The Elderly
"Whilst elitism is a characteristic of all East European countries (and the Soviet Union), the economic "targeting" of health care has reached an exceptionally level in Romania. It is best expressed in the refusal to treat the eldery "because they will soon die anyway". [1]
Transition to a free market economy has left Romania a staggering 8 times poorer than 10 years ago with 44% of Romanians living in poverty. The North East area is even much more deprived than the average and poverty rises to 80% in the rural parts.
Many of the Romanian older people live in poor, isolated rural areas having to struggle with very low incomes that are hardly enough for the daily food. This is because the elderly of today are those who used to work in collective farms during the communism era and their current pension is subsequently very low.
Those whose spouses are still alive are only slightly better off because they receive two pensions. However, the widowed very often cannot afford to survive. The situation has become so desperate that many Romanian widow and widowers literally freeze to death in their homes because they cannot afford to pay for heat. In addition to the poverty they endure, many must pass their remaining days isolated and alone.
According to a report released by ENEPRI, the European Network of Economic Policy Research Institutes, Romania has currently a major shortage of institutionalised services. Home care is the most commonly used care option for dependent elderly people because of the comfort the family provides and the reduced costs as compared to institutionalised care. This, however, raises many problems. Most family caretakers are women; the wives or daughters of the dependent. Many caretakers are elderly themselves and may also become dependent. Family care is more common in rural areas, where traditions and moral values are maintained to a greater extent, the report further states. [2]
According to 'Alzheimer Europe', all Romanian citizens who have a health assurance can access medical home care but only for 56 days per year (art. 2, annex no.27, order.1220/24.12.2003). In the past, people were entitled to medical home care for as long as it was needed. This was limited to 14 days maximum in 2003 and then extended to 56 in 2005. [3]
Many of the Romanian older people live in poor, isolated rural areas having to struggle with very low incomes that are hardly enough for the daily food. This is because the elderly of today are those who used to work in collective farms during the communism era and their current pension is subsequently very low.
Those whose spouses are still alive are only slightly better off because they receive two pensions. However, the widowed very often cannot afford to survive. The situation has become so desperate that many Romanian widow and widowers literally freeze to death in their homes because they cannot afford to pay for heat. In addition to the poverty they endure, many must pass their remaining days isolated and alone.
According to a report released by ENEPRI, the European Network of Economic Policy Research Institutes, Romania has currently a major shortage of institutionalised services. Home care is the most commonly used care option for dependent elderly people because of the comfort the family provides and the reduced costs as compared to institutionalised care. This, however, raises many problems. Most family caretakers are women; the wives or daughters of the dependent. Many caretakers are elderly themselves and may also become dependent. Family care is more common in rural areas, where traditions and moral values are maintained to a greater extent, the report further states. [2]
According to 'Alzheimer Europe', all Romanian citizens who have a health assurance can access medical home care but only for 56 days per year (art. 2, annex no.27, order.1220/24.12.2003). In the past, people were entitled to medical home care for as long as it was needed. This was limited to 14 days maximum in 2003 and then extended to 56 in 2005. [3]
In a newsletter from "The Hamby Foundation" (UK), whose aim it is to help the poorest and at risk children and old people of Romania, we read:
"It was this feeling of desperation and helplessness and the realization that practical aid as well as monetary aid was in short supply that led to a frenzied eight weeks of hard work, resulting in us sending out a 40 ton lorry full of aid. We have sent clothes, shoes and medicine. We were overwhelmed by the generosity of people giving us money and donating goods. Together we have achieved so much. Here are just a few examples of how much difference we made with 828 boxes of clothes, 183 boxes of soap, toiletries etc, 85 boxes of shoes, 50 sacks of bedding and 65 boxes or pallets of food, 24 bikes and lots more.
Baby clothes, nappies and baby soap and wipes etc went to the abandoned babies project in Mangalia.
In the isolated village of Poiana 140 people were given clothing and desperately poor families provided with much needed food.Bicycles were given to enable people to get work, or for children to get to schools, or to old people that previously had to walk many miles to get to the feeding centre.
Hospital equipment, wheelchairs and medicine went to Eforia Sud hospital. More money was given than was needed to pay for
the lorry so the surplus was spent on vitamins and antibiotics.
The old peoples centre, Heart to Heart also received many hundreds of boxes of clothing, shoes and food from us. They help around 50 elderly people each day. We were told that the items had arrived just in time, and when I went to where the old folk lived to help deliver things I was shocked. The poverty is getting worse. To see old men and women of 70 or 80 years of age sleeping on earth floors or under stairwells and in rooms with no heat or light is heartbreaking.
An old man, Gheorghe, lives in the burned out shell of his former home. A candle had caused a fire and now he lives outdoors with his few miserable possessions around him.
The Church has helped him with a temporary roof over one small area, but you could see the sadness in his eyes. But he was so thankful for the clothes and food we gave him.
