In this page
Work to co-produce the 'Strategy for an Ageing Society' began before the first outbreak of COVID-19 when the lives of older people in Wales were very different. The pandemic has touched everyone in some way but many older people have had their confidence shaken to its core. The unprecedented public health restrictions took older people away from their families, friends, volunteering roles, jobs and communities and we know that many are nervous about a return normality. This reticence will undoubtedly impact negatively on older individuals, but also on the families, friends and communities they support.
There is no doubt that the pandemic has changed the way we live and reshaped the services we access. Although life in Wales has changed considerably over recent months, the focus and vision of this new Strategy for an Ageing Society remains relevant. Creating an age friendly Wales that upholds older people’s rights and promotes intergenerational solidarity is more pertinent today than ever before. We have therefore updated sections of this document to reflect policy changes in response to COVID-19 and our public consultation responses, but the core elements of the strategy remain unchanged.
'Age friendly Wales: our strategy for an ageing society', sets out the action we will take to reap the benefits of growing number of older people in Wales as we rebuild our communities. This, in turn, will enable us to better support people living in challenging circumstances. To reflect the multi-dimensional nature of ageing and the intersectional nature of people’s experiences, we have worked across government departments to address the range of factors that influence how we age – from our health and transport systems to the way we socialise, work and care for others. The strategy aims to unlock the potential of today’s older people and tomorrow’s ageing society.
The pandemic has also uncovered some positives about life in Wales. For example, the capacity of communities to come together and support each other, the third sector’s ability to flex and adapt its services to meet individual need and the commitment and resilience of professionals who care for the most vulnerable members of our society. It has also sharpened our focus on the issues that matter most to older people, such as access to health services, loneliness and isolation, abuse and digital inclusion.
Although many of us are working longer than before, providing more unpaid care and spending more time contributing to our local communities, older people are often depicted as a drain on society. We need to change the way we think and feel about ageing. Older people are tax payers, consumers, local councillors and business owners. By acknowledging and valuing the contributions of all older people in Wales, we can reject ageism and work across generations to create an age friendly Wales. It is important to remember that people should not be judged by their economic worth alone – everyone has the capacity to make a difference.
Our ageing society should be celebrated
We cannot achieve our vision of an age friendly Wales alone - it is in everyone’s interest to plan ahead. The Well-being of Future Generations (Wales) Act aims to create a Wales that we all want to live in, now and in the future. There is no place for ageist stereotypes that create tension between generations. I am keen to explore how we can bring people of all ages together – by taking action to support older people today, we can create a better future for everyone.
I am proud that this strategy adopts a rights based approach that promotes equality and social justice across a range of policy areas and places the older people’s voice at the core of Welsh Government policy making. As restrictions are eased and communities re open, we must not let the pandemic embed stereotypical notions of ageing linked to illness and decline.
The United Nations Principles for Older Persons have informed the development of this document and will guide its implementation. Age does not diminish an individual’s right to fair treatment. By rejecting ageism and age discrimination, we aim to create a more equal society that enables people of all ages to fulfil their potential no matter what their background or circumstances.
Work to coproduce a delivery plan to support the implementation of this Strategy is already underway. The plan will be a ‘live’ document which can be updated at any point, but progress reports will be published annually.
One vision: age friendly Wales
Three cross cutting themes:
- Creating an age friendly Wales
- Prioritising prevention
- A rights based approach
- Enhancing well-being
- Improving local services and environments
- Building and retaining people’s own capability
- Tackling age related poverty
|Name of strategy/plan||Enhancing well-being||Improving local services and environments||Building and retaining people's own capability||Tackling age related poverty|
|Race equality action plan||Opportunities for broader contribution||Opportunities for broader contribution||Opportunities for broader contribution||Opportunities for broader contribution|
|LGBTQ+ action plan||Opportunities for broader contribution||Opportunities for broader contribution||Opportunities for broader contribution||Opportunities for broader contribution|
|National framework for bereavement care||Supporting policy||Supporting policy||Supporting policy||Supporting policy|
|Transport strategy||Opportunities for broader contribution||Direct contribution||Opportunities for broader contribution||Opportunities for broader contribution|
|Advancing gender equality in Wales plan||Opportunities for broader contribution||Opportunities for broader contribution||Opportunities for broader contribution||Opportunities for broader contribution|
|A healthier Wales||Direct contribution||Direct contribution||Direct contribution||Direct contribution|
|Strategy for unpaid carers||Direct contribution||Direct contribution||Direct contribution||Direct contribution|
|Together for mental health||Direct contribution||Opportunities for broader contribution||Opportunities for broader contribution||Opportunities for broader contribution|
|Dementia action plan||Direct contribution||Opportunities for broader contribution||Opportunities for broader contribution||Opportunities for broader contribution|
|Healthy weight: healthy Wales strategy||Direct contribution||Opportunities for broader contribution||Opportunities for broader contribution||Opportunities for broader contribution|
|Action on disability: the right to independent living||Direct contribution||Direct contribution||Direct contribution||Direct contribution|
|Cymraeg 2050||Opportunities for broader contribution||Opportunities for broader contribution||Opportunities for broader contribution||Opportunities for broader contribution|
|Connected communities: a strategy for tackling loneliness and isolation||Direct contribution||Direct contribution||Direct contribution||Direct contribution|
Purpose and long-term vision
Introduction – the opportunity and the challenge
In Wales, the central demographic projects that in 20 years (by 2038) 1 in 4 of the population will be over 65. The population aged over 75 in Wales is also projected to increase from 9.3% of the population in 2018 to 13.7% in 2038 (Office for National Statistics 2019). It is worth noting that despite these predictions, improvements in life expectancies have stalled since around 2011 and there has been little change in recent years.
However, there have been some stark societal shifts over recent years. For example, the estimated number of people living alone has been increasing steadily over the last decade. Today, people aged 65 and over make up 45% of single person households. Statistics from Alzheimer’s Research UK show that from 2006/07 to 2015/16, the number of people on the dementia register rose from 9,550 to 13,617, an increase of 43%. The number of unpaid carers in Wales is also increasing and people aged 65 and over are the fastest growing group.
Longer lives inevitably mean more years spent in retirement and for many, retirement offers the opportunity to try new things and live the life we chose. The National Survey for Wales shows some positive results for older people. For example, 69% of people aged over 75 said they have sense of community compared to only 51% of people aged 46 – 64. 35% of people aged 64-75 volunteer. 90% of older people feel in control of their lives and 80% feel they can do what matters to them.
The Welsh Government’s commitment to older people is longstanding. Wales has a proud and notable history of working with and for older people. We published our first 'Strategy for Older People' in 2003 which challenged traditional stereotypes of older people and encouraged local and national government to view ageing as a positive concept.
The first 'Strategy for Older People' recognised that governments can lead a cultural shift towards a society that values and celebrates its older citizens. That is why, in 2008, we established the world’s first Older People’s Commissioner to be an independent voice and champion for older people across Wales. We were also the first part of the UK to introduce a nationwide concessionary fare scheme in 2002.
Our new 'Strategy for an Ageing Society' is broader in scope than our previous strategies for older people. We have purposely not defined the age at which we become ‘an older person’ – we want people of all ages to engage with this work. This strategy also acknowledges that the life experiences and daily reality vary greatly for people in their 50s to those in their 80s and over. Consequently, this strategy spans a broad range of policy areas from health and social care for older people living with complex needs to support for working age carers and the foundational economy.
In 2018, the report, 'Living Well for Longer: The economic argument for investing in the health and well-being of older people in Wales' (Tudur Edwards et al), found that the economic value of the contribution made by older people in Wales was estimated to be £2.19billion per annum. However, an ageing population does bring new challenges for governments, communities and individuals. The impact of COVID-19, deep rooted social and economic inequality, austerity and the rising number of older people living with complex conditions cannot be ignored. By taking action now, we can address the barriers that prevent some older people from living well and maximise the potential of our ageing society.
Making sure that people can use Welsh language services, when and where they need them, in a way that suits their Welsh language ability; creating and maintaining opportunities to use our language and building capacity in Welsh language skills are central to creating an age friendly Wales and we will work with partners to ensure Welsh language policy permeates all aspects of the strategy’s implementation.
In planning for an ageing society, we must consider how technology is changing the way care is delivered, how we live and how we interact with others. Across this document, we provide examples of how technology is changing, or has the capacity to improve lives for older people in Wales. Our ‘Digital Strategy for Wales’ (March 2021) sets out a clear vision and ambition for a coordinated digital approach in Wales. It identifies a series of priority areas under six missions which, when taken together, aim to accelerate the benefits of digital innovation for people, public services and businesses in Wales. The strategy is clear that for people who cannot, or decide not to, participate digitally, we will continue to apply the principles of user centred design so that there are alternative ways to access public services in Wales - alternative access routes which will be as good as those offered online.
In any collective endeavour clarity of purpose is key. Harnessing the opportunities and responding to the challenges of an ageing society requires everyone to pull in the same direction. That intended direction is set out below.
- Our vision is an age friendly Wales that supports people of all ages to live and age well.
- We want to create a Wales where everyone looks forward to growing older.
- A Wales where individuals can take responsibility for their own health and well-being whilst feeling confident that support will be available and easily accessible if needed.
- A Wales where ageism does not limit potential or affect the quality of services older people receive.
- Ultimately, we want to be a nation that celebrates age and, in line with the UN Principles for Older Persons, a nation that upholds the independence, participation, care, self-fulfilment and dignity of older people at all times.
This national vision for an age friendly Wales encompasses the places where people work, their rights and entitlements, their relationships within their families and local communities and with governments. It also encompasses the relationships we have across the generations and aims to challenge and change the way we think about ageing.
