Social Situation and Politics
Towards the Elderly People in Slovenia
by Blaz Mesec
With 13.2 percent of the population aged 65 years or more (1997),
Slovenia ranks among the older societies in which the percentage
of elderly people continues to rise. The life expectancy of
individuals over 65 years of age is only one year shorter than
that in Germany, which suggests that pensioners enjoy a good
standard of living. Pensioners are evenly distributed between
all income groups. There are more indicators to challenge the
stereotype of the impoverished pensioner. Only people without
pensions, and elderly, isolated farmers live under the poverty
line. Problems arising from the social status of elderly people
include the increasing need for care, nursing and help in general,
burdening of family members, loss of the significance of life,
suicide, and an undefined culture of dying. Fulfilling the human
rights of the elderly would mean primarily providing for an
acceptable standard of living and preventing age-based discrimination.
The Old-Age and Disability Pension Insurance Fund and the Healthcare
Fund, as well as social welfare measures resulting from the
economic successes of the country as a whole, provide an acceptable
standard of living. All these fields are undergoing pluralisation
and reform processes, which, by clearly defining services and
the public service network, are expected to increase the responsibility
of individuals for their own well-being and to redistribute
the responsibility of caring for the elderly between institutions
other than the state.
Demographic Dynamics and Social
Position of the Elderly
Tree of Life and Population
At the end of 1997 there
were 262,417 people aged 65 years or more living in Slovenia,
accounting for 13.22 percent of the total population of the
country. The cohort comprising elderly people aged 65 years
or more has grown from a tiny bud sprouting at the apex of the
population tree in 1948 into a vigorous and robust section of
the trunk. The relationship between gender representation, however,
is very asymmetrical: there are far more women than men. Only
1027 percent of men and 16.69 percent of women are aged 65 years
According to projections for 1999, the number of people aged
65 years or more already exceeds 13.58 percent (all data: Statistical
Yearbook, Republic of Slovenia, 1998). Population statistics
projections for elderly people up till 2020 indicate an increase
of one percent every five years, and the percentage is expected
to rise to 14.5 by 2005, 15.9 by 2010, and 19.4 percent of the
total population by 2020 (figures given by Malacic indicate
that the percentage of people aged 65 years or more will increase
to 19.5 percent in 2021 and 23.5 percent in 203 I ; Malacic,
Data for people aged 65 years or more indicate that Slovenia
is, population-wise, an old society. A society is considered
»old« when more than 7 percent (or 10, or 12 percent
- different authors use different figures) of the population
are aged 65 years or more. The figures for Slovenia for 1997
(13.22 percent of the population aged 65 years or more) undoubtedly
places Slovenia among older societies.
The population ageing index, i.e. the relationship between
people aged 65 years or more and children up to the age of 14
years, is 79 - according to projections for 1999. A normal ageing
index, one which indicates a favourable reproduction rate for
the population, is between 32 and 40. An index of 72 is considered
the »demographic threshold«, i.e. the turning point
beyond which the population no longer reproduces its numbers.
Slovenia passed this threshold in 1996.
This fact is further corroborated by the negative natural population
growth coeffcient, which fell from 3.1 in 1985 to 0.4 in 1997
(Statistical Yearbook, Republic of Slovenia, 1998). The main
reason for this ageing of the population is the simultaneous
fall in fertility and mortality. The ageing of the population
is a reversible process: the population can be »rejuvenated«
by increasing fertility and mortality, or by the migration of
young people and adults. This means that the pessimistic prognosis
that predicts the beginning of the extinction of the Slovene
people is flawed, even though the data are not encouraging.
The population ageing index is predicted to be 116 by 2020,
which is three times higher than it would be if the reproduction
of the population were within normal limits (32 - 40).
The life-span is continually increasing: life expectancy of
men has increased from 65.56 years in 1958/59 to 70.01, whilst
that of women has increased from 70.68 to 78.62 during the same
period. The life expectancy for people of both sexes in Slovenia
who turned 65 in 1995/96 is one year shorter than in Germany,
for example. The age-specific mortality rate (number of deaths
per 1000 of population of a certain age) has fallen in the 85+
age group, from 286 in 1980 to 219 in 1997 for men, and from
23 to 185 for women (Statistical Yearbook, Republic of Slovenia,1998).
