Policy-making in the context of demographic change means policy-making that includes all age groups in all phases of their lives. Policy-making in this context means intergenerational solidarity and equity. Demographic change is the order of the day. Society is ageing - mainly as a result of the low birth rate and the fact that people are living longer. Leading an independent life in old age and participating in society is important to almost everyone.
Providing them with the support they need is one of the key objectives in policy-making for senior citizens and there are two priority goals. The first is to support older people in need of care, help or other forms of assistance. And second, to use the potential of older persons to foster cohesion between the generations and promote a society based on sharing and solidarity.
In many cases, responsibility for helping and caring for the elderly is assumed by close relatives but also by professional carers and in some cases by friends. Das Bundesministerium für Familie, Senioren, Frauen und Jugend (the Federal Ministry for Family Affairs, Senior Citizens, Women and Youth) places importance on promoting a better reconciliation of family, care and work. The Ministry constantly works to modernise and develop nursing care professions in order to meet the growing need for nursing staff. It would also like to see society give greater recognition to the care provided by close relatives. Making it easier to reconcile care with working life helps in this regard - for example with the right to take carers' leave.
With a Nationale Demenzstrategie (National Dementia Strategy), the Federal Ministry for Family Affairs, Senior Citizens, Women and Youth is developing a comprehensive approach in cooperation with the Bundesministerium für Gesundheit (the Federal Ministry of Health), the civil society, the Länder (states), welfare service associations and research institutions. The aims are to help those affected and their families by support networks that help make life with dementia easier. Furthermore, the long-term care as well as medical services should better suit for the needs of people with dementia.
Older people want to remain active, take part in society and assume responsibility. Multi-generational centres are just one way to provide meeting places for people of all generations and for them to engage in a wide range of activities.
International cooperation is also becoming increasingly important in view of the growing percentage of older persons worldwide. Germany therefore actively advocates for older persons in an international context - at the United Nations (UN), the European Union (EU), the Council of Europe and in direct exchange with partner states (for example France and Japan).
Demographic development will change our society profoundly. Solidarity between old and young is the order of the day. Only intergenerational equity and peaceful coexistence of all generations will bring about sustainable success as well as create and preserve an attractive living environment in municipalities and regions worth living in for all age groups during all life phases and in every condition of life. This is why, in a dialogue with science and practice, the Federal Ministry for Family Affairs, Senior Citizens, Women and Youth is developing new approaches on how municipalities can adapt and change accordingly.
The Federal Ministry for Family Affairs, Senior Citizens, Women and Youth created the project "Demografiewerkstatt Kommunen" (Municipality Workshop on Demography) in 2016. Over a period of five years, selected municipalities have been supported and assisted in shaping demographic change on the ground by external counselling teams. This also includes border regions. Participation of local stakeholders and the people on the ground is a crucial criterion for finding solutions which will be sustainably supported and developed further by them. The experiences are being analysed, evaluated and made available to all municipalities as tools for shaping demographic change on the ground.
In 2019, in order to address the growing regional imbalance, the Federal Government within the framework of the Commission on Equivalent Living Conditions decided on measures to further strengthen structurally weak regions.
Living together in a sustainable way
The 17 Sustainable Development Goals (SDG) of the 2030 Agenda provide a holistic approach to make peoples coexistence and the coexistence of individual countries future-proof and thus sustainable. Broken down to regions and municipalities, this also has an impact. Sustainability means not to live at the expense of the next generations, but to jointly set the course now to ensure solidarity in the long run: Solidarity between cities and rural areas, solidarity between age groups, solidarity in an increasingly diverse and heterogeneous society.
Germany's National Sustainable Development Strategy constitutes a substantial basis for this purpose. It includes topics from within the remit of the Federal Ministry for Family Affairs, Senior Citizens, Women and Youth. Not least, better reconciliation options and a better coexistence of the sexes also have a direct impact on the care for the elderly. Generations interacting with each other and assuming responsibility for the young but also for the old generation creates cohesion and, thus, a sustainable coexistence.
