1 THE ELDERLY IN ISRAEL: SELECTED TRENDS Jack Habib DIRECTOR MYERS-JDC BROOKDALE INSTITUTE February, 2010

2 Presentation Outline  AGING OF ISRAELI SOCIETY  SOCIO-DEMOGRAPHIC CHARACTERISTICS  CRITICAL CHALLENGES

3 The percentage of the elderly in the total population will increase rapidly from ,9859,3688,7708,1757,374 Total pop. 1,3671,2241, % of 65+ It will remain relatively lower than most developed countries.

4 Life Expectancy in Israel,

5 Total Fertility Rate, by Religion Moslems Druze Christians Total Jews

6 The elderly dependency ratio – the number of elderly divided by the total population of working age, aged – will increase (0-19) + (65+) Total dependency ratio= 87.0 Total

7 Elderly Dependency Ratio, Elderly dependency ratio=

8 Children Dependency Ratio, Children dependency ratio=

9 Total Dependency Ratio, 2007 (0-19) + (65+) Total dependency ratio=

10 Elderly Dependency Ratio, Elderly dependency ratio=

11 Total Dependency Ratio, 2030 (0-19) + (65+) Total dependency ratio=

12 7% 24% 11% Only 22% of the elderly were born in Israel New immigrants (since 1990) EuropeAsia -Africa 15% + 54% immigrants – before 1990

13 A relatively high rate of growth of the Arab elderly population will result in a greater proportion of Arab elderly ,500123,10093,50072,10052,600 Number of Arab elderly % of the total 65+

In the next two decades, a higher percentage of the elderly will be Israeli born Among middle age cohorts, there is a dramatic increase in the percentage born in Israel and a decline in the percentage of new immigrants. Age group ( ) ( ) 65+ (2008) Born in Israel Born abroad (immigrated before 1990) 19 24New immigrants (1990+) 100 Total

In the next two decades, the elderly will have higher levels of education Years of education by age cohort

The percentage of older men in the labor force has decreased between There is a slight increase since Percentage of men employed

The percentage of older women in the labor force has remained small. There is a significant and accelerating increase among women ages Percentage of women employed

Estimated Ability in Mobility Outside Home 65+, 2007 (%) 70.6Without help of another person or device 7.8With device (walking stick, walker) 8.0With help of another person 13.6Home bound

65+ Reporting a Physical Problem lasting 6 Months or more, which Causes Considerable or Severe Difficulty in IADL* * Source: National Health Survey, CBS, 2003/2004 Total

Estimated Percentage of Disabled Elderly in Activities of Daily Living, 2007 Total Men Women

21 Characteristics of 65+ Women 80+

22 The percentage of disabled elderly is not expected to change. Thus, no disproportional increase is expected in the need for long-term care services. However, because of the absolute growth in the elderly population there will be a continued need for investment in infrastructure %17%16.3% disabled* among 65+ * In basic activities of daily living

Prevalence of Dementia in Israel among Elderly Aged 65+ Living in the Community  17.2 % of those aged 65+ living in the community suffer from dementia at different levels of severity:  8 % mild  4.1 % moderate  5.1 % severe

Estimated Prevalence of Dementia among Elderly Aged 65+ Living in the Community by Age (%) (2007) 17.2Total

Proportion Entitled to Services under the Community Long-term Care Insurance Law (%)

Estimate of Institutionalization Rates by Age, 2007 (%) Estimate of Institutionalization Rates by Age, 2007 (%)

27 Trends in Parent Support Ratio* ages 80+/ages 50-64*

Primary Caregivers of Disabled Elderly in Israel  Most are women (about 2/3)  Most are spouses or a child  Most live with elderly or in geographical proximity  Average age is mid-50's, however a significant proportion are 65+  Primary caregivers provide wide range of activities (e.g. personal care, homemaking, errands, emotional support)  Significant proportion report difficulties, feelings of burden and stress

Percentage of Caregivers Reporting Burden, by Level of Disability of Elderly in Care Level of Disability Total: 75% Total: 96%

The Effect of Caregiving on the Caregiver's Employment (in %)

31 Key Challenges  Dementia and depression – diagnosis and care  Supporting families (i.e. information, training and emotional support)  End of life care - is relatively at early stages of development  Prevention- more emphasis on health promotion and rehabilitation to prevent functional dependency or deterioration  The elderly as a resource