On November 12 and 13, we conducted the Regional Policy Dialogue of the Social Protection and Health Division of the IDB, which this year was on the Pillars of Long-term Care: How to Build a System for Latin America and the Caribbean. This is an annual event that seeks to discuss the pressing issues of the region and generate an exchange between specialists, government representatives, civil society and the private sector.
Building long-term care systems is urgent for Latin America because it is the fastest aging region in the world. Here, dependency care services are still scarce and are often beyond the reach of large segments of the population. Therefore, the responsibility for care generally rests with families and mainly women, who provide more than 80% of the hours of care. It is estimated that by 2050 the number of adults over 60 with functional dependence could reach 30 million. Therefore, the need to ensure dependency care services will become increasingly pressing. Governments must prepare now.
The event allowed to know and discuss six crucial topics in the design and implementation of a dependency care system:
After a session in which Judy Feder and Marco Stampini presented a global perspective and regional vision on aging and care, the initial panel discussed how long-term care systems identify their target population and establish their eligibility criteria, stressing that the level of dependency should be the fundamental criterion. Concrete examples of France, presented by Catherine Dusseau and Uruguay, presented by Julio Bango, were shown. Ricardo Rodrigues compared the different European systems and discussed common trends and areas of debate while including an equity perspective.
What services to provide and how to manage the system?
To analyze how existing services are managed, Fred Lafeber presented the experience of The Netherlands, the country with the longest-running long-term care system with the largest budget and coverage in the world. Mayte Sancho of Fundación Matia, presented the perspective of civil society, explaining how her institution manages a wide range of services with an innovative management model centered on the person. In addition, two Mexican initiatives were presented, one from the public sector and one from the private sector, both with a limited scale but useful to understand the dynamics and possible evolution of the long-term care system in that country.
Fernando Fantova commented on his experience as the Vice-Ministry of Social Affairs of the Basque Country, implementing and managing services after the adoption of the Law on the Promotion of Personal Autonomy and Long-term Care. Myriam Petrongolo presented the case of PAMI in Argentina, which manages social and health services to the vast majority of the elderly population.
How to ensure the quality of long-term care?
The quality of services is complex to define, regulate and monitor; however, it is key to do so because only quality services can increase autonomy and improve the lives of people in dependency. Larry Atkins, presented the evolution of the debate on the quality of services in the United States, a country with developed markets, and how quality is measured today. Europe’s gaze was presented by Catherine Dusseau, who focused on three themes based on her experience in France: quality processes; the role of human resources information and training. Andrea Monaco focused on the definition of quality of services at the community level, and briefly reviewed the European Union’s regulatory framework.
How to finance the system?
Undoubtedly financing the system is central to discussions on building long-term care systems. This panel was attended by Professor Howard Gleckman, who exhibited the general trends in funding, highlighting the need for social insurance schemes, and also how the design elements of the system impact financing alternatives, and Professor Zhanlian Feng, who exposed China’s experience.
What challenges does dementia pose for long-term care systems?
The increase in longevity presents new challenges to long-term care systems. In particular, by over the age of eighty, the likelihood of developing dementia increases. Dementia, like other mental health diseases, is still the subject of prejudice and ignorance. In addition, it poses different needs of care, with a caregiver that must have different skills to those who care, for example, people with mobility problems. Adelina Comas spoke about this and presented STRIDE, the global initiative it leads to strengthening the responses to dementia being implemented in Brazil, Jamaica, and Mexico.
What can be the role of technology in Support services?
Technology can be a potential ally to support dependency care services and enhance the autonomy of older adults. Three panelists presented examples: Ignacio Pineda of Chile, Rachael Crook, CEO of Lifted, a start-up who provides services in the United Kingdom, and Fred Lafeber of the Netherlands, where the use of technology to support these services is common.
The event ended by presenting the conclusions by Ferdinando Regalia and Pablo Ibarrarán, who introduced 6 recommendations to begin with the construction of a care system in the region (for more details we invite you to watch the publication Age with Care).
We invite you to view the materials and videos of the event in the following link.
Do you know what policies are in your country to care for older adults in dependency? Leave us a comment or mention us in @BIDgente