Digitalisation and Senior Citizens
Digitalisation offers many opportunities for leading a good life in old age. Online banking, online bookings of doctors' appointments or video calls with relatives - digitalisation can enrich our lives and make our everyday lives easier. However, in order to use the opportunities of digital media and digital services safely, specific skills are needed. This is particularly true for older people. Access to digital services, the skills for using them as well as lifelong learning are all important prerequisites enabling older people to stay active for as long as possible and to participate in society in a self-determined way.
With the project "Digitaler Engel - sicher, praktisch, hilfsbereit" (Digital Angel - secure, useful, helpful) and the service point "Digitalisierung und Bildung für ältere Menschen" (Digitalisation and Education for Senior Citizens), the Federal Ministry for Family Affairs, Senior Citizens, Women and Youth fosters the active participation of older people in society and enables them to lead self-determined lives in an increasingly digitalised society.
The bus of the mobile team of advisers - "Digitale Engel" (Digital Angels) - has been touring Germany since November 2019 and stops during the corona pandemic. The aim is to provide older people with personal, real-life and on-the-spot support in the competent use of digital services. In personal conversations, the team of advisers answers any questions about digitalisation. It informs older people about how to use digital applications safely and points out local services. These personal conversations help to present digital services, to answer specific questions and to reduce fears. The "Digital Angels" visit the places older people go to in their everyday lives, for example the market square or meeting places for senior citizens. During their tour of Germany, the "Digital Angels" will stop at more than 450 locations across Germany. Here, they cooperate closely with existing local structures, such as Mehrgenerationenhäuser (multi-generational centres) and Seniorenbüros (senior citizens' agencies). Rural areas are the main focus.
In order to strengthen the digital confidence of older people, the Federal Ministry for Senior Citizens has been supporting the service point "Digitalisierung und Bildung für ältere Menschen" (Digitalisation and Education for Senior Citizens) of the German National Association of Senior Citizens' Organisations since 2017. The online portal wissensdurstig.de (keen to know) plays a key role in offering information about digitalisation, education and new media for older people.
Federal Programme "Multi-generational Centre"
Operated under the Bundesprogramm "Mehrgenerationenhaus" (Federal programme "Multi-generational Centre"), some 540 multi-generational centres provide places for people of all ages to meet and engage in a wide range of activities. The centres link and supplement the social infrastructure through close cooperation with other local stakeholders and the local administration. The multi-generation approach is the unique selling point of each centre, where young and old can talk to one another, help each other and benefit from an exchange of knowledge. Interaction between the generations fosters everyday skills, promotes participation and inclusion, and strengthens social cohesion.
Living in Old Age
Living an independent, self-determined life for as long as possible - that is the aim of the Federal Government's programmes and projects on "Wohnen im Alter" (Living in Old Age). The various projects focus on shared housing, age-appropriate home conversions, ambient-assisted homes, local support and advisory services and neighborhood help schemes. They also support the provision of social services and improve living conditions to help people stay in their homes by offering family carers a range of options that provide them some relief. Apart from government, the crafts and trades sector, local administrations and the housing industry, senior citizens' organisations and society itself can contribute to providing older people with comfortable homes and helping them participate in social life.
Non-statutory Welfare Organisations and Senior Citizens' Organisations
They are indispensable in promoting social cohesion in Germany: the associations of independent welfare organisations which operate under the umbrella of Wohlfahrtsorganisationen (the Federal Association of Non-Statutory Welfare Arbeiterwohlfahrt, German Caritas Association, the German Red Cross, Diakonie Deutschland, Der Paritätische and the Central Welfare Board of Jews in Germany). The same applies to the senior citizens' organisations which operate under the auspices of the BAGSO - Bundesarbeitsgemeinschaft der Senioren-Organisationen e.V. (the German National Association of Senior Citizens' Organisations). As critical partners, these support the Federal Government's policies, helping to shape Germany as a welfare state and enabling social inclusion.
Funding provided by the Federal Ministry for Family Affairs, Senior Citizens, Women and Youth makes it possible for these organisations to maintain the necessary structures at national level. They are thus in a position to play an active role in specific areas of social policy and to support the people whose interests they represent in a targeted way by conducting their own projects and programmes.