All data indicate that Slovenia has an ageing society which
has stopped reproducing, and the trend continues. This fact
is underestimated. »We have been witness in Slovenia over
the last few years to the unacceptable underestimation and negligence
of the influence of demographic factors in the fields in question,
as well as in a number of other fields«. (Malacic, 1998).
Other experts are of the opinion that we should not view the
ageing of the population with such pessimism. It was only in
this century that the life-span of a large part of the population
exceeded 70 years in Western societies, and we are still ignorant
of the ramifications of this fact. Old age is still youthful,
it is said (Baltes, 1999). This, at an individual level, means
that a child born into this society will have a relatively long
life. But what of the quality of that life?
Changes in the Population Structure
of Elderly People
structure of elderly people, who by definition become so upon
retirement or upon crossing the 60+ or 65+ age limit, has therefore
changed, and so has the image of the elderly person. This entire
category may be divided into two age groups (under 75 and over
75), the »younger« and the »older« group.
The vast majority of elderly people remain active and capable
of making independent decisions regarding their lives, and are
still able to contribute to the development of the society through
their work and social activities. In this regard, and especially
with respect to early (or premature) retirement, the problem
of their unexploited working potential is often mentioned (Jezernik,1980).
In reality, we do not know in what manner and to what extent
these potentials are being exploited; how much of this potential
is being spent on lingering and »killing time«,
and how much on various types of paying work or other sensible
and socially beneficial activities. The method and extent of
socially beneficial activities can be derived on the basis of
two factors. The educational structure of elderly people is
on the rise, and with it the probability of time being spent
of creative and sensible activities, as has already been determined
in previous research (Jezernik,1980). Because women comprise
a greater part of the older population than men, we must assume
that most elderly people spend their retirement performing (as
yet unrecognised) useful work at home and for their families,
offspring and relatives, and are involved in social and cultural
activities. Until these relationships are more carefully studied,
we must refrain from placing an exaggerated emphasis on the
loss of working potential because the impression given is that
elderly people are capable of utilising their time usefully.
In addition to the introduction of flexible retirement, which
has been enabled by the new Pension and Disability Insurance
Act, consideration must be given to more flexible forms of employment
that would enable pensioners to get paying jobs if they so wished
(according to 20-year-old figures, more than one-quarter of
the »younger« group of the older population are
engaged in such employment; Jezernik,1980). Encouraging elderly
people to become involved in various types of organised volunteer
work should be given even greater consideration.
Women comprise the vast majority of elderly people; the older
the age cohort, the greater the percentage of women comprising
it (»feminisation of age«). One of the implications
of this fact has just been mentioned. The second is the fact
that such an age structure relieves the community of the burden
of caring for the elderly because the male population is cared
for by the female population, which remains independent for
a longer period. Lonliness is one of the problems encountered
by older women, and as they grow older they too require the
assistance of others. Widowhood increases with age, from 38%
for younger women to 75% for older women, and from 8% to 47%
Indicators of the Financial Position
of Elderly People
Is old age related to poverty? Analyses of the demographic,
economic and social position of elderly people in Slovenia (for
the period 1978 -1993; Stanovnik, 1997) show that pensioners
are evenly distributed between the income groups, and that their
population is stratified in a manner similar to that of the
rest of the population, not concentrated in the lower income
brackets. The position of single pensioner households, which
are in fact more commonly found in the lower income groups,
is different; this is especially true in the case of single
retired women (Stanovnik, 1997). These individuals live a very
modest life and are on the verge of poverty. Social welfare
contributions that compensate the loss of regular income are
an insignificant source of income for pensioners.
If the poverty line is equal to one-half of the average income
in the country, we find that 13.1 percent of the women aged
60 years or more live under the poverty line; this accounts
for the highest percentage of people living under the poverty
line for any of the population subcategories of people aged
60 years or more, or among pensioner households. The 60+ category
includes pensioners as well as others. It is only those individuals
from this category who do not receive pensions, i.e. those who
are financially supported by others and those who simply have
no income, that are threatened by poverty. In general, poverty
in the developed world is considered more a problem of the younger
rather than of the older generations (»infantilisation
of poverty«). The situation of younger pensioners is more
favourable than that of older pensioners because they have other
forms of income in addition to their pensions, or they live
in households with active members of society.
