british center stimulus for arts and crafts

BRIEFS

Education

British Center Stimulus for Arts and Crafts

The Niccol Centre in the middle of the prosperous town of Cirencester in England is the only purpose-built center in the United Kingdom providing artistic and recreational activities for people over 55. Courses of six or twelve weeks duration are offered in painting, sculpture, calligraphy, woodcarving, pottery, photography, needlecraft, upholstery and oth~ subjects. An annual membership fee ofs 6 a year, course fees of.E9.60 per six-week block, some grants, and volunteer support sustain the centre. The renovation of the building that now houses the Centre was made possible through a generous legacy supplemented by funds raised through the efforts of the Centre for Policy on Ageing.

The Centre houses six workshops, a coffee bar and, in the middle, a theater-in- the-round with seating for 120. The theater is used not only by participants but by touring theater companies and musical groups. Performances are open to people of all ages. Part of the Centre is also used to exhibit the work of participants and local artists.

The Centre's success is in part due to the relatively well-educated and affluent clientele it serves. In addition to natives who have aged in place, Cirencester is a retirement mecca for persons with some means. (Charles Manton, "Training of Older Workers in the United Kingdom," Geneva: International Labor Organization, 1989)

Once a Student, Always a Student

In the largest study ever done of older adult learners undertaking distant learning and other educational courses at Britain's Open University (OU), several "universities of the third age" and 23 public-,sector adult education centers, relatively few persons were found to have taken up further education simply as a new retirement activity. Most had enjoyed their own school days and had undertaken further study

throughout their lives. Older students were also found to be

generally capable of keeping up with the required pace of study and of undertaking substantial periods of concentrated study. While an earlier study also conducted by OU's Older Students Research Group showed that 47% of older Off students had been worried about memory loss, in practice, only 26% experienced any difficulties.

Men are more likely than women to take courses leading to a credential. While, vocational training was not a significant motivator for older students, 25% of the OU r e s p o n d e n t s were s tudy ing mathematics, science or technology; 28% enrolled in public sector centers were in "practical crafts." (Charles Manton, ot7. cit.)

Employment

Pensioners' Demand for Work Unmet in Hungary

Among the people in Hungary who cannot find employment are many elderly, " r e t i r e d " individuals. Indeed, the " u n e m p l o y e d p e n s i o n e r , " a self- contradictory term in many countries, has been a growing problem in Hungary since

the late 19708 because of the inability of pensions to keep up with inflation. Thus, according to Zsnzsa Sz(nmn (Hungarian Academy o f Sciences), the economic situation of the elderly in that country "hardly fits near generalization" that may be applicable elsewhere.

The notion that inflation could seriously trouble the socialist economy developed slowly. Economic planners felt little urgency because of the widespread belief that the state could always finance whatever social programs might be needed. In the early 19808 it became clear, however, that the state was unable to meet the challenge. Obstacles included the growth of the senior population (by 1988, more than a quarter of the total population were pensioners or of retirement age), the uncontrollable rise in the costs of food and shelter, and the effects of having long ignored the accumulating costs of home repair.

The prices of necessities also began to rise when the command economy was partially relaxed and some market mechanisms were introduced. Prices rose slowly at first, but now the annual increase is in the lower double-digit range. Sz~man notes that the "majority of pensioners had some form of livelihood problems." Women, especially the very large number who were receiving reduced widows' pensions," were particularly affected.

As the economy worsened, active workers began to feel the effects of rapid impoverishment. By 1988, the real value of wages was equivalent to that of 1973. And during the period 1982-87, the real value of the average pension had increased only 3% compared with a 21% increase during the preceding five-year period. Seventy percent of pensioners reported serious difficulties in making ends meet. About half said they would not seek employment if it were not for economic difficulties.

At the same time, a national shortage of labor developed in some sectors in the 19708. The employment of pensioners in

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President--Dr. S.D. Gokhale (India); Treasurer General--Gem R.S. Pannu (India); Secretary-General--Charlotte Nusberg (U.S.); International Wace President--Dmfiel Thur~ (U.S.); Vice President for Australia/Oceania--CTlff Picton (Australia); Vice President for Asia--Y.F. Hui (Hong gong); Vice President for Europe--Sally Greengross (U.K.); V/ce President for the Americas--Horaee Deets (U.S.); Vice President for Latin America and the Caribhean--Joaqufn Gonzalez Axagtn (Mexico); Editor--Charlotte Nusberg; Associate Editors--Barry Robinson and Mary Jo Gibson.

2 Ageing International Winter 1990

various sectors rose to levels of 4% to 7%, with many employed as security guards. Thus, the pensioners' labor market was created both by the manpower shortage and the difficult economic situation of pensioners. They made up the shortage of manpower and, at the same time, offered to work for less money. By 1982, only a third of pensioners relied on their pensions as a sole source of income. However, their economic situation actually worsened--in part, because unemployed pensioners were not recognized as a labor market resource and were, thus, not represented during discussions about manpower policy.

In two Budapest districts, reports of thefts by older persons began to increase. In 1986, 38e of the thefts committed by pensioners involved essential foods and articles of personal hygiene. The authorities responded with stricter penalties. Many pensioners developed other survival strategies, including selling winter clothing or wedding rings. At least a quarter of the elderly are thought to prefer continued suffering to requesting charity from the state.

The great majority of pensioners were now existing at levels "below or around the social and biological m i n i m u m . " Inexpensive foods such as bread and those high in fat content became staples. Between 1987-88, the proportion of older persons seeking work in the Pensioners' Labor Exchange who reported eating only once or twice a day rose from 230]0-38%. Pensioners' problems were compounded further when the 1988 personal income tax penalized supplemental income and forced many pensioners out of the labor market.

Employers' Response

How did employers react to the pensioners' labor market? To fred out, Szcfman interviewed personnel officers and supervisory staff of large and small enterprises. Several firms informed her that their enthusiasm for supporting social welfare was dampened when the employment of pensioners resulted in decreased productivity.

In January 1988, twice as many pensioners sought work as a year earlier. Most importantly, during the year, "the mainstays of the employment office d e p a r t e d f rom the m a n p o w e r market"--that is, the very sectors that relied on retired labor in past years. These included heavy industry, chemicals, foods, light industry, construction, public

October I Declared International Day for the

Elderly

October 1 has been recognized as the International Day for the Elderly by the United Nations as the result of recent General Assembly action. Celebrations may start as o f October 1, 1991. The resolution to establish this day to honor the world 's elderly population was introduced by Austria, the Dominican Republic and Malta.

t r a n s p o r t , c o m m e r c e and telecommunications.

The regions df the country with the largest skilled labor supply were often far removed from regions where the demand existed. In other areas, vacancies remained unfilled.

In telecommunications, employment policy varied by locality, but management generally preferred to hire young people and train them for careers. In the food industry, managers saw themselves less as instruments of social welfare than as stewards of production goals. Hiring pensioners was not considered the best way to meet these goals. In the economically troubled railway industry, one of Hungary's largest managers claimed a willingness to hire pensioners for many jobs, but the older people could not meet the strict health standards for engine drivers, firemen, brakemen, switchmen and other positions. In Budapest, managers of the city's new metro system, preferred full- time work over the part-time work that pensioners were willing to put in.

