The Graz Declaration on Disability and Ageing resulted from the June 8-9, 2006 conference on Ageing and Disability in Graz, Austria.
The GRAZ DECLARATION on DISABILITY and AGEING
Preamble
Throughout this declaration we use the term “ageing people with disabilities”. People with disabilities are a diverse group including people with physical, sensory, intellectual disabilities[1], developmental disabilities, people with mental health problems as well as with complex and multiple disabilities as outlined in the International Classification of Functioning, Disability and Health (ICF) (WHO, 2001). These disabilities may be life-long, or acquired during the ageing process. It is broadly recognised that many of the disabling conditions for people as described here are caused by society.
In constructing a European area of rights, participation and inclusion, special attention should be given to elderly citizens with disabilities in order that they may be enabled to enjoy a life of opportunities that are equal to those of other citizens.
The topic of ageing has been recognised as a top theme on the European agenda. European societies are characterised by a rising proportion of old and very old citizens. A continuing increase in life-expectancy is predicted for the decades to come along with a continuing reduction in birth rates in most of the European countries (described in the European Commission’s Green Paper “Confronting demographic change: a new solidarity between the generations”, (March 2005). We are in a society that is increasingly getting older but one that is unprepared to meet the needs and interests of this group of people, particularly those with disabilities.
Fundamentally, we believe that ageing is associated with the development and acquisition of experience, wisdom, competence and respect. These developments and values apply equally to ageing people with disabilities. Ageing can often, however, be associated with negative connotations, such as declining physical health and cognitive abilities, inactivity, poverty, social isolation and social dependency. Moreover, with respect to ageing, greater prominence should be given to concepts of healthy and active ageing. Promoting positive perspectives through active ageing strategies may result in an added value to the individual as well as to society. We also recognise that ageing people with disabilities are progressing towards the ends of their lives and that this may bring particular challenges in ensuring that they achieve this with dignity and respect.
Issues for consideration by governments are the financial costs of providing for old age: the increasing needs for social and health care, as well as the growing need for assistance and care for older ageing people with disabilities (compare the special report 1/2006 of the European Commission, Economic an Financial Affairs: “The impact of ageing on public expenditure (2004-2050)”). Thus ageing and disability will be the test for inclusiveness of European societies for the decades to come, with community living and independent living being key elements on that journey. Overall, it will be about the quality of people’s lives in the community and about appropriate support services required. The greater challenge is to be able to recognise and address the general and shared needs of all ageing people and those with disabilities at the same time as being able to emphasise and meet the very specific and varied needs of the individuals in these groups.
Within the group of older citizens in general, two groups can be identified that need special attention in terms of policy planning, systems of supports and rights - groups specifically addressed in the Graz Declaration.
Firstly, people with intellectual disabilities who now enjoy a similar life expectancy to the general population, are not considered in most of the programmes, strategies and statistics either on European or on national levels. Systems of support for citizens with intellectual disabilities are often poorly or not developed when dealing with the issue of ageing. There are consistently gaps in the legislations in the various member states with respect to emerging groups of disabled older citizens, such as people with intellectual disabilities.
Secondly, a significant proportion of older people experience dependency for the first time during the later stages of their life, often as a consequence of age-related loss in functional capacity. A substantial proportion of older people with functional dependency may need long-term nursing-type care during the final years of their lives.
Recognition must also be given for both these groups to the increasing number of ageing people with disabilities who are living in mutual dependency with elderly family members.
There may be differences between these two groups in terms of their needs and supports, as well as differences between them and the general elderly population, a background often neglected and now addressed in the Graz Declaration.
Furthermore, policies tend to be focused only on the issue of care, disregarding necessary policy reforms for developing mechanisms for participation and independence. Without legislation that will allow the removal of barriers in goods and services, a more inclusive labour market, with measures for accommodating the work environment and facilitating job retention, society will be unable to meet current challenges.
Finally, little is being done to support the emergence of a “silver economy”, reflecting both the economic pressure of old age related expenses and the potential economic contribution of older citizens.
