20563_opinnaytetyon_asettelumalli Oikea Versio! Essay Cultural Perspestives Paper Oikea Versio

8/2/2019 20563_opinnaytetyon_asettelumalli Oikea Versio! Essay Cultural Perspestives Paper Oikea Versio

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Aku Forsman

Anna-Sofia Waltari

Jennika Ruohonen

Sanna Airio

HEALTH OF THE ELDERLY PEOPLE IN FINLAND

Bachelors Degree of Health Care

2012


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1 INTRODUCTION

This essay will describe the health and well-being of elderly people in Finland. First

we will look at some terms that are commonly used to describe the concept of healthand understand the different health determinants. The elderly people in Finland share

some common factors in their healthiness but there is great variation between indi-

viduals. Physical heritage, environment, personal choices and coincidence are known

to be very important throughout life.

We consider how the society tries to promote the healthiness of the elderly people in

Finland. We also look at some ways how diseases are prevented in this age group.We will tell you about some medical conditions that elderly people suffer from in

Finland. The essay includes goals and strategies for improving the health of the sen-

ior population. At the end of this essay we will introduce some everyday ways to

promote the health of the elderly people.

Making a diagnosis for an older person is often difficult. Symptoms may change rap-

idly and the information received from the patient or family is not always accurate.Many people between ages 75 and 85 have two or three separate diseases. Speech,

vision or hearing may be poor after a stroke or an operation. Overall well-being or

state of mind has an effect on the information given to the medical staff. You can still

sometimes hear older people in Finland claim that they were perfectly healthy until

they visited the doctors office, even if the doctor has come close to saving a life.

(Aejmelaeus, Kan, Katajisto & Pohjola 2007)

The regional differences in life expectancy are mainly caused by cardiovascular dis-

eases, alcohol, accidents and violence. Socio-economic mortality differences can be

explained by violent deaths, heavy use of alcohol, circulatory and respiratory diseas-

es. Lifestyles, the use of health services, living and working environment and even

marital status can make a persons health better or worse. (Health in Finland 2006)


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2 EXPLANATIONS OF THE TERMS

2.1 HEALTH

Health as the term is many-sided and the explanations vary very meaningfully

between the different cultures. There are very much different explanations for the

term and the only one is not going to be the best one. Health as a term can

be explained on many ways depending on the origin. WHO (World health organiza-

tion) claims that health is not only the lack of symptoms and diseases but also perfect

social, physical and mental health. Some problems can be found out because the

claim is utopian and its impossible to earn never.

FUNCTIONAL term examines the health functionally: human is healthy when he

survives from the normal every day routines.

SUBJECTIVELY human can feel him healthy although he suffers from some ill-

nesses or diseases like cancer. Humans attitude towards life is the best indicator

when finding out humans healthiness.

MEDICAL explanation describes health to be good or even excellent when nothing

symptoms, illnesses or diseases have been diagnosed by a doctor.

SCIENTIFIC explanations highlight health as the vital strength which helps human

to solve the problems and encourages meet them without fear.

RAATIKAINEN, STEDT-KURKI ERIKSSON AND HERBERTS tell that health

is the meaning of life and important for the humans well-being. This shows the mul-

tidimensionality of health: the gratification of the physical need, social relationships,

working order and the experienced good feeling are the combinations of health.

(stedt-Kurki 1992, Eriksson & Herberts 1992, DeMeester et al. 1994, Hggman-

Laitila 1999).