To drive progress towards this vision, we have set four national aims. It is these aims that are the focus of the strategy, and by which the extent of its success will ultimately be judged. The aims align with the four domains of the UK age watch index which has been specifically commissioned to support the implementation of this strategy:
- enhancing well-being
- improving local services and environments
- building and retaining people’s own capability
- tackling age-related poverty
By focusing on these aims, we aim to support people to live the life they chose free from abuse, neglect or the erosive impact of ageism and age discrimination. The aims contribute to our commitment in the Well-being of Future Generations Act to ‘create a Wales that we all want to live in, now and in the future’ by placing a specific focus on ageing. We want all sectors of Welsh society, individuals and communities to join us in considering the steps they should take to both plan for their own futures and to support us to achieve our national vision of an age friendly Wales.
Three cross-cutting themes
The following three themes do not fit within one specific section as their relevance spans across the entire document.
Theme 1: Creating an age friendly Wales
The global response to the world’s ageing population has been a move towards age friendly communities and cities. The World Health Organisation (WHO) states that ‘an age-friendly world enables people of all ages to actively participate in community activities and treats everyone with respect, regardless of their age.’ The organisation’s 2018 report ‘The Global Network for Age-friendly Cities and Communities’ elaborates:
By making cities and communities age-friendly, we ensure that cities and communities are inclusive and equitable places that leave no one behind – especially the most vulnerable older people. Equitable societies, in turn, have benefits for everyone.
In 2010, WHO launched its 'Global Network for Age-friendly Cities and Communities'. To become a member of the network, local leaders must commit to and implement the four steps:
- engage with and understand stakeholders including older people
- plan strategically to enable all stakeholders to develop a shared vision
- implement an action plan
- measure the progress of the age-friendly approach as well as its impact on people’s lives
These steps align with and can support public bodies to embed the Well-being of Future Generation’s Act’s five ways of working and a rights based approach. They provide a framework for Welsh Government and local authorities to broker new relationships with citizens and drive a cultural shift towards a more co productive way of designing and delivering services.
We want Wales to be part of this global movement towards age friendly communities and plan to work with the Older People’s Commissioner to encourage and support age friendly communities to be established throughout Wales. United and consistent progress at a local level will sum up to significant progress nationally. In 2021 -22, we are providing £550,000 between local authorities to support their work to become age friendly.
Theme 2: Prioritising prevention
Increases in life expectancies in Wales have stalled in recent years along with ‘healthy life expectancies.’ There is currently a difference of around 18 years in healthy life expectancy between the most and least deprived areas. If we are to achieve our aim of supporting all older people in Wales to live and age well, we must prioritise prevention, not just in traditional health and social care settings, but across every determinant of well-being.
Prevention and early intervention can stop problems occurring in the first instance. They can also support people living in challenging circumstances to cope better. The age friendly initiative is a preventative intervention. The programme supports local communities to take control and become more involved in shaping their local environment to better suit their lifestyles. It also supports policy makers to identify where they need to prioritise resources in order to design services that keep people well for longer. At a time when public budgets are so tightly constrained, the public sector cannot afford to ignore the key factors that make a difference to the quality of people’s lives and matter most to them.
By building communities, homes, transport systems and outdoor spaces that enable people to age well, we aim to support the population of Wales to live healthy and fulfilled lives for as long as possible.
Prevention and early intervention can also equip people with the skills and knowledge to take responsibility for their own health and well-being. The movement towards an age friendly Wales can also play a key role in empowering individuals to take control of how they live and ultimately how well they age.
This focus on prevention and collective action aligns closely with the aims of the Well-being of Future Generations Act and the requirement it places on public bodies to ‘to think about the long-term impact of their decisions, to work better with people, communities and each other, and to prevent persistent problems such as poverty, health inequalities and climate change.’
Theme 3: A rights based approach
Human Rights are universal and recognised rights for everyone as set out in the Human Rights Act (HRA) 1998. The Act came into force in the UK in 2000. Human rights are distinct from but closely aligned to the well-being agenda and represent a clear benchmark about the unacceptable nature of humiliating and degrading treatment to any of us. The HRA places an obligation on public authorities, including the Welsh Government, to treat people with fairness, equality, dignity, respect and autonomy.
Age is a protected characteristic under the Equality Act 2010 which means that people cannot be treated differently because of their age. The Public Sector Equality Duty is part of the Equality Act. It aims to ensure that public bodies, including the Welsh Government, consider how they can positively contribute to a fairer society. The duty drives sound decision-making. It encourages public bodies to understand how different groups of people with particular protected characteristics will be affected by their policies and services.
Raising awareness of rights can also empower people to take control and recognise when their rights are being compromised. Defining human rights in simple terms can empower older people to challenge and change the way services are designed and delivered in Wales, but it is equally important to raise awareness of rights amongst professionals.
A rights based approach is informed and guided by the legal framework outlined above and can transform people’s lives. The United Nations Principles for Older Persons have also informed the development of this strategy and will guide its implementation. The Principles for Older Persons were adopted by the UN General Assembly in December 1991 and although the principles do not create new legal obligations, governments are encouraged to incorporate them into their national programmes wherever possible. The 2016 report ‘Making Human Rights Real for Older People’ drafted by Professor Simon Hoffman, provides an overarching framework for older people’s human rights in public services.
The OPRA principles are:
- embedding older people’s human rights
- empowering older people
- non-discrimination and equality
Each of these elements feature strongly across this document – we aim to demonstrate how we will uphold a rights based approach by empowering older people to have choice and control over how they travel, where they live and work, their incomes and ultimately the choices they make when planning for later life. In Wales, the Welsh Language (Wales) Measure 2011 and Welsh language standards, provide the right to receive services in Welsh and require the Welsh language to be treated no less favourably than English. Public organisations also need to consider the impact of their policy decisions on opportunities to use the Welsh language.
Welsh Government has published a research report ‘Strengthening and advancing equality and human rights in Wales’ (Hoffman S et al, 2021). The research findings outline mechanisms to strengthen and advance equality and human rights in Wales, with the report including 40 recommendations for legislative, policy, guidance, or other reforms to meet this objective.
To further uphold and protect older people’s rights, we are embedding feminist principles across Welsh Government policies and programmes via the Advancing Gender Equality in Wales Plan.
Our engagement with older Lesbian, Gay, Bisexual, Transgender and Queer (LGBTQ+) and Black, Asian and Minority Ethnic older people revealed that individuals from both groups are feeling increasingly concerned about the changing attitudes towards marginalised groups due to Brexit, the fallout from the Windrush scandal and the rise of far right groups across Europe. Welsh Government has pledged to be the most LGBTQ+ friendly nation in Europe. A public consultation on our new LGBTQ+ Action Plan was launched in July 2021, which outlines our determination to achieve this historic ambition.
Race equality has not yet been achieved in Wales and the Welsh Government recognises it is time for urgent action. Together with policy leads, partners and stakeholders we have developed a 'Race Equality Action Plan' which includes a vision for the change we want for this work. Our vision for Wales is a country that is anti-racist, where everyone is treated as an equal citizen. We have commissioned ADSS Cymru to undertake a review of the barriers, challenges and decisions taken by members of the Black, Asian and Minority Ethnic communities when they require formal care and support.
Action on 'Disability: the Right to Independent Living' focuses on what the Welsh Government is doing to achieve greater equality in Wales. Underlying the whole framework is the ‘Social Model of Disability’, which recognises the need for society to be transformed by removing barriers so that disabled people are able to participate fully. Although not all older people are disabled, the chance of having a functional impairment increases with age. Therefore older people with a disability will also benefit from this wider approach to independent living.
It is important to note that many individuals do not experience one form of discrimination in isolation. Ageism could compound feelings of alienation experienced by people who live with other protected characteristics such as disability, race or sexual orientation. Through our delivery plan, we will consider how we can work across government departments to address the intersectional nature of discrimination and disadvantage.
Making rights work for older people
We are undertaking a series of actions to ‘make rights work for older people.’ In November 2019, we launched a national campaign to make older people and unpaid carers aware of their rights under the Social Services and Well-being (Wales) Act 2014. We have also worked with older people and key partners to coproduce practical guidance demonstrating how health and social care professionals can embed a rights based approach. The guidance shows how simple changes to the way we work can uphold an individual’s human rights and have a major impact on their well-being. The group also produced a version of this guidance for older people. It is intended that these two documents will be used together to guide conversations and inspire a common understanding of the transformative effect of a rights-based approach.
In 2021- 22, we will be taking forward further work to promote older people’s rights and will set out these actions in our supporting delivery plan to be published by the end of 2021.
Recent months have highlighted the critical role of human rights for policy makers tasked with balancing the rights of citizens with the need to protect them from COVID-19. Throughout the pandemic, we worked with the Older People’s Commissioner and EHRC Cymru to monitor its impact on older people and take appropriate action. We have shared details of the scientific data and engagement that informed decisions relating to older people living in care homes and will continue this working relationship to ensure older people’s rights are strengthened as we plan for the future.
Tackling ageism and age discrimination
Fundamental to an age friendly Wales and a rights based approach is the elimination of ageism and age discrimination. Global awareness of the impact of ageism on individuals and societies is growing. In 2020 the WHO commissioned a report as part of their Global Campaign to Combat Ageism. The report: Global reach of ageism on older persons’ health: A systematic review found that ageism harms the health of older people in 45 countries and across 5 continents. The study had over 7 million participants.
The 2018 report 'That Age Old Question: How attitudes to ageing affect our health and wellbeing' by the Royal Society for Public Health has linked ageism to a negative attitude to growing older. As with other forms of discrimination, ageism has deep roots in our society’s cultural norms and practices, including in the language we use. During the pandemic, older people have voiced their fears that ageist narratives have become embedded in public dialogue and that negative ageist stereotyping, of both younger and older age groups, are contributing to an intergenerational divide.
