, elderly people are still active members of society, they can learn new things and applied them from their previous Knowledge and experience. In this way, the intellectual dimension is still important, so it must be kept active in order to have a good life quality and to face, in the best possible conditions, the transformations which people at this stage experience.
Frequently, politicians do not take into account this social resource, so that the more moderate, and less risky, consideration of this aspect on the national-regional policies tend to state the right of elderly people to access education, at any level, and in connection with continuing education systems of adult education. Besides, many specific offers for elderly people are provided, oriented to wide their educational level and trying to maintain active their cognitive, dialogic and relational abilities.
It is, of course, fostered access to cultural life, as well as to social cultural wealth. Now, the important thing is to progress in the idea that elderly people are protagonists in their own educational and cultural development, which is achieved with the generation of participation processes in social and cultural development dynamics in their own and daily environment.
Some common facts in the different countries of European Union are observed:
a small number of adult people have educational and training experiences after leaving formal education.
among these people that take part in educational processes a minority are elderly people
people who have more economic resources are the ones who accede to them with more frequency
when training processes are joined to access, maintenance and progression in the job, the implication of men is greater; participation of women is larger and wider in the rest of educational and cultural offers and possibilities.
In the four countries where the analysis has been carried out the following situations are noticed:
In Germany and Denmark there are equipments, such as centres of day, that offer programmes of educational and cultural activities for elderly people who live in their area.
In Spain socio-cultural awakening and educational programmes are developed in centres of day, associations, clubs and rest homes (where they are being introduced and begin to be general).
In Great Britain these programmes exist in centres of day, but elderly people who live in rest homes rarely have opportunity of taking part in their activities, this is due to the development of a politics that tries rest homes assume the responsibility of including training and educational programmes as a part of the services which they must offer. Nevertheless, these entities cannot offer a wide range of these activities to elderly people because of labour pressures that working people suffer there, economic resources scarcity to carry out and the necessity of adequate equipments. The activities offered are re-creative (bingo, bowling alley, table games, musical entertainment and one day trip) though there are some cultural (mobile library, crafts and art workshops, etc).
Cultural and educational proposals of the four countries vary (KROGH & SALLING, 2000, 8; STADELHOFER & ÜHLEIN, 2000 12; PRADO ET AL., 2000; BRETT & SHANAHAN, 2000,6).
- Leisure activities, which are not structured in schemes, like dancing, handcraft workshops, expositions, etc. The reports collect activities of this kind in Valladolid (Spain) and Ulm (Germany).
- Social tourist which include camps, travels and hot baths, which are intended to help interaction among elderly people. Camps favour meeting other communities and people. Travels are planned to help interaction among elderly people by organising common life that share leisure activities, as well as daily life.
- Cultural and artistic or literary creation Prizes and Contests to promote creativity and artistic and expressive possibilities of this collective.
- Training/educational activities are offered in Ulm (Germany) by "Seasons' Academies", which take place twice a year and are organised by Zentrum für Allgemeine Wissenschaftliche Weiterbildung (ZAWIW), founded in 1994 at University of Ulm, and in Spain its provincial administration (Diputación Provincial de Valladolid) offers "Winter School". The activities implemented are lectures, debate, discussion groups, workshops, etc.
- Adult education/continuing education programmes, are implemented in urban context as well as in rural environments, offering access to different educational and cultural processes like literacy, basic culture, diplomas, or other learning processes. People who incorporate these educational and cultural programmes involve in social participation dynamics from the conception that everybody has right and necessity to learn and face up challenges which bring social changes that are appearing in present days. Among these programmes we highlight studies circles, discussion circles and work teams by Internet in Germany; study groups, traditional courses and computer cafes in Denmark. In Spain elderly people involvement in adult education groups represent a significant percentage.
- University for elderly people, means the incorporation of elderly people to university. There is a wide rage of courses of different specialities (arts studies, sociology, health, image science, etc.) in some Spanish cities for people who are elderly than 55 and in Northern Ireland for people who are elderly than 50. Different resources and infrastructures are provided for their development. It is obvious the difficulty of access to this offer for people who are living in rest homes owing to mobility and movement required to take part in them. Nevertheless, In Northern Ireland among the services which are given to carry out this educational offer are: possibility of lodging in local Trust, attention to disabled people, reading and theatre room and technology room and the proposal of social and re-creative activities.
Socio-Cultural awakening and socio-community awakening activities are usually offered in "elderly classrooms" as places for meeting with culture and for participation and debate. Information and training shared with others bring about a commitment with the community which they belong to. From these places respect, tolerance, self-esteem, health, solidarity, living together and mutual help values are enhanced, as it is in Valladolid (Spain), in third age "classrooms" offered from its provincial administration (Diputación Provincial de Valladolid), or in Denmark in "Senior Academies".