2.2 WELL-BEING

Every person has personal possibilities and abilities to feel him well-being. Accord-

ing to scientific resources the most important thing for persons we ll-being is per-

sons own acceptance and this kind of way to feel him enough good. These feelings

and thoughts impact straightly persons zest for life and are included in the develop-


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ment of personal qualities. Eric Allardt describes this term with the words having

(You have something around you), loving (You have somebody to love) and being

(You feel yourself happy and lucky). High feeling of coherence (SOC by Aaron

Antonovsky) helps person to solve the hardships and problems better than them who

dont have as good abilities to solve them. Some sources claim that the people who

think positively about life will live even ten times longer compared with the others

whose attitudes towards life are negative. The scientific resources explain this kind

of resources with positive peoples good ability to organize time between family-life,

work-time and free- time. They can concentrate on one thing at one moment but they

have possibilities to do many times at the same time if needed. Lucky people have

aims and dreams which they can dream on. The most important thing, they think that

they have aim at reach them some day. People who flourish are very much connect-

ing with their family, friends and society where they live. They know the meaning of

life: they have reasons to wake up every morning. (Fredrickson, 2009, 17, translator

A. M.)

2.3 REHABILITATION

Rehabilitation is a process which you may need after a serious injury, illness or sur-

gery. You may recover slowly. Your speed of rehabilitation depends on your need to

regain your strength, relearn skills or find new ways of doing things you did before.

Rehabilitation often focuses on physical therapy to help your strength, mobility and

fitness, occupational therapy to help you with your daily activities, speech-language

therapy to help with speaking, understanding, reading, writing and swallowing and

treatment of pain. The type of therapy and goals of therapy may be different for dif-

ferent people. For example an older person who has had a stroke may simply want

rehabilitation to be able to dress or bathe without help so he needs help with the

normal every day routines. The goal of rehabilitation is to assist an ill person, physi-

cally challenged or bad working orders well-being, initiative, employment, co-

operation and personal survival (Ministry of social affairs and health 2012).

Rehabilitation of people with disabilities is a process aimed at enabling them to

reach and maintain their optimal physical, sensory, intellectual, psychological and

social functional levels. Rehabilitation provides disabled people with the tools they


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need to attain independence and self-determination. (web pages of WHO, citation

26th March 2012).

2.4 HEALTH AND ENVIRONMENT

The connection of health and environment is clear. Environment impacts health ei-

ther positively or negatively. Many other things like physical heritage or genes, per-

sons ways to live and happenstance impact at the same time humans healthiness.

Persons own choices and his health behavior are only one part of the whole comb i-

nation but their significance is certain. Environmental health includes those views

about humans health and disease which are impacted by environment factors. Itmeans too that theory and those operations by can be established and controlled the

impressive factors of health. (Ympristterveystoimikunta 1997, 13). Many scientific

resources have been made about environment health. According to surveys environ-

ment impacts very meaningfully humans health. For example this kind of infor-

mation we can notice if we start to find out the disaster of Tsernobyl in 1986. People

living at that site of accident in Ukrainian have suffered very much from environ-

mental poisons, pollution and high radiation enlarging the risk to get a cancer etcetera. We have an one confident evidence why its important to live in healthy area

in the world.

2.5 HEALTH PROMOTION FOR ELDERLY PEOPLE

Active Ageing relates to many aspects of the ageing experience health care, life-

style, social involvement, productivity and active engagement. The World HealthOrganization adopted the term in the late 1990s. Older people sometimes face chal-

lenges in trying to remain active and healthy. The most important thing is to sustain

elderly peoples working order avoiding as much as possible succumbing to hospi-

tals. Someday ageing person will need more intensive care and in this case its very

important that nurses will utilize elderly persons own capacity to make every day

routines.

Salutogenesis concentrates on humans positive sides. The term describes an ap-proach focusing on factors that support human health and well-being, rather than on


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factors that cause disease. More specifically, the "salutogenic model" is concerned

with the relationship between health, stress and coping.

PREVENTION

Primary prevention is the first step to preventive diseases and illnesses before noth-

ing has been appeared and person is healthy. The most important is to understand and

know the risks of different illnesses and diseases. For example you should know how

you can avoid different symptoms and health problems by eating and exercising right

for example.

Secondary prevention means the eliminating of the noticed or diagnosed health

problems avoiding the worse health treats. For example the patient or customer can

have very high blood pressure. He tries to decrease it by eating healthier and exercis-

ing more and having less stress. These kinds of ways he can diminish the risk for

blood pressure disease.