We welcome the work of the Older People’s Commissioner and Age Cymru to place a specific focus on ageism and will work with them to better understand its causes and impact in order to realise our aim of a more equal Wales.
We also aim to identify ageist and age discrimination via our policy assessment process. All Welsh Government policies are subject to a full integrated impact assessment, which gives full consideration to their impact on all members of society. We are reviewing our integrated assessment tool and will engage with Commissioners, policy makers and stakeholders.
Where are we now? Benchmarking the situation of older people in Wales
The UK age index
In 2019, the internationally recognised Centre for Innovative Ageing (CIA) at Swansea University was commissioned by Welsh Government to use Global AgeWatch Index to benchmark the situation of older people in Wales against the other 3 UK nations – Northern Ireland, Scotland and England. This measure was updated in 2021.
CIA used a range of measures to create a UK Age Index (UKAI). The results for the overall UKAI show that Wales was ranked 1st, with the highest overall score, followed by Scotland (2nd), England (3rd) and finally Northern Ireland (4th). This shows that there is much that we are doing well and we should feel proud that our commitment to support older people is clearly evidenced.
To accompany this strategy, we have published the full results of the Age UK Index and a report benchmarking the situation of older people in Wales.
A coproduced strategy intended for further engagement
The strategy for an ageing society has been co-produced with older people and their representatives. This means older people have been involved in creating this document from the onset – they have informed its design and development and ultimately will be involved in its delivery.
Initial work was led by the Ministerial Advisory Forum on Ageing (MAFA) whose membership is 50% older people. The forum convened five working groups to focus on the key areas that members felt we must get right in planning for an ageing population; transport; participation; housing; making rights real and planning for the future. Members of the working groups included older people, leading academics, and representatives from the public, voluntary and private sectors. The Older People’s Commissioner was also represented on all groups.
To build on the work initiated by MAFA, over the past year we engaged over 1000 older people in a conversation about ageing. We visited national groups and local forums and older people also took part in community engagement events led by Age Cymru. We also commissioned Age Cymru to hold focus groups with older people from minority groups. During the pandemic we continued to engage with older people via MAFA, the Older People’s Commissioner and surveys into the experiences of older people during lockdown led by Age Cymru and five national older people’s organisations – Cymru Older People’s Alliance (COPA), National Pensioners Convention, National Pensioners Forum, Active Wales and the Welsh Senate of Older People. We will also held regular meetings with local authority staff leading on policy for older people. This will allow us to monitor progress towards an age friendly Wales at a local level.
Work to produce this strategy has also involved Ministers and officials from across government portfolios. The process has sharpened our focus on ageing and we will maintain and build on this momentum to secure the realisation of our long term vision to be an age friendly nation.
This strategy focuses the macro and the micro - the system-level changes that we are making, for example to our health and transport services, but also the smaller things that older people tell us make a difference to their daily lives such as variable access to GP appointments, hospital transport and the availability of public toilets.
All these issues are referenced in this document and we are continuing to engage with our stakeholders to draft a delivery plan which will be published by the end of 2021.
Aim 1: Enhancing people’s well-being
Our health and care system is changing and improving to meet the changing needs of our increasing and ageing population. In line with our ambition to be an age friendly nation that upholds and protects people’s rights, we are working to create a fully integrated health and social care system that supports people to take responsibility for their own health and well-being whilst feeling confident that support will be available and easily accessible if needed.
The Social Services and Well-being (Wales) Act, launched in 2016, is embedding a rights based approach by legislating for citizens to be an equal partner in their care and support. ‘A Healthier Wales,’ published in 2018, sets out the Welsh Government’s long term vision for a ‘whole system approach to health and social care’. It promotes a greater emphasis on preventing illness, on supporting people to manage their own health and well-being, and on enabling people to live independently for as long as possible, supported by new technologies and by integrated health and social care services which are delivered closer to home.
We have invested significant financial resources into prevention and early intervention via the Integrated Care Fund (ICF) since its establishment in 2014-15. This year we are investing a further £89 million in the ICF; £40 million of which is to directly support older people. Our continued investment to this important fund is enabling a wide range of projects and services to be developed to support older people; many of which are aimed at reducing loneliness and isolation and keeping people out of hospital or residential care. Through new ways of working, care is often provided at, or close to home, so that people can stay living at home independently and remain part of the community.
As a Programme for Government commitment the ICF was due to come to an end in March 2020. However, the ICF (and Transformation Fund) have both been extended until March 2022 to allow time for a new regional funding programme to be developed. This extension will enable older people across Wales to continue to benefit from seamless, integrated health and social care services.
Key players in achieving our aim of an age friendly Wales are third sector organisations. The third sector delivers preventative services to some of the most marginalised older people in our communities. Their services can be flexible and responsive to individual need and can empower older people to take control of their well-being regardless of their individual circumstance. Phase 2 of Welsh Government’s Sustainable Social Services Third Sector Grant, 2020 - 23 supports Welsh Ministers’ priorities of an equal relationship between people and practitioners; early intervention and prevention; and transforming the way people’s needs for care and support are met. Many of the projects funded will support the delivery of this strategy and some are referenced in this document.
Right now we are enhancing well-being by:
- Supporting healthy ageing programmes and initiatives - our 'Healthy Ageing Programme' aims to increase activity in older people, reverse physical decline and frailty, and help people live independently as they get older. It also seeks to educate and empower people with the skills and knowledge to understand the benefits of being active as well as including the social element which is equally important. Via the Healthy and Active Fund, we have committed £5.4 million over three years to projects that support healthy and active lifestyles. Our 'Healthy Weight: Healthy Wales Strategy' aims to ensure that the environment enables people to make healthier choices, as well as encouraging opportunities for older people to be healthy and active. The COVID-19 pandemic has demonstrated the importance of the strategy, with poorer outcomes linked to weight and lifestyle choices across our population. A £14 million Sport and Leisure Recovery Fund will support the sector with the ongoing challenges resulting from the pandemic and provide longer-term sustainability.
- Introducing an all-Wales framework to roll out social prescribing to tackle isolation.
- Targeting interventions at areas of high deprivation and minority groups - there are groups and individuals who, for a variety of reasons, require targeted support to access health and social care. We also recognise the needs of our cohort of older prisoners in Wales. Through the (all-age) Partnership Agreement for Prison Health, we have prioritised the development of new standards for mental health services (which includes a focus on dementia), a substance misuse treatment framework, medicines management and the role of the wider prison environment in supporting men in prison to improve their health outcomes. Via our Sustainable Social Services Third Sector Grant 2020/23, we are funding Women Connect First to improve access to preventative services for older ethnic minority women in Cardiff and the Vale of Glamorgan. The organisation is working with a range of partners to provide culturally appropriate, co produced activities that support the women to live and age well. It will also pilot delivery in other regions across Wales so a model can be developed for national roll out. We are also funding the HOPE project to support older people and carers to access community based preventative services through a range of advocacy models led by peers, volunteer groups and citizens. We are providing funding for Race Equality First to engage with ethnic minority people of all ages via one-to-one advocacy; drop in coffee mornings and volunteer champions trained in advocacy.
- Making it easier for people to access Welsh language services and use their Welsh wherever they are on their Welsh language journey - we want to create an environment where everyone will want to use their Welsh and feel comfortable to do so in all aspects of their lives. This is important for all services, but even more so in health and care as the quality of care may be compromised by not communicating with people in their first language. For many older people using their Welsh is a matter of clinical need, especially those suffering from dementia or stroke who may lose their English language skills.
- Embedding a compassionate approach into our communities - by taking a view of health and wellbeing that embraces citizenship and community empathy, directly supporting its citizens to address the negative health impacts of social inequality and marginalisation attributable to dying, death, bereavement and loss. Our compassionate Cymru charter sets out the actions we are taking to support people living with life limiting and complex conditions at the end of their lives and how we will deliver on our ambition to make Wales a compassionate country.
- Recognising the importance of high quality end of life care by establishing a national programme for palliative and end of life care to provide greater central direction and to support the local transformation of services.
- Implementing our dementia action plan. The plan embeds a clear rights based approach and to support its implementation, we committed £10m annually from 2018/19. The plan is subject to review to ensure the actions remain ambitious and relevant.
- Preventing falls by supporting a range of activities both nationally and locally to help prevent falls in both care homes, community and hospital settings.
- Improving care homes by working with Improvement Cymru to deliver the ‘care home Cymru programme’. The programme is focusing on three key areas - person and family centred care; safety and reliability and leadership and team working.
- Recruiting more GPs by launching the This is Wales: Train Work Live marketing campaign, both within the UK and wider afield.
How technology is driving improvement
Ensuring people are digitally confident can have a significant impact on well-being by supporting people to independently take control of their health care. Through our procured Digital Communities Wales: Digital Confidence, Health and Well-being programme, we aim to ensure there is appropriate support available to improve the digital confidence of citizens and front line staff across all sectors.
Sometimes, diseases affect our ability to speak. So we’ve funded the ability to create personalised synthetic voices in English and Welsh. These will enable us to use a personalised speech synthesis engine, based on our own human voice if we lose the ability to speak (for example, because of throat cancer).
Going forward, our three priority areas for action in this area are:
1. Support for unpaid carers
Wales has the highest proportion in the UK of older carers and of carers providing more than 50 hours’ care a week. Since the start of the pandemic, more people have taken on a caring role – people have moved homes, left their families or given up work to care for and protect relatives or friends. The legion of unpaid carers has helped key services in Wales to cope with the increased pressure caused by COVID-19. As our society ages, the number of people living with complex needs is increasing. It is therefore inevitable that more older people will take on a caring role. Ensuring preventative support is available for carers is not purely an economic imperative. It is a key element of an age friendly Wales which aspires to support all citizens to live and age well.