On average, pensions amount to approximately two-thirds of
the average salary (for 1978-1993), and despite a slight increase
in the amount, the relationship between the two remains more-or-less
stable (Stanovnik,1997). According to data for 1998, the average
pension amounts to 67.4 percent of the average salary, whereas
the average old-age pension amounts to 74.5 percent of the average
salary (Institute of Pension and Disability Insurance, 2000).
However, we cannot expect to maintain such pensions in the future
without additional saving. According to Stanovnik, any person
whose only source of income is a pension will fall below the
Research covering geographically limited regions of
Slovenia indicates that the vast majority of elderly people,
or their relatives, own their own apartments or houses (84%
in three Gorenjska municipalities; Klinar, 1997; earlier research
conducted on elderly people in Ljubljana 15 years ago places
the figure at two-thirds). Research into the housing problems
of vulnerable groups (Mandic, 1999) mentions »older people«
as being part of the vulnerable group (which is not treated
in greater detail), but also concludes that younger generations
would have nowhere to live if they were not living with their
parents. However, the housing standard of elderly people, especially
the older ones who live in old apartments, is often poor. Here,
again, the average is satisfactory, but there are sub-categories
in which the situation is poor.
In general, we can conclude that the financial situation is
good, however, we must pay particular attention to the elderly
individuals living in single households. A study conducted on
elderly people in Berlin arrives at the same conclusion (Baltes,
1999). Old age should, therefore, not be equated with poverty,
as was previously done for political propaganda reasons. It
would be strange if an individual living in a developed country,
after an active life of 35 to 40 years, were to be unable to
secure the material conditions for a relatively good standard
of living in old age.
Other Factors of Social Status
average number of household members in Slovenia continues to
fall. There is an increasing number of families in which two
generations, parents and children, live under the same roof,
as well as an increasing number of pensioner households. In
1987, 21.7% of all pensioners lived in pensioner households
consisting of one or two members. By 1993, this figure had increased
to 43.1 %. Almost one-half of all female pensioners (49.7%)
lived in such households; one-third (28.7%) lived alone. The
average age of female pensioners living alone was 68.7 years
in 1993, and is significantly higher than the average age of
all female pensioners (Stanovnik, 1987). In addition to this,
the number of divorces, single-parent families, nonconventional
families, and partner relationships is increasing.
The readiness and ability of families to nurse and care for
others is falling all over the world. In a poll conducted in
1978 in Japan, where traditional relationships still thrive,
one-third (34.5%) of those polled gave an affirmative answer
to the statement »I shall care for my elderly parents,
regardless of my own situation«. This figure dropped to
one-fifth (23%) by 1993 (Beckman, 1997, after Takahashi, 1995).
One the one hand, the large proportion of employed women means
that many women, through employment, secure for themselves a
pension as the primary source of their income for the future,
whilst on the other hand, employment prevents them from tending
and caring for their elderly relatives who need their help.
Indeed, a participant at an international conference on elderly
people is said to have responded to the conclusions on the issue
of caring for elderly people within the family, by saying: »Am
I to expect my son's divorced and fully-employed wife to care
for me when I shall most need help?« (K. Brown; Mesec,
According to some sources (Gosar, 1999), the ageing index of
the rural population is 147, a result of the migration of the
younger segment of the population, leaving behind only elderly
farmers, who spend the remaining years of their lives isolated
The characteristics of old age in the postmodernist era, according
to Ida Hojnik (1997), include: personal financial independence,
solitary habitation in most cases, an intellectually and culturally
active life backed by a well-developed social support and assistance
mechanism for the fourth period, and poor family links.
From a sociological point of view, the problem of contemporary
old age is the integration of elderly people - a search for
new ways of bridging the gap between generations and respect
for their creative potential and their capacity for solidarity.
Problems Related to the Social
Position of Elderly People
The need for assistance
increases with age. It has been estimated that 15% of the people
aged 65 years or more need assistance (Mesec, Majcen, 1984),
as do 30% of the people aged between 70 and 80 years, and 60%
of the people aged over 80 years (Development Programme...).
