The city of Ostend has an elderly population. 36% of the inhabitants are older than 60. How can we promote the participation of the elderly in local policies? An elderly needs assessment was developed to explore the needs of these increasing elderly group.
1. Situation
1.1. BACKGROUND
On 21 April 2004, the Flemish Parliament passed a decree concerning ‘the stimulation of an inclusive Flemish policy on ageing and policy participation of the elderly’. The name ‘participation decree’ derives from the aim of this decree to promote the participation of the elderly in local policies. Municipalities were encouraged to develop elderly policy plans. In order to do so, however, they needed figures that were not available. Local authorities and senior advisory boards requested support in developing an elderly policy plan from the provincial authorities.
In order to provide the data required to draw up an elderly policy plan, an elderly needs assessment was developed by the Free University of Brussels (VUB) and the province of West Flanders. An extensive survey should map the living conditions of the elderly and provide insight into their needs. The survey includes many topics that the local authorities can base their policy on, such as housing, neighbourhood characteristics, mobility, loneliness, insecurity, assistance, health, civic engagement, etc. After all, in order to meet people’s needs, you need to know what they are first.
1.2. METHODOLOGY
The elderly needs assessment will be offered as a package to the local authorities. This package includes a scientifically sound questionnaire, a script, processing software, support and training for interviewers, standard reporting and a module to process the results.
When a municipality decides to participate in the study, a municipal steering group will be set up that is responsible for the development and monitoring of the project. The steering group consists of the provincial research supervisor, members of the local senior advisory boards, an official (of the municipality or the Public Centre for Social Welfare [PCSW]) and a municipal policymaker.
The research supervision is performed by the provincial authorities in consultation with VUB.
The local authorities adopt an active role during the entire procedure. The active participation of local authorities in the research offers a greater guarantee that the results will actually be used.
Data for the elderly needs assessment are collected through a unique peer research system, which means that the surveys are collected by the respondents' peers. In this case, standardised questionnaires were administered to and by the elderly themselves. The peer research system ensures a very high first response rate. 65% to 85% of the elderly who were asked to complete the questionnaire actually participated. This way, the study is not only about the elderly, but is also conducted by the elderly.
The peer research system uses a multi-stage system to recruit the interviewers. In the first stage, we are looking for key figures. Key figures preferably have a lot of acquaintances among the elderly and are actively involved in elderly matters or elderly care. These key figures subsequently start looking for elderly interviewers. The interviewers have to bring the questionnaires to people who are part of the sample and collect them afterwards. The personal contact between the interviewers and the respondents results in a high response rate.
Once enough volunteers have been found, they receive a short training, which includes guidelines on the content of the questionnaire and the way the questionnaires are to be distributed. From then on, the interviewer is responsible for the distribution and the collection of a number of questionnaires.
When all the questionnaires have been returned, the data are entered into the system by a staff member of the municipality or the PCSW, or by a volunteer, with software created especially for this purpose.
Within each municipality, a proportionally stratified sample is taken, in terms of age and gender. When a particular respondent did not reply, a similar replacement address was assigned to the interviewer, so that the representativeness was not compromised. The figures are always representative at a municipal level.
The primary objective of the elderly needs assessment is a representative dataset at a municipal level. The standardised methodology (the same questionnaire is used each time) has furthermore resulted in a quite extensive Flemish dataset, which can be used at a municipal, provincial and Flemish level and makes (further) research possible. More information: http://www.belgianageingstudies.be/
1.3. PUTTING THE RESULTS INTO PRACTICE
Investing in an elderly needs assessment requires a significant effort from the local authorities, the elderly volunteers that distribute and collect the questionnaires, the elderly people who complete the questionnaires as well as the provincial authorities (research supervision and data processing). That is why it is important not to conclude the study after the study phase, but to actually put the results into practice.
The research report does not provide any ready-made policies. The transition from research results to possible policies still has to be made.
As participation is a key principle in this assessment, it is advisable to actively involve the elderly in the next phase as well.
We will now explain the approach adopted by Ostend.
Interested elderly people were invited through a broad appeal to participate in the follow-up phase of the elderly needs assessment. In June 2015, three sessions were organised. The civil society organisations active in this area were involved in those sessions too, depending on the topic that was covered.