As a society Europe is only at the beginning of a learning process about old age. The fundamental challenge is to make the shift from the “welfare state” to the “welfare society” through developing structures and regulations that allow people at all ages, whether they have a life-long disability or age-related dependency, to have equal opportunities for participation through inclusive policies and adequate support which are the main ingredients for a good life for older citizens with disabilities.
The delegates of the European conference on “Disability and Ageing – Ageing and Disability”, held in Graz, Austria, including various stakeholders from both the disability and ageing field:
· People with physical, sensory and intellectual disabilities,
· Older people,
· Family and professional carers,
· Service providers,
· Authorities,
· Politicians and policy makers,
· Academics and researchers
· Health professionals
a) promote a positive ageing concept in which ageing is seen as a performance and achievement on the individual as well as a societal level;
b) affirm that ageing people with disabilities are entitled to basic human rights and fundamental freedoms as proclaimed in the “Charter of the United Nations” (1948), and as embedded in many other international declarations and conventions;
c) recognise the importance of the principles and policy guidelines contained in the “United Nations Standard Rules on Equalization of Opportunities for Persons with Disabilities” (1993) as well as recognising the “UN Principles for Older Persons” (1991) promoting the principles of independence, participation, care, self-fulfilment and dignity “in order to add life to the years that have been added to life” (UN, 1992);
d) recognise further the diversity of persons with disability as well the diversity of older disabled persons;
e) refer to the “Treaty of Amsterdam” (1997), developing the concept of citizenship in the European Union and reinforcing the guarantee of non-discrimination (Article 13);
f) are mindful that according to the “EU Charter on Fundamental Rights” (2000) discrimination both on the grounds of age and disability is prohibited by Article 21 and thus is a violation of the inherent dignity of the human person, and are mindful of the right of elderly people and people with disabilities to benefit from measures designed to ensure their independence and to participate in the life of the community (Article 25 and 26);
g) re-affirm the principle of “nothing about us without us”; striving to ensure that policies and measures affecting disabled persons cannot be decided without their involvement and consultation.
1) Declare
a) that all ageing persons with disabilities are full citizens, entitled to exercise their rights on the basis of respect of their individual choices and their differences;
b) that a culture of autonomy, dignity, choice and respect should be promoted towards ageing people with disabilities;
c) that all ageing persons with disabilities have the same right as others to make decisions about their own lives;
d) that there should be a presumption of capacity to make decisions and choices;
e) that support may be required for those with limited capacity to express choices and decisions, to enable the individual to do so. It is essential that such support respects the will and preferences of the person and is free from undue influence;
f) that it is unacceptable that ageing persons with disabilities continue to face significant barriers in terms of activities and full participation in society;
g) that it is unacceptable that a significant number of ageing persons with disabilities live without dignity in inappropriate, restrictive, secluded, non person-centred accommodation settings, regardless of their will, preferences, requirements and rights;
h) that there are strong concerns about the high risk of multiple, aggravated forms of discrimination, such as social exclusion, marginalisation, poverty, neglect, violation and abuse for ageing people with disabilities;
i) that ageing people with disabilities have as equal a right as the general population to health promotion / disease prevention programmes and health care as well as to appropriate support systems, enabling better quality of life and thus facilitating active ageing and full participation in society;
j) that it is essential to respect human and civil rights in the day-to-day lives of ageing people with disabilities;
k) that home care and independent living measures should be promoted and segregating residential arrangements (e.g. institutions with no respect for options and choices) be replaced by community living in small groups, fostering social participation and citizenship, through adequate incentives and reform of social protection systems;
l) that elderly people, disabled people, and families should be involved in the definition of policies;
m) that professional as well as family carers should be consulted about their needs in the care of ageing people with disabilities;
n) that dialogue among all stakeholders (people with disabilities, families, providers, policy makers, researchers) be promoted by governments at all levels;
2) Agree
a) to promote a positive approach to, and empowerment of, ageing people with disabilities;
b) to defend human and civil rights of highly vulnerable ageing people with disabilities;
c) to strengthen social inclusion, integration and participation by promoting self-help and by respecting as well as supporting existing social, community and family networks;
