At the 5th Society for All Ages National Conference, which took place 5 and 6 October 2017 in Moscow, Russian and foreign experts discussed ways to set up a state-of-the-art elderly care system in Russia, provide an environment conducive to healthy longevity and promote positive public attitudes towards the third age. All of the above is expected to enable us to meet old age without fear and with dignity.
All sections of the conference themed as “Old People Welcome Here” focused on a honest and open discussion of practical solutions, including intense controversies such as: prospects for and obstacles to full life in the third age, as well as building an effective system for assistance to the elderly by the family, society and government agencies. In all, over 500 experts, scientists, representatives from governmental and non-governmental organizations, the business community and the media took part in activities at 18 venues of the conference over two days. The conference featured both conventional plenary panel sessions and sections and individual TED-style presentations, interactive strategic sessions and open mic. Thanks to special grants, the conference was attended by professionals from Russia provinces who are directly involved and in contact with elderly people. Experiences were also shared by experts from Japan, Germany, the USA and Canada.
The programme of the first day was called “Care Interfaces” and focused on the environment of the elderly – the services and processes that are instrumental to the quality of senior life. The title of the second-day programme was “Mature Life”, which invited the participants to put themselves in the shoes of a senior citizen and discuss whether they were ready for old age, their internal barometer and dealings with society.
Day 1. Care Interfaces
“People should have as many options as possible for deciding where and how to spend their old age”
The conference was opened by Maria Morozova, CEO of the Charitable Foundation of Elena and Gennady Timchenko – the initiator and main organizer of the event. Ms Morozova said that the attitude to the subject of ageing in Russia has changed dramatically over the last five years. Public interest in the subject has increased; changes have taken place in government regulation. There has been adopted Action Plan for the Benefit of Senior Citizens, which was called for at the very first conference in 2013; the Law on the Framework for Social Services to Citizens in the Russian Federation has come into force; the RF President has issued guidelines on the establishment of a long-term care system. Nevertheless, a great deal still remains to be done, and this requires the pooling of efforts by the government, not-for-profit sector, business community and society at large.
Aleksey Vovchenko, first deputy minister of labour and social security of the RF, detailed the government’s priorities in respect of the older generation and said that in future the share of senior citizens will keep increasing, so it is important to pay attention to this demographic: “Between 2016 and 2025, the share of old age pensioners will increase dramatically — from 24.6% to 27% — this means nearly 40 million people. It is of great importance to develop a strategy for long-term elderly care. Its primary objective is to enable an active senior lifestyle. This is the first time that such an objective has been identified in a policy paper. We are already moving to develop practical mechanisms for its implementation.”
Dmitry Kolobov, head of staples manufacturing development, Minpromtorg [Ministry for Industry and Trade] of Russia, said: “Manufacturing is an industry that must also think about senior citizens. These are consumers who have their own ideas about the goods and services they need. The task of Minpromtorg of Russia is to build a two-way street: understand what consumers need and explain it to manufacturers. Businesses need to grow in this direction.”
A similar view was presented by Anatoly Vishnevsky, a well-known Russian demographer and professor at the Higher School of Economics: “Population ageing changes the typical trajectories of individual and family life, takes virtually all systems of social infrastructure out of their comfort zone. The impossibility of living as before in a new environment and the need to abandon former beliefs are often seen as a source of insurmountable problems. The same changes, however, also provide a way to solve problems. The increasing life expectancy opens up unprecedented opportunities for using the personal potential of every person, for growing society’s aggregate resources. The thing is to learn to use these new opportunities. This involves gradual adaptation to the new environment in all dimensions of societal life. Anything and everything that can only be compatible with young life must change.”
The development of various forms of informal and family care has emerged as the most topical trend in the fastest-aging countries in the world, which are already feeling the rising burden on social systems.
Hidetoshi Endo, head of Teaching and Innovation Centre, National Centre for Geriatrics and Gerontology, Japan, said that his country operates a single informal-care programme, which enables systemic assistance to all elderly people, based on their needs. The expert said that Japan, a country with the world’s highest percentage of the elderly, faces the task of creating a cohesive community of mature people, where prophylactic, care and support for the elderly will be provided by healthy elderly people.
Horst Krumbach, member of the Board of Directors at Generationsbrücke Deutschland [Generations Bridge Germany], said in describing Germany’s best practices: “The country has put in place a long-term senior care insurance system, which provides assisted living services, but with limited options available. Sweden seems to have the best implementation of such a system, with 16 different care options available. And this is what we should be working to achieve – to give people as much choice as possible as to where to spend their old age.”
Vadim Nosov, head of Near and Dear Ones non-governmental social service centre, in presenting the findings of a survey of private home care market in Russia, concurred in the need for a similar approach in Russia, too: “90% of the elderly want to stay at home as long as they live. That said, constant competent care is needed by 1.8 million elderly Russians.”
Aleksey Sidnev, CEO of Senior Group and chairman of the board of the World of the Elderly not-for-profit partnership of private elderly service providers, emphasized that a long-term care system can become a bridge between the medical and the welfare sectors, formal and informal care. The speaker went on to say, however, that at this juncture Russia has no comprehensive strategy for putting such a system in place, no care standards or family support system have been developed, which results in a shortage of skilled labour.
The discussion segued into an expert debate at the section called “The Family and the System”. All speakers emphasized that it is impossible to talk about the quality of life of an ailing senior citizen in isolation from the living standards of his family. Relatives who care for a patient are care providers and beneficiaries at the same time. The speakers articulated the most pressing current issues in this field: these are, on the one hand, familial violence against the elderly and, on the other hand, physical and psychological burnout of family carers where there is a severe shortage of all resources and unspoken social pressure.