Tertiary prevention is linked with the ill and sick patients whose have gotten ill al-

ready. Their sufferings and diseases are going to ease or even better as well as possi-

ble. In these cases extra symptoms and their getting worse are going to be prevented

and the possibility of extra diseases are eliminated by caring the patient and monitor-

ing the patients condition. Rehabilitation is too tertiary prevention.

3 HEALTHINESS OF THE ELDERLY PEOPLE IN FINLAND

3.1 Social health inequalities between different socioeconomic groups among the

elderly people

The health of the retired population is challenged by two things; ageing as a normal

process and different diseases that require medication, health care and additional at-

tention. Retirement in Finland is possible between ages 63 and 68, variation may de-

pend on line of work, personal health or personal preference. Part-time retirement is

also an option if the set conditions are met. (Aejmelaeus, Kan, Katajisto & Pohjola

2007). WHO estimates that Finnish males born in 2007 will be healthy and able to

function until the age of 69 and women until the age of 74. The average life expec-tancy for Finnish males born in 2010 is 76.7 years and for females 83.2 years. In


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2010 about 17.5 per cent of the Finnish population was aged 65 or over, the figure is

estimated to rise to 23 per cent in 2020 and to 26 per cent in 2030.

(www.terveyskirjasto.fi). The age group 65 and over comes close to 980 000 people

in 2011. The dependency ratio in Finland is 51.6 per cent. The total fertility rate is

1.7 children per woman, about the same number as in the other Nordic countries.

(www.stat.fi).

The next article is going to be described health inequalities between different socio-

economic groups. The healthiness has gotten better very much during the latest 25

years but the health gap has increased clearly at the same time. According to statis-

tics the lower socioeconomic groups suffer many times often from different long-

term diseases compared with the higher socioeconomic groups. This kind of devel-

opment can be observed too when clarifying the retired peoples dietary behaviors:

smoking and binge drinking are more common among those with lower income. In

fact the higher socioeconomic classes follow over ten times more dietary recommen-

dations compared with the lower social groups.

There are huge socioeconomic differences in the use of health services that dont ful-

ly correspond to the estimated need for care. It seems to be so that people suffering

from the lack of money dont go to municipal health centerif needed. Elderly people

with higher income use more occupational services and private practice services and

their need to get medical help especially in more serious illnesses seems to be lesser

than those with lower income. The quality of the health care has varied meaningfully

between different socioeconomic groups. For example medical operations especially

surgery operations have been done much more for the elderly patients with higher

income in the private health care system.

Reducing health inequalities will not be easy because of the lack of time and re-

sources. The most difficult question is: How to get all socioeconomic groups are in-

terested in changing their bad health behaviors? Many projects and programs have

been developed and the aims are going to be fulfilled some year but it will require

time. (Palosuo, Koskinen & Lahelma 2007, 7)


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3.2 The most common diseases among the elderly people in Finland

Various indicators show that the health of the Finnish population has improved

among the elderly people but socioeconomic health inequalities have generally re-

mained or even widened. It appears increasingly difficult to reach the Health 2015

Public Health Programmed goals for reducing differences in mortality by a fifth by

2015. Long-term illnesses are about 50 per cent more common among the lowest ed-

ucational and other socioeconomic groups than in the highest groups. These differ-

ences have increased among those aged 65 or over. (Palosuo, Koskinen & Lahelma

2007, 7)

Older people between ages 75 and 85 require up to three times as much medical at-

tention and help than people in the younger age groups. There is an increase in inju-

ries caused by falling down or tripping, circulatory disorders become more common

and many people suffer from osteoarthritis. Muscles and bones weaken due to lack of

exercise and poor intake of food and drink. Infectious diseases are caught easily and

recovery slows down. Relationships literally die or diminish and people rely more

and more on hired help to assist with everyday functions. Prevention and effective

treatment of diseases is seen as an excellent possibility to make life easier and more

fulfilling for people in this age group. (Aejmelaeus, Kan, Katajisto & Pohjola 2007)

