Ageing in the Twenty-First Century: - HelpAge International

Chapter 2: A fresh look at evidence – Age-friendly environments
Sometimes there are problems putting policies into
practice, however. For example, even when respite
services are available, caregivers are often reluctant to
use them because they are concerned about the quality
of care, the impact of the disruption on the person
they are caring for, or the cost. 273
Eligibility criteria, such as defining who is the primary
caregiver and measuring caregivers’ work, can be
difficult to assess and may be viewed as arbitrary. 274
Restrictive criteria may prevent abuses, but can also
limit uptake. 275 In the United Kingdom, for example,
fewer than 10 per cent of caregivers received the carer
allowance in 2008. 276
Examples of policies which aim to ensure a continuum
of care include:
• In Australia, the Home and Community Care Act of
1985, which provides for assistance both directly and
through caregivers, was revised in 2007 and the Carer
Recognition Bill was passed in 2010. There are also a
number of programmes, such as the National Respite
for Caregivers Programme, the National Carer
Counselling Programme and the Carer Advisory
Service. Grants are also available for caregivers.
• In Canada, the Government offers caregivers a wide
variety of support including financial assistance
though tax measures. In 2011, the Government
announced new supports for unpaid caregivers that
include the creation of a new Family Caregiver Tax
Credit and enhancements to the Medical Expenses
Tax Credit and Infirm Dependant Tax.
• In Finland, the Act on Support for Informal Care of
2006 makes provision for a care allowance, services to
support caregivers, including respite leave, and the
persons being cared for. In 2004, Finland introduced
a voucher system which allows caregivers to choose
service providers.
• In Hungary, the One Step Forward Programme of
2009 offers training courses for caregivers and those
who receive a care allowance. Other provisions are
made through the national health insurance system.
• A number of legislative provisions have been made
in Japan: the Act to Amend Part of Long-Term Care
Insurance Act on Social Welfare Service for Elderly and
the Act on Improvement of Treatment of Long Term
Care Workers Aiming at Securing Human Resources of
Long Term Care Workers (Act 44) were passed in 2008
to provide more support to caregivers because high
rates of turnover had become a problem. A law on
Elder Abuse Prevention and Caregiver Support was
introduced in 2006.
• In New Zealand, the aim of the Caregivers’ Strategy and
Five Year Action Plan of 2005 is to provide support to
caregivers and, in general, to ensure a continuum of
care.
• Singapore encourages informal care arrangements and
has a national grant for caregivers to enable them to
undertake training.
• In the United States, there are financial resources for
community-based programmes and services, such as
adult day care or home health care.
Increasingly, community-care systems are being
developed as an alternative or addition to family care.
In Asia, for example, the growth of the older population
and a decline in traditional family support as younger
family members have moved away to work has left many
older people to cope alone. In spite of these changes, the
overall weight of the evidence shows that family support
of older persons is still prevalent in both developing and
developed countries. 277
A volunteer-based programme launched in 2003 is helping
to fill this gap in all 10 ASEAN countries. The programme
is based on a model developed by HelpAge Korea and is
funded by the Republic of Korea ASEAN Cooperation
Fund. In some countries, care is provided by trained
volunteers from a partner agency. In others, partneragency
volunteers collaborate with local older people’s
associations. Volunteers visit older persons each week
to help with household activities, accompany them to
shops or social activities, and provide friendship and
company.
92 Ageing in the Twenty-First Century: A Celebration and A Challenge