The number and percentage of people aged more than 80 years
in also expected to increase from 2.22 percent in 1999 (projection)
to 4.62 percent in 2000. As the life-span increases, so do age-related
illnesses. The previously-mentioned Berlin study on elderly
people (for 1992) concludes that practically all people aged
over seventy years take some form of medication. This finding
counters the overly optimistic prediction of affliction-free
Nursing and the Burden on Family
Many families that
include an elderly person eventually face a situation in which
the elderly person requires not only occasional attention but
permanent caring. It is also true for Slovenia that elder members
of the family are usually cared for by a female family member,
usually a daughter or daughter-in-law. In research conducted
on 43 cases of domestic nursing in a Ljubljana community (Jakic,
1997), only 37 percent of the family members caring for an elder
relative declared that it was a responsibility they were »still
capable of handling«, whilst the remainder considered
it a burden; 37 percent said that it was a »significant
physical and mental burden«. Most of the family members
questioned named help and home care as the type of assistance
to which more attention should be paid in the future. This was
followed closely by accommodation in retirement homes (Mesec,
Ogric, Jakic, 1997). Caring for the elderly at home is a heavy
burden for those responsible, as well as for the entire family.
It can exhaust the family, result in family conflict, and impair
the health of those caring for the elderly relative (Pentek,
1994). Such families must be handled in a realistic not moralistic
manner and their situation must be alleviated; elderly people
must also realise that there are limits to what they can expect
from family members (Adams, 1996). Retirement homes due to lack
of skilled nurses are characterised by a dangerously high overburdening
of nurses, thus paving the way for neglect and abuse.
Neglect, Abuse and Violence
Although very little is spoken
about this topic, which is very difficult to research, the problem
does exist, both in families and retirement homes (Majhenic,
1999). Research conducted in other countries reports the existence
of many types of neglect and abuse, from disregard to torment
and homicide. Although there is less violence against the elderly
than against children, it is better concealed. It is also more
difficult to protect the elderly than it is to protect children.
We must pay attention to such cases in order to protect the
victim and help all those involved because neglect and abuse
are often the result of overburdened relatives.
Loss of the Meaning of Life and
Suicide among the elderly
contributes to the sombre statistics on suicide in Slovenia.
The suicide coeffcient is highest among people aged about eighty
years. Social processes, such as the migration of young families
from rural to urban areas, the decay of farms and farmsteads,
as well as other cultural and historical factors, contribute
to the rate of suicide among elderly people. The sense of emptiness
and hollowness is partly the result of misplaced values during
the active part of life, craving for wealth, consumer goods,
prestige, etc. - in short, a superficial life which is encouraged
by society and whose emptiness only becomes painfully clear
in our old age; it is also partly the result of the unavoidable
losses that accompany old age and the breakdown of relationships,
which leads to loneliness. As emphasised by Ramovs (1999), not
having someone with whom to share a close and trusting relationship
can often be fateful for elderly people. There are indications
that, in addition to officially recorded suicide, there exist
cases of wilful self-negligence that lead to death (such as
secretly refusing to take life-saving medication, exposing oneself
to infection or traffic, exaggerated activity, sport, etc.).
These are categorised as calls for help and as »indulgent
or concealed suicide«. It is unlikely that we shall ever
uncover the full extent of this phenomenon. The fact that it
is rarely spoken about seems to suggest that there are no »plaintiffs«;
that it takes place with the connivance of others.
Culture of Dying
Humans have always dreaded death and dying.
They have always been afraid of being present during someone's
death, having to witness death itself. In traditional societies,
however, people were accustomed to seeing and witnessing death
throughout their lives and, like other natural occurrences,
death was not regarded with great awe. Furthermore, specific
rites and rituals performed on such occasions alleviated the
confrontation with death. Families today are more isolated and
it is perfectly understandable that the fear of death occurring
at home is considerable, often exceeding all limits. Without
realising it, most people will in such cases do everything they
can to prevent death from occurring at home. And yet, it is
my belief that there is nothing as tragic as dying alone. Assistance
should therefore be offered to such families to help make the
acceptance of death less painful and to help them understand
that doing so would be the ultimate demonstration of their love
and devotedness; and that this can be a fulfilling experience
for the living. There is a movement emerging in Slovenia that
supports »complete care for dying patients and their families
» (Klevisar), hospices, help in dying, and assistance
for the relatives of the dying. No-one wishes to be alone when
departing from life, the world and one's loved ones.