In March 2021, we published a new strategy for unpaid carers and announced funding of £3million to diversity and increase access to respite services across Wales. We are working with unpaid carers, professionals and members of the Ministerial Advisory Group on Carers to publish a supporting delivery plan by the end of 2021.
Improving access to health and social care services
A growing number of health and well-being services are moving closer to people’s homes as we help build A Healthier Wales. Whilst, the COVID-19 pandemic has had a profound effect on the delivery of NHS and social care services and changed how the general public access healthcare, the vision we set out in A Healthier Wales remains sound. We will continue to support vulnerable people in their own homes, in hospitals, in care homes, in supported accommodation or other settings, building on new ways of working and innovation where appropriate. For example, the use of technology as a key part of the COVID-19 response helped provide alternatives to face to face consultations, reduced the need for travelling and kept people in touch.
We will further improve access to services by:
- Acting on the findings of the evaluation of the Social Services and Well-being (Wales) Act 2014 which began in 2018. Due to the recent pandemic, it was necessary to pause the evaluation temporarily, but work recommenced in September 2020 and will now include an additional strand focusing on the impacts of COVID-19. The final report, including recommendations, will be published in autumn 2022, however, a number of key interim reports will also be published between now and then.
- Publishing a new performance and improvement framework to ensure all local authorities in Wales are collecting the same data to demonstrate their compliance with the Social Services and Well-being (Wales) Act 2014. Local authorities will be required to collate data on the number of care needs assessments completed during the year where there was evidence of the Active Offer of Welsh, where the offer was accepted and where the assessment was undertaken using the language of choice.
- Improving access to primary care services including GPs - the primary care model for Wales is informing people to understand how to live longer, healthier and happier lives and to remain independent and at home for as long as possible. Priorities for action include prevention, a 24/7 service, the multi professional workforce, data and digital technology, communication and engagement, cluster working and the reform of the national primary care contracts.In March 2019, we introduced new access standards for GP services, which we expect practices to meet by March 2021. In March 2020, over half of Practices in Wales were achieving every standard.
- Reviewing funding for social care - We welcome the expectation of additional and more secure funding for social care in the future as a result of the UK Government’s decision to increase National Insurance contributions from April 2022. These will become a health and social care levy from April 2023, however we must wait for the outcome of the UK Government’s Comprehensive Spending Review before we have any certainty about the exact amount of funding Wales will receive as a consequence. The Inter-Ministerial group on paying for care that met regularly during the last Senedd term is to reconvene. The Group will consider the way forward with specifically Welsh solutions that will meet the different circumstances and the different landscape in Wales. The Welsh Government recently published the Rebalancing Care and Support White Paper consultation. The White Paper proposed to re-orientate commissioning practices towards managing the market and focusing on outcomes. Commissioning has a fundamental role in the social care system in developing and delivering the care and support that people require to ensure their fundamental rights are realised. The Programme for Government includes a commitment to establish a National Framework for social care. The Welsh Government will establish technical groups in Autumn to co-produce the Framework and advise on how equality and human rights principles and standards should be embedded into the framework.
- Paying for care - social care is a devolved matter, and it is very important that our Social care provision is suitable to meet the needs of Wales. Detailed consideration will need to be given to the implications of the UK Government proposals, including their proposed revisions to the adult social care charging regime in England. These include potentially complex cross-border issues and how the UK Government proposals interact with the welfare and benefits system. These are not devolved matters, but have a significant impact for the people of Wales.
- Publishing a national framework for the delivery of bereavement care in Wales The framework is being supported by a £1m bereavement support grant and will include national standards, examples of existing models of bereavement support, and learning from COVID-19.
2. Improving access to mental health services
Together for Mental Health, our 10 year Strategy, published in 2012, is an all age strategy. It reinforces the need to promote better mental well-being among the whole population and looks to address the needs of people with mental health problems, ensuring those vulnerable people in most need receive the appropriate priority. It focuses on how to improve the lives of service users and their families using a recovery and enablement approach. This strategy is supported by a series of delivery plans with the final one covering the period 2019-2022.
Why have we chosen these priorities?
These three areas have been identified through consultation with older people and their representatives who told us that accessing GP appointments (Age Alliance Wales, ‘Access to GP services by older people’) and travelling to hospital appointments can be challenging. Age Cymru’s survey of older people’s experiences during the pandemic cited access to health and social care survey as a key concern. We also know that people can struggle to make that first point of contact with local authority care and support services. In line with our preventative and rights based approach, it is vital that we get these factors right. Both the demographic data and the views of our stakeholders clearly show that improved support for unpaid carers is needed.
UN Principles for Older Persons: Care: 10 -14; Dignity 17 and 18.
Aim 2: Improving local services and environments
Housing, transport systems and the natural and built environment fundamentally affect how well we live and age. Getting these crucial elements of our society right can be the defining factor in how successful we are in achieving our vision of an age friendly Wales. Regardless, of background, health or income status, our homes, public transport, local places and spaces and access to community services can influence how well we live and how well we cope with any challenging circumstances as we age.
Prosperity for All recognises the bedrock of living well, is a good quality affordable home. Suitable housing can become increasingly important as we age, our needs change and we spend more time at home. However, in planning for an ageing population, it is vital to consider the housing needs and aspirations of people of all ages.
The UN Principles state that ‘Older persons should be able to live in environments that are safe and adaptable to personal preferences and changing capacities.’ In line with our rights based approach, we are working to ensure housing in Wales supports people to live well at every stage of their life. Given the link between housing and health, good quality affordable housing must be seen as a preventative intervention.
Housing should recognise the diverse range of need across Wales. We want to provide housing in communities which enables older people, whatever their background, financial position or circumstances to fulfil their potential and lead meaningful lives. Poor quality housing can create a risk to health and exacerbate long term health conditions and many older people struggle to afford to repair or improve homes they live in.
Right now to build housing for an ageing population we are:
- Reviewing our affordable housing supply and ensuring all Welsh Government grant funded new housing complies with the Lifetime Homes Standards.
- Tackling fuel poverty - we launched a new plan to tackle fuel poverty in March 2021 which sets ambitious, but deliverable targets for the further reduction of fuel poverty by 2035. Further work has started to assess the level of fuel poverty in Wales in 2021, which will inform interim targets for fuel poverty to be added to the plan.
- Investing £104m in the Warm Homes Programme between April 2017 and March 2021 to improve up to a further 25,000 homes of people on low incomes or living in the most deprived areas of Wales. We will be consulting on the next iteration of this programme and proposals to maintain the Warm Homes Programme Next Scheme Health Conditions Pilot. This will continue the additional support which has been made available to older households through the pilot scheme. The new Warm Homes Programme is expected to come into effect from spring 2023.
- Improving access and availability of affordable homes by building 20,000 new affordable homes by 2021 and working with local authorities to begin council house building at pace and scale for the first time in decades.
- Ensuring older people have equal access to good quality, timely adaptations that support their independence, regardless of housing tenure.
Going forward, our three priority areas for housing are:
1. Supporting the growth of new housing models
We will support the growth of new housing models that support people to age well. This will include contemporary sheltered housing and extra care housing.
2. Co-ordinating housing, health and social care capital programmes
We are working closely with the health, social care and housing sectors as well as Regional Partnership Boards to deliver a scalable programme of capital investment to ensure housing plays a significant role in the work of the Boards. We believe there is further scope to extend independent living, maximise the contribution housing interventions can make to improving service delivery whilst also alleviating the pressures on the NHS and social care.
3. Making sure housing in Wales is of an acceptable standard
Approximately £60m is spent each year on housing adaptations, many of which make substantial improvements to the condition of the housing stock. The vast majority of service users are aged over 50. We also invest significantly in preventative housing solutions through our Integrated Care Fund (ICF) Capital Programme, worth £145m over 4 years, and our Social Housing Grant, worth £250m in 2021-22 . Older people are the main beneficiaries of ICF capital projects which include 300 extra care units. To date, the Social Housing Grant has funded 53 extra care schemes, providing 2,500 units for older people.
How technology is driving improvement
The Awen Institute (www.aweninstitute.com) is a £3.5m project joint funded between the European Commission, Swansea University, University of South Wales and University of Wales Trinity Saint David. The project started in 2019 and over last two years has been developing a state-of-the-art ‘Living Lab’ facility on Swansea University’s Singleton campus, where diverse stakeholders including researchers, older people and the creative industries, can come together to develop and test new products, services and environments for ageing populations. The space features a mock-up of a home that also can be adapted to simulate other internal environments e.g. work places or shops; a ‘VR garden’ to simulate external environments and test new VR technologies; and a ‘Café lab’ which is a relaxed space for holding workshops and ‘co-creating’ research ideas with different groups of people and businesses.
4. Exploring how to help people to move
They build these extra care places and we all think we’re too young, then you get to 85 and you’re too old to move!” (Attendee at engagement event).
The dominant culture in Wales is for older people to remain in their own homes for as long as possible. However people do need to consider whether their accommodation can be adapted to suit their changing needs before crisis hits or their circumstances change and staying put is no longer a viable option. Supporting people who wish to move to do so could also increase the availability of housing stock for younger generations.
Attendees at our focus groups with older people from minority groups recognised that moving home can be a very taxing process and felt that some form of advocate, to assist a person to make a move would be of great help. Group members were careful to add that any decisions regarding a possible move should be made by the residents.
Care and Repair Cymru is currently piloting a ‘Help to move’ service in Bridgend and Carmarthenshire. The service provides counselling and emotional support which allows people to assess their housing needs and consider different options.