The goal of these sessions was to explain the results of the study, to ask feedback about the results (are the results acceptable and can the results be explained/interpreted) as well as to brainstorm about the possible approach to the problems/challenges identified. Interpreting and explaining the results is also called contextualisation of the data. It enables researchers to outline the local context, which can help explain some of the phenomena identified. Local input into the debate is very important, as it often offers the first step towards a solution.
By involving the elderly in this phase, they are given a voice in the debate. Furthermore, it often offers the opportunity to stimulate the elderly people's (political) responsibility. Creating partnerships between the municipality, senior advisory boards, facilities and civil society organisations appears to be essential to develop sustainable, age-friendly community initiatives.
2. Results for Ostend
In the summer of 2014, a total of 403 seniors took part in a survey.
For the discussion of the results, we take into account different age groups (ages 60-69, 70-79 and 80+), genders (man or woman) and locations in Ostend (centre and other neighbourhoods).
The large Flemish dataset makes benchmarking possible. The municipality is compared with Flanders and the province of West Flanders. For the benchmark figures, a sample is taken from the data available in Flanders and the province of West Flanders. The same provincial and Flemish sample is used for a year every time, after which a new sample is taken, so that the data of new participating municipalities are included as well.
The complete results of Ostend can be found in the research report and de presentation of the results.
3. Evaluation of the study
3.1. Population in Ostend (and by extension other Flemish coastal municipalities)
The West-Flemish coastal municipalities are strongly characterised by retirement migration. That can be clearly observed in the graph below: there is a large net migration in the 55-69 age group.
As a result, the elderly population in Ostend is a mix of 2 population groups: the native residents of Ostend on the one hand, and the large group of elderly people who arrived at a later age on the other hand. These 2 groups show considerable socio-economic differences. These differences often become invisible or are filtered out from the figures at a municipal level.
Social disadvantage in West Flanders is highest in Ostend, which is shown by several social deprivation indicators. Ostend is confronted with metropolitan social deprivation issues in many areas: Ostend is the only West-Flemish city with an social deprivation profile similar to that of Ghent or Antwerp. The results of the West Flemish social deprivation atlas point in the same direction: Ostend has the largest number of underprivileged neighbourhoods of all West Flemish municipalities. The elderly who were born and bred in Ostend often have this more vulnerable/disadvantaged profile.
The other group (retirement migrants) often has a higher level of education, is part of a better socio-economic class and has a higher income. This group often participates more in social life too.
When conducting and designing a study in a city with such a mix, these two different groups have to be kept in mind. It is advisable to stratify the sample on the basis of age and gender as well as of ‘how long someone has lived in the city’. People from lower socio-economic classes usually participate less in surveys. We should make sure that those elderly who are born and bred in the city are proportionally represented in the sample, in order to adequately assess the needs of this group as well.
3.2. The study itself
The elderly needs assessment aims to map the living conditions of the elderly in particular municipalities by means of sample surveys. Several topic are thoroughly analysed: living conditions and neighbourhood, health, care and assistance, well-being and civic engagement. The focus is primarily on the participation of the elderly in social life and definitely not only on the elderly’s need for formal care.
15 years of elderly needs assessments in West Flanders and the experience acquired in several West Flemish municipalities have taught us that ageing studies mostly provide useful insights into the topics of housing, neighbourhood and civic engagement (in relation to the different age groups within the elderly population), which the local authorities can put into practice.
The proportion of elderly people who need care / assistance is often small in comparison with the proportion of elderly people who do not need care / assistance. The sample size does not allow for additional analyses for that specific group within 1 municipality.
The Flemish database that was generated on the basis of municipal data offers some possibilities in this respect. Within that large dataset, a selection can be made of the elderly who need care. This group can subsequently be studied in depth, beyond municipal boundaries.
The topics ‘housing and neighbourhood’ and ‘civic engagement’ in particular offer quite useful insights, which can be used to invest in active participation of the elderly at a local level.
Hilde Coudenys
Coordinator of Data & Analysis Support Centre - West Flanders
22/12/2020