Social Care for Elderly People
Human Rights in Old Age
In a speech, entitled »For a Society
of All Ages«, delivered at the final event of the International
Year of the Elderly, organised by the competent Government committee
(January 2000), the Human Rights Ombudsman of the Republic of
Slovenia noted: »An important part of socio-economic development
is the inclusion of people of all ages into a society in which
age based discrimination and involuntary isolation will be eliminated.
The right to protection from poverty and social inclusion is
especially important for their elderly. It is therefore necessary
to stimulate solidarity and mutual help between the generations.
Ageing is a life-long process and must be dealt with as such.«
The general principle of equality before the law also guarantees
human rights and fundamental freedoms to elderly people, who
have the same entitlement to respect of their human dignity
as other members of society. They have the same right to privacy,
their own life style and respect for their decisions, taking
into account the various stages of the ageing process. Most
of all, every elderly person has the right to social care.«
(Bizjak, 2000) The Human Rights Ombudsman continues to point
out that the European Social Charter binds Slovenia, either
directly or in co-operation with public and private organisations,
to adopt or encourage suitable measures whose main purpose is
primarily to enable elderly people to remain full members of
society for as long as possible by providing adequate resources,
enabling them to lead a decent life and play and active part
in public, social and cultural life; by providing information
about services and facilities available for elderly people and
their opportunities to make use of them. The measures are further
intended to enable elderly people to choose their lifestyle
freely and to lead independent lives in familiar surroundings
for as long as they wish and are able. The Human Rights Ombudsman
did not mention any breaches of the human rights of the elderly
on this occasion, but made several recommendations regarding
their social and health welfare and pointed out that the attributes
of the generation that is currently moving into the homes are
changing. The new residents of the homes are better educated
and more demanding; the standard of living in the homes should
therefore change to meet the new demands, and activities and
the rules governing the homes should also be changed. (Bizjak,
These thoughts, which draw attention to the dangers of age-based
discrimination, coincide with those of sociologists. If the
current trend of increasingly longer life-spans continues, we
would expect the statistical »age limit« to move
upwards, but it remains at 65 years because this roughly coincides
with the administrative age limit, which determines retirement
age. Thus, the status of pensioners, their privileges and their
restrictions are perhaps the only social characteristics common
to the majority of elderly people. Pension insurance has in
actual fact institutionalised old age as a distinct social category
(Kolaric, 1990). Indeed, the responsibility for caring for the
elderly has been transferred from individual and family level
to intergenerational solidarity. This has created a new independent
phase of life with a span of 20 to 25 years (Foelster, 1997).
If it were not for this coincidence, the statistical age-limit
would probably move upwards, making way for a rise in average
life expectancy. This means that an individual that might today
be classified as »old«, might tomorrow no longer
fall under that category. Further, it also means that we must
maintain the fine balance between the attention that must constantly
be paid to ensuring that social welfare is provided to people
who are no longer fully capable of working, and the caution
that must be taken in order to prevent the corroboration of
the category defined by this motif, and to prevent us from attending
to the gain of various social agencies in the name of welfare
for the elderly. Such colonisation is rejected by the elderly
themselves - who are liberating themselves from the attributes
that society ascribes to old age and from overly zealous trustees
The Constitution of the Republic of Slovenia does not provide
for age-based rights or privileges and, with the exception of
pension insurance, the legislation also rarely uses age as a
basis for special norms (Kavar Vidmar, 1989: 117). The National
Social Welfare Programme makes mention only of »elderly
people who can no longer care for themselves« as one of
the risk groups of the population in general and not of the
older population as a whole, thus making very clear the level
to which interference into the lives of the elderly is still
considered legitimate. The risks accompanying age, such as the
deterioration of the standard of living, are related to a diminished
working capacity, and thus the ability to secure an income.
Insofar as the state has a social security system that works,
i.e. a functioning pension insurance, medical insurance and
social welfare system - and it seems that, for the moment, Slovenia
still has one - the risk to the vast majority of elderly people
is reduced to a minimum. Under these condition, it is considered
that a seventy-year-old person requires the same kind of care
as a forty-year-old person, and that a patronising attitude
towards elderly people, simply because they have exceeded a
certain conventional age limit, is superfluous. The question,
therefore, as to whether the elderly can at all be dealt with
as a single, undifferentiated social category, is still very
relevant and, indeed, increasingly so (Svetlik,1989).