In the chemical industry, elderly workers could not maintain the required pace or work the full number of hours alongside younger workers�9 In general, poor skills and health or low physical endurance proved pensioners' greatest handicap in f'mding industrial jobs.

In a large research and teaching hospital (with more than 3,000 beds), severe labor shortages existed, especially for cleaning staff and in the internal medicine clinic. The hospital did employ about 1,000 pensioners. Many pensioners, though, especially those close to 70 years of age, are unable to do heavy cleaning or work a full

eight-hour shift. Some 80%-85% of employed pensioners suffer f rom disabilities that prevent them from doing heavy work. Nevertheless, most members of the cleaning staff are pensioners, who accept a wage that is 70%-80% that of active workers. While some pensioners do work as nurses, they compete for jobs with elderly nurses who postpone their retirement in exchange for incentive pay. Although the clinics' requirements are dutifully compiled and sent to the Pensioners' Labor Exchange, only I% of the supplied candidates meet the physical requirements. Sz~man concludes that "the demand reported by the health institution. �9 is an artifact." Pensioners are employed only when there is no alternative.

Smaller industries, sharing some market-type characteristics and relative freedom from bureaucratic constraints, publicly stressed quality in the workplace and favored a "welfare policy" regarding pensioners. When it came to approaching the Pensioners' Labor Exchange, however, they wanted "manpower and not sick persons.' '

In summary, the "unemployed pensioner" problem came about for several reasons, including a labor shortage, non- indexed pensions that were outpaced by inflation, a tax law that penalized pensioners if they received supplemental income, and a nat ional planning mechanism that failed to develop realistic social welfare programs. The supply of pensioner labor continues to grow as the demand for it declines. (Zsuzsa Sz~man, Pensioners on the Labor Market: A Failure in Welfare, Budapest: Hungarian Academy of Sciences, 1989)

� 9 and Elsewhere in Eastern Europe

The combination of both labor shortages and inadequate pension systems are likely to create "pensioners' labor markets," according to Z.mnum Szemaa. This was the case for Hungary and holds true for other Eastern European countries, as well. A new complicating factor is the labor market pressure resulting from the migration of minority, ethnic groups from one country to another. In some cases, this may cause a l~bor surplus, diminishing employment opportunities for pensioners; elsewhere, it may result in labor shortages, strengthening opportunities for older persons who seek work. A country-by-country overview follows.

Ageing International Winter 1990 3

German Demeeratle Republic: Unlike other Eastern European

Countries, older persons retired both later and with more adequate pensions. With no severe labor shortages either (at least before the borders with West Germany were opened), the result was that pensioners did not re-enter the labor market on a large scale. In part, the GDR's favorable situation was made possible by the financial stability provided through special arrangements with West Germany and easier access to Western markets.

Czechoslovakia Although the economic situation was

less favorable than in the GDR, pensioners were guaranteed a basic income which covered necessities. While there was no great economic need to continue working, those employed were not forced out of the labor market.

Bu~arla While the situation of older persons in

Bulgaria until recently was similar to Czechoslovakia, a pensioners' market may come about because of the sudden and dramatic decline in the labor force as the result of the emigration in 1989 of 300,000 citizens of Turkish origin. They had represented 5.4% of the labor force. Attempts to compensate for this decline have included lengthening working hours in agriculture and industry and hiring pensioners.

Yugoslavia High unemployment in Yugoslavia

(around 13%) is undoubtedly a major reason for public law forbidding the employment of pensioners. However, since pensions until recently have been indexed reasonably well to keep up with inflation, pensioners do not suffer unduly from this state of affairs.

Romania Under the repressive regime of

Ceaucescu, pensioners were simply given no official recognition in any form. Their health care and other needs were simply ignored. Pensioners could often be found in queues in front of shops, waiting to buy basic necessities for their working family members.

Poland The need to work among pensioners

certainly exists in Poland where low pensions, inadequately indexed, cannot

keep up with rampant inflation--more than 100% in the f'n~t half of 1989. Officially, pensioners may undertake only limited, seasonal employment. Unofficially, many participate in the "shadow" economy, from which as much as 10% or more of Poland's income may be derived.

The importance of the agriculture sector in Poland means that many pensioners can continue to work on their farms--a blessing given the fact that agricultural pensions are lower than those for urban pensioners.

USSR Low pensions, labor shortages and

financial incentives have all served tO expand labor force participation by pensioners in the Soviet Union. A system of bonuses and improvements in the work setting have served to increase the proportion of older workers agreeing to postpone their retirement beyond age 60 (for men; age 55 for women) from 49% in the 1970s to 61~ in 1986. At the same time, they have extended their period of employment from an average of three years beyond the pensionable age in the early 1970s to an average of eight years by the mid 1980s.

Ymancial incentives such as the ability to retain one's pension at the same time as drawing full wages no doubt explain in great part the increase in the number of pensioners returning to work--from 19% in 1975 to 35070 in 1984. Most remain employed in the same jobs held before i; e r ~ t i r i n g . ' '

Even though per capita productivity for pensioners in the labor force is an estimated 13%-15070 lower than that of younger persons, their estimated production level still provides approximately 4070 of national income--a figure higher than the total of pensions and wages paid to them. And in some jobs, the average annual output of part-time working pensioners is estimated to be 7%-15070 higher than that of full-time able-bodied workers! (Zsuzsa Sz~man, ibid.; report submitted to ILO older worker training project by USSR, 1989)

Health Care

Canadians and Americans at Polar Opposites in Satisfaction with Their Health Care Systems

A ten-nation Harris survey measuring consumer satisfaction with their health care showed that only in Canada did the majority of the public (56070) agree with the statement "On the whole, the system works pretty well and only minor changes are needed to make it work better." At the bottom were the United States and Italy where only 10%o and 12070 of the population respectively could agree with this statement.

Consumer Satisfaction with Health Care in Ten Nations

Canada 56% Netherlands 47~ West Germany 41070 France 41070 Australia 34070 Sweden 32~ Japan 29070 United Kingdom 27070 Italy 12~ United States 10070

With the conspicuous exception of the United States, there is a fairly close correlation with the amount of moneyper capita spent on health care and the popularity of the system. The British, Italians and Japanese spend less and their systems are less well-regarded; the Canadians spend the most (with the exception of the U.S.) and have the most popular system.

These attitudes were reinforced and explored in greater depth in a three-nation Harris survey involving Canada, the United Kingdom and the United States. Again,


Canadians were the most satisfied, the Americans least satisfied and the British in between.

Satisfaction With Services

Those very satisfied with:

Health care services used in last year

Most recent visit to a doctor

Most recent hospitalization

U.K.U.S .A. Canada

39 35 67

63 54 73

67 57 71

Further, the proportion of Americans who are very satisfied with their health care services has declined from 52% in 1980 to 35% in 1988. And the number of people who think the system works pretty well is at an all time low. Almost one person in three (29%) in the United States agreed with the statement "Our health care system has so much wrong with it that we need to completely rebuild i t ," compared to 17% of the British and 5% of Canadians.

