Mur Lura
OPENING SPEECH BY THE HON. ANTOINE MIFSUD BONNICI, PARLIAMENTARY SECRETARY IN THE MINISTRY FOR SOCIAL POLICY, AT THE INTERNATIONAL SHORT-TERM TRAINING PROGRAMME IN ‘HEALTH AND LONGEVITY’. SALINA – 22nd October 2001
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22/10/2001
22/10/2001
Ladies and Gentlemen,
Fellow Colleagues,
| In my capacity as Parliamentary Secretary in the | Ministry for Social Policy, on behalf of the Government of Malta, I extend my welcome to you all to this International Short Term Training Course in Health and Longevity, organized by the International Institute on Ageing (INIA). My welcome goes first to the foreign participants from twelve developing countries who are gathered here this morning but also the local participants, fellow countrymen, from whom we are expecting their valid contribution in the realization of our policies and programs in the field of the elderly. My sincere welcome to you all is two-fold: not only in my official capacity but also as a medical doctor who has been exercising his profession as a family general practitioner for over 40 years. I therefore consider it a privilege to be with you at the opening of this Short Term Training Course this morning. |
| In the past few years, billions of dollars have been | spent on conquering and subduing disease. Still more billions are being spent on the general well-being and on slowing the ageing process. Some of the progress has been made in medical advances and some in pharmaceuticals; some has been due to fighting specific ‘killer’ diseases and improving health habits. Also, increasingly people are changing their attitudes about the limitations that ageing was supposed to automatically impose. The result is: people are living longer. |
| Longevity is a function of social and economic | progress, better public health and nutrition, and the application of important medical concepts. Furthermore, in the past century we have enjoyed steady success in meeting the challenges posed by the increasing number and proportion of older persons in many nations, through such advances as social security, health insurance, and biomedical research. The longevity revolution fundamentally affects everything: the family, economic productivity, the health care system and culture. The revolution in ageing is also contributing to a transformation of our health care and service delivery systems by requiring a more comprehensive and integrated approach to patient care, by the development of new technology to deal more effectively than we presently do with the frail and the bed-ridden, and by advancing long-term care programmes for all ages and conditions. |
| Ageing is a life-long process and should be | recognized as such. Ageing, in additional to being a symbol of experience and wisdom, can also bring human beings closer to personal fulfillment, according to their beliefs and aspirations. Most older persons want to be able to live as independently as possible. They want to live lives of dignity. They want to participate and contribute as members of their families and communities. They want to feel safe in their own homes and familiar environments, and they want to continue to learn and develop as citizens of a dynamic world. |
| Although ageing is irreversible, most of the problems | of old age can be prevented or ameliorated. Most of the problems of older people are not caused by the ageing process but by disease, loss of fitness and the social changes that accompany ageing. Staying healthy in old age is greatly influenced by environmental factors, by the lifestyle of the person, by the early diagnosis of disease, by adaptation to increasing disability and more intangibly, to a sense of usefulness and value. An active policy to promote health among the elderly does not aim to keep a person alive irrespective of the quality of that life. |
| The promotion of health amongst the elderly is | closely linked to promoting the health of the population generally. Health promotion is a process which aims at altering and developing fundamental features of society with a view to promoting good health and removing hazards and obstacles in the way of doing so. It seeks to mobilise resources for health and to pursue healthy public policy. The concept of health promotion is based on an understanding that health is more than an absence of disease. |
| Health promotion policies aim to add life to years by | enabling as many persons as possible to remain healthy and active throughout the years of their life; to add health to life by reducing the occurrence of illness and accidents and to add years to life by increasing the average life expectancy of the individual. A successful policy of health promotion would enable more people to reach old age, reduce the incidence of disease and handicap among the elderly and increase the number of elderly who are healthy and active. On each of these counts, the evidence suggests that there is much room for improvement. |
| Of particular importance in promoting and protecting | the health of the elderly are policies affecting housing, security, social cohesion, air quality, road safety, retirement and income. It has long been recognized that inadequate housing is a major impediment to older people leading an active life at home. The quality of the environment is also important to the well-being of the elderly. Policies which encourage greater flexibility in the age of retirement give older people more discretion in planning their lives and make the transition to retirement easier for many. The level of income at the disposal of the elderly is of vital importance to their well-being. If elderly people cannot afford to feed, house and warm themselves they will not be healthy and active. |
| Health promotion is a broad concept aimed at | facilitating citizens to achieve a healthier life through the co-ordination of public policy and health education directed at the individual. Health education emphasises the need for self-care, self-help and mutual aid. It makes relevant information about health and disease available to individuals and target groups and motivates people to live healthier lives. The elderly have much to gain from a health education program to encourage a healthy old age. |