Day 2. Mature Life:
“I first felt happy being old when I was past 85”
The second day of the conference focused on active senior lifestyle. The overarching theme of the general discussion was the question: “how to grow up if you are a government, society, family, person?”
In the course of a plenary session Yelena Topoleva-Soldunova, member of the Council of the RF Civic Chamber and head of Social Information Agency, highlighted personal responsibility of each person for their dignified old age: “Society is fairly infantile. Most people remain teenagers in many aspects of personal development for all or most of their life. It has negativistic and nit-picking tendencies (‘they’re going to decide for us, no matter what’, ‘we can make no difference’, ‘life sucks’ etc.), belief in that good will always be trumped by bad. To free yourself from that condition and your fear of old age, you need to learn to evolve. This is what those who design curricula for schools, colleges and universities must think about.”
Personal responsibility for active senior lifestyle, as well as measures to support third-agers were also discussed by Yelena Nikolayeva, head of the Social Initiatives working group of the ASI expert panel: “Senior citizens are the hall of fame of this nation. They are the custodians of society’s moral compass and a wealth of experience. But senior citizens themselves need to evolve lest they ‘drop out’ of the fast-changing world, to become part of the community’s life in order to feel needed and sought-after. It has been proved that if a person does not retire from the world upon retirement, but continues working, learning, pursuing a hobby, he feels better and lives longer. It is not possible to develop effective mechanisms and tools for implementing the government’s social policies targeting the elderly other than in coordination with civic institutions, the business community, volunteers and non-profits. We should probably set up an integrated national programme called ‘Senior Citizens’ and use it to work out arrangements for coordination, building a generational bridge, geriatric assistance, volunteering and other mechanisms.” The changes that are already taking place in education were described by Yelena Bryzgalina, head of philosophy of education department, philosophical faculty, MGU, and member of RF State Duma Chair’s Council. “The educational limits of age and age-specific educational content have changed dramatically due to the change of economic paradigms and differentiations between formal and informal education. The continuous education concept treats education as a process that lasts as long as life itself. The implementation of this concept, closer attention to the formation of personal resource qualities, and custom repurposing of education will change the model of education management.” Yelena also said: “The purpose of education in the third age is look for and find evidence of the value and meaning of one’s life, and use it to remain true to oneself.”
By far the greatest attention was given by the conference attendees to the contribution by Irina Antonova, President of the Pushkin GMII [Museum of Fine Arts] and author of a course of art lectures for third agers, who was 95 this year. In speaking at the Ageing Trajectories section, Irina Antonova admitted that she had first felt happy being old when she had been over 85: “It was an amazing feeling: I started to take more interest in everything, to see what I couldn’t see before or simply had no time for it. I came to realize how I was supposed to judge the world and myself. Another period of awakening to my personal happiness was when I was over 90. I found that, frail as I was physically, I could enjoy life to the very full. I started to rediscover things that I had seen a thousand times before, to see new opportunities for further growth. I achieved new understanding, discovered new areas of interest, stretching through everything and across centuries.”
As part of the section called “A City for all Ages”, the experts agreed that cities of the future are not futuristic conglomerates, but spaces catering equally to the young and the elderly. Louise Plouffe, head of the WHO Age Friendly Cities initiative, said that environment barriers affect not only the elderly but also their families. Maria Troyan, an architect and teacher at the Residential Architecture department, MARKhI [Moscow Architectural Institute (MAI)], said in her contribution that urban lifestyle has not always been in sync with senior life, but everything has changed. In the near future the aged will opt for an active lifestyle, and the environment must accommodate this. Maria described the modern accommodation options for active third agers such as coliving, cohousing etc., which not only provide comfortable living conditions but also create new urban communities.
The attendees also showed a lot of interest in the section called “We Are Tomorrow’s Old People. XYZ in Old Age”, focused on longevity. Leonid and Natalia Gavrilov, gerontologists and researchers at NORC at the University of Chicago, presented their study of life expectancy trends. Its findings indicate that we can expect a further decline in the mortality rate for people under 100 in the short-term. In the long term, there could be a biomedical revolution and a dramatic rise in the life expectancy for healthy people, up to and including 150 years, an all-time high, which can be achieved by 2150.
“Modern medicine treats not the cause, i.e. ageing, but symptoms, i.e. aging-associated diseases, thus extending old age rather than youth,” said Aleksey Moskalev, head of the genetics of longevity and ageing laboratory at MFTI [Moscow Institute of Physics and Technology (MIPT)]. According to him, the process of ageing is a pre-clinical stage of some 200 aging-associated diseases, which increase the mortality rate exponentially with age. “Preventive medicine of the future will seek to reduce the period of ageing-associated diseases.”
The conference will traditionally deliver its main document in the form of a resolution, whose draft will be posted online at http://www.ageing-forum.org by the end of November. For two weeks after the publication, anyone can give their feedback on the draft resolution using the feedback form.
Main conclusions of the 2017 conference:
Old People Welcome Here — in our country, society, family.
Positive changes have been observed recently at the level of the government’s and society’s attitude to senior citizens. These changes are insufficient, however, to enable active senior lifestyle in this country.
These social challenges also create opportunities for problem solving whose success hinges on concerted efforts by all stakeholders: the government, business community, society and not-for-profit sector and, naturally enough, the elderly themselves.
Conference programme and speakers: http://www.ageing-forum.org/ru/event/forum-2017/program/
Video of the Conference: https://www.youtube.com/user/fondtimtchenko/videos