A key factor making for satisfaction with health care is access. When asked whether in the previous year they had failed to obtain health care services which they thought they needed, affirmative responses were obtained from 4% of Canadians, 5% of the British and 13% of Americans. When the reasons for failing to obtain care were explored, 7.5% of Americans attributed it to financial reasons such as inadequate insurance or inability to afford care. In Canada and the U.K., less than 1% gave financial constraints as a reason for their lack of access.

Similarly, with regard to quality of care and services, Canadians, to a large extent, and the British, to a smaller extent, express greater satisfaction than do Americans, although, by and large, most people are "somewhat satisfied."

The affordability of health care is another key component in overall satisfaction with the health care system. In the U.S., there seems to be a direct correlation between increases in consumers' out-of-pocket costs for health care and dissatisfaction with both the services they use and the overall system. With the greater emphasis being placed on cost-sharing, out- of-pocket costs have, in fact, been increasing at a faster rate than overall health care costs.

Finally, with 28% of the U.S. popu la t i on exper iencing no hea l th

insurance coverage at all at some point over a twenty-four month period, feelings of security with regard to health care coverage for acute, catastrophic and long-term illness cannot be very great. The numbers of uninsured have been rising every year since 1981. And many of those who are insured have only minimal health care coverage.

It is probably no accident that not only is the U.S. the only industrialized country examined that lacks national health care coverage, but that it is the most expensive health care system, "the most inequitable," in terms of access, and the "most unpopular."

These trends are likely to continue for some time because, while there is a growing consensus that something must be done, there is no consensus about what to do. In the meantime, older Americans who, to some extent have better health care coverage than the population at large through Medicare, will also suffer as political pressures to cut back Medicare benefits mount. Further, employers are increasingly cutting back on the health care benefits of future retirees. This means "a rapidly growing number of retired people will have no health benefits, or inadequate coverage, until they are old enough to be covered by Medicare." (Remarks by Humphrey Taylor, President, Louis Harris and Associates, September 1990)

Home Sharing Expanding in the United States

Shared living that includes elderly persons has become more common and is growing rapidly in the United States�9 The home provider is usually an older person who may need help with home tasks, seeks companionship, or needs help with expenses. The home seeker is often a younger person who agrees to provide help or companionship in exchange for i n e x p e n s i v e l iv ing q u a r t e r s . The arrangement may be private and informal but, in recent years, social organizations have arisen to help providers and seekers to find each other and work out mutually s a t i s f a c t o r y a r r a n g e m e n t s . T h e organization may be public or private, staffed by paid help or volunteers.

There are now some 170 programs in 31 states and the District of Columbia facilitating matches between older persons and others. According to Barbara Robins (Barrientos and Associates, Madison, Wisconsin) and Elizabeth Howe (University

of Wisconsin): "Programs occur in all kinds of communities, and the best predictors of the existence of a program are simply the size of the community, the percentage of its population over the age of 65, and the region of the country." Interestingly, programs' existence cannot be attributed " to the nature of market demand for home sharing in a particular c o m m u n i t y . ' '

How do older persons feel about the idea of home sharing? In Los Angeles, about a third of middle-aged or older homeowners liked the idea, but were not necessarily ready to participate. According to Dale J. Jaffe (University of Wisconsin), those favoring it "were more likely to be living in large houses, reside in high crime areas, be black rather than white, be in the young-old rather than the old-old category, and generally in a low income group and in poor health." Further, "college students �9 . . were more inclined to live with older adults than older adults with students."

Home sharing can solve a variety of individuals' needs at virtually no public cost. Moreover, it strengthens communities by e n c o u r a g i n g i n f o r m a l soc ia l arrangements among its members. When volunteers do the "match-making," it also strengthens volunteefism in solving social problems.

There are also some strong obstacles facing advocates of home sharing. Joyee Mantell (Nat ional Shared Housing Resource Center) and Mary Gildea (Delaware Valley Shared Housing Services) list the following: 1) a prevailing value system that favors privacy, autonomy, and self-sufficiency; 2) the highly labor- intensive nature of matchmaking and the meager undependable public funding available to support it; 3) the enforcement in some neighborhoods of laws that restrict the use of dwellings to members of one family; and 4) concerns of some elderly persons that the existence of a sharing arrangements will reduce their welfare payments.

Does home sharing work in a rural setting? The answer is yes if the needs of the rural elderly are met "with an informal approach directly suited to their needs, t r a d i t i o n s , va lues , and sp i r i t o f independence," according to Norma M u t a and her associates who studied project SHARE in the rural town of California in the state of Pennsylvania. California has a public university with 5,000 students and a perennial shortage of student housing. Regional poverty and unemployment rates


are high. In this area, elderly persons are much less likely than their urban counterparts to know about community services and they tend to resist using them. They are more isolated, suffer poorer health, travel longer distances for daily needs, and have poorer telephone service. The overwhelming need of elderly clients was for companionship, not financial help. Most of the home seekers were university students, typically older, serious types with family orientations and previous experience with older people.

To ensure participation of shy clients, project SHARE got permission to interview potential home sharers in their own homes. Staff delivered application forms and face- to-face requests personally. Staff also joined local churches, frequented local shops and banks, and served on community boards and committees to establish confidence and trust.

Not all organizations set up to facilitate home sharing have been successful. According to Robins and Howe, "failure seems to reflect problems of small size and tenuous funding." Success is more likely in a moderate-size community, "perhaps in the 200,000-300,000 range to support a home sharing program with 30.40 matches a year." It is also helpful if the organization serves some non-elderly as well as elderly segments of the community. "It does also seem that a higher proportion of elderly in the population helps to make a program succeed." (Dale J. Jaffe, "An Introduction to Elderly Shared Housing Research in the United States," in Dale J. Jaffe (ed.) Shared Housing for the Elderly. Westport (Connecticut): Greenwood Press, 1989; Joyce Mantell and Mary Gildea, "Elderly Shared Housing in the United States," IBM.; Barbara Robins and Elizabeth Howe, "Patterns of Homesharing in the United States," Ibid.; Norma Maata et al, "Homesharing in a Rural Context," Ib/d.)

Ontario Supports Home Sharing

To help promote the matching of home providers with home seekers, Ontario, Canada's most populous province, has provided financial and logistics support to 15 local and regional agencies--seven of which primarily target older persons. According to David H. Spenee (Ministry of Housing, Ontario), a governmental response seemed desirable because home sharing was attractive to many citizens, about 30% of residential dwellings were considered "'underused," and the costs of matching were low.

Local governments apply to the province for funds to support a matching agency either as part of their housing or social service departments. Sponsorship by the latter has the advantage of facilitating counseling on non-housing-related issues. A staff of one to two persons is then hired, assisted by volunteers, and a community- based advisory committee is formed. Agencies need not restrict their clientele to seniors, but they are expected to be particularly sensitive to their needs.

Public awareness of the program is stimulated through f~mily networks, the media, and social gatherings. Clients are often referred by other community agencies, as well. In the several years that the agencies have been in existence, an average of 36.4 matches have been made each year. In a recent period, nearly two- thirds of the home providers were single, and half were persons 55 years of age or older. Less than half (42%) of the matches were intergenerational. About one match in six involved service to be performed by the home seeker. An estimated 13% of clients were thought to have been able to avoid premature institutionalization because of the program. In one case out of seven, the match enabled the home seeker to move out of publicly-funded or temporary shelter. According to Spence:

These numbers indicate the dramatic potential that home sharing can have in terms of lessening the financial pressures placed on governments in providing shelters and care for seniors and lower income adults and youth.

