“A piece of the puzzle for greater autonomy for older people”

The Federal Council is keen to promote the independence of older people in their own homes. They plan to do this by expanding supplementary benefits. But why is this measure necessary?

Until now, support for older people at home has been limited to medical and nursing services, such as are provided by Spitex at-home care. No provision is made for social insurance to finance non-care-related services that support pensioners’ everyday lives and so make it easier for them to continue living a self-determined life at home.

This means that the desire to live independently in their own four walls for as long as possible is currently only realistic for elderly people who have the necessary financial means at their disposal or are supported by people from their social environment that perform the support tasks. With its proposal, the Federal Council addresses this gap in social provision.

What exactly is the bill about?

Pensioners who receive supplementary benefits will be supported in their everyday lives to enable them to go on living at home. To make this possible, the range of recognised benefits in the context of supplementary benefits is being expanded.

These include services such as home help, meals on wheels, a chauffeur or companion service, an emergency call system, but also measures such as structural adaptations to the home or a rent allowance for an age-appropriate or barrier-free home.

What are the merits of the Federal Council’s proposal?

First of all, it is to be welcomed that politicians have also recognised the need for action at national level. Generally, older people still have sufficient resources to organise their everyday lives and participate in society. However, slowly dwindling strength or illnesses make occasional support necessary, such as having someone to carry heavy shopping, perform strenuous household chores, or accompany them to a theatre performance.

The proposed remuneration of certain support services will promote the general self-determination of older people in their everyday lives. This development has already been observed at the municipal level. The cities of Bern, Lucerne and Zurich all have remuneration schemes in place that provide help and support for pensioners in financially precarious situations.

Who will benefit from this, assuming Parliament approves the bill? Only people who already receive supplementary benefits, or others as well?

The bill envisages that only people with supplementary benefits will receive funding for everyday assistance. Unfortunately, it excludes people who don’t qualify for supplementary benefits, despite having hardly any financial resources. Like most pensioners who are currently unable to pay for support services, they will probably continue to get by without them.

In addition, I suspect that it will also relieve the burden on carers who support elderly supplementary-benefit recipients in their everyday lives. These changes to the supplementary benefits scheme would let them delegate certain more-strenuous care activities to others.

How many people will be able to go on living at home thanks to the support?

It is hard to forecast numbers with any precision. The funding of support services is an important piece in the puzzle of promoting independent living for elderly people. That they have great need of support in everyday life is confirmed by what happened when the care coverage system was launched in the city of Bern, for instance.

Already during the pilot phase, there were more applications and remuneration approvals than expected. The remunerated services made life at home noticeably easier for people and improved their quality of life. Legally mandated support services for everyday life have a positive effect on the situation of pensioners in precarious life situations.

What are the new rules expected to cost?

The federal government anticipates annual costs of CHF 300 to CHF 620 million. At the same time, it assumes that the bill will save CHF 280 million because the expansion of supplementary benefits will mean that fewer people will have to move prematurely into a care home. The challenge in terms of financing is that the cantons have to bear the entire cost and the federal government is not willing to contribute.

Will the bill solve the increasing shortages in care and support for older people?

It is likely to make the most difference to people who have only limited care needs, but have to be placed in a home because they cannot afford everyday support services. These people will certainly be able to live at home for longer, which will reduce the burden on care services and healthcare costs.

Do you see a need for further action in support of elderly people?

If we look at the proposed range of benefits that are to be financed via supplementary benefits in the future, there is a lack of benefits that promote people’s social inclusion. For example, it could involve shared activities such as meals together or the person being taken to visit a museum. It is of little benefit if a person has a balanced diet thanks to the meal service and is well looked after by Spitex at-home care, but then just sits around at home and doesn’t participate in any social activities. This will have a detrimental effect on their wellbeing.

Psychosocial factors are very significant to us as humans, because they strengthen a person’s self-esteem and their ability to live a self-determined life. It is extremely important for people to spend time together, to keep each other company. In this way, we prevent increasing loneliness in old age, when a person’s social environment tends to shrink, and we bolster people’s mental health.