The evaluation of these projects will provide valuable information on the level of need for Help to Move services. They will also help us to understand how the service operates at a community level and whether the service is successful in improving independence, health and well-being.
Why have we chosen these priorities?
We will continue to implement the recommendations of the Expert Group on Housing for an Ageing Population - each of the priorities relate to a recommendation within the report.
Attendees at our engagement events were generally open to the idea of entering supported housing or a residential care home, should they need to, but would still like to maintain their autonomy (otherwise they envisaged staying at home for as long as possible, with appropriate support and adaptations). Attendees told us that they would like to continue to contribute to society for as long as possible, but housing in poorly chosen locations could prevent people from spending time in and contributing to their local community.
UN Principle for Older Persons: Independence 5 and 6
Open spaces and buildings
To support our rights based approach, the natural and built environment must be conducive and safe for walking for older people and public buildings must be fully accessible to all. Our framework, “Action on Disability: the Right to Independent Living” and supporting action plan sets out how we are addressing social barriers to equality and inclusion so disabled people have access to the same opportunities as everyone else. It is supporting the creation of age friendly communities across Wales and we will align the implementation of this strategy with its actions where appropriate.
Right now, to improve open spaces and buildings, we are:
Investing in active travel by providing funding for local authorities to design and develop routes that support people to walk and cycle to where they want to go. For 2021-22 we have awarded £75 million of active travel funding to local authorities to support the creation and maintenance of active travel routes.
Part of this funding allows local authorities to upgrade existing routes where minor works are needed to remove trip hazards or obstacles.
- Improving green spaces and other green infrastructure so that local residents can benefit from the health and well-being benefits associated with increased exposure to natural environments and improved access to local green spaces.
- Involving local people in improving their communities by continuing to support the Community Land Advisory Service in Wales that enables community groups, local authorities and landowners to help people access, own and improve green spaces in their local areas.
Greener Grangetown is a large scale retrofit sustainable drainage scheme which aimed to make the local area a cleaner, greener place to live. The local community were engaged throughout the design and development of the scheme. The scheme is an innovative £2 million partnership project between Cardiff Council, Dŵr Cymru Welsh Water and Natural Resources Wales. The project uses the latest sustainable drainage techniques to catch, clean and divert rainwater directly into the River Taff instead of collecting and pumping it eight miles to a treatment works in the Vale of Glamorgan and then discharging it out to sea. This is the first time that these techniques have been retrofitted into an urban environment at this scale.
Going forward, our three priority areas are:
1. Ensuring our natural and built environment is safe and age friendly
We are pressing on with amending existing legislation so that local authority enforcement officers can issue fixed penalty notices for vehicles obstructing the footway and looking at introducing legislation for a national default speed limit of 20 mph in residential areas. With these two measures in place it will be easier for an ageing population to move around their communities, as they will feel and be safer.
2. Improving availability of public toilets
We introduced a requirement for all local authorities to deliver a strategic approach to the provision of toilets across Wales. We have also worked with local authorities to map the toilets identified within the local toilets strategies, and this is available online.
Once we have met the significant challenges that continue to be presented by the pandemic response, we will revisit our approach to the provision of public toilets to assess the most effective and safest way forward.
Through the age friendly communities programme and our support for older people’s groups and forums, we will actively encourage older people to have their voices heard when local authorities are planning key services, such as public toilets. For example, older people have told us that far more could be done to encourage businesses such as shops and cafés to open up their toilets to the general public.
3. Reinvigorating our town centres
We will reshape and relaunch all existing regeneration capital programmes from 2021 as a single Transforming Towns Fund to create town centres that provide jobs, homes, leisure and services, but that also look great, feel safe and are easily accessible and vibrant whilst also supporting actions on the climate and nature emergency. Town centres in Wales should instill a sense of pride and celebrate their individual heritage. We want to create an experience, to make towns places where people want to be.
A vibrant, exciting town centre can attract people of all ages, however, for older people, especially those living alone, face to face contact in shops and post offices can be the only conversation they have all day. Post offices, banks and shops can also limit the impact of our digital world on people who do not use the internet.
Why have we chosen these priorities?
The availability of public toilets is a constant concern for many older people - numerous people at our engagement events and meetings noted that toilets are a significant factor in whether people chose to leave their home or use public transport. One person explained that
without access to public toilets people find it increasingly difficult to leave the home and integrate with village life.
Evidence shows the importance of making our streets and pavements safer and more age friendly. For example, people over the age of 60 make up 20% of the population of the UK, around 8% of pedestrian activity, yet account for 41.5% of all pedestrian fatalities (Musselwhite C.B.A. 2018). Poorly maintained pavements, poor crossing facilities and poor lighting among other things can contribute to this figure (Musselwhite C.B.A. 2018).
UN Principle for Older Persons: Independence 5
Accessible public and community transport can be a lifeline for people of all ages and is frequently cited as a priority issue by older people’s groups and individuals. It is imperative that we create an age friendly transport system that is accessible to all older people. Public transport services support the economic, social and cultural and environmental development of local communities and can allow older people to realise their human right to independence, participation, care and self fulfilment. However, cuts to local bus services and a lack of co-ordination between bus and rail networks can make even short journeys difficult for older people. Poor quality signage, seating and public toilets can also make older people feel less confident about using public transport.
COVID-19 has had a huge impact on travel demand. This, coupled with on-going Welsh Government advice that people should work from home wherever possible and only use public transport when no other means of travel is available, has meant prioritising our funding to support our bus industry through this difficult period and has made forward planning extremely challenging. However, our long-term vision for integrated transport remains to:
- Provide an integrated public transport network that is safe, reliable, punctual, environmentally sustainable and accessible, and that meets the needs of the travelling public.
Right now, to build an integrated public travel network, we are:
- Improving accessibility - Transport for Wales is investing £200 million across all rail stations in Wales for step-free access, better waiting rooms, shelters, toilets, lighting and seating. Transport for Wales is also improving the services it offers to people in need of assistance on their journeys. We are also investing £25 million to improve provision of bus services and accessibility on buses.
- Introducing new legislation in relation to Public Transport that will provide local authorities with the tools to respond flexibly to local public transport needs.
- Reshaping Wales’ bus network in response to COVID-19.
'Llwybr Newydd, the new Wales transport strategy 2021' was launched after significant consultation with key stakeholders including older people and those who represent them. The headline vision for the strategy is a more ‘accessible and sustainable’ transport system which is in keeping with the ambitions within the 'Strategy for an Ageing Society'.
- Continuing to offer free bus travel for those aged over 60 - The mandatory concessionary fare scheme means that persons over the age of 60, or who meet the Government's disability eligibility criteria, can travel for free on most bus services in Wales. The scheme, which has been successful since its introduction in 2002, now extends to discounted or free travel on many rail services.
Going forward our three priority areas for transport are:
1. Developing more demand responsive transport
The availability of community transport can be the deciding factor in whether an individual can continue to live the life they chose or whether they become socially isolated and at risk of loneliness. It provides a key preventative service and is a core element of any age friendly community.
We want to explore how we can integrate community transport with public transport services to support people to get to work and vital health appointments. To achieve this, we are funding new pilot projects. The Valleys Taskforce is working closely with Transport for Wales (TFW) to determine what the pilots will look like and explore the viability of further pilots in this area. TFW are also planning to consider how to make better use of mini buses that are unused for large parts of the day, such as school transport services.
Transport for Wales is piloting a “fflecsi” community transport initiative across Wales in both rural and urban settings which will help to understand where Fflecsi and demand responsive travel fit in as part of the suite of measures to achieve an integrated transport network across Wales.
2. Improving bus services
We have set aside £2.5m for Bus Network Reform. This funding will allow us to make better use of data to inform our future investment. It will also provide valuable information on how we can continue to improve the passenger experience. To support us to develop our integrated vision for transport in Wales, TFW are working with local communities to learn more about the journeys they make.
We will introduce high quality buses in Wales that can be run with green energy and are equipped with up to date technology including Wi-Fi access and charging points.
3. Supporting people to plan journeys door to door
Stakeholders have told us that, in the future, they expect people to be able to plan their services ‘door to door’ confident that the streets, pavements, station facilities and information will support them to reach their destination safely. This is our vision for an age friendly transport system. The previous section has outlined how we are improving our built environment to support this aim, but we are also developing a new national technology platform that will, in the future, allow us to implement an account based ticketing solution for bus, rail, cycle hire, park and ride and access to other forms of transport. This system will form the foundation of how people across Wales pay for and access buses across Wales in the future.
We are also looking to put in place strengthened arrangements for the TrawsCymru bus network to provide better quality services and improved connections with rail and other key bus services at important hubs and interchange points.
Why have we chosen these priorities?
Improving the availability of local bus services is always cited as a priority in our wider engagement with older people – we asked participants ‘what matters most to you?’ and transport was the most popular response. This was reflected in our transport working group discussions. Statistics showing the impact of austerity on local bus services further support our decision. The working group also prioritised the need to support people to plan their journeys from door to door to allow people with limited mobility to use public transport with confidence.
UN Principle for Older Persons: Independence 5.
Aim 3: Building and retaining people’s own capability
Community participation is the process by which an individual engages with locally-based activities which may benefit them and their community.
Effective forms of community participation rely on people being aware of and able to exercise their rights and responsibilities. It requires people to be empowered and enabled to actively engage with and influence things that impact on them or their community. This should be carried out in a way that is meaningful to the individual. However, for disadvantaged communities and individuals, community participation can be hindered by a lack of available resources and opportunities.