Of the ongoing matches (as of June 1988), 39% lasted under 3 months, 23% between 3 and 6 months, 23% between 6 and 12 months, and 15% beyond 1 year. With incompatibility being the most frequent reasons for terminating a match, it is not surprising that as the programs mature (along with the skills of the matcher), so does the length of ongoing matches. The matching agency recommends trial periods of shared living and encourages formal agreements between the parties; it also helps to negotiate the agreements. Agency staff will also visit the homes of providers to verify the success of the match.

Criteria for Saece~ul Matches What factors favor a good match7

Among the "objective" factors considered important to explore are housekeeping s tandards , age, gender, cultural background, pets, location, transportation, smoking, employment status, and any requirement for services.

Among more subjective factors that should be considered are personality compatibility, flexibility, honesty, ability to communicate problems openly, willingness to meet other's expectations, the balance between privacy and companionship desired, and ability to adhere to agreed upon terms. It is hardly surprising that the perceptiveness of the matching agency's coordinator is of great importance in assuring successful matches.

Criteria for Program Success According to Spence, "substantial lead

time is required before a service is operating at a peak level of performance." At least one full year is needed to develop procedures, market the program, and build a cfient pool. Another two years are needed to fully test the feasibility of the program. Hence the need to provide a stable source of funding for at least three years, so that staff can devote themselves fully to program implementation.

"Carefully designed and targeted advertising materials are essential in developing and maintaining heightened community awareness." Not only does Ontario's provincial government assure three years of funding, but it provides the agencies with central delivery of promotional material and standardized forms and procedures for interviewing clients, providing quarterly statistical reports, matching clients, and the like. As a result, "it has been possible for agencies to converse in a common language using agreed-upon definitions, terms and procedures." This will also facilitate evaluation efforts.

It was also found that "a minimum urban population is required to sustain the activities of the central or primary office." Agencies serving communities of more than 50,000 are more likely to succeed. "Agencies functioning in areas with populations much smaller than 50,000, particularly if the target group is limited to seniors, may find it difficult to build and maintain the sizeable client pool necessary to make successful matches."

This does not mean that rural areas need to be excluded. Some of the agencies are regional in scope, serving both urban and rural areas.

Finally, involving local politicians in the home sharing program, such as on an advisory committee, has proven invaluable in increasing community exposure to the program. (David H. Spence, "Ontario's Homesharing Program," in Shared Housing for the Elderly, op. cir.)

Continued on page 12

Ageing International Winter 1990

home help assistance, mid-day meals, general care of the elderly (visits by voluntary workers), and advice centers. Staff would be made up of social workers, nurses and other specialists. An estimated 151,000 DM would be necessary to fund each center for the first six months of 1991. Another 35,000 DM would be needed for medical apparatus. These are quite large sums when one recotmizes that a comparatively small area of East Germany, such as Cottbus County, would need at least seven such stations initially. Caritas also wants to set up day centers in East Berlin but expects this will take some time. O'he organization needed nine years to set up its day centers in West Berlin.) Local authorities will be able, in part, to finance such centers, as well as projects involving the elderly, in the longer-term, but this does not solve immediate problems.

service. New containers are being used, allowing food to remain hot, the quality has improved, and pensioners can now choose between a number of menus. In time, there also should be considerable improvements to facilities and furnishings in existing residential and nursing homes.

Above all, there is now room for initiative to be shown, for lobbying on behalf of the elderly and for discovering new functions for elderly people in society. Here, not only can the West Germans play a role, but access to international experience, especially in the areas of fund-raising, the development of self-help groups and the raising of the public image of elderly would be welcomed by many involved with the elderly in East Germany. This would be seen by them as a positive international contribution and a symbol that they are not being left alone with their problems.

Conclusion

Unification with West Germany has meant the end of many promising policies and programs for the elderly. Above all, the loss of an integrated societal approach towards the elderly, contacts with their former place of employment, as well as with children and adolescents, and the break-up of the "veterans brigades" are regrettable.

Yet, there are also a number of positive and hopeful changes. The economy will develop quickly over the coming years and, with it, the standard of living will rise for most of the population. Already, the elderly are enjoying a much greater range of foodstuffs and consumer goods, and can take inexpensive holidays in most parts of Europe if they have the money. At present they are reasonably well- supported financially and, if all the promises made by the West German politicians are kept, East German pensioners need not be afraid of the future. Importantly, there are many more organizations which are working for the elderly and their needs, and some, at least, can draw on the experience and resources of their West German counterparts.

The quality of the support given to the elderly should increase with pluralism and competition. For instance, there has been a considerable improvement in the meals-on-wheels

Select Bibliography

E.G. Edwards. GDR Society and Social Institutions, Facts and Figures. London: Macmillan Press; New York: St. Martin's Press, 1985. R. Matthesius and B. Schmidt. "Zur Betreuung der iilteren Bfirger im Wohngebiet", Zeitschrift fiir die gesamte Hygiene und ihre Grenzgebiete, 36, vol. 1, 1990. Klaus-P.eter Schwitzer, (ed.). "Altenreport '90", in Bliitter der Wohifahrtspflege, no. 10-11, 1990. Klans-Peter Schwitzer. "Family Life Cycles: Their Effects on Old People's Family Relations." In Mogey, John (ed.) Aiding and Aging. The Coming Crisis in Support for the Elderly by Kin and State, Westport, CT: Greenwood Press, 1990. Gunnar Winkler, (ed.). Frauenreport "90, Verlag Die Wirtschaft, Berlin, 1990. Guunar Winkler, (ed.). Sozialreport "90. Daten und Fakten zur soziaien Lage in der DDR, Verlag Die Wirtschaft, Berlin, 1990. Gunnar Winkler, (ed.). Sozialunion. Postionen und Probleme, Berlin: Institut fiir Soziologie und Sozialpolitik der Akademie der Wissenschaften der DDR, 1990. Zentraiansschnss der Volkssolidaritiit (ed.). "Ausserordentliche Zentraie Deleglertenkonferenz tier Volkssolidarit~t e.V. am 26-27. 5. 1990, Volkshelfer Sonderheft, Berlin, 1990.

Briefs continued from page 6

Long-Term Care

Long-Term Planning For Long-Term Care In Japan,

Canada and Germany

With people age 75 and over continuing to comprise the fastest growing segment of the populations in many nations around the world, there is increasing concern about caring for the health and related needs of the so-called "old-old" cohort--and early alarm about the potential costs. In some

countries, this has served to stimulate long- term planning--or at least long-range speculation--about how to provide long- term care to an expanding "frail elderly" population at a time of increasingly limited resourees, both economic and human.

During the past year or so, while the Japanese Ministry of Health and Welfare was unveiling its "Ten-Year Gold Plan" For the Prosperous Old-Age and Welfare Society of the 21st Century, a consortium of government ministries in the Canadian province of Ontario was formulating its own Strategies for Change: Comprehensive Reform of Ontario's Long-Term Care Services.

