Among the blessings which we are bestowed with as a people is the respect and care our senior citizens enjoy. Our erstwhile and now rarely used epithets ix-xih or ix-xiha when referring to our parents had nothing derogatory or demeaning about it. It rather was an endearing term pregnant with respect and honour for the experience old age brings with it. Though the extended farming family, where three or four generations lived under one roof, has long become extinct most of our families still feel in duty bound to look personally after their elderly relatives. It is true that some do it out of pecuniary motives, mostly connected with inheritance. But many do it out of religio-cultural motives.
Demographic, cultural, economic pressures are slowly weakening this respect. The very success of our health system, mostly responsible for the enormous improvement in our life expectancy, has created the issues of old age or rather the issues of the very old. We frequently meet with 80-year-olds cared for by 60-year-old sons and daughters, mostly the latter. On some but not rare occasions, mostly due to disease, the very old parents have to take care of their old offspring.
The fact that frequently all siblings and their better halves work is slowly reducing the capability of children looking after their aged parents. As long as the old enjoy good health, they are a boon to their working children as they frequently prove the most reliable baby sitters. As long as no one abuses of any one else, the system works beautifully and no one should feel scandalised because sometimes tension is created which may result in strained family relations. Tension exists in all types of human relations.
The cultural changes are more insidious. Smaller families with fewer children are bound to translate in less likelihood of at least one member being available to take care of the parents in their old age. The loss of traditional religious values without their substitution by alternative solid value systems is eroding our strong family bonds. Alternative types of families are too bound to affect negatively the traditional responsibility for elderly relatives. New hedonistic lifestyles and consumerism breed egoism and irresponsibility towards others, including the elderly.
The Church was the pioneer of charitable institutions, including homes for the elderly. Fewer vocations have meant that even the existing homes have to increasingly rely on paid lay workers, making it more problematic to make ends meet.
As soon as the Nationalist government was returned to power in 1987, these issues started being tackled vigorously. We believe that the best place where the old should spend their last days is with their loved ones, in the same community where they have lived for long years, in the same old haunts of their youth and middle age. Transplanting the old from familiar surroundings to an institution where everything is new frequently creates shock and dismay.
But we recognised that time or circumstances compel some to seek institutionalisation. Our policy is to retard that point as far as possible.
Another important tenet is that even the very old have to be treated with dignity and we should never let them feel they are a problem. Their experience is a bonus to society and should be utilised, first and foremost for their own sake and self-esteem, and secondly in the interests of the community.
The creation of the parliamentary secretariat for the elderly was essential. It meant that an organ of government would focus on elderly issues holistically. The fact that we always placed it under social affairs was meant to drive home our concept that the elderly were not a health issue. John Rizzo Naudi and Antoine Mifsud Bonnici proved to be pioneers who revolutionised the concept of caring for the elderly as well as the range of services available to the old. They had the task to put in practice the Nationalist Party vision. Both performed magnificently.
They succeeded so much to confer dignity to those institutionalised by radically modernising St Vincent de Paul, that they turned it from the dreaded bogey of the elderly into a coveted residence. The list of those waiting to be admitted is getting longer and longer. Environmental conditions and services were so ameliorated that the seasonal peaks in deaths were eliminated. Some even complained because the institution was too luxurious. We believe that the elderly are receiving what they deserve. We should not collectively grudge them what is their due.
But the greatest success lies perhaps elsewhere, in our ability to create a range of services to keep the elderly as long as possible in the community. Zammit Clapp Hospital rehabilitates elderly patients so that they could return to live independently in the community. Residential homes in various parts of Malta cater for the semi-dependent. Services for the elderly were created out of nothing, all meant to help keep the elderly at home. Home Care Help, Telecare, Handyman Service, Meals on Wheels, Rebate Telephone Rent, Incontinence Service, pensions for carer relatives of the elderly are all familiar and effective. Day Centres and the University of the Third Age nurture a continued healthy interest in life. Kartanzjan, besides helping the elderly materially, generated prestige, respect and empowerment.
Private public partnership is the latest project. This is the future. Already more than 100 elderly persons are being subsidised by the government to live in private homes.
As the bulge moves from the old to the very old and as these increasingly have recourse to health services it was most apt for the Prime Minister to decide that the care of the elderly should find its home in the Ministry of Health but with a parliamentary secretary focused on elderly issues. Helen D'Amato has brought a new insight as well as enthusiasm. I am sure she will prove a worthy successor of both Prof. Rizzo Naudi and Dr Mifsud Bonnici.
Dr Deguara is Minister of Health.