Our senior citizens

Within the space of 11 days two important events were held at St Vincent de Paul reflecting two diverse aspects of our policy for the elderly.

On the first occasion we inaugurated Mother Theresa Wards. Before the election of 1987 we had stated we wanted our elderly to reside in the community for as long as possible. But we were also aware that there comes a time in one's advanced age that, due to failing health, adverse social circumstances, or both, the best place in the interest of the elderly person is an institution. However, the institution has to respect the dignity of the elderly.

To implement this facet of our policy, we have opened quite a number of residential homes in the community for those who could live quite an independent life and modernised radically St Vincent de Paul. We had inherited a ghetto of a place with such a stigma that many elderly were terrified if their family even remotely suggested they should spend the rest of their days there.

The place was valued as a constituency rather than a nursing home. Anecdotes of visiting politicians distributing pictures of the Sacred Heart while at the same time the aristocracy of the workers was desecrating the Curia abound.

Due to the political discrimination and the brainwashing of the elderly, the Nationalist Party never managed to garner more than a handful of votes from what was turned into a Labour stronghold. The place was forgotten once the elections were over. So much for the hallowed social conscience of the Labour Party!

We have bit by bit transformed the place and the process is continuing. Since it escaped attention I have to underline the taste of and the high standards in the modernisation of the area, creating an atmosphere of a village piazza, where the elderly can meet each other as well as their relatives. All those who paid a visit marvelled at the achievement, but otherwise it was generally ignored by the media.

An extensive mix of services was built out of nothing to make life in the community easier for those who, due to old age, became physically or emotionally dependent. All this was possible because in 1987 a Parliamentary Secretariat for the Elderly was set up for the first time. The PN as usual could read the signs of the times. We were aware of the impending demographic revolution and wanted someone to focus on the needs of the aged. We were fortunate to have had as pioneers John Rizzo Naudi and Antoine Mifsud Bonnici who have left an indelible imprint on the elderly sector.

With the attainment of retirement age of the baby boomers, now the demographic revolution is at its flood. We have taken a new look at the needs of the elderly. In a previous article I mentioned the plans for a larger rehabilitation centre to replace Zammit Clapp Hospital, which has become too small for Malta's current and future demand. Besides providing more long-term beds for the elderly ourselves, we are seeking to find different solutions in partnership with the private sector. In the past, we have contracted the private sector to manage two state homes for the elderly. In the Mellieha project we are breaking new ground.

On the second occasion we were celebrating the other aspect of our policy, the determination to keep our elderly as long as possible with us in the community. The prize for the elderly person of the year has now become a traditional highlight. Through this award we exalt the spirit of active aging so common among our elderly and exhort others to emulate them. The event mirrors our principles. We do not want to look at the aged negatively as a financial problem. The standards we have established are concrete evidence of this affirmation.

When looking at health expenditure we should not look solely at the Lm15.7 million voted for the elderly in the 2006 budget. The increase in the health budget expenditure over the last decade is largely due to technological innovation. But when looking closely at the beneficiaries of this new technology we find that the bulk is made up of the elderly.

Higher quality healthcare is leading to a longer and healthier life. We have more aged people living longer, who proportionally consume more healthcare services. The proportional increase of the aging population is bound to drive future health expenditure upwards. Because people are living longer, more combinations of serious health disorders will occur. This will impact both curative care as well as long-term care. Long-term care can be very human resources intensive and financially expensive.

In this scenario, it pays both healthwise and financially to change our mentality regarding old age. We should strive to prepare for old age by promoting healthy lifestyles early in life, so that added years are healthy and active ones. We have to tackle ageism and discrimination against the elderly. We have to dispel stereotypes of old age and actively seek to profit from the skills of the elderly. Society will be the poorer if we discard them. We must ensure that older people play a vital role in society. We should remove as much as possible barriers to their employment. We should facilitate the spirit of voluntarism among the elderly.

Work, whether paid or not, has great therapeutic benefits, physically but especially mentally. We all know people who have given up. Now they look older than they actually are. And we all know individuals who do not look their physiological age because they are physically or intellectually always engaged. The feeling of self-fulfillment works wonders.

The more active older persons are, the later they will become dependent and become a financial burden on the community. Economically, the work of the elderly, whether voluntary or paid, has the same value as that of the young.

All of this we have done. We must continue building on these practices that have succeeded. But in the next 20 years, as the demographic changes intensify, as the baby boomers progressively become the old and the demographic balance is significantly changed, an important feature of our strategy is to deal with the issues of the elderly in synergy. Housing for the elderly, health, long-term care, social policies readily come to mind as among the sectors that should not be dealt with in isolation.

Dr Deguara is Minister of Health, the Elderly and Community Care.