Meanwhile, new questions are being raised in Germany about both the adequacy and financial feasibility of long-term care services available to the disabled and elderly under the Federal Republic's 1988 Health Reform Act, a consideration which may be further complicated by the economic ramifications of the country's recent reunification.

As in most industrialized nations, much of the current thinking in planning for long- term care (LTC) in the three countries under discussion is moving away from the traditional reliance on nursing homes and related institutions and toward a new



Satya, Brink. "International Experience with Government Policy Initiatives for Housing the Elderly" Housing and Society, Volume 2, Number 2, pp. 169-175, 1988.

Satya, Brink. "International Experience in Housing the Very Old: Policy Implications for Canada" in Gutman G. and Blackie, N. Housing the Very Old, Burnaby, British Columbia: The Gerontology Research Centre, Simon Fraser University, 1988.

Satya, Brink. Housing Policy Directions Based on a Review of Environmental Design Research: A Comparative Study of Housing Policies for the Elderly in Canada, the United States, Sweden and France. Paris: The Ministry of Construction, Housing,

Management of Territories and Transportation, 1988. (Available in French and English from the Gerontology Research Centre, Simon Fraser University, 515 West Hastings, Vancouver, Canada.)

Satya, Brink. Living Arrangements for the Elderly--An International Policy Comparison. Paper presented at the Scientific Colloquium on "The Economics of the Care of the Elderly" organized for the European Commission and the Flemish Government, Brussels, March 22-24, 1990.

OECD. Urban Policies for Ageing Populations, Paris, OECD, in press.

Briefs continued f rom page 12

emphasis on utilizing medical and home care services to enable people to remain in their homes as long as possible. Since all three countries provide national health insurance, there is substantial public sector involvement in LTC planning and financing.

Japan: Reverence and Pragmatism Like other Asian countries, Japan has a

long tradition of reverence for elders and ancestors. While that tradition is still very much alive, there has already been considerable change, and more seems inevitable. For years, Japanese parents, grandparents and children have frequently lived under the same roof, and caring for the elderly has almost always been a family responsibility, with much of the load usually being borne by the wife of the eldest son. In today's world, however, multi- generational households are no longer as predominant as they once were, and many wives work, thus making them less available for careglving chores. Nonetheless, Japan is the one remaining industrialized nation in which a relatively large share of elderly parents still live with their adult children.

While the Gold Plan's "Ten-Year Strategy to Promote Health Care and Welfare for the Aged" would appear to continue this traditional emphasis on home and family as the primary site and source of care for the elderly, it seeks to lighten the load of family members by providing them with supportive services and occasional respite. At the same time, some aspects of the plan would shift part of the financial burden for such care from the government health insurance program to individual consumers and initiate the development of a volunteer service corps in a country that has not heretofore had an established tradition of voluntarism.

In general, Japan has not relied heavily on nursing homes as such to provide custodial or skilled care for those older

persons not capable of living independently in their own homes. Rather, such individuals have obtained care in acute-care hospitah which tend to be more costly than the nation's relatively few nursing homes. While most of the cost is borne by Japan's national health insurance program (or perhaps because of this), there is a social bias favoring care in hospitals: if an elder is placed in a nursing home, his or her family is often regarded as uncaring, but if the same elder is in a hospital under the similar cirolm~tances, the family is considered to be properly concerned and doing its duty. Thus, ff the Gold Plan is to prevail, attitudes as well as poficies will need to be changed.

At present, 700,000 Japanese age 65 or over, or 4.6% of that age group, are bedridden. Of these, 42% are housed in geriatric hospitals, 20% are in skilled nursing homes, and 36% live at home. Over the next 10 years, the Gold Plan proposes to reduce those percentages to 12, 24 and 35, respectively. To encourage infh'm older persons to remain in their own homes or with their families, the Gold Plan calls for a 300% increase in the ranks of visiting homemakers employed by the government, a 1200% increase in respite care centers and a 1000% increase in day nursing home (or day care centers). On the other hand, the nation's elders and/or their families will be required to pay a portion of the costs for the services they receive.

With the goal of "complete efimination of bedfastness among the elderly," particular emphasis is to he placed on expanding geriatric rehabilitation facilities up to 280,000 beds by the year 2000 and of establishing 10,000 24-hour emergency home care support centers throughout the country to assist family careglvers in dealing with their elders' conditions and their own personal caregiving problems. Staffed by two nurses and eight volunteer counselors, each of these centers is expected to serve an area with about 2,100 elders,

approximately 100 of whom may require constant supervision.

The estimated cost of these and other measures over the Plan's 10-year span comes to Y6 trillion (US $43 billion), with a proposed first-year expenditure of Y360 billion (US $2.5 billion). The proposed ten- year cost is four times as much as Japan's government spent on aging services during the 19S0s. One indication of the potential economic benefits to be derived from the plan may be found in a 1984 Japan Economic Planning Agency report which estimated that the annual cost of caring for a disabled person in a nursing home was Y2.3 million (US $16,000) while caring for the same person at home cost Y475,200 (US $3,300); when the value of family labor was factored in, the home care cost rose to Y1.1 million (US $7,700).

An additional uncited and seemingly unplanned-for cost to which some in the aging field have pointed is the need to adapt Japan's existing housing to make it feasible to provide home care for infirm elders; it is possible, however, that such modifications might fall into the domain of another government ministry, such as Housing. Also to be overcome in the effort to eliminate bedfastness is the socio-cultural tradition of some older Japanese to take to their beds, even for non-disabling illnesses (such as diabetes) which do not require bedrest. Yet another important question being posed is where the manpower will come from for the planned massive expansion of home care services at a time of anticipated labor shortages.

While the Gold Plan encompasses the usual spectrum of aging issues--income adequacy, medical research, reemployment opportunities, etc.--it places its strongest emphasis on the development of sufficient home health care and related services to support aging in place, an approach that will be highly dependent upon Japanese women being willing to continue being their nation's principal source of hands-on


caregiving for the elderly. There is some question, however, as to how long that willingness will prevail in the face of the expanding workforce roles already being played by women and at a time of emerging feminist resentment of - -and resistance t o - - t h e nat ion 's t radi t ional ly male- dominated society.

The surfacing of this resentment, according to some political observers, was one of the major factors behind Japanese women's widespread opposition to the national 3% sales tax enacted by the dominant Liberal Democratic Party, and the powerful role played by them in unseating at least one--and possibly two--prime ministers. Although it also had other economic purposes, the sales tax was promoted by its sponsors as a means of paying for the aging of Japan in an unsuccessful effort to create an almost obligatory social acceptance of an otherwise undesired levy. The Gold Plan--with its built-in support services and respite facilities for caregivers--is thus seen by these observers as an attempt to placate this criticism. The question is whether this will be enough.

To economist Masako M. Osako, the Chicago-based representative of the Japan Well-Aging Association, " the answer depends largely on the disposition of women in the Baby Boom generation." Writing in Productive Aging News (May 1990), Dr. Osako observes: "The plan a s sumes tha t f a m i l y c a r e g i v e r s , predominantly middle-aged women, will continue to be available . . . Unlike the current generation of middle-aged women for whom career aspiration is generally limited, the Baby Boomers may prefer gainful employment to being a caregiver without pay . . . The key to the plan's success depends on the extent to which Japanese women would accept a daily schedule of eight hours at work plus several hours of housework and caring for an aged parent."