Enabling older people to effectively participate in community activity requires the support and involvement of a wide range of actors. Older people may lack the confidence and the resources to engage in community activities, or face barriers to accessing information. This can be exacerbated in communities which have lost traditional key community services such as banks, shops, post offices and community centres which previously acted as informal community hubs.
Research has found older people who feel they have a ‘purpose’ are more likely to experience positive ageing. For some, purpose could come from work, but in their consultation response, the British Psychological Society has also highlighted the need to consider ‘meaningful activity’ rather than just work.
We know that closures of community venues, cuts to local transport services and third sector led groups can seriously limit older people’s ability to take part in community activity. In order to mitigate the impact of austerity and the pandemic, local authorities are considering new ways of working. This includes redesigning frontline services; developing new partnerships with citizens and focusing more keenly on preventative measures. It is vital that both national and local governments lead difficult conversations about the changing responsibilities between statutory bodies and citizens. COVID-19 has bought these issues to the forefront of public attention. The pandemic has encouraged individuals to re-imagine their role in their communities and required all sectors to adapt and develop new ways of working.
In line with a rights based and preventative approach promoted by this strategy, we recognise that targeted support is needed in areas particularly affected by disadvantage to address current inequality in opportunities between richer and more disadvantaged areas in Wales. We also are mindful of the impact that discrimination or even verbal and physical abuse can have on an individual’s ability to participate.
Members of our focus groups noted that in much of Wales there may be insufficient numbers of LGBTQ+ people to sustain businesses designed for them alone. It was recognised that a more achievable ambition (and one which is attempted, with differing degrees of success), is to have a “gay friendly” evening in a coffee shop or pub.
Right now, to support community participation we are:
- Investing in local support that matters to older people - our consultation responses showed how 50+ forums can provide valuable social and practical support to older people. For example, during the pandemic, members of one forum hand delivered packs to people living alone which provided a chance to have a socially distanced chat. It was also stated that in addition to influencing local and national policy, some forums provide an opportunity for people to extend their social networks and form friendships.
- Improving digital confidence through our digital companions and digital heroes initiatives. Digital companions look to train individuals delivering doorstep services to older people to provide digital support. Digital heroes is an intergenerational initiative to help tackle loneliness and isolation by supporting young people to spend time with older people to show them the benefits of being online. Prior to the pandemic (March 2020) over over 5,000 digital heroes had been trained to help older people in hospitals and care homes stay in touch with friends and family or access key online public services. Throughout the pandemic, we have adapted both models to provide virtual support. Our intention, pandemic restrictions allowing, is to re-start the digital heroes initiative from September 2021 and for the digital companions are slowly starting to re-engage face to face where allowed.
- Promoting volunteering by working with partners to develop more opportunities for people to volunteer and generate maximum potential for volunteering in Wales. Volunteers make a significant contribution, in unpaid hours, to the economy of Wales. It is estimated that every year volunteers contribute 145 million hours, which is worth £1.7 billion (WCVA 2016). This is equivalent to 3.1% of Wales GDP. Data from the National Survey for Wales (2020) showed that the majority of volunteers in Wales are aged over 65. Indeed many community groups are almost totally dependent on older people’s contributions and have struggled to continue during the pandemic due to public health restrictions.
- Improving access to information and advice - Through our engagement with older people and their representatives we know that the following points will support community participation:
- access to accurate and up-to-date information about community services and groups
- promotion of community opportunities to lead a healthier lifestyle
- promotion of a range opportunities to volunteer within the community
We are taking action against all of the above points. DEWIS Cymru is a national well-being directory developed, owned and resourced by local government in Wales. It is able to share information with 'Infoengine' (a third sector directory) and the NHS Direct Wales Directory of Health Services to provide a single, shared directory of local and national services. The creation of this single, shared directory of resources can enable the public and frontline staff to identify and connect with the right care, from the right service, organisation or person, at the right time.
Going forward, our three priority areas are:
1. Tackling loneliness and isolation
Since Phase 3 of the Strategy for Older People was launched in 2013, there has been an increased recognition of the impact of loneliness on physical and mental well-being. Welsh Government published its response Connected Communities; Loneliness and Isolation Strategy in February 2020.
Connected Communities addresses the ways in which loneliness can affect people across their life course. Although the causes of loneliness and social isolation are complex and can vary for different age groups, many of the trigger points, such as bereavement, retirement, giving up driving, taking a caring role and the onset of ill health, are more common in later life.
Via our Sustainable Social Services Third Sector Grant 2020/21, we are funding Cruse Bereavement Care Cymru to transform national and local bereavement services, by developing a ‘Bereavement Hub.’
We are also funding 'contact the elderly' to reduce loneliness and social isolation among people aged over 75 by delivering co produced community activity and social groups. The project will target the most marginalised older people.
As we age and leave the workplace, our social networks can diminish. The research report, Retirement transitions in later life, by the Centre for ageing better showed that the main thing that retirees miss from work is the social contact it gave them. In addition, the sense of isolation following bereavement can be particularly acute. Closures of places to meet, such as libraries, community centres, pubs and churches can make it more challenging for older people to develop and maintain social networks.
Whilst Connected Communities explores the complex issue of loneliness across the life course and aims to develop solutions across a range of policy areas, the 'Strategy for an Ageing Society' considers the issue through the lens of age friendly communities. This strategy sets out how we aim to create an age friendly Wales that builds resilience across the life course and prevents people from becoming socially isolated. From legislating for person centred care to developing travel systems and housing that cater to individual need, we aim to keep people connected within their local communities.
We will work with partners to ensure the implementation of Connected Communities addresses the needs of older people experiencing, or at risk of loneliness.
2. Improving access to and availability of places to meet
Suitable spaces for community groups to meet and flourish are vitally important in the development of an age friendly Wales. We will encourage local authorities to work with town and community councils and public sector organisations to make spaces in existing publicly-funded or publicly-supported buildings available for community participation. It is also important to consider how informal meeting hubs such as coffee shops, pubs and church halls can support community participation. Transport to and from meeting places should also be considered.
The Fire and Rescue Service offers use of its premises to any collaborative partner or community group. Organisations currently using the facilities include a community bingo club, cadet groups and various community volunteers. The Fire Service also shares its facilities with the Police, WAST, local authority and any other collaborative partners.
3. Encouraging intergenerational contact
Recent reports and media articles on ‘intergenerational fairness’ risk pitching one generation against the other. We must not let such rhetoric take hold in Wales. It is vital that we use the emotional bonds we all have with younger people in our families and communities to build mutual respect and intergenerational solidarity. Working across generations can support the statutory sector to develop services that meet the needs of all ages and, ultimately, to plan for an age friendly Wales.
Working closely with the implementation of the Strategy for Loneliness and Isolation, we will encourage all local health boards across Wales to establish, embed and grow intergenerational practice. Older people have told us that cross generational work should not just be an opportunity to “tap a little old lady on the head”, to “mollycoddle” or patronise older people, or to 'force' younger and older people to meet. There should be genuine opportunities to share skills and knowledge.
We will talk to the Commissioners for Children and Older People to discuss resources to support intergenerational practice. We will also work with third sector organisations to organise a ‘national summit’ to discuss the recommendations contained in the Welsh Government commissioned Review of mechanisms in intergenerational practice and their effectiveness in reducing loneliness/isolation.
We know that historically, the intergenerational transmission of Welsh has been problematic in some areas and some Welsh speakers, for many reasons, haven’t transmitted their Welsh to their children. So we’ll examine how we can use intergenerational work to help younger people gain or improve Welsh language skills in line with our national policy on Welsh language transmission and use in families.
Why have we chosen these priorities?
Loneliness was measured for the first time in Wales, in the National Survey 2016-17. In 2017-18, it found 16% of those participating in the survey, of just over 10,000 people aged 16 and above, were lonely and 53% of people had experienced some feelings of loneliness. 11% of people aged over 75 said they felt lonely. Recent estimates by Age UK (2019) indicate that over 3.6 million older individuals in Britain live alone. Furthermore, additional research by Age UK (2016), No-One Should Have No One, argues there are 1.2 million chronically lonely older people in Britain, while over half a million may go up to a week without speaking to someone. Although Wales ranked 1st for social connections in the UK Age Index, our engagement and working groups have clearly shown that closures to community venues and lack of community transport is limiting older people’s ability to connect with others. At our engagement events, older people were keen to counteract ageist stereotypes and wanted to be portrayed as valuable members of society with skills and knowledge worth sharing.
UN Principle for Older Persons: participation 7, 8, 9
Ending abuse of older people
The UN Principles for Older Persons state that
Older persons should be able to live in dignity and security and be free of exploitation and physical or mental abuse.
As a government we are clear that abuse or neglect in any form against older people will not be tolerated. This includes financial scams, physical and mental abuse and neglect. Age does not diminish an individual’s right to live with dignity and respect.
Scams can have a terrible effect on victims and older people can be particularly at risk of this form of abuse – evidence from National Trading Standards shows that 85% of victims of doorstep scams are aged over 65. The impact on health and well-being can often be far greater than the financial loss.
People lose confidence and can suffer from increased isolation and become more fearful. This in turn leads to a deterioration in both mental and physical health.
Right now, to prevent abuse of older people we are:
- Continuing to implement Our Violence against Women, Domestic Abuse and Sexual Violence (Wales) Act (VAWDASV) which acknowledges that victims can be from across the whole spectrum of society, including older people, all ethnicities, religions and beliefs and disabled people.
- Working with stakeholders to draft a new VAWDASV National Strategy which will also acknowledge victims across the whole spectrum of society. Prevention, early intervention and education are key components of the strategy which will be published later in the year.
- Exploring how we can provide additional training for professionals working within VAWDASV or with older people via our National Training Framework.
- Funding 500 additional Community Support Officers to carry out awareness raising about scams with local residents, particularly older people.
