Final Project Conference

On Tuesday, 28th November, ENNHRI held the final conference of its European Commission-funded project, The Human Rights of Older Persons and Long-term Care to share the project’s findings and hear reflections from policy-makers and care providers.

Opening of the Final Project Stakeholders Conference 28 November 2017

Attended by care providers, advocates for older persons, academics, policy-makers and staff from European National Human Rights Institutions (NHRIs - state-mandated bodies, independent of government, with a broad constitutional or legal mandate to protect and promote human rights at the national level), discussions at the conference highlighted the need for greater investment in the long-term care (LTC) sector throughout Europe, but particularly in Central and Eastern European countries, to ensure an adequate supply of services (partuclarly home- and community-based services) as well as adequate staffing levels and human rights training for care workers.

Dr Ciara O’Dwyer, Co-ordinator of ENNHRI’s project started by outlining:

  1. The 13 human rights standardsthat protect older persons in long-term care in Europe
  2. Common human rights concerns in long-term settings throughout Europe, as identified through monitoring work by national teams: a lack of respect for individuals’ right to dignity, privacy, autonomy and access to justice. Examples of concerning practices included older persons being forced to live in residential care without their consent, residents being transported along corridors in a state of undress, the heating turned off to save money and residents given tranquilisers in order to prevent challenging behavior.
  3. The main causes of these human rights concerns, including a lack of knowledge by policy-makers and care providers of their human rights obligations and a lack of financial resources within the LTC sector. Indeed, it is clear that statutory investment in the LTC sector varies widely throughout the EU, with several Central and Eastern European countries having lower than average support for the sector.
  4. The benefits of a human rights-based approach (HRBA) to long-term care, which aims to empower older persons to know and claim their rights and increase the ability and accountability of policy-makers and care providers to respect, protect and fulfil their human rights obligations.

Two members of the Project’s Pilot Group, Vytautas Valentinavicius, Chief Public Relations Counsellor at the Seimas Ombudsmen’s Office of Lithuania and Dr Timea Csikos, Senior Legal Advisor at the Commissioner for Fundamental Rights Office in Hungary, shared how there is a heavy reliance on the informal provision of long-term care services in both countries. Both highlighted the challenges facing staff in residential care settings, who typically receive low-pay, may have had little training and suffer high rates of burnout, highlighting the need for more support for care workers as well as residents.

Prof. Dr. Matthias von Schwanenflügel, Director General of the Demographic Change Unit, Senior Citizens and Welfare Department in the German Federal Ministry for Family Affairs shared information on how Germany seeks to strengthen the human rights protection of older persons seeking and in receipt of long-term care, through legislation – most notably the introduction since 2015 of three Acts to strengthen long-term care. Act I provided better home care benefits and additional staff for residential care settings; Act II introduced a new needs assessment and increased statutory funding for the sector, while the third Act seeks to strengthen the role of municipalities in long-term care services. Prof. Dr. von Schwanenflügel also highlighted initiatives to support dementia; legislation to promote better work-life balance of informal carers; and the adoption by the state of the German Charter of Rights for People in Need of Long-term Care and Assistance in 2006, originally initiated by Federal Ministry for Senior Citizens.

Mr Maksims Ivanovs, Director of the Social Services Unit in the Latvian Ministry of Welfare, spoke about the benefits of funding from the EU Structural and Investment Funds to strengthen the process of “de-institutionalisation”in Latvia (independent living in the community for clients of State social care institutions) in the context of a heavy reliance on informal care throughout the State. As a result of this reform process, formal home- and community-based services will support children, adults with disabilities and older persons with long-term care needs to stay living in the community. Training for care workers is a key element of this approach.

In the first of two parallel workshops on implementing a HRBA to LTC, Dr Claudia Mahler from the German Institute for Human Rights (GIHR) and Dr Polina Aronson, Debate Editor at Open Democracy Russia and formerly of the GIHR - authors of the German national report- provided insights in how an NHRI can carry out human rights monitoring work within the sector. Using mainly interviews with all stakeholders in the care home and some observation, the German monitoring team were able to understand how care workers and managers understood and fulfilled their human rights obligations, as well as the consequences when their obligations were not fully clear. They highlighted the need for working with policy-makers in the area of long-term care to discuss the findings and identify solutions (such as training for care workers) collectively.

The second workshop, given by Mr Davy Verhard, formerly of Unia, Belgium’s national human rights institution and co-author of the Belgian national report, sought to develop a clear understanding of the right to dignity and the importance not just of respecting each individual, but of ensuring that they have the support to live according to the choices they made before coming to live in the care centre. The workshop also discussed the importance of leadership, whereby any questionable behaviour by staff must immediately be highlighted and prevented. Otherwise begins the “slippery slope” to a wide range of questionable practices.

Ana Carla Pereira, Head of the Modernisation of Social Protection Systems Unit in DG EMPL, outlined the European Commission’s current actions to support the improvement of LTC in Europe, including guidance from the Commission, peer support and sharing of best practices (e.g. through the European Semester and EU’s Social Protection Committee); a proposed new Directive on Work-Life Balance; as well as the European Pillar of Social Rights, which includes the right to long-term care (Principle 18) to give direction to Europe’s social dimension by Member States.

Jiří Horecký, President of the European Association for long term care directors and providers (E.D.E), outlined the efforts that care providers throughout Europe have made to learn about their human rights obligations, including by creating the European Charter of the Rights and Freedoms of Elderly People Accommodated In Homes in 2010. Mr Horecký also highlighted the challenges that care providers face in upholding human rights in care homes, most notably through limited awareness of their obligations and financial challenges.

The final session of the day was a roundtable discussion with key stakeholders from the LTC sector. Stecy Yghemonos, Executive Director of Eurocarers, the European network representing informal carers, highlighted the need to support informal carers through the provision of high quality formal community-based LTC services. Care providers Dirk van Herpe, Lucienne Swinnen, both from Den Olm Care Home in Flanders and Norbert Vajda, Technical Director with the Catholic Charity in Hungary, highlighted the importance of communication when implementing a HRBA in LTC settings. Nena Georgantzi, Human Rights Officer with AGE Platform Europe, suggested that a new international convention on the human rights of older persons could increase our understanding of the human rights of older persons and make them easier to implement, while Nevena Peneva from the EU’s Fundamental Rights Agency highlighted the need to ensure older persons had access to justice when seeking and in receipt of care.