Canada: Consensus Via Diversity Unlike Japan, which has comparatively

few nursing homes and thus greater freedom to develop a geriatric care model without having to be concerned about current organizational constraints, the Canadian province of Ontario is seeking to reshape its existing, relatively rigid system into a more flexible configuration that will be both cost-efficient and responsive to the evolving needs of a population that is changing in many ways other than age.

Where Japan's population is basically homogeneous, the people of Canada--and especially Ontario where 25070 of the residents were not born in Canada--are increasingly heterogeneous, a tendency that is expected to continue for some time to come. To many, the changes taking place in Ontario are regarded as forerunners of situations that may soon be confronting the nation's other jurisdictions, so how it deals with long-term care now could set a pattern for others to follow or avoid in the near future.

Canada's national health insurance system is implemented by the country's 10 provinces and two territories. While each has its own programs which vary in response to local needs and circumstances, they are required to meet such federal guidelines as universal availability to all Canadians, no deductibles or coinsurance requirements, full coverage for all medically necessary services, public administration on a nonprofit basis, and complete portability between provinces. Since provinces do look to each other to learn about health planning and service delivery, what works in one province might very well influence others.

While both Japanese and Canadian planners espouse greater coordination-- and even unif icat ion--of health care and soc ia l se rv ices , the O n t a r i o proposal envisions a "one-stop access approach to obtaining services" which would result from the develoi~ment of " a truly integrated system of long-term care and support services" in which " a single administrative organization, or agency, will be identified or established in each community to act as the point of access,

r e f e r r a l , a s s e s s m e n t , and se rv ice coordinator for the care and support services of the reformed system." Among the responsibilities of such an agency would be "ensuring that all community and in- home service options have been fully e x p l o r e d and e x h a u s t e d b e f o r e [institutional] placement is approved."

Acknowledging that "the informal [caregiving] network, which involves the support and care given by family, friends and volunteers, represents over 80070 of help received," the proposal calls for increasing home services in order to "support the efforts of family members and other informal c a r e g i v e r s . . , assist people with functional dependencies to participate as fully as possible in community l i f e . . . [and] facilitate early discharge from hospitals and p r e v e n t u n n e c e s s a r y acu te ca re readmi~ions."

With a system already in place, and vested interests seeking to preserve their positions, the Ontario planners admit that the reforms they are proposing "will involve years of cooperative work. Substantial challenges are to be expected at the local, regional and provincial levels; however, partnerships among those involved will help to create a better service system for all ." Thus, even as the Japanese Gold Plan is being criticized by some as an attempt to rationalize actions already taken, Canada's planners seem to be adopting one of Japan's usual approaches to governing and doing business, and by calling for the development of a consensus among the many diverse interests involved in the situation. Toward that end, the Ontario proposal is currently being made the object of community discussions throughout the province and may yet undergo considerable change.

Although government officials estimate that C$2 billion will be spent on reforming the province's long-term care system over the next six years, there is no firm indication of exactly how the money will be allotted or by when the project is to be completed. The proposal was a joint undertaking of Ontario's Ministry of Community and Social Services, Ministry of Health, Office for Senior Citizens' Affairs, and Office for Disabled Persons. Turning its recommendations into reality will be the responsibility of the new Division of Community Health and Support Services which was created for this purpose under the aegis of the two Ministries. [Copies of Strategies for Change are available from: Publications Ontario,


5th Floor, 880 Bay Street, Toronto, Ontario M7A IN8, Canada]

Gernmay: Reasse~ng Reform Unlike the reform programs of both

Canada and Ontario, which are still in relatively early stages of development, Germany has already begun implementing the Federal Republic's 1988 Health Reform Act amidst growing concern about the adequacy and appropriateness of its provisions for the long-term care of disabled and elderly Germans. While the Act's primary intent was to increase the cost effectiveness of the nation's overall health care system, some of its provisions also reflect a desire to help people remain in their homes and out of institutional care, and to relieve caregiver burdens.

Toward this end, the Act mandates the development of special rehabilitation clinics geared to the needs of elderly patients, and provides support to infirm individuals in need of services to enable them to continue living at home.

Home help benefits, which become available in January 1991, provide up to 25 hours of home care per month (valued at 750 DM), or a monthly cash benefit of up to 400 DM. Under the preferred service delivery approach, the German health insurance program assumes responsibility for delivering services via subcontractors or its own staff. The 400 DM cash benefit can be paid to permit recipients to reimburse caregivers of their own choice. Emphasis is being placed on the first strategy in order to better assure that the needed care is provided. There is also a short-term custodial care benefit, which went into effect in January 1989, of up to four weeks a year to permit caregivers to take vacations.

To Gerhard Igl, professor of public law and social legislation at the University of Hamburg, the home care provisions are not sufficient to help people of moderate means stay out of nursing homes--a monthly maximum of 25 hours of home care is simply inadequate in many cases. At the same time, he maintains that, while the law seeks to encourage family care rather than residential care, the government has not addressed the issue of the economic penalties incurred by family members who are often obliged to give up their own employment and social security protection in order to become caregivers.

"The main goal [of the reform law] was to create more cost effectiveness, not to give better health protection," he observes.

"There is a concentration on providing benefits but not on the kind of help really needed. The links between giving social benefits on the one hand and the necessity of delivering adequate services on the other hand are not respected."

Even when institutional care becomes necessary, it is not covered under the public health insurance program. The health care reforms did not address this issue at all. As in the United States, individuals must be paUl~'ized before social assistance is available to help pay for such costs.

"I t is still a scandal," charges Prof. Igl, "that one of the most harmful social risks, the catastrophic risk of being severely and long-term disabled is not yet sufficiently protected [9~alrtst] in a social SeCUrity system which is considered to be one of the most adyantageous in the world."

At the time health care reforms were being enacted in the Federal Republic, German reunification was still generally regarded as an unachievable dream. As the West assumes many of the East's economic burdens within the framework of reunification, there are questions of how advantageous the new united Germany's social security system can remain, and how long-term community care will fare under these changed circumstances. (For the Prosperous Old-Age and Welfare Society of the 21st Century, Ministry of Health and Welfare, Tokyo, Japan, 1990; Productive Aging News, Mount Sinai Medical Center, New York, May 1990; Strategies for Change: Comprehensive Reform of Ontario's Long-Term Care Service, Ministries of Community and Social Services, and Health, and Offices for Senior Citizens' Affairs, and Disabled Persons, Toronto, Ontario, Canada, 1990; Gerhard Igl, Problems of ~naneing Long- Term Care for the Disabled and Elderly in the Federal Republic of Germany, unpublished paper, 1989.)

New Organizations

International Leadership Center on Longevity and Society

Formed

Conceived initially as a joint United States- J a p a n e f fo r t , the newly fo rmed International Leadership Center on Longevity and Society aims to a~ist in poficy development for the world's a_~in8 population. The private, non-profit Center seeks to assist decision-makers in making

wise policy choices for an aging world and to stimulate cooperation among scientists and policy-makers.

The Center will conduct studies, hold conferences, and promote exchange programs for scholars and students.