Social Security: Pension and
At the end of
1998, there were 474,862 pensioners in Slovenia, of which 276,764
were on old-age pensions, and the remainder on disability, family
or farmer pensions (Institute for Pension and Disability Insurance,
2000). The total number of pensioners far exceed the number
of people aged 65 years or more. By the end of 1996, 87.5% of
all people aged 65+ were receiving pensions. The rest were receiving
financial assistance and other contributions, or had not yet
been classified as being socially threatened. In Slovenia, 92.8
percent of the people aged 65 years or more benefit from one
of the public social security systems. The pension of most of
the beneficiaries is higher than the minimum required for survival.
»... the ageing factor of the elderly has had no significant
influence on the funding of the two treasuries (pension and
health) so far. This means that the full force of this influence
will only be felt in years to come (Malacic, 1998).
Because of the sharp increase in the number of pensioners -
which is not so much the result of an ageing population as the
consequence of a misplaced policy of early retirement - an increasingly
larger percentage of the gross domestic product is being diverted
towards pension and health insurance (from 7.64% in 1985 to
14.89% in 1997), including funds for the compulsory health insurance
for pensioners. The total obligations of pension and health
insurance are expected to amount to one-quarter of the gross
domestic product by 2040. The ratio between pensioners and insured
persons was 1:3.00 in 1984, 1:2.15 in 1990, and 1:1.67 by 1998.
The reform of pension and health insurance was necessary for
several reasons, which cannot be discussed in great detail at
this point, but was only partially completed. The new Pension
and Disability Insurance Act, which came into force on January
1 st, 2000, does not go far enough to fully implement the changes
anticipated by the »white paper« launched at the
beginning of the campaign for reform in this field. In comparison
to the original proposal, the provisions that have been passed
are far more moderate and gradual, and the sluggish harmonisation
of pensions is taking place within a very long transitory period.
The »white paper« anticipated a new method for determining
the contributions rate for self employed persons, separate disability
insurance, »flexible« superannuation, equal rights
for both genders, and foremost, a system of funding that will
be based on the three pillars of pension insurance. Only two
of the anticipated changes have been fully implemented. A new
minimum contributions base for self employed persons has been
determined; changes to disability insurance include separate
contributions for disability insurance and for injury at work
or professional disease (valid only for employers). The difference
between the retirement period for men and women was not nullified,
but it was reduced; another novelty is that parenthood has replaced
motherhood as a factor in determining the retirement period.
»Flexible« superannuation has been introduced, but
with more modest incentives for increasing the length of service
than had been hoped for. The reform proposal also anticipated
three types of pension and disability insurance; compulsory
insurance based on intergeneration solidarity, insurance on
the basis of pension savings accounts, and compulsory and voluntary
additional insurance. Voluntary additional insurance has now
been introduced alongside compulsory insurance: this paves the
way for the establishment of privately-owned insurance organisations
(pension mutual funds and public limited companies) to which
insurance premiums shall be paid either by the insured persons
or their employers, for which tax relief shall be granted. The
new act attempts to compensate for the lowering of pensions
by introducing additional insurance. The proposers of the act
are of the opinion that a more radical reform will be required
in the mid-term. Until then, we can only hope that we shall
still be able to claim that the »position of pensioners
in Slovenia is, in relative terms, the best in the world«
(J. Mencinger, in: Stefanec, 1999), and that such a situation
will not have adverse effects on the position of younger generations.
When incorporating new funding, such as voluntary insurance,
the financial position of the pensioners in the future - according
to the expectations of the architects of the reform - should
not change significantly (Development Programme…).
The Social Security and Health Insurance Act (12992,1993) reaffirmed
health insurance and abolished the state-controlled system of
health care. There have been changes in several fields: in the
introduction of new providers and the obligations of the providers;
in the network of health services providers (introduction of
the private sector); in the introduction of contractual partner
relations; in the introduction of compulsory and voluntary health
insurance (Development Programme...). There is also greater
emphasis on individual responsibility for one's own health.
