Expert’s opinion – excerpts from interviews with specialists in the field of services for the elderly (Nicoleta Palcu – Director of the Department for the Elderly at Caritas Blaj Association)

Anyone who has had a grandmother, a grandfather to care for can confirm that there is a need… Let’s be open to new models of care, to new strategies to cope financially with these changes.

Q: How would you rate services for the elderly in Romania?

A: Undersized and underfunded on the non-governmental sector side. I don’t know how professionalised. I had no experience of beneficiaries being included in state services. A bit unintegrated – still the mentality of socio-medical services goes in 2 totally different directions. For those of us working in home care this is the biggest off – double work in maintaining relationships with authorities and lots of paperwork. The NGO world has been hit hard by pandemics, budget cuts… We are not where we should be.

The palliative side is very underdeveloped. We have a big shortage of places in residential centres, there is no very clear differentiation by type of illness: you find patients with psychiatric problems, there are no centres for elderly people with neurological psychiatric deficiency (dementia).

There is no village where there are no elderly people who need support at home. Because of family history, people are reluctant to take someone into their home (especially those with relatives). They would appeal to that, in the later stages of the beneficiaries’ functioning. The early phases where the problems of lonely seniors are lack of socialization, interaction, reintegration into the community, getting out of the house – are seen as services that anyone could do. They are trivialised.

What is dignified ageing, support services for older people, in the true sense of the word? It is not only the bed-ridden who need home care, it might also be useful for a 65 year old with certain pathologies and isolated at home.

Thefunding part – considering the experience of more than 15 years is the first problem for NGOs, there is no uniform system and no obligation for public authorities to allocate a share of the annual budget for social services and to be broken down according to the real need in the community. I don’t want to get into conflict with children with disabilities, families with no income or Roma people. The only program that is constantly being fixed is the Act 34 subsidy. I don’t think those subsidized costs have changed in the last 10 years. I totally disagree with what is meant by subsidized services, 200 lei does not cover 2 hours of care.

Social and medical services – separation, on the medical component there is no program in Law 34, the only option is to contract services through health insurance houses – for 3 years we have not contracted because the budget is divided according to the number of employees and number of specialists you have within the service. We are becoming a beneficiary raider, I am fighting with the other 2 service providers to pick up the beneficiary at the hospital gate and take them to my service. The house provides funding for 3 months out of a year. During this time access to health care was almost non-existent.

We were not a very visible group, with punctual interventions, without being a real discussion partner. Interventions were made, senioriNET has been running for some time, but taken from these proposals the percentage was very low. There is a general great uncertainty in the relationship with the authorities.

Lack of specialist staff in rural areas where services are provided, migration of staff from the private/NGO sector to the public sector (nurses in hospitals, social workers in DGASPC, mayors) or carers abroad.

If we sit down to discuss development, strategies, what services should be like and what we dream of, we can discuss it long and hard but these are the biggest problems.

Q: Do you think there is a need for a network to serve NGOs working with the elderly in Romania? What do you think are the most important needs of NGOs in this field that could be addressed through SenioriNET?

A: If it takes a legal form, its members will be interested in the plans and objectives and results of the federation. From our initial experience, we came away with a positive impression, with information we received that helped us all, I think, and with interventions made on different topics in the social field.

If we manage to become a federation, if we show perseverance and seriousness in lobbying and advocacy, especially on the legislative component, and later on the component of law enforcement at the local level, I think we will have much to gain.

I want it to be a place where providers – I see it as a big support group in a way, once because pretty much all of us have been in a process of decimation and resisting on positions, a lot of the providers have closed their doors and I think it’s time for us to fall back, reposition ourselves, ally and call a spade a spade.

If we are going to start having interventions on what actions that touch on social services means there is no way we are not going to have a long term gain for all of us.

Q: What areas should SenioriNET focus on in the period 2022-2026, from the perspective of representing NGOs working with the elderly? What would be a priority from your perspective?

A: Needs assessment first – in very, not very, I think somewhere around 90% of localities we don’t have a needs assessment. We find as an organization that 20 people come in and ask for different types of services but most of the time the municipality doesn’t know. Until the social assistance law is properly implemented so that the LPAs identify and manage the needs we will not be able to justify an allocation of funds for the provision of services in a real way.

I believe that in the Moldova area they have done NGO studies with LPAs, but we can start from the needs of the providers. Then definitely monitoring and intervention on the legislative component, both on the social and medical component.

In order to become visible, credible, we must ally ourselves with structures and networks that have proven in one way or another their credibility and seriousness in the area of social services.

The more the merrier – more voices, more impact.

Q: From your experience with relevant coalitions and networks, what elements ensure their success/failure?

A: Failure – in my experience, even being part of a federation or community or network, interest fluctuates, when it’s a topic you are passionate about you get involved and take an interest, when it’s something you are not really interested in you let it go.

The important thing is permanent communication. From the smallest actions to the biggest goals. People want a lot of transparency nowadays. A good communication and a good planning of activities I think would lead to a greater involvement of members at the level of a federation.

Members need to be empowered. They need to know that they have joined a network to which they have to contribute. Accountability by assigning different tasks to each would contribute to greater success.

Q: What would you like to find in this network, from the perspective of the organization you represent?

A: Perhaps some training for staff/people who are part of member organisations on different areas. I find it very hard to talk to my subordinates about how to lobby and advocate to Mayor x to give them funding. Training in areas they are not really familiar with.

Information support – training, professionalisation of network members would make them more committed to be permanently and more involved in the smooth running of the big structure.

To find support on the legal component. I think that not many people can afford to have a legal adviser or a person who can answer their questions punctually. A support on this legal component, legality, legislation would be very useful.

I’d like it to be a place where we can advise each other, where we can complain to each other, where we can find solutions to problems that one or another of us is facing.

To find representation – to know that if I have a problem in a ministry I have a resource person there where I can ask a question, find an answer, set up a meeting and have a discussion partner at central authority level.

Maybe that wouldn’t be bad – exchange of experience, productive and interesting for our employees. I have noticed for a while that people are starting to get bored. Exchanges of experience of specialists working directly with beneficiaries – in the field, with day-to-day work.

Support in approaching authorities – there are larger and smaller providers who don’t have those inputs somewhere. A meeting with the chairman of the county council, e.g.

Q: If you were to get personally involved, what would motivate you to get involved in network activities? What would you do?

A: The smooth running of my services. The organisation is a partner in the project. It would help if I had access to people with information resources superior to my own. I would broaden my knowledge about the providers in the field, the services offered, how some and others manage to survive. I really enjoyed the SenioriNET period when we used to meet, we used to do joint campaigns, we used to try to intervene on different topics. I learned new things. To go beyond some preset thresholds, to get out of my comfort zone and to be more active and more present in the field of ensuring the sustainability of services, of analysis and intervention on the legislation side and also on the contracting side.

Anyone who has had a grandmother, a grandfather to care for can confirm that there is a need… Let’s be open to new models of care, to new strategies to cope financially with these changes.