The U.S. office is located at the Ritter Dept . o f Ger ia t r i c s and A d u l t Development, Mt. Sinai Medical Center, Box 1070, New York, HY 10029; the Japan office at the Japan College of Social Work, 3-I-30 Takeoka, Kiyose-shi, Tokyo 204, Japan.

New Roles

Retired Businessmen Sought After in the Netherlands

Through several initiatives of the Federations of Netherlands' Industries (VNO/NCW), retired managers and businessmen are finding that their skills are still in demand.

In the "Become Your Own Boss" program, individuals seeking to start their own businesses are welcome to pose their questions free of charge to any of VNO/NCW's 35 senior consultants--all retired entrepreneurs now working as volunteers two days a week at one of the 25 Chambers of Commerce throughout the Netherlands.

In a similar effort, small established industries can obtain organization and management advice from 130 retired entrepreneurs registered with the Kieinnood Foundation.

The Om project, an offshoot of the Nieuw elan program, uses 100 senior coaches--mostly retired managers--to help higher.educated unemployed adults obtain jobs. Job seekers obtain constructive criticism and assistance in developing individual job strategies.

Finally, in cooperation with the Ministry o f Fore ign Affa i r s , the Netherlands Management Consultancy Program for Developing Countries (NMCP) established in 1979, assists small f'u-ms in the Third World to obtain management, professional or technical skills for which they could not afford to pay. The host enterprise covers local expenses. NMCP covers all other costs for the volunteer and spouse. On the average, 120 volunteers are sent abroad each year. (Card R. Tenhaeff, "Training of Older Workers in the Netherlands," Geneva: International Labor Organization, 1989)



Development of Human Potential

Older persons have the right: Principle 20

to continuing opportunities for full development o f their personalities.

Principle 21 to equal access to educational opportunities to permit informed planning and decision-making, enhance personal fulfillment, facilitate employment and active contributions to the improvement o f society, and permit sharing knowledge and life experience.

Principle 22 to full access to the cultural, spiritual, and recreational resources of society.

Principle 23 to remain contributing members o f the community according to their capacities and desires, and to serve as volunteers in positions appropriate to their interests and capabilities.

RESPONSIBILITIES OF OLDER PERSONS

Consistent with individual values and as long as health and personal circumstances permit, older persons have the responsibility:

Principle 1 to remain active, capable, self-reliant and useful.

Principle 2 tO learn and apply sound principles of physical and mental health to their own lives.

Principle 3 to take advantage of literacy training.

Principle 4 to plan and prepare for old age and retirement.

Principle 5 to make informed decisions about their health care and to make wishes known to their physician and loved ones about terminal care.

Principle 6 to accept new roles in family relationships with changing circumstances.

Principle 7 to update their knowledge and skills, if needed, to enhance their employability if labor force participation is desired.

Principle 8 to share knowledge, skills, experience and values with younger generations.

Principle 9 to participate in the civic life o f their society.

Principle 10 to seek and develop potential avenues o f service to the community.


German Academics Found Expert Service

for Women

Dr. Angelika Wagner, Vice President of Hamburg University, and Dr. Sigrid Rotering-Steinberg, an educator, have launched a Senior Expert Service to advise and assist younger professional women at the start of their careers. Participating female volunteers will share their expertise and experience, maintaining intergenerationai contact and insuring that their lifetime of knowledge gets the use it deserves. Initially, female lawyers, engineers and entrepreneurs will be asked to collaborate.

The initiative grew out of the realization by the SES founders that a similar service in the Federal Republic primarily consists of and serves men. The proportion of women recruited by this service, for example, is less than ten percent. (KDA Presse-und Informationsdienst, 4/89)

Retirement Preparation

U.K.'s Pre-Retirement Association Provides National

Focus

The Pre-Retirement Association of Great Britain and Northern Ireland (PRA), a private, non-profit organization has been designated as the "national focus" for pre- retirement education, planning and provision by the U.K.'s Department of Education and Science. It both organizes such training itself and encourages others to do so. Its members include major employers in both the public and private sec to rs , t r ade un ions , v o l u n t a r y organizations, and individuals.

PRA also seeks to improve quality. One thrust is to encourage a shift from the typical short courses provided immediately preceding retirement to a process of counseling starting ten or even fifteen years before retirement. The emphasis here is on each individual's responsibility to create a

life plan which will reduce the stress of retirement.

A Resource Centre based in the Adult Education Dept. of the University of Surrey provides advice and information and publishes a newsletter, "Resources Unit News" for pre-retirement trainers. A Field/Training Centre based in the Extra- Mural Department of the University of Manchester offers short courses to trainers. (Charles Manton, "Training of Older Workers in the United Kingdom," Geneva: International Labor Organization, 1989)

Pre-Retirement Education in France

Pre-retirement education began to gain a foothold in France during the 1970s as pension funds sought to curb the incidence of illness found in the years immediately following retirement and employers sought to sweeten older workers' departure from the labor force made necessary by "downsizing." It was given a further boost in 1984 when monies raised from payroll


taxes to fund continuing education opportunities were permitted to be used for pre-ret i rement educat ion, as well. Nevertheless, no more than an estimated 5% of the eligible population is exposed to any formal training; personnel in professional or management positions are particularly underrepresented. (This figure, however, is no worse than the overall average of the population found to be exposed to pre-retirement education among the member states of the International Labor Organization.)

Pre-retirement education tends to be concentrated in the last two years before retirement and is usually organized by the employer, often using outside trainers. Most courses last four or five days, arranged consecutively or intermittently over a period of time. As elsewhere, they are organized for small groups of persons, but there is still considerable debate about including spouses--an argument that has been settled in their favor in most countries. Follow-up after retirement is rare.

Interestingly, courses offered by educational centers cover the same content whether the audience is composed of pre- retirees or pensioners. No distinction is made between preparation for and adaptation to retirement.

The provision of information remains a major concentration of pre-retirement education, but the encouragement of group discussion and personal interchange is playing a larger and larger role. Hobby workshops, too, are added from time to time. (Philippe Bianchard and Veronique. Wallon, "La Formation des Travailleurs Ages France," Geneva: International Labor Organization, 1989)

Retirement Preparation in Israel Given Boost by Authority for

Pensioners and the Aged

The majority of Israeli workers now receive pre-retirement training within the last two years preceding retirement thanks to the efforts of the Authority for Pensioners and the Aged, a nat ional non -p ro f i t organization founded in 1978 and largely funded by the Ministry of Labor and Social Affairs and the National Insurance Institute. A national survey of all organizations employing more than 150 workers conducted in 1987 indicated that approximately 20,000 persons had attended pre-retirement courses. The survey also showed that 41% of organizations reported

26

participation rates of 90-100%; 70% reported 80q) or more. Participation rates for blue and white collar workers were comparable. According to the Authority:

The stigma which was associated with the retirement process is gradually being replaced by a positive attitude which regards this transition as another stage in the life course (offering) new and challenging opportunities for personal development and growth.

The Authority's initial efforts coincided with and was facilitated by the growing public awareness about the rapid aging of Israel's population and companies' desire to address a wider range of employees' needs than those directly attributable to the work environment. "'Welfare offices" were created within many organizations and one of the first activities they embraced was the organization of pre-retirement courses.