It must be highlighted the programme called "dark horse adventure", which is being developed in Northern Ireland, (United kingdom) since it tries to recuperate the skills that elderly people have and they are put to community development service. The programme is divided into four areas in which different proposals and contributions are distributed: learn and do (it is offered an opportunity to develop an educational or training contribution according to languages, literary creation, music, art or craft), exercise and elaborate (sports, trips, cultural visits, walking, etc.), generations working together (elderly and young people with volunteers involved in social projects to carry out an education and orientation function) give and share (elderly people skills are put to community development projects service )Educational activities and socio-cultural awakening programmes in rest homes for elderly people. As these entities are lodgings and homes for elderly people that for different circumstances, familiar or social, cannot live in their own homes, a relevant development of educational and cultural dimension must be taken account to guarantee a good life quality. Among the known experiences highlights the rest home "Cardenal Marcelo" of Provincial Administration of Valladolid where a socio-cultural awakening programme is being developed. In this programme a socio-cultural director together with the rest of staff, volunteers and students of university in practices take part in it.
The general objective is to improve life quality of residents, delaying their dependence, decreasing their invalidity and unburdening their social isolation situation. Socio-cultural awakening programme include ("CARDENAL MARCELO" REST HOME,1999):
Permanent activities programme: press workshop, audio-forum sessions, elderly people "classrooms", basket workshop, cinema-forum sessions, school (adult education class), participation workshop and leisure activities.
Special programmes and activities plan which include parties at the end of the month, trips, excursions and celebrations such as Christmas, carnival and typical Spanish feasts.
An organ of participation called committee of residents Environmental stimulation programme through the elaboration of posters, exhibitions, use of new technologies (PA system, television interior channel, video…), games outside the building, tombola etc.These model practises must be analysed, assessed and transformed gradually so that elderly people can get real and total leadership in decisions which affect all dimensions of these programmes and besides, from their educational and cultural development, in those decisions which determine their life quality in the respective rest home.
In addition to the mentioned proposals, it must be considered as a valuable effort, in terms of education and cultural interchange, the intergenerational meetings, which take place among young people (university students or not) and elderly people, as well as cultural voluntary work, through all these activities elderly people are able to implement a role as a cultural guide and human routs.
The necessity of promoting the change in elderly people social perception must be highlighted because in spite of the declaration of intentions and objectives it seems that there is a trend to maintain these people protected but not included in social dynamic. Transformation that is taking place in the social consideration of this collective is related to development of social protection policies, noticing an effort in economic cover through improvement of pensions system, a sanitary service specialised in social security system and an attendance attention through a great variety of social services
A coincidence in social action philosophy is dispose of resources and necessary services so that elderly people can stay, with a good life quality, in their homes and in their habitual environment or in a context which guarantees their independence and privacy, with necessary support and attendance. These efforts from economic, sanitary and attendant ambits are not useful if we do not change excluding and negative attitudes towards elderly people.
Evolution of elderly people social protection towards integral attention is being an achievement, but it must also include the socio-cultural dimension. In this sense it is being confirmed how different kind of professionals that work with this collective agree with considering cultural and educational aspects as determining factors in life quality improvement. The context which is being configured opens doors and ways for an interdisciplinary and co-ordinated work, in which, from different ambits of intervention, has to be worked to carry out a common action and to achieve life quality improvement and elderly people participation in the development of a more plural and equal society. This new possibility is being studied from adult education approaches.
Cultural and educational initiative must be considered an important item as far as active participation in citizenship is concerned, therefore elderly people access to education and cultural wealth must be promoted, as well as their democratic participation, through social organizations, and their participation in all life activities. This ambit has been developed less than the economic, sanitary and attendant ones, in spite of the different offers in education, social awakening and spare time.
Therefore, it is necessary to promote the educational and cultural dimension of these people and to recognise and use socially their knowledge, experience and creative potentiality. Elderly people are still active members of society, they can learn new things and apply them from their previous knowledge and experience. In this way, the intellectual dimension is still important, so it must be kept active in order to have a good life quality and to face, in the best possible conditions, the transformations which people at this stage experience.
Now, the important thing is to progress in the idea that elderly people are protagonists in their own educational and cultural development, which is achieved with the generation of participation processes in social and cultural development dynamics in their own and daily environment.
Elderly people participation in cultural life and their access to cultural wealth established by the whole society must be promoted. Different specific activities, offered in rest homes or in centres of day, must be taken into account. Different practises must be analysed, assessed and transformed gradually so that elderly people can get real and total leadership in decisions which affect all dimensions of these programmes and besides, from their educational and cultural development, in those decisions which determine their life quality in the respective rest home.
It is necessary the diffusion of information about these items, about progressive improvement possibilities of these people concerning their life quality and about the importance of their daily contributions to our society. An intergenerational debate about this is positive to generate attitudes of solidarity, social integration and to provide the access to educational and cultural possibilities with regard to this sector of population.
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