The reduction of the “close family” in the coming years as a result of demographic changes leads to the need to develop policies for older people. Life expectancy is increasing, fewer children are being born and couples are getting divorced more easily.

The welfare state in the near future will have to meet the needs of many older people – today people over 65 make up 22.6% – who, in old age, will find themselves alone, and their income will not be able to meet the increased needs. In fact, at a time when Greek long-term care spending as a percentage of GDP was only 0.2% in 2019, while the European Union average was as high as 1.7%.

Elderly people without family care

Tanya Georgiopolu

The image of grandparents telling fairy tales to children by the fireplace will soon have a museum value. The airbag is called “family”, which is traditionally Hellas cared for the elderly when they could no longer live independently, will be less and less able to fulfill this role in the coming years due to demographic changes. At the same time, the number of elderly people in the country and in Europe as a whole in relation to the total population will continue to increase in the coming years as a result of increased life expectancy and infertility. Today, there are 775,704 people over 80 living in Greece, with 22.6% of the population over 65. “The welfare state will be called upon to cover the needs of the elderly, since there will be no “close family” for many, and benefits for the elderly will not be able to cover their increased needs in private,” emphasizes Byron Kotzamanisprofessor of demography.

Over the past hundred years, there have been significant changes in the course of the main demographic components – mortality, fertility and family (marriage) in Greece. “We are much older as a population, we live much longer, we marry less and divorce more, we have fewer children, and as a result, the composition of families has changed significantly,” Mr. Kotzamanis describes in his study of the impact of demographic changes in the family environment. people aged 65 and over in Greece.

average life expectancy

Women born in the 1980s will live longer but have fewer children later in life.

Since the beginning of the last century, there has been a significant increase in life expectancy, which, although initially due to a decrease in infant and child mortality, in recent decades has been almost exclusively due to a decrease in mortality in old age. It is estimated that in the middle of our century average life expectancy it will reach 90 for women and exceed 85 for men.

The researcher records the changes that have taken place on the example of women, who are traditionally the main caregivers for both the elderly and minors. In the early 1920s, the proportion of women who were not married by the age of 50 was 12%, famous old women. For women born in 1980, this percentage has already doubled, and they divorce much more easily: every third marriage ends in divorce. At the same time, we are witnessing an increase in illegitimate births, as a result of which single-parent families are multiplying.

Also, women born in the interwar period gave birth to 2.3-2.5 children, those born in 1985, for example, give birth to an average of 1.45 children and even at a relatively advanced age after 31 years. In addition, 25% of women born in the 1980s will not have children at all. The corresponding percentage in the pre-war generations did not exceed 15%. Describing the marital status of women born in the early 1920s on the basis of demographic data, Mr. Kotzamanis states that 60-70% of them will be over 65 years old. Also, these women were widows for about half the years of their lives after 65, but had 2-3 children and 4-6 grandchildren aged 10-20 years. “Thus, in the last and most difficult years of their lives, there were 6-9 people in their close family.”

However, 90% of those born in the 1980s will live to age 65, and on average live another 25 years. In the last years of their life, their “close family” environment will consist of 2-5 people. Their children, who were born at an older age, will have to take care of both their elderly parents and their minor children at the same time, naturally not being able to adequately respond to both roles.

Social security ends at retirement

Greece, probably relying on the family model of care for the elderly, despite demographic changes, represents the lowest percentage of long-term care spending as a percentage of GDP. The state benefit ends at retirement.

In particular, in 2019, the share of public spending on long-term care in GDP was 0.2%, while the corresponding EU average was 1.7% (data from the EU – Aging Report 2021). Norway has the highest percentage of long-term care spending relative to GDP, at 4% of GDP, followed by the Netherlands at 3.7% of GDP and Denmark at 3.5%.

Demographics are not going to change. In 2022, 1/5 of the inhabitants of the EU. were over 65 years old, while half of the population of the Union was over 44.4 years old.

10.5% of the EU population aged 65-69 cannot live independently without support. This percentage at the age of 70-74 increases to 13.5%, at the age of 75-79 to 19%, at the age of 80-84 it reaches 25.9% and over 85 to 35.9%.

In Greece between 1951 and 2019, people over 65 and over 85 grew much faster than the active population, i.e. people aged 15-64. The number of people over 65 has more than quadrupled, and the number of people over 85 has increased twelvefold.

There is a need to develop policies for the care and protection of older people without a supportive structure, and to increase public spending to create public structures that will provide decent long-term care for older people.

The imperative of a multilevel strategy for the elderly

Joanna Photiadis

Family solidarity has always been strong in the Mediterranean countries, because for various reasons, social and economic, they did not have adequate structures for the elderly. Unlike the Anglo-Saxon countries and the countries of the European North, which for many decades have had highly developed social protection for the elderly.

However, in recent years, the Mediterranean has rapidly westernized, people are changing their thinking and behavior, and as a result, there is an increasing need for tough measures to protect the elderly, especially those left … alone. Our country needs to take quick steps in many areas on the issue of old age.

The gradual aging of the population, for example, makes the need to institutionalize the specialty of geriatrics in Greece all the more pressing. We remain the only country in the European Union where this specialty is not a recognized branch of medicine. Although it has been proven that the contribution of gerontologists to improve the quality of life of older people, to support their families and save NHS resources, can be decisive.

“A geriatrician is not the kind of doctor we visit when we get sick.” Ms. Athena Greka explains “K”.specialist pathologist-gerontologist, “is a doctor who will constantly monitor us after 60 or 65 years and guide us in such a way as to prevent possible age-related health problems.”

Thanks to his special knowledge, he can comprehensively approach each patient. He examines his diet, his mental, emotional and social state. “We are just as necessary to children as pediatricians,” she says. In the near future, when a large number of elderly people will live without relatives, the role of the geriatrician will become even more necessary.

“With careful and individual medical supervision of the elderly, unnecessary multi-day hospitalizations and polypharmacy can be avoided.” In old books one can observe the endless repetition of the same recipe.

Of course, the needs of Ms. Greki’s patients differ, “because the elderly are divided into four age groups,” she recalls.
And he explains: “In the first two people are still working, they are fully active, they have a social and sexual life.” As he remarked, “today’s 75-year-olds are not like those who lived in the 80s or even in the 90s.”

As the famous Mediterranean family model recedes, the need for a multi-layered long-term care strategy for the elderly will increase, especially in Greece, which appears to be aging rapidly.