Many of the homeless old people previously had good housing. But after Communism fell the original owners of a property previously seized could, in theory, reclaim it. Instead, people who can afford to bribe crooked lawyers to forge ownership papers claiming these properties for themselves are forcing people out of their homes, often after 30 or 40 years with only one weeks notice.
We have seen some old people go mad, or commit suicide presented with such a despairing situation. Old age pensions, already miniscule, are being cut, as are many workers wages by 25%. There are already demonstrations and one hears talk of another revolution. The situation is very grave."
Hundreds of thousands of old people suffer chronic illness alone at home in terrible conditions. Recent health reforms that have produced fund-holding GP's have done nothing to address the needs of the elderly sick, particularly in rural areas where the few scattered GP's cannot reach patients in outlying villages.
Added to all this, greater poverty has significantly increased the suffering of the elderly sick and their capacity to afford even the basic necessities.
Aid intervention in Romania over the past ten years has largely focused on children and orphans. The elderly have been mostly forgotten and excluded from NGO initiatives in social and health care. There is no community based social care network in Romania. [4]
The Romanian Orthodox Church doesn't do much for its community, and even less for the elderly, although it claims at least 86 percent of the population as adherents. [7]
This has been exemplified in a very sad but not uncommon event published in the Romanian media, where the priest from Costinesti-Leorda refused to let the coffin of Maria Ivan in the church because the relatives and neighbors could not pay the tax of 50 Romanian LEI (+/- 12 EURO).
This old woman lived out the rest of her life on a monthly pension of 300 Romanian LEI (+/- 65 EURO) and because her relatives were very poor, the hole community chipped in to pay for her burial expenses. When they tried to deposit her remains in the church until burial, the priest refused and asked his helper to remove the coffin until the money was raised and the Church fee paid.
The neighbors had to leave with the coffin and deposit Maria Ivan in one of their own houses. [8]
This story is even sadder given that Romania has undertaken an aggressive campaign to build an extraordinary number of churches across the country, regardless of expense.
According to a BBC report, about 10 new churches are built every month in the country – or one every three days - with a huge cathedral currently under construction in the center of the capital city of Bucharest.
When it is finished, the 125-meter (410-foot) Cathedral for the People's Salvation is expected to become the tallest house of worship in southeastern Europe - larger than former Communist dictator Nicolae Ceausescu's massive Palace of the People, which stands next to it. The rapid expansion of churches reflects the resurgence of the Orthodox Church in the country’s political and cultural life, almost 25 years after the fall of the repressive Ceaușescu regime. [7]
Added to all this, greater poverty has significantly increased the suffering of the elderly sick and their capacity to afford even the basic necessities.
Aid intervention in Romania over the past ten years has largely focused on children and orphans. The elderly have been mostly forgotten and excluded from NGO initiatives in social and health care. There is no community based social care network in Romania. [4]
The Romanian Orthodox Church doesn't do much for its community, and even less for the elderly, although it claims at least 86 percent of the population as adherents. [7]
This has been exemplified in a very sad but not uncommon event published in the Romanian media, where the priest from Costinesti-Leorda refused to let the coffin of Maria Ivan in the church because the relatives and neighbors could not pay the tax of 50 Romanian LEI (+/- 12 EURO).
This old woman lived out the rest of her life on a monthly pension of 300 Romanian LEI (+/- 65 EURO) and because her relatives were very poor, the hole community chipped in to pay for her burial expenses. When they tried to deposit her remains in the church until burial, the priest refused and asked his helper to remove the coffin until the money was raised and the Church fee paid.
The neighbors had to leave with the coffin and deposit Maria Ivan in one of their own houses. [8]
This story is even sadder given that Romania has undertaken an aggressive campaign to build an extraordinary number of churches across the country, regardless of expense.
According to a BBC report, about 10 new churches are built every month in the country – or one every three days - with a huge cathedral currently under construction in the center of the capital city of Bucharest.
When it is finished, the 125-meter (410-foot) Cathedral for the People's Salvation is expected to become the tallest house of worship in southeastern Europe - larger than former Communist dictator Nicolae Ceausescu's massive Palace of the People, which stands next to it. The rapid expansion of churches reflects the resurgence of the Orthodox Church in the country’s political and cultural life, almost 25 years after the fall of the repressive Ceaușescu regime. [7]
Elder abuse
Romania does not have prevalence data on elder abuse. The problem of elder abuse is still a taboo in Romania, ignored by authorities and not targeted within a national strategy.
A study (Caciula I et al. 2010) on how home care workers and older people receiving home care services recognize elder abuse asked care workers and clients of a non-government home care organization serving four areas in Romania to complete the Caregiver Scenario Questionnaire to measure ability to identify abuse. No staff and only one older person correctly identified all four abusive strategies in a vignette.
Staff with more professional caregiving experience recognized fewer abusive strategies. The study showed the rates of identification were worryingly low among professionals. It was suggested that mandatory abuse training and strategies to support people reporting suspected abuse, could help improve the management of elder abuse.
This starkly contrasts with:
clearly indicating that Romanian caregivers don't know how to identify elder abuse because they simply don't see abuse as such.
