The privatisation of institutional care for older persons in Sweden has recently been marked by scandals. Media have revealed that a business company running a number of such institutions has prioritised profit making and bonuses for top managers over decent care for the residents.
Cases of urgent health conditions were mishandled as there were too few nursing personnel. Existing staff were asked to find ways to limit costs even on food, diapers and protective gloves. For instance, they were asked to weigh used diapers to assess whether they were full or could be used again.
Some of the local authorities have now cancelled contracts with this particular company and the Swedish government has stated that the control of such institutions will be improved. However, there are more lessons to be learned.
Such violations of the rights of older people are not unique to Sweden or the system of privatised care. Last year the Health Service Ombudsman in England published a report on the failings of the English national health system towards older patients.
Lack of compassion
The Ombudsman concluded that any expectation that older persons may have of dignified, pain-free end of life care in clean surroundings are not being fulfilled in reality.
“The findings of my investigations reveal an attitude – both personal and institutional – which fails to recognise the humanity and individuality of the people concerned and to respond to them with sensitivity, compassion and professionalism”.
Investigative journalists and active Ombudsmen have discovered and reported on such problems in other countries as well. Still, it is my strong impression that these situations are grossly under-reported. Whistle-blowing is discouraged as acts of disloyalty and the elderly themselves hesitate to complain fearing a negative reaction from staff – or are unable to raise their voices because of their disability.
The truth is that elderly people have been disproportionately victimised by the ongoing economic crisis. Many elderly live in abject poverty; old and lonely women with little or no pensions are particularly vulnerable.
Admittedly, attempts have been made in several countries to protect vulnerable groups from the consequences of austerity budgets, but the combined effects of the cuts – on nursing personnel, pensions, allowances and also on monitoring bodies – have hurt people who no longer have the possibility to earn money or otherwise cater for themselves.
This is also a question of attitudes, as the English Ombudsman said. Older people are often seen as unproductive and merely a burden. The fact that people live longer nowadays – thereby changing the demographic pattern - is referred to as a “crisis”.
“Positive ageing” in Ireland
To challenge such ageism a coalition of non-governmental groups in Ireland, “Older & Bolder”, has identified negative stereotypes and petty humiliations poisoning the daily lives of older people.
One of their messages is that we should stop talking about the elderly as a separate group - old age is a phase in all our lives. The problem is not that many people live longer nowadays but that society as a whole has not come to terms with the increasing average life span.
Older & Bolder is campaigning for “positive ageing” policies, based on views expressed by older people themselves. For instance, respect should be given to the wish among many to have a possibility to remain at home and still have access to services – which should be organised on an outreach basis.
The Irish coalition refers repeatedly to the United Nations Principles for Older Persons adopted in 1991 – elaborated under the headings of Independence; Participation; Care; Self-fulfillment; and Dignity. This document makes important points, but the fact is that neither the UN, nor any other intergovernmental body, has done enough to protect the rights of older people.
No treaty, no agency for the elderly
There is no special treaty protecting the rights of the elderly and no specialised agency similar to, for instance, UNICEF. There will be a possibility to remedy this later in the year. A UN ministerial conference will be held in Vienna in September to review developments since a previous conference on elderly people held ten years ago in Madrid.
There will be discussions on how to allow for a longer working life for those willing and able; on how to prevent discrimination and promote social inclusion; and on how to create an environment enabling independence and healthy ageing in dignity.
Millions of individuals in Europe will be affected, and their number will continue to grow in the future.
Thomas Hammarberg