3.2.1Cardiovascular diseases

Predominance of cardiovascular diseases is very much more common among those

with the lower education than among the well-educated retired. Nowadays 20 per

cent of over 65-aged lower-educated men suffer from cardiovascular diseases and

only 13 % of well-educated men have some cardiovascular disease. This difference is

statistically meaningful. Elderly women have not as meaningful differences as men

because the predominance of the cardiovascular diseases is more impartial. Both so-

cial groups have 10 % cardiovascular illnesses. Although the mortality caused by

coronary heart disease has fast decreased, the appearance of heart attacks has in-

creased meaningfully in the end of twenties. Becoming common of the heart attacks


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must be caused by the recuperated intensive care. The lower educational groups have

more risk factors like obesity, diabetes and worse dietary behaviors than the higher

educated retired population.

3.2.2Memory illnesses

Memory illnesses are very common in Finland. They are one of the most expensive

diseases because of the huge care costs and the long-term cognitive illness. The ca-

pacity of memory worsens in the cycle of normal ageing but when worsening dis-

turbs a normal life the elderly person should be worried about it. Memory illnesses

cant be healed and they are getting worse all the time. The most common memoryillnesses are dementia and Alzheimers disease. Symptoms of dementia can be cate-

gorized into two groupscurable and incurable. Generally these symptoms become

more complex due to the onset of other issues like delusions, delirium, depression

and other mental dysfunctions. There are almost 90 000 over 65-year-old patients

suffering from dementia and the amount of the patients will be over 100 000 in 2015.

(The webpages of Duodecim 2012)

People suffering from dementia have evidently Alzheimers disease in 80 per centcases. About 20 per cent of over 80-year-old retired have Alzheimers disease.

3.2.3Urine problems

Its is estimated that over 50 per cent of the elderly people suffer from urine prob-

lems. There are many kinds of levels and they vary very meaningfully depending on

the other illnesses at the same time. Pain and difficulty with urination are commonconditions in both men and women. But urination problems may be a sign of more

serious problems. The most common urine problems are urine infections and

The most common causes of urinary symptoms are drinking too much or too little,

urinary tract infections, passing of kidney stones, changes in urine color, and prob-

lems controlling urination. Urinary symptoms can happen to anyone. Rarely, urinary

symptoms can be due to serious causes, such as cancers of the urinary tract. (The

webpages of Better medicine from health grades 2012).


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3.2.4Fractures

Elderly people suffer more common from the fractures compared with the younger

population. Because of this fact the prevention of fractures is very importantthroughout the whole life. The most important thing is to identify the risk factors of

the broken bones and to avoid the situations in which the older population is the most

vulnerable to get broken bones. The costs of these kinds of injuries are very huge es-

pecially as incidence increases with age, and the population of elderly people is

growing. Especially the retired women suffering from osteoporosis are more vulner-

able to fractures than the coeval men. Of the fracture costs, 88 per cent are due to

fractures in women. (Web pages of Duodecim, 2012)

3.2.5Musculoskeletal diseases

15 per cent of the population aged 65 or over suffer from osteoarthritis of the hip. 15

per cent of the male population aged 65 or over suffers from osteoarthritis of the

knee. One fifth of the women in age group 6574 and one third of the women aged

75 or over are affected by osteoarthritis of the knee. The main reasons for hip and

knee arthritis are obesity, accidents and physical stress in the workplace. In the early2000s, 16 per cent of the retired population was diagnosed with chronic back syn-

drome. There has been a decrease in musculoskeletal diseases of the whole popula-

tion in Finland, but it will remain an important issue in public health care because of

the change in age structure. Treatment and rehabilitation are needed to improve func-

tional capacity, as well as emphasis on general health promotion and physical activi-

ty throughout life. (Health in Finland 2006)

