Fraternity-Testvériség, 2010 (88. évfolyam, 1-4. szám)
2010-04-01 / 2. szám
Fraternity I Testvériség Elder Care in Hungary By Kathy A. Megyeri L ike America, Hungary too is coping with its elder care dilemma. The life expectancy of its citizens has declined by over 2 years since the 1960’s. The increase in male mortality was especially large, and males can now expect to live an average of 67 years as opposed to females who live an average of 74 years. However, the mortality of both males and females in all age groups is higher than in all industrialized countries for the following reasons: Hungary’s cardiovascular disease is the highest in the world, followed by cancer, chronic respiratory disease, cirrhosis, and suicide. Hungarians’ unfavorable health status can be attributed to socio-economic factors such as unhealthy lifestyles, overwork and related stress, occupational and environmental hazards, incidence of high cholesterol, high blood pressure, obesity, and the country’s traditionally permissive attitude toward consumption of alcohol and tobacco. Comparable to America’s aging population, the current proportions of Hungarians 65 or over are projected to increase by over 23% by 2025—already the highest in Central and Eastern European countries. The oldest old (those 80 and over) constitute almost 20% of all elderly in Central and Eastern Europe, but Hungarian villages have a higher proportion of elderly population than in urban areas. And Hungary has had below replacement fertility since the 1980’s (25% of Hungarian elders have only 1 living child and 15% have no children). The proportion of elderly households with less than 75% of the median household income was substantially higher than that of other household types. Elders’ continued economic security is contingent on the state’s willingness and fiscal ability to allocate substantial resources to this part of the social budget. It is all too obvious that changes in laws governing retirement and design and eligibility of state pension programs will affect the elderly’s economic security in the future. Like in America, the elderly’s social involvement affects their quality of life, their health and their longevity, but Hungarians report decreased numbers of friends, an increase in being without friends and a withdrawal from interhousehold exchanges (1/3 of elders lost friends between 1994 and 1997). Older persons in general and pensioners in specific are less likely to have dense networks of social relationships than younger persons or elders who are still employed. Elders’ access to health services in villages which no longer have doctors, dentists, and other health professionals locally available will have a large impact on their quality of life and their longevity, and a reduction of the elderly’s social network resources is adversely affecting their material well-being and increasing their already high dependence on state pension programs. Similarly to America, aging is disproportionately a woman’s issue. In Hungary, there are 60 males per 100 females after age 65. Women’s longevity results in low marriage rates among elderly women and the high likelihood that elderly women will live alone—1/3 now live alone, 38% live with spouses and 28% live with family members. Thus, women’s economic security is highly dependent on the state’s will and fiscal capacity to maintain a strong gender-neutral pension system. The good news is that transportation is free for pensioners and pensions have retained their value better than any other form of income since I989, but the ratio of active workers to retirees will decline over the next several decades. In rural areas, an in-migration of displaced kin Hungary’s Elders from larger towns and cities will provide opportunities for a more intense social life for the elders but will stretch thin the villages’ already modest economic and housing resources. Rural poverty is great. Marginal persons attracted to rural areas become trapped there, and in-migrants place additional burdens on already sparse family and community resources. The state of care varies as it does in the U.S. In Hungary, nursing homes are controlled by municipalities. They operate on central government funding with co-payment by the elderly or their families. Basic services including medical treatment are provided for nominal fees based on an individual’s monthly pension. But the capacity of state-run homes is small so privately built and managed nursing homes are being established by charitable organizations, foundations, and private companies. In 2000, the Hungarian market for home care and rehabilitation products was estimated to be at almost $250-300 million. The medical product market is dominated by imports (Germany is the sales leader), and there is an increasing degree 11