Images of Ageing
Senior citizens today are generally healthier, better educated and more vibrant and energetic than earlier generations. They also want to continue their involvement in the working world, in industry and in society as a whole. However, prevailing images of old age are still based on those of previous generations. These usually relate to illness and decay rather than available skills, experience and potential.
Perceptions of age can strongly influence what young people expect from their own old age and what older people think they are (still) capable of. The Federal Ministry for Family Affairs, Senior Citizens, Women and Youth thus wants to sensitise social stakeholders to this situation - and sensitise older people themselves. Working with other federal ministries, the states, central municipal associations, non-statutory welfare associations, civil society organisations and industry and business, the Ministry discusses and explores the kind of additional participation opportunities that can be offered to people aged 55 and above.
Reconciliation of family, care and work
The Caregiver Leave Act and the Family Caregiver Leave Act make it easier for employees to take care of close relatives in need of long-term care.
Close relatives have the option to stay away from work for up to ten working days in order to organise appropriate care in an acute care situation or to ensure care during this period. A Pflegeunterstützungsgeld (carers' grant) is provided during this time for a maximum of ten days. The right to be absent from work applies to all employees regardless of their employer and the size of the company or business. Employees also have the right to take full or partial leave from their jobs for up to six months to provide long-term care for a close relative at home (Caregiver Leave). They also have the right to apply for an interest-free loan from the Bundesamt für Familie und zivilgesellschaftliche Aufgaben - BAFzA (the Federal Office of Family Affairs and Civil Society Functions) to cushion the effect of losing their income. The right to Caregiver Leave does not apply to employees who work for an employer with a regular staff of 15 or less.
When close relatives need to be cared for over a longer period of time, families face the challenge of reconciling the provision of that care with their responsibilities in working life. Employees have the right to partial leave (from work) for a period of up to 24 months and to take out an interest-free loan. The right to partial leave does not apply when an employer has 25 or fewer regular employees (excluding employees in vocational education and training).
To accompany a close relative during their final phase of life, an employee may take up to three months off work in one go or be released intermittently for shorter periods of time. When looking after an underage relative in need of care, an employee may be released from work for up to six months in accordance with the provisions of the Caregiver Leave Act or the provisions of the Family Caregiver Leave Act. The care or support given need not be provided in the home.
Not only adults take care of persons who are chronically ill or in need of care. According to a study conducted by Universität Witten/Herdecke (Witten/Herdecke University) on behalf of the Bundesministerium für Gesundheit (the Federal Ministry of Health) (published in July 2018), around 479.000 children and young people nationwide take care of relatives who are chronically ill or in need of care. The project "Pausentaste - Wer anderen hilft, braucht manchmal selber Hilfe" (Pause - Sometimes, those who help others need help themselves) has established low-threshold counselling services specifically for children and young people who provide care. "Pause" aims at helping them to take a break, reflect and make use of offers to assist them or to speak about their individual situation - also anonymously. Services offered include the website www.pausentaste.de, telephone counselling and email counselling. Since the end of October 2019, the service has been expanded to include webchat counselling. The services offered by "Pause" are mainly geared towards caregiving children and adolescents. The project also seeks to make teachers, home care providers, social services at schools and hospitals as well as youth organisations and the public aware of the issue. In support of the project, a network of the various stakeholders was launched, which meets at least once a year for professional exchange. Members receive regular internal newsletters within the network.
In September 2015, additionally, an Unabhängiger Beirat für die Vereinbarkeit von Pflege und Beruf (Independent Advisory Committee for the Reconciliation of Care and Work) was set up. The Committee addresses matters relating to work-life balance, accompanies the implementation of relevant regulations and discusses their effects. Every four years, the Committee submits a report to the Federal Ministry for Family Affairs, Senior Citizens, Women and Youth, which may include recommendations for action. The first report was officially presented to Federal Minister Dr. Franziska Giffey in June 2019. In addition to detailed insights and assessments of studies, the report includes in particular recommended action on further developing the topic of "work-life balance".