| To prevent many of the diseases associated with | disability in old age it is necessary to take action in childhood or early adult life. For this reason, most health education programs concentrate on the young. But the onset of some diseases can be postponed and the disabilities associated with others reduced by action within the capacity of most elderly people. Such action includes stopping smoking, weight control, eating a balanced diet, limiting consumption of alcohol, stimulating mental activity, regular involvement with other people and keeping fit. The elderly no less than other age groups need the information and motivation to adopt healthy habits. Elderly people, because they had reached maturity before the relationship of certain habits to disease was demonstrated, may be the least affected of any age group by the health education campaigns of recent times. It is also more difficult to change the habits of a lifetime in advanced years. |
| Health education for the elderly should provide | information on issues directly affecting health such as nutrition and exercise, as well as useful advice on cooking, heating, insulation, accident prevention and security. There is also a need for information on particular problems associated with ageing such as coping with the disability of strokes and arthritis, and the management of incontinence. As far as possible, health education should be integrated with the social activities of elderly people in clubs, community and parish centres. It will require the involvement of professionals working with the elderly, in particular public health nurses, general practitioners, physicians in geriatric medicine and occupational therapists. |
| Those professionals working with the elderly have the | greatest potential for educating the elderly and their carers about health, for preventing disease, for the early diagnosis of treatable diseases and the management of disability. The role of the medical practitioner, public health nurse, dentist, physiotherapist, occupational therapist and chiropodist is particularly important in this respect. The International Plan of Action on Ageing recommends that practitioners and students in the caring professions should be trained in principles and skills in the relevant areas of gerontology, geriatrics, psychogeriatrics and geriatric nursing. It further recommends that education and training be interdisciplinary and be available at all levels. |
| In Malta, the care of the elderly in the community | has become the accepted perspective of present health and social policy. Various public and private policies and programs have been formulated and implemented to supplement family support to the growing elderly population so as to enable them to remain within the desirable environment of their own family and community for as long as possible. |
| Social policy in Malta has dramatically developed | from the traditionally "problem-oriented" depersonalized approach, to the present day community oriented depersonalized approach covering the totality of the individual’s well-being while reflecting the centrality of the human person and human family. |
| The concept of welfare and security is of a | multi-dimensional nature. Longevity of life has to be complemented by quality of life. Universal pension entitlement does not in itself ensure that the elderly remain active or that they preserve their relationships with family, friends and familiar surroundings. In this context, and in the light of the fact that the elderly are not a homogenous group, there has been a total shift in the nature of service provision in Malta in the past years. Particular focus is now being placed on community based care strategies that cater for the individual, thus providing for personal needs as distinct from former policies that maintained age as their criterion basis for entitlement when age alone is not a reliable indicator of needs. |
| The community care services help the elderly to | maintain good health and to live independent lives in their own homes and in the community, while at the same time enable families to cope, thus preventing or at least deferring the need for long-term institutional care. The trend is to hospitalize geriatric patients only in acute cases and to return them to their families and community as soon as possible furnishing them with appropriate follow-up treatment and supportive services. Range of community services include Domiciliary nursing, Home Help service, Home Care, Telecare, Handyman service, Day Care Centres, Incontinence service, Meals on Wheels and Respite Care. Whenever institutionalisation is necessary or inevitable for elderly persons, the utmost effort must be made to ensure a quality of institutional life corresponding to normal conditions in their communities, with full respect for their dignity, beliefs, needs, interest and privacy. In addition to the improvement in the community setting, including the setting up of a number of local residential homes, we have overseen to improvements to geriatric institutional care by the opening of Zammit Clapp Hospital and by the ongoing continuous refurbishment and modernisation of St. Vincent de Paul Residence. |
| My government is committed to seek Malta’s entry in | the European Union and I can safely state that certainly we are not lagging behind other European countries in the care of the elderly. Malta’s achievement in the field of ageing can be argued to be outstanding both from national as well as from international perspectives. My Secretariat within the Ministry for Social Policy in all it has done in the field of the elderly since its very inception in 1987, has always looked upon the elderly person as that man or woman who has given a life time service to his country through work or through family rearing. Therefore, society is duty bound to treat the elderly with respect, generosity and dignity whilst providing the necessary services or care to guarantee the quality of life to the older person. Older people in Malta are experiencing a steady improvement in the quality of life not only materially, but also equally important from the social, cultural, educational and recreational aspects. |
| During this 2-week course you will be listening to | the learned contributions of international tutors as well as local experts in the field of the elderly. However, my experience with previous courses is that much is learnt from each other by you, the participants of this course. You have been through the difficulties of working with or for the elderly in your own field within your own counties. Each of your unique experiences contributes greatly to the realistic approach to geriatric training as facilitated by this INIA program. I wish you all every success in your deliberations and discussions of these 2-weeks in our hospitable island. |
Thank you.
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