A study (Caciula I et al. 2010) on how home care workers and older people receiving home care services recognize elder abuse asked care workers and clients of a non-government home care organization serving four areas in Romania to complete the Caregiver Scenario Questionnaire to measure ability to identify abuse. No staff and only one older person correctly identified all four abusive strategies in a vignette.
Staff with more professional caregiving experience recognized fewer abusive strategies. The study showed the rates of identification were worryingly low among professionals. It was suggested that mandatory abuse training and strategies to support people reporting suspected abuse, could help improve the management of elder abuse.
This starkly contrasts with:
- Finland with a prevalence study on violence and abuse towards older women living in private households showed that 25.1% of women aged between 60 and 97 years experienced some form of abuse. Emotional abuse was the most common form of violence experienced followed by financial abuse (AVOW Project, 2011).
- and also Ireland where the national prevalence study (Naughton et al, 2010) showed that approximately 18,000 (4%) older people living in the community had experienced abuse since turning 65 years. The main type of abuse experienced was financial abuse. Abuse was more commonly experienced by women and the prevalence of abuse increased with age. [5]
clearly indicating that Romanian caregivers don't know how to identify elder abuse because they simply don't see abuse as such.
Homeless elderly
Homelessness doesn't end simply because people get older. Those who have lived on Romanian streets their entire life, often since a very young age, will most likely also remain homeless as an elder person.
Today, many years after the fall of Communism, Romania’s infrastructure is still lacking the basic needs in many villages. The elderly often live without electricity, clean water, and proper sanitation. In desperate cases, they end up living on the streets.
The elderly in Romania who find themselves homeless are usually either widowed, abandoned by family, or stuck in a cycle of poverty they cannot escape due to advanced age, poor health, or other circumstances. [6]
Today, many years after the fall of Communism, Romania’s infrastructure is still lacking the basic needs in many villages. The elderly often live without electricity, clean water, and proper sanitation. In desperate cases, they end up living on the streets.
The elderly in Romania who find themselves homeless are usually either widowed, abandoned by family, or stuck in a cycle of poverty they cannot escape due to advanced age, poor health, or other circumstances. [6]
A few shelters for homeless elderly exist in Romania, like the one in Batar village (Bihor county) and Cermei village (Arad county), or the Dumbrava home which was started by a Romanian pastor after he heard that two seniors had frozen to death on the streets.
Elder Orphan Care (a division of Remember the Children) who supports the Dumbrava shelter, stated that though the home has limited indoor plumbing and heating, no cafeteria or meeting area, and no activities for the residents, it’s still better than the streets. [9]
The Christian Charity Maranatha also supports the elderly, the homeless and other people in dire need in Romania and on the website of the charity, you will find many heartbreaking stories like the ones told in the following videos.
List of References
1) Page 73 in 'Social and Economic Rights in the Soviet Bloc' http://books.google.fi/books?id=Xcreg7M7k4UC&printsec=frontcover&hl=fi#v=onepage&q&f=false
2) http://www.ancien-longtermcare.eu/sites/default/files/ENEPRI%20_ANCIEN_%20RR%20No%2085%20Romania.pdf
3) http://www.alzheimer-europe.org/Policy-in-Practice2/Country-comparisons/Home-care/Romania
4) http://www.relieffundforromania.co.uk/homecare.html
5) http://www.combatingelderabuse.eu/?page_id=85
6) http://l.b5z.net/i/u/10225336/f/EOC-brochure-rev-nov2011.pdf
7) http://www.ibtimes.com/why-poverty-stricken-romania-building-so-many-churches-1375913
8) http://adevarul.ro/locale/botosani/mort-scos-biserica-bani-1_50ad67d37c42d5a663948858/index.html
9) http://wow-xroads.blogspot.fi/p/kims-ministry-elder-orphans.html
10) picture via Maranatha Charity: http://maranathacharity.org/category/help-homeless/homeless-shelter/
1) Page 73 in 'Social and Economic Rights in the Soviet Bloc' http://books.google.fi/books?id=Xcreg7M7k4UC&printsec=frontcover&hl=fi#v=onepage&q&f=false
2) http://www.ancien-longtermcare.eu/sites/default/files/ENEPRI%20_ANCIEN_%20RR%20No%2085%20Romania.pdf
3) http://www.alzheimer-europe.org/Policy-in-Practice2/Country-comparisons/Home-care/Romania
4) http://www.relieffundforromania.co.uk/homecare.html
5) http://www.combatingelderabuse.eu/?page_id=85
6) http://l.b5z.net/i/u/10225336/f/EOC-brochure-rev-nov2011.pdf
7) http://www.ibtimes.com/why-poverty-stricken-romania-building-so-many-churches-1375913
8) http://adevarul.ro/locale/botosani/mort-scos-biserica-bani-1_50ad67d37c42d5a663948858/index.html
9) http://wow-xroads.blogspot.fi/p/kims-ministry-elder-orphans.html
10) picture via Maranatha Charity: http://maranathacharity.org/category/help-homeless/homeless-shelter/