3.2.6 Diabetes

About 150 000 people in Finland suffer from type 2 diabetes and 70 per cent of these

people are over the age of 65. Activity and exercise often become less frequent and

irregular and this causes a raise in blood sugar levels. Muscle tissue is gradually re-

placed by fat tissue and muscle cells do not use sugar in the same way anymore. Dia-

betics stand at a greater risk for depression and many arterial diseases. Up until theage of 80, type 2 diabetes is generally treated with a regular healthy diet and exer-


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cise. If blood sugar levels continue to rise, tablet medication or insulin injections are

necessary. (Aejmelaeus, Kan, Katajisto & Pohjola 2007)

3.2.7Chronic Obstructive Pulmonary Disease

About 200 000 people suffer from Chronic Obstructive Pulmonary Disease (COPD)

in Finland and it causes 1 000 deaths every year. Another 200 000 are estimated to

have chronic bronchitis, a preliminary stage of COPD. Smoking is the main cause of

COPD, but it may also be a hereditary disease or caused by an unhealthy working

environment. Farmers smoke less than the average population, but chronic bronchitis

is three times more common among them. COPD causes three times more deathsamong men than women, which is mostly due to smoking, but the number of deaths

among women is increasing. COPD cannot be cured, medication can be used to re-

lieve symptoms and possibly slow down the progression of the disease. It is estimat-

ed that 15 to 20 per cent of the smoking population will suffer from COPD, quitting

smoking even at later age is strongly recommended. Around the year 2000 treatment

of chronic bronchitis cost the Finnish taxpayers 250 million euro, most of the costs

are caused by hospitalized patients. (National Institute for Health and Welfarewebpages 2012)

3.2.8Mental illnesses

It is estimated that 16 to 30 per cent of people over the age 65 suffer from some sort

of disturbance of the mind. Symptoms may vary and psychological needs are not al-

ways recognized. There are too few psychologists working with the elderly in gen-eral health care and medication is often the only available treatment. Schizophrenia,

psychosis, delusions, personality disorders, depression and anxiety disorders are

common among older people. Schizophrenics are more likely to smoke and drink and

have unhealthy eating habits, they may have poor hearing or vision and do not bother

with dental care. Care plans focus on relieving symptoms with medication and avoid-

ing difficult situations by building up a strong social network and a long-term rela-

tionship with the nursing staff. (Aejmelaeus, Kan, Katajisto & Pohjola, 2007).


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Depression is seen as the most common psychological condition among the retired

population, especially after the age of 75. Often the patient suffers from tiredness,

physical symptoms, memory loss, unclear thinking, delusions and suspiciousness.

The person may be irritable, hostile, confused and refuse to eat or drink. (Aejmelae-

us, Kan, Katajisto & Pohjola, 2007). In the age group 65 and over 175 people com-

mitted suicide in 2007. People with a suicide in the family, widows, people who suf-

fer from alcohol abuse, physical pains, depression or prolonged pains have a higher

suicide risk. Deterioration of cognitive skills and depression are not a favorable com-

bination. In Finland suicide is committed by hanging, drowning or taking an over-

dose of medicine. (Punkari 2009, 14)

3.2.9Cancer

One in four of the Finnish population will have cancer at some point in their life. In

2004 there were 26 000 cancer cases. Cancer is the second largest cause of death in

Finland, about 10 000 people die because of cancer every year. It is estimated that 75

to 90 per cent of all cancer cases in industrial countries are caused by environmental

factors and ways of life. Breast cancer, prostatic cancer and cancer of the large intes-tine tend to run in the family. All in all, genes account for only about ten per cent of

all cancer cases, though the number varies with different types of cancer. (National