Improving vocational training and education in nursing care
The quality of life of people in need of professional care is reliant on the nursing staff who care for them. The Federal Ministry for Family Affairs, Senior Citizens, Women and Youth is working with the Federal Ministry of Health to improve the quality and the attractiveness of vocational training and education for nursing care professionals. With the Care Professions Reform Act taking effect, the training for geriatric nurses, general nurses and pediatric nurses has fundamentally changed since January 2020. To further improve the vocational training and education in nursing care as well as the working conditions and payment for the care profession, the campaign "Konzertierte Aktion Pflege" (Concerted Action for Nursing) was launched under the leadership of the Federal Ministry of Health and the co-leadership of the Federal Ministry for Family Affairs, Senior Citizens, Women and Youth and the Bundesministerium für Arbeit und Soziales (the Federal Ministry of Labour and Social Affairs) in partnership with the Länderregierungen (state governments), the local authority associations, social insurance agencies, care providers and the various nursing care associations. It was organized in five working groups focusing on different targets, with the results published in summer 2019.
As the result of the first working group, the "Ausbildungsoffensive Pflege" (Vocational Training Initiative for the Care Sector), containing 111 specific measures, was launched under the leadership of the Federal Ministry for Family Affairs, Senior Citizens, Women and Youth. Within a period of five years from 2019 to 2023, the partners of the initiative have committed themselves to the following key objectives:
- Supporting the ongoing implementation of the Nursing Professions Act.
- Increasing the number of nursing trainees and the number of training institutions by ten per cent until 2023.
National Dementia Strategy
Dealing with dementia is one of the biggest challenges faced by society today. In Germany, some 1,6 million people suffer from the illness. Without a breakthrough in dementia prevention and treatment, that figure is expected to rise to around 2,7 million in 2050. Thus, the task at hand is to improve circumstances both for people with dementia and for their families to ensure their protection and participation, and to secure their inclusion in society as a whole.
In 2018 the Federal Ministry for Family Affairs, Senior Citizens, Women and Youth and the Federal Ministry of Health started the process to develop a National Dementia Strategy. This is done in close cooperation with the states, welfare service associations and research institutions. In 2020 the strategy will be passed by the Bundeskabinett (Federal Cabinet). The aim of the strategy is to improve the living situation of people with dementia and their relatives in Germany and to create sustainable structures for the future.
The National Dementia Strategy defines four fields of action:
- Develop structures for the social participation of people with dementia on site
- Support people with dementia and their families
- Improve medical and nursing care for people with dementia
- Promote excellent research on Dementia
The National Dementia Strategy ties in with the work of the Alliance for People with Dementia at the federal level and the Local Alliances for People with Dementia on site and brings the activities together in one strategy.
Hospice and palliative care - Support on the last journey
The Federal Ministry for Family Affairs, Senior Citizens, Women and Youth supports the following measures in hospice and palliative care: It has been supporting the implementation of the Charter of Rights for People in Need of Long-Term Care and Assistance in Germany and its recommendations for action since 2016. This also includes the online search tool "Wegweiser Hospiz- und Palliativversorgung Deutschland" (Guide to hospice and palliative care in Germany). It provides information on inpatient and outpatient services for adults, children and young people in nine languages. With a pilot project by the specialist unit for hospice work, palliative care and bereavement services of the German relief agency Malteser Hilfsdienst young adults are to be introduced to the topic and inspired to get engaged in end-of-life care and bereavement services.
A long-life society is also characterised by an increasing demand for hospice care, for palliative medical and care provision as well as for psychosocial and possibly spiritual support. Ensuring that the last stage in life can be led in a self-determined and dignified way as well as supporting relatives and persons of trust is a challenging task. It requires a high level of comprehensive, multi-professional and interconnected inpatient and outpatient hospice and palliative care. In order for all seriously ill and dying persons to receive the care they need in their chosen living environment, a targeted advancement and improvement of hospice and palliative care, particularly with a view to older people, is necessary. The Federal Ministry for Family Affairs, Senior Citizens, Women and Youth aims to break taboos and to promote more openness within our society for dealing with the topics of illness, dying, death and grief. We want to encourage people to consider or to continue with volunteer work. We want to assist relatives who provide care and to facilitate access to hospice and palliative care (equal access for special groups, for examplevulnerable groups, decreasing structural deficiencies) and to support the creation and expansion of local networks.