The Authority organizes symposia on the importance of pre-retirement training for c ompany di rec tors , personnel managers, union officials and workers' committees, condu~:ts training courses for counselors and organizers in the pre- retirement field and publishes materials on the subject directed at both older persons and trainers. Its comprehensive retirement guide, "'Towards the Third Age," is commonly purchased by companies and given to course participants.

To date, most pre-retirement training takes place in a work setting with participation by spouses. The most common pattern is a series of sessions spread out over a period of time. Program length varies from 15 hours to 50 hours. As elsewhere, the programs cover both factual material through lecture formats and, increasingly, encourage group discussion around social-psychological aspects of retirement. Opportunities to meet with successful retirees, visits to arts and crafts centers, museums and senior clubs, physical exercise and creativity workshops may be included, as well.

Interestingly, participation in pre- retirement courses is usually preceded by a personal interview with an organization's welfare officer in order to learn about the individual's attitudes towards retirement, problems and concerns, expectations and needs about the training and, if necessary, to persuade him or her to participate! To the extent possible, these concerns are fed back into program planning. In several organizations, seminars on the importance of pre-retirement education are held for all managers in order to create a supportive organizational atmosphere.

The Authority is now expanding its efforts to provide pre-retirement training to community groups. Other specialized groups served are the Israeli Defense Forces, where retirement takes place between ages 40-45 and the training necessarily must focus on obtaining new careers, and Israel's agricultural collectives, where gradual rather than complete retirement is the norm. ("Preparation for Retirement in Israel," Jerusalem: The Authority for Pensioners and the Aged, February 1990)

French and Flemish Communities Both Offer

Pre-Retirement Training in Belgium

Connexion, Based at the University of Liege, is Belgium's major center offering pre-retirement training to the French- speaking parts of the country. Many large employers pay for their employees', as well as spouses', training at this university-based setting. Detaching employees from their work setting for the training is considered particularly beneficial.

The nine-day program is offered once a week for nine weeks in order to permit time for reflection and avoid the discomfort that could be caused by unaccustomed living circumstances. Groups of 15-20 persons are organized on the basis of similar occupation, but employees from different firms are mixed wherever possible.

Lectures and discussions are organized in the fields of health, law, finances, culture, relationships, and emotional fife. Participants are encouraged to approach their new leisure time as active participants rather than as passive consumers. Social contacts are encouraged and some groups continue to function independently and hold meetings following the training (a few people have as much as 12 years of such activity).

The Nationaal Institunt Voor-bereiding op Pensioen (NIVOP) is Belgium's major institute reaching out to Flemish-speaking persons in their last year or two before retirement. Unlike Connexion, a five-day board and lodging option is recommended to permit couples to develop friendships and allow for more in-depth discussions. This is preceded by a one-day introductory program, followed by three separate days of discussion in ensuing months. In addition to the subjects covered by


Ageing International Winter 1990

Continued from page 49 facilities and flexibility o f provision are closely linked elements in guaranteeing older persons the right to educational opportunity. Models o f low-cost, imaginative educational offerings in different settings are urgently needed. (Reported by Joanna Walker, Department o f Educational Studies, University o f Surrey, England)

Note: the next conference of the Association of Educational Gerontology on the theme of Education, Older Citizens and Social Change will take place March 25-27, 1991 at the University of Keele. For further information, write: Mr. Robert Elmore, Hon. See. AEG, c/o Dept. of Continuing Education, University of Oxford, Rewley House, 1 Wellington Square, Oxford OX1 2JA, England.


Connexion, the NIVOP also teaches participants how to use the media, recognizing the major role it plays in the life of retirees. Death is also discussed in order to begin to alleviate some of the anxieties surrounding this subject.

Leaders of both Connexion and NIVOP are psychologists or sociologists with considerable training experience. They are supplemented by experts in various fields. (Jacques Grnloos, "Training of Older Worke r s in B e l g i u m , " Geneva : International Labor Organization, 1989)

Mental Health Sought for Belgium's Early Retirees

Connexion has also been asked to develop a program to prevent stress-related mental illness at the end of the worklife to which early retirees, aged 52-62, particularly, seem to be vulnerable. This request was initiated by the Erasme Hospital at the Free University of Brussels which found itself treating increasing numbers of persons suffering from this syndrome. Two indicators of the problem were the incidence of illness six months before the end of the career and early deaths registered soon following retirement.

The lack of models or standards to follow to guide one's life axe thought to be particularly problematic for early retirees who are still capable of launching an active new life. (Grnloos, op. cir.)

Pre-Retirement Training Spreads in the Netherlands

Half of the Dutch labor force was entitled to pre-retirement training in 1985 on company time as a result of collective bargaining agreements. Of 756 agreements

in force at the time, 323 contained clauses on pre-retirement training. Interestingly, the proportion of workers actually taking pre-retirement training declined slightly during this period because of the number of companies in which the minimum age for participation exceeded the minimum age for early retirement! (Carel R. Tenhaeff, "Training of Older Workers in the Netherlands," Geneva: International Labor Organization, 1989)

Japanese Unions Promote Life Planning

Several Japanese trade unions have extended the notion of pre-retirement planning to the "midd le yea r s , " recognizing that sound planning must begin earlier than the last few years before retirement

The Mitsubishi Electrical Workers" Union's "S i lve r Life Enr ichment Program" is open to all members in their mid-to late 40s. Participants are first required to read a 250-page monograph covering topics in life planning, such as personal finance, career management, health maintenance and community and family relationships. This is followed by a weekend meeting in a resort facility involving lectures and discussions.

Another program offered to mid-life workers (about age 45) by the Heavy Industry Union seeks to help members 1) make the best use of their remaining working life; 2) assist in personal financial planning; 3) help enrich personal life. The format here, too, consists of lectures and discussions. This mid-life training is followed by pre- and post-retirement counseling. (Masako M. Osako, "Training of Older Workers in Japan," Geneva: International Labor Organization, 1989)

Pre-Retirement Holiday Organized in England

E n g l a n d ' s leading Pre-Ret irement Association organizes a unique one-week program of entertainment and education in a holiday village in southern England twice each year. Each event attracts about 500 participants aged from the mid-40s to the mid-80s. Many attend after retirement, and some attend more than once.

The program includes entertainment and introductions to crafts and hobbies, as well as the usual pre-retirement subjects of finances, retirement residence, and even second careers. The goals behind the holiday atmosphere remain serious--to encourage participants to think and start planning about their retirement years and reduce their anxieties by sharing them with others. The cost per person is ,L'135 for the week, excluding transportation. (Charles Manton, Opo cit.)

Training

In an effort to narrow the gap between the often stated need for more training materials in the field of aging and the considerable amount of materials that do exist worldwide, IFA has embarked on a project to develop a series of annotated bibliographies of existing quality training materials, both written and audio-visual, in the areas of health promotion and self-care, fami ly s u p p o r t and caregiv ing , vo lun t ee r i sm , and p re - re t i r ement education. Individuals knowledgeable of good materials in these areas are kindly requested to notify IFA regarding their availability. Please write: International Federation on Ageing, Attn: Toby Brookes, 1909 K St. NW, Washington, D.C. 20049, USA.


british center stimulus for arts and crafts

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