Supposedly, the primary reason for the reform is limited funding,
considering, of course, the presumed allocation of the funding,
which can be a bone of contention. We must remember that basic
health insurance is an invention of the 20th century and that
it signifies the »democratisation of survival and longevity«
It would seem, therefore, that despite the reforms and the
streamlining of both social welfare systems, the latter still
provide social security for elderly people.
Social Welfare for the Elderly
Changes in social welfare. Over
the last few years, after the Social Welfare Act was passed
in 1992, the following changes took place in the field of social
welfare for the elderly (in order of importance according to
my own judgement):
1. The state, by way of the relevant ministry, assumed its
role, as defined by the Constitution and the Social Welfare
Act, and began to establish legal, programme and organisational
frameworks for the operation of a social welfare system, which,
following the enactment of the Social Welfare Act, led to the
enactment of by-laws (Standing Orders on Standards and Norms
for Social Welfare Services) and to the adoption first of the
National Social Welfare Programme up to 2005, and at the end
of 1999 of the Programme for the Development of Institutional
Care up to 2005 as well.
2. Streamlining Public Contributions and Services. This is
occurring simultaneously with the rationalisation of public
benefits and services, and the limitation of budget funding
for other activities in this field (and activating the responsibility
of local communities), as well as improvement of the internal
organisation of public services and a heightening of its public
accountability by introducing mechanisms for identifying needs,
monitoring and supervision, evaluation, and strengthening the
role of users.
3. Pluralising providers of social welfare means that the state,
together with the Social Chamber as an association of professional
workers in the field of social welfare, is attempting to encourage
the participation of the private and non-governmental sectors,
and to establish a system in which public services represent
the backbone of a system onto which the private sector and non-governmental
organisations that are expected to assume most of the services
4. The establishment of a social welfare network at local level
is taking place simultaneously with the pluralisation process,
because pluralisation can first be achieved within a local framework
where the services are actually being rendered. A condition
for the establishment of a local network of social security
providers is the participation of the local communities, i.e.
municipalities that must assume their responsibility and its
share of contribution of funds to this cause. Such awareness
has only just began. It is my hope, and development confirms
it, that the »withdrawal of the state« does not
extend beyond limiting budget funding and encouraging other
sources of funding, not simply deferring the responsibility
and encouraging, organising and supervising other providers.
I think that in Slovenia, the maxim »Not only the family
and the state are responsible for the social security of the
elderly, but others as well - including the private business
sector and nongovernmental organisations« is heard rather
more often that the motto »Back to the family«,
which has so often been criticised in the West, especially by
the left wing.
Existing and Anticipated Help
The principles of social
welfare for the elderly, as stated in the Programme for the
Development of Social Welfare for the Elderly in Slovenia up
to 2005, are modern and take into account the accomplishments
of the endeavour to achieve a »society of all ages«,
as well as the findings of the science of social work with elderly
people (gerontoboetics). In accordance with these principles,
we are bound to guarantee the integrity of the proceedings,
autonomy of choice, equal access and spatial coverage, plurality
of implementation, thriftiness, adaptability, and a link to
the social environment, all of which are expected to guarantee
a satisfactory standard of living for the elderly.
The social welfare network consists of the providers of public
services (centres for social work, retirement homes, anticipated
regional centres for help at home, providers of other public
services within the living environment), providers in the private
sector (which is developing too slowly), non-governmental and
voluntary organisations, among which self help groups and organisations
of pensioners and elderly people play a special role. This picture
is completed by the informal sector - family, relatives, neighbourhood.
A glance at a map shows a high concentration of public institutions;
if we were to supplement this with functioning non-governemental
organisations in municipalities or local communities, the map
would become unintelligible. The duties and activities of individual
providers of social welfare for elderly people are well understood
and we shall therefore merely enumerate them. Centres for social
work (of which there are 53 across Slovenia) are carrying out
public mandates (allocating financial assistance, welfare of
disabled persons, guardianship), social prevention services
(self help groups for the elderly), social first aid services,
personal assistance services, assistance to families at home
and for the home, organising common activities. In addition
to their basic activity, retirement homes (63 of them) also
offer external services, including delivering meals to local
population of elderly and nursing.