Institute for Health and Welfare webpages 2012) There is an increase in cancer cases

among those aged 80 or over, in 1981 there were 3 000 cancer patients aged 80 or

over in Finland, in 2008 the number is 13 000. Age in itself does not rule out cancer

treatment. Problems arise because older patients often have existing medical condi-

tions in addition to cancer or they are on heavy medication already. Misunderstand-

ings are quite common; older people may believe they are not being treated properly

or in the best possible manner only because they are too old. The most common

types of cancer are breast cancer, prostatic cancer, skin cancer and cancer of the in-

testines. (Web pages of Cancer Society of Finland 2012)


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4 HOW SOCIETY TRIES TO PROMOTE ELDERLY PEOPLES

HEALTH IN FINLAND

4.1 The Ministry of Social Affairs and Health

The Ministry of Social Affairs and Health has overall guidance and supervision re-

sponsibility for health promotion of people in Finland (Webpages of Ministry of So-

cial affairs and Health 2012). Activities are based on Well-being 2015 lines as well

as the Health 2015 program. Operations will be directed to reducing the risk factorsof national diseases, prevention of accidents and creating circumstances that support

and promote health of population. The Ministry of Social Affairs and Health is pre-

pared for the danger of contagious diseases. (Ministry of Social affairs and Health

2006, 9) There is good experience on prevention of contagious diseases in Finland.

Vaccination program and the good hygiene of hands are the important ways of pre-

vention. (Ministry of Social affairs and Health 2012)

Health promotion of people is based on the Primary Health Care Act and it is part of

the public health work. Primary Health Care Act and also important law called

Health Care Act gives instructions how municipalities implement health promotion.

Communicable Diseases Act and Tobacco Act give some instructions about health

promotion too. (Ministry of Social affairs and Health 2012)

The Ministry of Social Affairs and Health actions have influence on health-

promoting life-styles of elderly people and the cleanliness of living environment, se-

curity and accessibility. Accidents are the major public health problem and that's

why prevention of accidents is very important. (Ministry of Social affairs and Health

2012) Its very dangerous for elderly people if they fa ll into accident (for example if

they fall down) because they are most likely in poorer condition than younger peo-

ple, and thats why they receive more severe injuries. Also the treatment costs a lot to

society so prevention is much cheaper option. Elderly safe physical activity is one

important way to prevent the falls. Healthy and well-balanced diet (which contains


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protein, essential minerals and vitamins) is great way to prevent the accidents and

injuries caused by accidents. Also the ability to maintain, accessible environment,

access to public transport service promote an elderly person's participation in society,

allow for daily physical activity and social life. These are the key issues of an elderly

well-being and quality of life. (Mankkinen 2011, 16-17, 31, 32)

4.2 The targets and strategies of the Ministry of Social Affairs and Health

Elderly people's average life expectancy has increased considerably in the last few

decades, especially in the case of those over 80. 69 to 75-year-olds overall functional

capacity has improved and though long-term illnesses are common, nearly all peoplein this age group still live in their own homes. (Government resolution on the

2001, 25)

The Ministry of Social Affairs and Health have following targets for the elder peo-

ple, which should be achieved by 2015. Health difference gap between population

groups have narrowed, elderly people's ability to function and social wellbeing have

improved, people have longer careers in their jobs (about 3 years longer), health andwelfare promoting have become established in social policy and availability of ser-

vices for the elderly, effectiveness and quality has improved. (Ministry of Social af-

fairs and Health 2006, 7)

There is a huge and important challenge to reduce the great health disparities be-

tween different socio-economic groups. Low social standing and social exclusion are

linked with higher morbidity and reduced functional capacity earlier in life among

ageing people, too. Preconditions for promoting the health of elderly people and for

reducing health differences should also be created by reducing attitudes and preju-

dices contributing to age discrimination. (Government resolution on the 2001, 25-

26)

One of the main strategies of The Ministry of Social Affairs and Health is to promote

elderly peoples health and ability to work by finding new ways to support elderly

peoples ability being self-contained (Ministry of Social affairs and Health 2006, 8).