German Government Report on the Elderly
The local community and the local environment are especially important as people get older. In addition to municipal provision of services and support, caring communities play an increasingly important role. Against this backdrop, the Siebte Altersbericht (the Seventh German Government Report on the Elderly) focused on care and responsibility in the community and addressed the following issues: what role can local authorities and local communities play in securing social, political and cultural participation for the elderly and in helping them lead as independent a life as possible as their lives progress?
The Commission for the Seventh Report on the Elderly has made concrete recommendations for action to be taken by relevant social stakeholders: municipalities should be given more policy responsibilities, their financial resources should be increased, and networking and cooperation between stakeholders should be expanded.
The Altersberichtkommission (Commission for the Report on the Elderly) presented the Achter Altersbericht "Ältere Menschen und Digitalisierung" (the Eighth Report on the Elderly "Older People and Digitalisation") in January 2020. The expert commission examined how digitalisation and technology can contribute to a good life in old age. The commission also studied the societal, social and ethical challenges which are connected to an increasingly technological daily life for older people.
The Bundesregierung (the Federal Government) is currently preparing its statement on the report. The expert commission’s report together with the statement by the Federal Government is expected to be published in early summer 2020.
International Policy for Senior Citizens
The percentage of older persons in the population is on the increase, not only in Germany but worldwide. International policy for senior citizens deals particularly with the challenges posed by demographic change and serves the exchange of experience among countries.
The Federal Republic of Germany works within international bodies to support the strengthening of the rights of older persons - at the United Nations, in the Council of Europe, in the European Union and in direct exchange with partner states.
United Nations Open-ended Working Group on Ageing
Once a year, in New York, the United Nations (UN) open-ended Working Group on Ageing (OEWG-A) deliberates ways of strengthening the rights of older persons. The following topics have been on the agenda since 2017:
- Discrimination in old age
- Violence, abuse and neglect in old age
- Right to long-term care and palliative care
- Right to autonomy and self determination
- Education, training, lifelong learning and capacity-building
- Social protection and social security
Second United Nations International Plan of Action on Ageing
The Second United Nations International Plan of Action on Ageing was adopted in Madrid in 2002 (Madrid International Plan of Action on Ageing - MIPAA). This political plan of action is being implemented by the Member States by means of national action plans that are based on regional implementation strategies.
Responsible for the implementation of the Second International Plan of Action on Ageing at European level is the United Nations Economic Commission for Europe (UNECE) Regional Commission. The corresponding working group on ageing (UNECE-Working Group on Ageing - UNECE-WGA) holds a conference of ministers every five years to further develop the 56 Member States' strategy for the future.
The last UNECE Ministerial Conference on Ageing was held in Lisbon in 2017. The Ministerial Declaration adopted by the 56 Member States lists the measures for the subsequent five years:
- Recognising the Potential of Older Persons
- Encouraging Longer Working Life and Ability to Work
- Ensuring Ageing with Dignity
Detailed information can be found in the Policy Briefs published by the UNECE Working Group.
National Expert Discussions
The Federal Ministry for Family Affairs, Senior Citizens, Women and Youth regularly invites experts from science and practice, as well as representatives of organisations for the elderly, to attend national expert discussions. In these discussions, the points of view and needs of older people are deliberated and the resulting considerations subsequently inform the international debate. Conversely, such discussions also serve to incorporate the results of international debates at national level. Important partners of the Federal Ministry for Family Affairs, Senior Citizens, Women and Youth are the German National Association of BAGSO - Bundesarbeitsgemeinschaft der Seniorenorganisationen e.V. (German National Association of Senior Citizens' Organisations) and Deutsches Institut für Menschenrechte DIMR e.V. (German Institute for Human Rights).