- Piloting a project to increase our understanding of how best to enable diverse groups of survivors to participate in a national engagement framework. We will take on board recommendations within the evaluations and reports to ensure victims of VAWDASV across Wales are able to inform and shape policy, service delivery and the support they receive.
- Continuing to raise awareness and challenge attitudes of violence against women, domestic abuse and sexual violence across the Welsh population, through campaigns such as “Home shouldn’t be a place of fear”, and will continue to ensure that all victims and bystanders of violence and abuse know the support that is available to them.
- We will continue to support partnership working amongst organisations to safeguard the people of Wales and address the devastating impact of scams and fraud on victims and their families.
Going forward, our priority is:
- Continue to work with the Older People’s Commissioner and key partners to publish and implement a national plan to prevent abuse of older people by end 2021.
UN Principle for Older Persons: Dignity – 17, 18
Planning for the future
Attendees at our engagement events said that although they had retired from full-time paid work, they were as busy as they had ever been, with voluntary jobs, part-time jobs and caring roles (for adults and grandchildren). They questioned what is meant by the concept of “retirement”, as they could not envisage a time when they would not have some sort of responsibility towards others or calls on their time.
The number of people working past state pension age is increasing and perceptions of retirement are changing. Later life can offer the opportunity to change career, move house, travel, take up a new interest or make new friends. It can also bring unexpected challenges such as ill health, a drop in income or taking on a caring role.
Everyone’s experience of ageing is different, but we all aspire to enjoy later life. For some, the move from full time employment to full time retirement can be a difficult. Effective planning can ease this transition and allow individuals to realise their ambitions after a lifetime of compromise. It can also build the financial and emotional resilience needed to cope well with adverse circumstances. From an early age people are encouraged to save for their future, but consideration should also be given to the wider range of social and environmental factors that can support people to live and age well. It is also vital to consider the situation of people who have not been able to save for retirement and for whom choice in later life may be limited.
Going forward, our three priorities are:
1. Encouraging individuals to consider a range of factors when planning for later life
We will work with the Ministerial Advisory Forum on Ageing to explore how we can encourage people to consider the psychosocial factors that can support them to age well.
2. Encouraging employers to deliver mid-life reviews
The Age at Work programme in Wales, supported by the National Lottery Community Fund, supports older workers (50+) to remain in work, to stay connected, develop new skills, continue to earn and have a fuller working life. The five year programme is being delivered by Business in the Community Cymru in partnership with Age Cymru and aims to raise awareness of the need for an age friendly agenda in government, business and wider society.
3. Working with Money and Pensions Service to align our work with the implementation of their UK Strategy for Financial Well-being
4. Encouraging employers to consider their corporate responsibilities by supporting employees to volunteer
Our conversations with older people have shown that the transition into retirement can be difficult. Some said that they would have preferred to reduce their working hours gradually so they could take part in community activities but were unable to do so. Participants felt it was important that people develop a plan for what they intend to do in retirement, whether that’s taking up or continuing a hobby, learning something new or travel. Some people described the ending of their paid work as a 'bereavement', instantly moving from the workplace to “doing nothing” led to a loss of their sense of purpose.
We will encourage employers to consider their corporate responsibilities by supporting employees to volunteer.
Why we have chosen these priorities?
The Ministerial Advisory Forum on Ageing advised us that encouraging people to plan for their futures must form part of a Strategy for an Ageing Society. Consequently, a working group was convened to advise on the issue. We want local and national governments to work with third and private sector organisations to ensure people of all ages have the confidence to access the skills and knowledge they need to plan well for the future.
UN Principle for Older Persons: Independence 3
Civic engagement is an essential component of the WHO’s age friendly communities programme. In order to join the WHO’s Network of Age Friendly Cities and Communities, leaders must demonstrate that they are engaging effectively with older people. This approach also supports the Well-being of Future Generation’s Act’s Five Ways of Working which focus on involvement, collaboration and prevention. By listening to the experiences of older people today, rural and urban communities can plan for future generations.
In line with our commitment to embed a rights based approach across the Welsh public service, we are working to improve citizen engagement and participation across health and social care. The drive towards closer integration of health and social services with improved public engagement is reflected in the aims of A Healthier Wales.
As previously highlighted, this strategy has been coproduced with older people and their representatives and the consultation responses stressed that this coproductive approach of involving and listening to older people must be sustained and further improved.
Right now, to support civic engagement with older people, we are:
- Supporting and working with national older people’s organisations so that they are well placed to influence the design and implementation of Welsh Government policy and delivery.
- Supporting and working with Age Alliance Wales which is an alliance of 21 voluntary organisations working with and for older people.
- Supporting and working with the Older People’s Commissioner for Wales who acts as an independent voice and champion for older people.
- Encouraging and supporting the use of citizen panels to inform the work of Regional Partnership Boards.
- Facilitating a Ministerial Advisory Forum on Ageing (MAFA) to place older people’s voice at the heart of Welsh Government policy making. 50% of MAFA members are older people, including representatives from a diverse range of backgrounds. The work of MAFA will be informed by community outreach events held with older people who do not traditionally take part in formal meetings or groups.
Going forward, our priority is:
2. Continue to review of mechanisms for engaging with older people
In 2003, the launch of the Strategy for Older People provided funding to support 50 and over forums in each local authority. Since then, tightening local authority budgets have seen some forums struggle whilst others flourish. We are reviewing these structures to ensure all local authorities have robust mechanisms in place for engagement.
UN Principles for Older Persons: Participation 7, 8, 9
The UN Principles state that ‘Older persons should have the opportunity to work or to have access to other income-generating opportunities.’
Between 2003 and 2018, the number of people aged 50 – 64 in employment has increased from 56% to 69%, with the number of women rising by 14 percentage points. During this period, the number of people aged 65 and over in employment rose from 5% to 10% (StatsWales May 2019). Alongside the financial benefits of employment, going to work can support people to stay physically and mentally well for longer.
It is an economic imperative that employees in Wales are supported to adapt their skills to fit emerging new technologies and the changing jobs market. This can be achieved in part by equipping the workforce with the skills they will need across their working lives, but it will also require employers to provide more flexible working policies and environments. If Wales is to have a workforce that is fit for the future, employers must consider the health and caring implications of this demographic shift and identify ways to create more age friendly workplaces and combat ageist stereotypes of older workers. This should include a consideration of what an age friendly workplace would mean in practice.
Right now, to support older workers we are:
- Recognising the impact of the pandemic on employment, our firm priority has been on supporting people to stay in jobs and helping them find work through our commitment to support anyone aged 16 or over to access advice and help to find work, increase their skills, qualifications and employability, secure an apprenticeship, a job or to start a business.
- Adopting the Fair Work Commission’s definition and characteristics of fair work across Welsh Government and using it to promote fair work. The re skilling of older workers is included in the definition.
- Ensuring older workers are represented in a positive way across all of our mainstream communications and programmes. We are also working with partners to ensure older workers’ skills and employment needs are actively considered and employers are encouraged to retain, train and recruit older workers.
- Supporting working carers by funding Carers Wales to host an Employers for Carers Wales Hub which helps organisations in Wales to support staff with caring responsibilities. The Hub provides practical guidance, expert consultancy and training as well as supporting employers to share best practice.
Going forward, our three priorities for older workers are:
1. Promoting re-skilling of older workers
We will work with Working Wales and other partners to ensure that older workers are encouraged to think proactively about their career opportunities and skills needs throughout their lifetime.
2. Promoting and actively encouraging age friendly workplaces
We will work with employers and their representative bodies to encourage them to provide age friendly workplaces that support the increasing number of older workers and carers in our workforce.
3. Delivering our Employability Plan that sets out our vision for making Wales a full-employment, high-tech, high-wage economy. The plan also made it clear to employers that they have a responsibility to nurture, train and sustain their employees to ensure that the future of the Welsh workforce is a stable and forceful one.
Why have we chosen these priorities?
Wales ranked third in the UK Age Index for employment and education of older people. Across all the other categories Wales scored 2 so it is clear more must be done to support older workers and learners. The profile of the Welsh workforce is changing. Welsh Government population projections (2019) show that around a third of the Welsh workforce is now aged 50 or over. An increasing number of older workers are balancing work alongside caring commitments or health conditions. Taking on a caring role can be an isolating experience and for those who have had to give up work or go part time to care, it can have major impact on their pension and savings. This can disproportionally affect women who are more likely to take on the caring role.
UN Principles for Older Persons: Independence 2, 3, 4
We believe people of all ages in Wales have a right to lifelong learning. Learning as a form of social engagement and mental stimulation is extremely important for older learners not only to help them to stay active and to stay healthy; but also to help to address loneliness and isolation. Research from Alzheimer’s UK suggests that people who take part in activities that stimulate the brain are less likely to develop dementia compared to those who do not engage.
Right now, to support lifelong learning we are:
- Providing funding for digital e-learning to support the development of on-line delivery and to provide digital resources for adult learners.
Going forward, our three priorities for lifelong learning are:
1. Delivering a new right to lifelong learning
The Minister for Education is committed to exploring how the Welsh Government can deliver a new Welsh right to lifelong learning – to give everyone in Wales access and opportunity to learn throughout their lives.
2. Supporting informal learning
We aim to support the provision of social engagement courses through clubs and self-directed learning groups which will support people to continue to learn in an informal way to benefit their health and well-being.
3. Promoting digital confidence
Digital Confidence remains a key priority of Welsh Government, as outlined in our Digital Strategy for Wales (March 2021). We must ensure our Adult Learning policy and lessons remain not only free to learners, but available both digitally and offline and that there is equal access to Adult Learning available across all our local authorities, which are flexible to the needs of our citizens. Much of the provision offered is specifically targeted at older learners to ensure they can engage in the digital technology that is prevalent in today’s society.