It should be emphasised that, with over 400 pensioner associations,
pensioners in Slovenia have a well-developed system of self-organisation.
There are many elderly people working voluntarily for the benefit
of other elderly people, and we have an unique movement of self
help groups and intergenerational groups (over 300 in 100 different
places; Ramovs, 1992) under the professional guidance of the
Institute for gerontopedagogics Anton Trstenjak. Despite the
social trauma and significant changes that have taken place
during this century, the informal sector still nurtures the
norm that obliges children to care for their parents when the
latter grow old, and that as long as it is able, the family
provides assistance to the elderly.
A care network, as roughly described above, is not something
basically new, but has been established over the last few decades.
The last decade has seen the need for services in one's living
environment become practice. The first limited attempts at introducing
home help to the elderly date to the second half of the 1980s
(Vojnovic, 1988). Today, several areas have organised household
help, delivery of meals to the home, and in some places (urban
centers) have centres for remote help, which have been enabled
by telecommunications services, such as telephone help. It is,
however, important that services in one's living environment
have been defined in documents such as the Programme for the
Development of Social Welfare for the Elderly up to 2005. The
programme anticipates the development of day care in institutions
(day centres), purchasing and building apartments for the elderly
and pension apartments (guarded apartments, a hostel for elderly
people, housing groups, group apartments), mobile forms of help
(delivery of daily meals, transportation, etc.), services at
home (from medical services and personal nursing, to household
help and company). The respite care for family carers and help
in dying are in development. Remote services, by way of telecommunications
(security, emergency calls) have already been mentioned.
This overview of social care for the elderly within the framework
of social welfare, which describes existing forms, some of the
forms currently being implemented, and some of the anticipated
forms, shows that there is hardly anything to add to the system
of services. The network of public institutions has also been
established for the most part, and in addition to a number of
new retirement homes that have been planned, the only thing
missing are regional centres for help at home. The Programme
for the Development of Social Welfare for the Elderly up to
2005 proposes the establishment of centres for help at home
as part of the network of public welfare services. The function
of the centre would be to plan individual programmes of home
care for individuals that would otherwise require institutionalised
care; assess the needs for help at home; receive requests for
help at home; offer counselling and advice; organise assistance;
co-ordinate assistance; monitor and supervise help; animate
services networks of the providers of help at home and expand
the network of beneficiaries; analyse the status of help at
home; strategically plan the expansion of the programme; connect
the providers of social and health welfare services; help shape
the national information system.
The centre would encourage self help, family, neighbourhood
and other forms of mutual help and solidarity. Its activities
would also relieve still active family members of the burden.
The centre may also incorporate informal providers, non-governmental,
private providers, charity organisations. The programme is expected
to informationally and operationally unite the beneficiaries,
providers and experts in social welfare for the elderly and
health care. The centres are expected to take the form of organisational
units of existing or newly-established institutions (retirement
homes, centres for social work), and when this solution cannot
be applied, as independent institutions as well. Individual
centres would unite to create a network and a coordinated system
(Development Programme..., 1997). The Centre for Social Work
in Maribor (the 2nd largest city), for example, proposes that
the Maribor regional centre for help at home includes: a unit
for social care at home, a social service, emergency service,
and a the co-ordination of the volunteer network for fulfilling
the emotional, spiritual and social needs of elderly people
Providers from the private sector are, therefore, expected
to join the network of providers over the next few years. When
pluralisation is finally completed, the network too will be
almost complete. However, there remains the question of its
co-ordination and effective co-operation with various sectors
(public, private, volunteer, informal) and subsystems (health,
social security and others). This issue has also already been
tackled in Slovenia. This is illustrated by the successful example
of co-operation in the strategic planning of the social welfare
of elderly people at local level in Maribor, where the City
Municipality and the local Retirement Home organised a conference
on the strategy for the development of organised help for old
people in the wider Maribor area, held in November 1999. This
was a good example of co-operation between different providers
of social welfare at local level in planning care in the future.
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This is a conference paper prepared for "Intensive Program
Socrate Erasmus" Coimbra, Portugal, March 12-16, 2001.
Dr. Blaz Mesec is associate professor of the Methodology of
Research in Social Work at the University College of Social
Work, University of Ljubljana, Slovenia, and is presently the
dean of the college.