1. Healthy life expectancy at birth (male) 1. Japan, Sweden 2. Italy, Switzerland 3. Germany, Netherlands, Spain, Malta, Norway 4. France, Finland, Belgium, Austria, Denmark, UK, GR 5. Ireland 6. Slovenia, Cyprus, Portugal 7. Czech Republic 8. Slovakia, Bulgaria, Poland 9. Hungary 10. Romania 11. Estonia, Lithuania 12. Latvia 13. Belarus 14. Ukraine 15. Russia 72 71 70 69 68 67 66 63 62 61 59 58 57 55 53

2. Health State of Older People in Hungary  Chronically ill (male, female)  60-64 years1/3  75-84 years 40%  10% of the population have a disability, reduced capacity for work  at 65 male survival probable*59% (AT 79.7 %, CZ 72 %) Problems: males in danger HALE also for women only 68 y *Source:Kopp, Magatartástudomány 2003/11 1352

3. Care Problem Care demand not covered by formal care/help system  40% of municipalities unable to provide, problem of financing (mandatory service)  Demand for care is much greater than available services High care demand already in an early stage of life cycle Family help for older people has been important  short term care,  sickness, also for chronically ill  perform physical task,  financial help,  in kind help) Has not changed  longitudinal study 1986-2001;  majority of the elderly would ask family for help (Utasi, 2002, A bizalom hálója, 119) no change during 15 years.

4. Family Care Types in Hungary 1. Retired women 2. Economically active women + caring task 3. “Employed” family carer: nursing fee 4. Family tries hiring somebody  documented  undocumented work black work, migrants, Hungarian Caregiver: gender, age specific, women mainly the sandwich generation 50+

5. Type 1: retired women as Typical Earlier low exit of women  Retirement age of women 55 years (until 1998)  Early retirement from 50+  Exit still rather low (new channels of early ret.)

6. Inactivity rates of older persons 55-64 by sex and main reason for not being economically active, 2005 (Eurostat-LFS)

7. Inactivity Rate of Women (by age group) Pen. type50-54 55-59 60-64 Old age3.6 61.0 83.8 Disability22.114.45.0 Widows0.61.63.5 Unempl.3.60.80.2 Other ina.9.94.83.2 Empl. pen.1.46.03.2 Active58.811.41.1 Act. Male61.944.34.9

8. Changing trend: later exit from the labour market increasing Average age of new retirees YearMaleFemaleTogether 199558.854.656.1 200059.955.957.4 200160.057.659.2 200259.956.658.4 200359.658.459.2 200459.857.358.5 200559.957.758.6 200659.957.558.5 200759.757.758.6 http://jogalkotas.hu/drupal/files/ins_terv_090508.pdf

9. Problems Part time employment of women 55-59 y. low (11 %) Retirement age 62 years 65 years raising gradually,in 2010 born in 1952 62y. 183 days) De creasing family resources Deteriorating formal care structure for those living at home (restriction made recently)

10. Type 2: Economically active women + caring task Substantial care demand – need for long- term care Can act as substitute By giving up work  Possible consequence  Unemployment  Use up reserves Combined family efforts, sharing care tasks Pay someone else to provide care

11. Care type 3: nursing fee  Could make possible to give long term care at home  not functioning, few carers  not part of labour market, although counts to service periode, social benefit dominant, 60% of minimum wage;  not specifically eldercare

12. Care type 4: hire somebody Makes possible to provide long term care at home Strategies of family hire Documented from the labour market expensive, not possible for the majority of families Undocumented  Hungarians  migrants

13. Type 4: undocumented migrant carers  Characteristics  From neighbouring countries almost exclusively Hungarians 1. Greatest number from RO, Hungarian minorities 2. UKR, Hungarian minorities  Remark: Hungarians living in RO (Transylvania) or migrating to HU are called „Transylvanians”

14. Invisible migrants, ongoing research on migrant elder- carers  Methodology:  informal, snowball,  Age of carers:  majority older, retired women (retirement age in Romania was also low) Research financed by OTKA (K76236)

15. Reasons why „employers” hire migrants  Family member has to work (decision is to keep job)  Family member lives far away  Family member has to care somebody else (child, etc.)  It is impossible to carry out a task which needs long term care

16. Care types given by migrants in the survey Characteristics:  Living in with the older person/older couple  Tasks: complex  General care  In some cases nursing is needed (cancer, the caregiver was a nurse?)  household, cooking,  entertainment (reading, talking)  partial help-care  older person able to care for self but does not wish to be alone for security reason  Free time of carers: limited  Payment:  full board  in net more than the earnings in a public long-term institution, much less than a private documented carer  other costs as well: visa, etc ( migrants from Ukraine).

17. Problem of sharing care among family members in the future  Decreasing marriage (1970: 9.3 per thousand, 2007: 4.1)  Increasing number of singles  Increasing high divorce rate (marriages per thousand in 2000: 498.6, in 2007: 610.3)  Increasingly late marriage  changing family structure (one parent family, etc.)  Decreasing fertility rate 1.34 in 2008 Possibility of having no or only one child,  Less family resources (less children)

18. Time spent as carer Less than 1 year 1 year 3 years 6 years or more  Some reasons for giving up care of elderly: 1. older person dies, 2. for some reason has to look always for new older people; 3. her own health is deteriorating, tired, getting older 4. other task, reasons

19. How carers manage to give „living in” care  1 carer, no replacement  1 carer with alternating occasional replacement  carers with regular replacement (e.g. every 30 days/Ukraine)

20. Who are the carers by occupational activity ?  Mainly  retired,  unemployed  „houswife”  Coming mainly from rural settlements Original qualification: semi-skilled, skilled

21. General problems of giving long-term care at home by migrants New trend of invisible migration - decreasing number, new target countries Who can substitute for them? Probably Hungarian from Ukraine Difficulties, visa regulations Lack of suitable home environment Lack of suitable technology Decrease of family resources Lack of suitable services to keep the elderly in their own apartment/house Negative changes in regulation – having impact not only on public formal care but also on NGO actors

22. How can be helped to hinder institutional long-term care By using high technology Develop new technology to answer older people’s need Changing environment –obstacle-free environment

23. questions Consequences of migrants in sending and received country Ageing and declining societies Financial contribution of families to long term care Care gap not estimated by state

24. Solutions include increase part time work, increase number of service providers, incorporate family care into pension system (flexible pension age, bonus for family carers, etc.) improve state of health (prevention, rehabilitation, etc.) improve health protection at work new forms of care high tech in care used at home and long-term care institutions improve quality of present services involve more NGOs into care explore the supply offered by undocumented migrants in eldercare and find substitution find new forms of long-term care facilities suitable environment

25. Solution Must be a complex policy covering pension scheme, labour market-employment policy, health system, social policy.