Active ageing into practice! Experiences of civic engagement in health policies Alessio Terzi, Teresa Petrangolini, Giulia Savarese Cittadinanzattiva

General Purposes 1. increase awareness and information on the active participation of ageing citizens in the enforcement of their patients rights in all EU countries with their double role of: empowered patients; active citizens who act in the community; 2. demonstrate how the active role of "empowered ageing patients/users" can contribute to face the challenges resulting from the crisis of the European social and "demographic"model, maintaining the health care universalism. 3. promote the active participation of ageing people in health-care policy and services in order to enhance well-being in old age and avoid that diseases can be cause of their social exclusion.

A Survey on best practices of Active Ageing 40 best practices coming from 18 member states were collected, studied and subdivided in three areas: 1. Ageing empowerment on policies 2. Ageing empowerment on communities 3. Individual empowerment.

Areas have been analyzed in order to four highlight: * actors * empowerment processes * the relation with welfare systems * working procedures used by the active citizenship

Actors: a multi-stakeholder approach Ageing empowerment in policies Ageing empowerment in communities Ageing individual empowerment Public Authorities 326 Universities =31 Scientific Societies =22 Third Sector 119 Civic Organisations 424

An empowerment process a mechanism allowing people, organizations and communities to boost their capability to control their lives (Rappaport).

Ageing empowerment in policies 1. The integration of active citizens on decision-making and evaluation of public policies process, with particular reference to the health field. 2. The establishment of new services 3. The advocacy field (Bulgaria)

Ageing empowerment in communities 1)Spotting and education of a new resource: proximity agents. 2)Setting up at local level protection, information and animation centres managed by associations or elderly groups in collaboration with experts

Ageing Individual Empowerment Access to services through the IT Management of disease Management of medicines and dressing Lifestyles and autonomy Rehabilitation Self-help group participation Tumble prevention Violence prevention Public transport to access services Relation with youngster

On the look-out for a new welfare One of the characteristic of the European identity is the spread all around EU member states of a social model with high levels of protection enabling the improvement of the quality of life. This means the consequent increase of the average longevity. However, this great success caused severe problems to the entire sustainability process, as numberless of experts and politicians underlined.

Are we going toward a shared welfare? The reform of the welfare models is intended to produce relevant changes in the public life. Two conditions are necessary to avoid that it becomes only a limitation to the rights of the citizens: a further democratization of the public institutions with a strong assumption of responsibility by the decision makers and policy makers, the transparency in the decisions taken, the decrease of wastage and of privileges, the fight against corruption and influence peddling, the introduction of serious form of evaluations of the policies and of governing; an important involvement of the citizens and their resources.

Some possible characteristics of a new way of operating in the health service The empowered user (patient centered care) Community agents (information and education) Seniors Networks (communication and monitoring) Seniors Socializing Centers (to decrease solitude and exclusion) The development of civic participation (to really include active citizenship in planning and implementation of policies)

Mobilization of active citizenship/1 The promotion of civic activism. There is a significant proportion of elderly people who, having a significant life expectancy, for various reasons, would undertake social activities. BP show that a simple public announcement may be enough to mobilize this energy.

Mobilization of active citizenship/2 Relevance vs. representation The relevance can be defined as the ability of civic organizations to make a difference in policy making thank to one or more of their characteristics … Thanks to the concept of relevance, the question of representativeness of civic organizations can be interpreted as a matter of capacity rather than as a match to abstract criteria (Moro).

Mobilization of active citizenship/3 The construction of a civic environment In general, all examined initiatives acted in this way, creating centers of reference, resulting in mobilization and animation of public debates in which the issues of older people acquire a general relevance and doesnt remain confined within the health and welfare.

Mobilization of active citizenship/4 Create information to set up new policies. The success of many public policies depend on the information provided by citizens (one need only consider health, immigration and the environment). Nearly all the initiatives on the empowerment of policies and of communities focus their attention to the data collection and processing techniques.

Mobilization of active citizenship/5 Communication. One of the biggest problems of civic activism is the lack of visibility, namely the difficulty to represent what you do, who are the people doing it, and which results have been achieved. All good practices examined have paid particular attention to the problem of communication, but it remains a weak point.

Directions for Recommendations 1.National governments must ensure universality of older people rights. 2.A specific commitment should concern to develop both Europe and local community strategies on ageing. 3.Policy makers must consider the aging population not as a burden to bear with the least possible commitment of resources but as a resource for the resumption of growth processes

Some proposal 1.EU: capitalize the 'European Year for Active Ageing and Solidarity. 2.NG: remove obstacles in order to enable a patient centered implementation of Healthcare 3.Local authorities: invest money and energy on the training of senior community agents and the establishment of socializing centers 4.Civic organizations: align their organizations and their actions to the information provided by the good practices

THANKS FOR YOUR ATTENTION