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It's very important to increase satisfactory early balanced, preventative and rehabili-

tative action. Self-organized physical activity and physical rehabilitation play im-

portant roles. It is an important thing to guide an elderly person to eat wholesome

food, because eating healthy food improves health. Another important thing is to

make sure that social networks are alive. Activity must be organized in elderly per-

son's home or neighborhood. Elderly people must have been motivated and support-

ed to take responsibility to maintain health and ability to function. (Ministry of So-

cial affairs and Health 2006, 10)

Accessibility, functionality and safety in the elderly people's homes and neighbor-

hood must be arranged, because those support elderly person's independent initiative

when ability to function deteriorated (Ministry of Social affairs and Health 2006, 10).

A healthy environment has great importance for public health (Ministry of Social

affairs and Health 2006, 8).

The Ministry of Social Affairs wants to ensure functional services and reasonable

living for elderly people (Ministry of Social affairs and Health 2006, 18). The availa-

bility and quality of services for the elderly people are ensured by increasing more

resources for the services when the number of elderly people will increase. Attention

is focused on services those are given in home and neighborhoods. Treatment ser-

vices and rehabilitation services must be timely and practical. The starting points for

the services are elderly person's ability to function, own resources and the closest so-

cial network. Elderly people's services are organized in their mother language. Ser-

vices will use a systematic preventive and rehabilitative approach to work. Treat-

ments that are offered in services are customer-oriented, activating and multiprofes-

sional, in order to give best care for elderly that is possible. Elderly people are givenchoices to organizing and financing home help service and nursing service. (Ministry

of Social affairs and Health 2006, 19) The most important thing is that elderly people

will receive services they need that they can continue living in their own homes as

long as possible.

Social welfare and health care have formed functional concept. Important parts of the

concept is adding supply for home help services, supporting elderly people's coping


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as long as possible in their own apartments and arrange smooth transition from inten-

sive services, when that is necessary. (Ministry of Social affairs and Health 2006, 19)

Elderly people's need for care and attention grows particularly rapidly after the age of

85, when they also tend to need various long-term care services (Government resolu-

tion on the 2001, 25.) It's must cheaper for the society to promote elderly people's

health, functional capacity, independent functions and living in their own apartments

than pay enormous number of money when elderly people can't live in their homes

anymore. It's very important to have rehabilitative approach to work when treating

elderly person in long-term care services, because that promotes remaining ability to

function.

The Ministry of Social Affairs tries to add attraction of working life because time to

retirement moves forward, between the ages 64-70, due to the aging of population

(Ministry of Social affairs and Health 2006, 13). Due to the overall functional capaci-

ty of 60 to 75-year-olds has improved, people can make longer career in work (Gov-

ernment resolution on the 2001, 25). Challenges for the future include keeping

workforce able to work and wanting to work, as long as possible. (Ministry of Social

affairs and Health 2006, 42)

4.3 Health 2015- public health program

Health 2015 is the long-term health policy program of health promotion, which target

is adding healthy and functional years of people's life and reducing health-disparities

between different population groups. Implementation of the program is based on

health in all policies so it try to promote health and wellbeing in public health and in

all other fields in society. A number of different actors (including municipalities,

economic life and organizations) are parties in this program. The program is based

on the World Health Organization's Health for All programs. (Ministry of Social af-

fairs and Health 2012)

The Government gives emphasis to the following lines of action:

11. Ageing people must be ensured opportunities for functioning actively in society,

for developing their knowledge and skills, and the ability to care for themselves, and


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for continuing to live an independent quality life with an adequate income for as long

as possible.

12. Residential, local service and transport environments must be developed for age-

ing population groups that will safeguard the conditions for an independent life even

when their capabilities deteriorate. Local authorities should work for these targets

through an old age strategy incorporated into the municipal plan, as part of their

well-fare programs, in traffic planning, and in developing and adding to housing are-

as.

