Demographic Trends in Germany and current challenges of Senior Citizen Policy

Demographic Trends in Germany and

current challenges of Senior Citizen Policy

Dr. Matthias von Schwanenflügel, LL.M.Eur.

Head of Directorate General

Facts & Figures

Demographic change

• A shift in the age structure – low birth rates and a higher life expectancy

Geriatric care

• About 2.73 mn people are in need of long-term care

• 1.93 mn (71 %) thereof are in out-patient care

• About two thirds of the people in need of long-term of care are exclusively cared for by relatives

Overview – Challenges



To manage the Demographic Change



Active Ageing - Potential and Challenge



To combine Work, Family life and Care



Challenge Dementia and Local Alliances



Intergenerational Networks



LongTermCare Reform



Nursing Professions Reform Act

Challenge: To Manage a Demographic Strategy

To

manage the

demographic change

the federal

Government has developed a demographic

strategy

– augmenting pertinent laws and measures –

•

for a better coordination of measures and projects

•

to push joint projects in conjunction with partners from the

Länder

, local authorities, labour & management and

business, science and civil society associations

The challenge

 As part of the demographic strategy Germany has to develop the untapped potential of their elderly people

 Germany is expecting about one million Baby boomers going into retirement; starting 2020 for 10 consecutive years. The German Baby boomers are born between 1955 and 1964. Comparatively they are much wealthier, healthier and more active than the former generations.

 Currently the Ministry is trying to adapt the Active Aging Index for the local level (cities, counties, communities) to identify the untapped potential; exactly were it matters for the Elderly themselves

 A Round Table organized by the Ministry together with different national associations of our civil society and our local authorities and also the Länder prepares Germany for the challenge of our Baby boomers reaching their After-Work-Life starting 2020.

Challenge:

How to combine Work, Family life and Care ?

Time flexibility and security

Reducing bureaucratic burdens and costs

New regulations:

Familiy Caregiver Leave Act

Caregiver Leave Act

Alliance for People suffering from Dementia

P

art of the Federal Government’s demographic

strategy

–

run jointly by the Family and Health Ministry

Alliance of competent people and authorities plus a

pooling of initiatives at the federal level in conjunction with

the

Länder

and local authorities, civil society and self-help

organisations

•

Objective

:

Agenda to improve dementia patients’

and their relatives’ quality of life

•

Guiding principle

: Inclusion, self-determination,

participation, UN-CRPD

(WHO)

47 mn people suffering from dementia

This number is globally going to triple by 2050

Almost 60% live in middle and low-income countries

In 2010, the estimated total dementia care costs stood at US$ 604 bn

2014 - 1.5 mn

2020 - 1.8 mn

2050 - about 3 mn

Local Alliances:

Support Networks in the Neighbourhood

Model program by Ministry - the agenda‘s central measures

Objectives:

Self-determination in social contexts despite

dementia

Sensitisation of the society to better deal with people

suffering from dementia

More assumption of mutual responsibility



by networking initiatives and measures at the local

level

Important are local networks:

Example: The average multi-generational centre (

Mehrgenerationenhaus

)*

open meeting space

open 40 hours (38) during the week

57 (54) users/visitors daily

integration and education

10 (9) services

aging and care

5 (5) services (supporting) volunteering 4 (4) services household-related services 4 (4) services staff 5 (5) permanent employees 39 (34) volunteers 81 (73) cooperation partners 108 users/visitors daily 67 % female 25 % with a migration background

Challenge: LongTermCare Reform

First stage: First Act to Strengthen Long-Term Care

1

Better home care benefits

Additional staff for institutional care, benefiting all people in need of long-term care (ratio improved from 1:24 to 1:20)

Establishment of long-term care provident funds to cushion any future increases in contributions (caused demographically)

Most benefits raised by 4%

A better combinability of short-time and respite

care benefits

A better combinability of day and night care with in-kind benefits and the

nursing allowance

First ever part-time institutional and short-time

care in-kind benefits for

dementia patients with no level of care

New low-threshold support to finance

household or neighbourhood services

Grants for home-improvement measures (modifications) increased from € 2,557 to € 4,000

LTC Reform (Reform of SGB (Social Code) XI) – second

stage

Second stage:

Second Act to Strengthen Long-Term Care

in the pipeline: to be implemented during this parliament

Introduction of a new “need of long-term care” concept with

a new assessment (Neues Begutachtungassessment, NBA)

Funding: contributions raised by 0.2 %

 2 model projects to test the new “NBA”

The Second Act to Strengthen Long-Term Care will be based on the results

Five degrees of care replacing three levels of care, thus benefits and services can be better geared to what is actually

needed

Nor more differentiation between physical impairments and

cognitive or emotional impairments (dementia in

particular) The essential criterion for the

degree of care to be assigned will no longer be the time needed for nursing but the

degree of autonomy

First-time-ever consideration of the special help and support people suffering from cognitive or emotional impairments need

Current training in geriatric nursing

I

Training in figures

I

Trainees in geriatric nursing: 62,355 (+5.04% over previous year)

I

10,000 nursing facilities provide training, 740 geriatric nursing schools

I

Skills shortage

I

40 job-seekers for 100 reported vacancies

I

No shortage in helping professions

I

Training structure (as per German Act on the Care of the Elderly)

I

3 years training ends with State examination

I

Theory courses: 2,100 hrs / clinical experience: 2,500 hrs

I

Overall training responsibility: Geriatric nursing school

I

Training contract between trainee and institution

Nursing Professions Reform Act (working title)

I Subject of the reform

I Merging of training programmes for geriatric nurse, general nurse and pediatric nurse (“generalist programme“)

I Vocational training with graduation and certification of expanded practice

I Consideration of supplementary introduction of academic training (target figure according to German Science Council: 10%)

I Standardised and equitable financing involving the Laender

I Free of charge for the trainee

I Legislative procedure beginning in 2015

I Leadership shared between Federal Ministry for Family Affairs, Senior Citizens, Women and Youth & Federal Ministry of Health

l Parallel need for improved working conditions

Inclusive Housing - Living in Old Age

Demographic change

Living independently in old age as a political goal

As people age, their own home becomes more and more important – elderly people spend more time at home than younger people

Federal programme, term: 2013 – 2016, approx. 300 projects nationwide

Goal: strengthening neighbourhoods, setting up low-threshold services

that provide assistance in everyday life Examples:

I Conversion/ renovation / furnishing of places of encounter and meeting

and information rooms

I Assist with picking and organising services in place

I Provide shopping transportation and grocery shopping assistance for the

elderly

I Volunteer qualification and deployment (e.g. assistance with filling in

forms, computer courses)

I Volunteer visiting and escort services (organisation of everyday life)

Questions?

Contact:

Dr. Matthias von Schwanenflügel, LL.M.Eur.

Bundesministerium für Familie, Senioren Frauen und Jugend D-11018 Berlin

Tel.: +49(0)3018-555-1700 Fax: +49(0)3018-555-41700