d) to promote the needs of ageing people with disabilities within mainstream policy and strategy development, at the same time to promote the specific needs of this population within special parts of policy and strategy documents (twin-track approach);
e) to support a human rights and person-centred approach, recognising the individual needs, requirements, and preferences in the planning, development, funding and evaluation of national service provision;
f) to request the availability and affordability of community-based services and community living be developed in order to replace all kinds of segregating settings;
3. Recommend to
3.1. The European Commission
a) to produce, within a green paper, a framework for the development of standards of support and living conditions for ageing people with disabilities. The green paper should address topics such as living in the community, access to health and social care, the barriers to employment, design for all, e-inclusion, as well as ageing and dying with dignity;
b) to address this issue within the open method of coordination on social protection;
c) to develop comprehensive non-discrimination legislation in all areas of EU policy on the ground of disability and of age;
d) to address barriers in access to goods and services in the development of legislation in the internal market and transport;
3.2. The Member States
a) to develop supports for ageing people with disabilities that will ensure equal participation in the community, and to address affordability, accessibility, availability and adaptability of services, including health services (EU Charter on Fundamental Rights, Article 21, 25,26 and 35);
b) to take a human rights and person-centred approach to enabling ageing people with disabilities to live and participate in their community;
c) to gradually replace all kinds of segregating settings by community-based individual and small group living arrangements, and support for ageing people with disabilities living with their families;
d) to develop specific programs of health promotion / disease prevention for ageing people with disabilities;
e) to actively involve ageing people with disabilities and their families, in an outcome-based quality-management system of service provisions;
f) to develop existing and new, independent systems of advocacy, free of undue influence, to specifically address the individual needs of ageing people with disabilities who cannot advocate for themselves or have no natural informal social support network (e.g. family);
g) to be proactive in anticipating and developing specific support for ageing people with disabilities who live with ageing family carers;
h) to ensure that national legislation promotes and recognises supported information and decision making for ageing people with disabilities and to replace single- person substituted decision making and removal of legal capacity;
i) to adopt a stakeholder approach to involving people with disabilities, families, social service providers, policy planners and researchers in the definition of policies, and frameworks of provisions, services and supports;
j) to develop formal educational programs, training and information provision on ageing and disability issues (knowledge, attitudes and values), including a human rights and citizenship perspective for staff and other carers;
k) to recognise, encourage and reward informal social support arrangements through attractive frameworks;
l) to encourage and invest in both fundamental and applied research (holistic approach), including assistive technologies and new technologies on issues of age-related disabilities, as well as the ageing effects on people with disabilities, through public and private funding strategies;
3.3. Various social and civil actors
a) to develop existing or new social/civic structures to monitor and uphold the human rights and fundamental freedoms of ageing people with disabilities;
b) to promote collaboration between stakeholders both in the fields of disability and of ageing;
3.4. National and international organizations
a) to disseminate the principles of the Graz Declaration and to communicate their support of the present declaration to national and regional governments and bodies;
b) to communicate their support of the present declaration to the President of the Commission of the European Union.
______________________________________________________________
The GRAZ Declaration coalition:
European NGOs (in alphabetical order):
AGE: European older people’s platform www.age-platform.org
ARFIE: Association on research and training in Europe www.arfie.info
EASPD: European association of service providers for people with disabilities
www.easpd.org
EDF: European Disability Forum www.edf-feph.org
EURAG: European Federation of Older Persons www.eurag-europe.org
Inclusion Europe: The European association for persons with intellectual disability and their families www.inclusion-europe.org
Austrian NGOs (in alphabetical order):
Lebenshilfe Österreich www.lebenshilfe.at
Die Steirische Behindertenhilfe www.behindertenhilfe.or.at
Supportive correspondence will be transmitted through the GRAZ Declaration consortium via EASPD to the President of the Commission of the European Union.
Address:
EASPD
Av. d’Auderghem / Ouderghemlaan 63, B-1040 Brussels
Tel: +32/2/282 46 10, Fax: +32/2/230 72 33, e-mail: info@easpd.be
[1] Terminology: in the UK people with intellectual disabilities are commonly referred to as people with learning disabilities.
Siource:
http://www.ageing-and-disability.com/aad/index.php?seitenId=4