13. A program of services for old people should be worked out with the municipali-

ties, aimed at developing care services needed in daily life and long-term care, incor-

porating informal care, voluntary work, commercial services and government action,

and utilizing modern technology. (Government resolution on the 2001, 26)

4.4 KASTE program- health promotion in municipalities

Kaste-program is the National Development Plan for Health Care and Social Welfare

and it is a strategic steering tool that is used to reform and manage health and social

policy (National Development Program 2012).

The targets of the Kaste-program are that inequalities in health and wellbeing will be

reduced and health care and social welfare structures and services will be organized

in a client-oriented way. Improved services for older people is one of the six sub-

programs achieving the targets. (National Development Programme 2012)

The Government Program and the Strategy of the Ministry of Social Affairs and

Health will be implemented in the Kaste-program. The program defines the key

health and social policy targets. The program has been prepared at national level.

(National Development Program 2012)


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4.5 Health Care Act

The objective of this Act is to promote and maintain the populations health and

welfare, work ability and functional capacity, and social security; reduce health ine-

qualities between different population groups; ensure universal access to the services

required by the population and improve quality and patient safety; promote client-

orientation in the provision of health care services; and improve the operating condi-

tions of primary health care and strengthen cooperation between health care provid-

ers, between local authority departments, and with other parties in health and welfare

promotion and the provision of social services and health care. (Health Care Act

1326/2010, 2 )

Availability of services and universal access are told in Section 10. Local municipali-

ty should arrange health care services near people, and that helps elderly people to

receive health care services easier. (Terveydenhuoltolaki 1326/2010, 10 )

Chapter 2 provides guidelines on health promotion. Section 20 relates to counseling

for older persons. Municipalities must provide counseling services that promotes

health, welfare and ability to function for elderly people who receive old-age pen-

sion. (Terveydenhuoltolaki 1326/2010, 20 )

4.6 Senior Citizens Services Act (in progress)

In the near future the new law comes into force called Senior Citizen Services Act.

The act will safeguard that elderly will receive Social and Health Services so they

can live in their own homes. Senior Citizens Services Act would guarantee a service

plan, responsible nurse and right to get help at home and daily activities outside

home (Ministry of Social affairs and Health 2006)

4.7 Everyday life of the Finnish elderly

The National Institute for Health and Welfare in Finland has carried out a survey

every other year since the year 1993 about the health and health behavior among the


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Finnish elderly in the age group 65 to 84 years. In addition to health and health be-

havior, the survey studies functional abilities, the use of aids and domestic services

and feelings of insecurity among the retired population in Finland. In 2009 more than

half of these people lived in city areas and almost half of them felt healthy or quite

healthy. (Health Behavior and Health among the Finnish Elderly, spring 2009).

Almost 50 per cent of the people had higher blood pressure than recommended and

about half of the respondents were on medication for both high blood pressure and

above-average cholesterol levels. In 2009 17 per cent of the men and 23 per cent of

the women were overweight (BMI 30 or above). Butter is used less frequently and

skimmed milk is chosen more often. Almost one third of the respondents eat vegeta-

bles, fruits and berries every day. Dental care has improved and smoking has de-

creased in the age group 70 and above, a slight increase was noted in the age group

65 to 69 years. Alcohol intake has increased since 1993, except in the age group 80

to 84 years. The elderly population was mostly concerned about becoming dependent

on other people, sufficient retirement pay and memory loss. (Health Behavior and

Health among the Finnish Elderly, spring 2009).

The health and well-being of an elderly person reflects the life he or she has lived.

Suitable housing for the elderly, focusing on both physical and mental health of the

socio-economic group with the lowest income, encouraging exercise, preventing in-

juries and promoting a healthy diet with reduced smoking and alcohol intake are

some ways in which the Finnish society tries improve the health of the elderly. Par-

ticipating in sports, traveling and many other leisure activities are offered to retired

people at lower prices or free of charge. Promoting a healthier lifestyle, preventing

and treating chronic illnesses and encouraging independent initiative even in the lateryears of life is still worthwhile and rewarding. (Terveyskirjaston www-sivut 2012)


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LHTEET

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