Why have we chosen these priorities?
Wales ranked third in the educational attainment of older people in the UK Age Watch Index.
Members of our working groups were keen to emphasise that older people should have a choice about how they take part in their local communities - informal clubs and self-directed learning clubs can allow people to engage on their own terms and help to mitigate the impact of austerity on more traditional forms of adult community learning. Finally, in an increasing digital age, it is a concern that half of those aged 75 or over do not use the internet (Welsh Government 2019). Whilst we recognise using technology is a choice, we want to ensure those who wish to use online services, are supported to do so.
UN Principles for Older Persons: Independence 4; Self fulfilment 15, 16.
Aim 4: Tackling age related poverty
The percentage of pensioners living in relative income poverty increased for 4 consecutive periods reaching 20% between 2014-15 and 2016-17 before falling to 19 per cent between 2015-16 and 2017-18 (StatsWales). Although these figures are still below what they were in the mid to late 1990s, the impact of austerity, soaring rents and the zero hour economy are making it difficult for people in middle age to save for retirement. This could have an impact on rising levels of pensioner poverty for future generations.
Aside from stark choices between heating and eating, older people living in poverty can have limited choices about how to spend their free time. Older people told us that their financial position has a significant influence on their social life. People who do not own a car or are unable to pay for taxis, are far less likely to take part in evening time activities.
In the period 2015-16 to 2017-18, 17 per cent of working-age people living in working households in Wales were in relative income poverty. Worryingly, the rise of in-work poverty means that we have a ‘ticking time-bomb’ waiting. People who are struggling to make ends meet now and who perhaps have irregular and unstable contracts are unlikely to be able to make provisions for their futures.
We have a range of employability programmes which are helping people to build their skills and enter sustainable employment. Nevertheless, changes to working age benefits made by the UK Government under its programme of Welfare Reform means that increasing numbers of working adults are living in poverty.
Right now, to tackle age related poverty, we are:
- Investing in employability programmes. Since its launch in April 2018, Communities for Work Plus has engaged 25,157 participants up to the end of June 2021with 10,186 of them securing employment. Up to the end of June 2021, the Communities for Work programme has provided employment support to 31.875 people, and helped 12,733 people into employment across Wales.
- Delivering a national employability advice service, 'Working Wales'
- Continuing to express our concerns to the Secretary for Work and Pensions on the impacts of the increase in state pension age for women.
- Limiting the amount people are required to pay for their non-residential social care - since 2011 people who require social care and support at home, or in the community, cannot be charged more than a maximum weekly amount by their local authority. In addition, a number of financial protections and allowances are in place to ensure a person is not left in financial hardship when required to meet the cost of their non-residential care.
- Allowing those in residential care to retain more of their capital - for people requiring residential care, the Welsh Government has introduced a capital limit allowing them to retain up to £50,000 of their savings or other capital without having to use this to pay for their care or accommodation. This is the highest allowance of this type in the UK.
Going forward, our priorities are:
1. Commencing the socio-economic duty
The Socio-economic duty came into force on 31 March 2021. The duty requires certain public bodies, when making strategic decisions such as ‘deciding priorities and setting objectives’, to consider how their decisions might help to reduce the inequalities associated with socio-economic disadvantage.
2. Increasing take up of pension credit
You may know of people who you think could be in need, but how do you bring this up with them without insulting them, because of the image of benefits, being seen as scroungers, it’s very hard to suggest to a friend that they should claim.” (Attendee at engagement event).
Against rising levels of poverty, an estimated £214 million of Pension Credit and Housing Benefit (which is unlocked via a Pension Credit claim) goes unclaimed every year (Older People’s Commissioner for Wales, 2019). There remains a stigma attached to claiming welfare entitlements that could be contributing to this high figure. We know that advice services are invaluable in helping people navigate through the benefit system to understand what they may be entitled to and how to claim, but many people only access advice when they are in a crisis. This is why we asked our Single Advice Fund (SAF) partners to target the groups who consistently fail to access their entitlement from the social security system.
In Mid and West Wales, SAF partners worked together to reach older people and their unpaid carers to raise their awareness of their welfare benefit entitlements and to encourage them to access the advice services they need to claim welfare benefits.
In March 2021, the Welsh Government delivered its first National Welfare Benefit Take-up Campaign encouraging people to check and claim the benefits they are entitled to. Older people were targeted within the campaign, with the largest number of views on Facebook being the campaign’s Pension Credit video. The campaign ran for 25 days and people who responded were helped to claim additional income of more that £500,000.
The National Assembly’s Equality, Local Government and Communities Committee (ELGC) conducted an inquiry into Benefits in Wales: Options for Better Delivery in 2019. Their report published in October 2019 included 17 recommendations for the Welsh Government of which one was;
We recommend that the Welsh Government establish a coherent and integrated 'Welsh benefits system for all the means-tested benefits for which it is responsible. As part of this, the Welsh Government should develop a set of principles underpinning their design and delivery. These principles should be co-produced with people who claim these benefits'.
We are now working with our stakeholders to devise the Charter that will be at the heart of a Welsh benefits system, which works for everyone in Wales.
3. Investing in Wales’ foundational economy
The foundational economy describes the goods and services we all use in our daily lives regardless of what background we are from or what age we are. Estimates provided by academic researchers suggest four in ten jobs in Wales and £1 in every three that we spend fall within this economy. By investing in the foundational economy, we can make our communities stronger and resilient and reach out to people who are feeling disengaged or left behind. It will enable us to help older people who are finding life difficult today, but it is also an investment in all our futures.
In line with a rights based approach, the Welsh Government’s Foundational Economy Challenge Fund is offering more than £4 million to support projects that develop regional economies so that prosperity can be shared more evenly across Wales.
We recognise that older people are involved in the foundational economy as consumers, workers and as business owners and innovators. We will explore how to support older people to thrive within our ageing economy.
How technology could provide new solutions
Foundational Economy Challenge Fund is enabling Cartrefi Cymunedol Gwynedd Cyf to develop the infrastructure required to install monitoring sensors in properties that can respond to specific triggers such as temperature changes and movement. The sensors will support older people to remain safe and independent in their homes for longer.
The sensors can send ‘live’ information to a dashboard which allows users to identify patterns of behaviour. It is envisaged that this dashboard would be monitored centrally by a designated officer or partner agency.
The project will conclude by 31 March 2021 and the project leads aim to spread beneficial learning across Wales to help support our ageing society.
Why have we chosen these priorities?
Wales ranked third in the UK Age Index on financial support for older people, but the high level of unclaimed pension credit shows that we could be performing better. Unclaimed entitlements were raised as problem by all working groups and at our engagement events. Finally, it is vital that older people are not overlooked in any new initiatives relating to the Welsh economy. The tired stereotype of older people lacking new ideas and solutions must not limit the potential of older workers and entrepreneurs.
UN Principles for Older Persons: Independence 1, 2; Participation 7, 8, 9; Self fulfilment 15, 16.
How we will monitor progress
From the outset, members of the Ministerial Advisory Forum on Ageing and our key stakeholders, including the Older People’s Commissioner, were clear that this strategy should focus on actions against which progress can be measured.
The membership, terms of reference and purpose of the Ministerial Advisory Forum on Ageing have been refreshed to ensure this group can play a pivotal role in overseeing the implementation of this strategy.
We are working with the forum to draft a delivery plan which will set out actions, milestones and timescales by which progress can be measured and we will publish annual progress reports.
We have commissioned and specifically produced the UK Age Index for Wales which has shaped this document and which will be used by which to measure its success. It will show us what is working, where we need to improve and where we need to develop more data.
For more information on the Age UK Index and monitors for measuring progress, please see 'United Nations Principles for Older People'.
The UN Principles for Older People encourage governments to incorporate the following principles into their national programmes whenever possible.
1. Older persons should have access to adequate food, water, shelter, clothing and health care through the provision of income, family and community support and self-help.
2. Older persons should have the opportunity to work or to have access to other income-generating opportunities.
3. Older persons should be able to participate in determining when and at what pace withdrawal from the labour force takes place.
4. Older persons should have access to appropriate educational and training programmes.
5. Older persons should be able to live in environments that are safe and adaptable to personal preferences and changing capacities.
6. Older persons should be able to reside at home for as long as possible.
7. Older persons should remain integrated in society, participate actively in the formulation and implementation of policies that directly affect their well-being and share their knowledge and skills with younger generations.
8. Older persons should be able to seek and develop opportunities for service to the community and to serve as volunteers in positions appropriate to their interests and capabilities.
9. Older persons should be able to form movements or associations of older persons.
10. Older persons should benefit from family and community care and protection in accordance with each society's system of cultural values.
11. Older persons should have access to health care to help them to maintain or regain the optimum level of physical, mental and emotional well-being and to prevent or delay the onset of illness.
12. Older persons should have access to social and legal services to enhance their autonomy, protection and care.
13. Older persons should be able to utilize appropriate levels of institutional care providing protection, rehabilitation and social and mental stimulation in a humane and secure environment.
14. Older persons should be able to enjoy human rights and fundamental freedoms when residing in any shelter, care or treatment facility, including full respect for their dignity, beliefs, needs and privacy and for the right to make decisions about their care and the quality of their lives.
15. Older persons should be able to pursue opportunities for the full development of their potential.
16. Older persons should have access to the educational, cultural, spiritual and recreational resources of society.
17. Older persons should be able to live in dignity and security and be free of exploitation and physical or mental abuse.
18. Older persons should be treated fairly regardless of age, gender, racial or ethnic background, disability or other status, and be valued independently of their economic contribution.