In December of year 2020, Dr. António Fonseca of the Catholic University of Lisbon published a paper “Ageing in Place in Portugal”. In its eighteen pages, he made a systematic analysis of the initiatives presented by eighty public and private organisations for improving the care of the elderly in their “twilight years”.

Especial reference was made to the desirability of enabling older adults to continue living in their familiar surroundings by providing medical and social services through local clinics and both voluntary and paid care-takers. In this it was supported by the World Health Organization as being an urgent matter of global concern.

At that time, charitable bodies such as the Brigadas de Intervençâo Rápida of the Red Cross were outstanding for the provision of local services such as the delivery of “meals on wheels” and taking groups of pensioners by mini-bus for weekly shopping and visits to cultural events. Volunteers made house visits not only to check physical disabilities but to aid recovery in mental health simply by engaging in social conversation concerning the trivialities of day-to-day existence.

An important step forward was achieved in 2023 when The Radar Social project commenced activities in Portugal. This was an initiative funded by the EU under the Recovery and Resilience Plan. It´s aim is to offer a centralised service that will co-ordinate the existing schemes of local and regional entities which endeavour to combat poverty and loneliness. By integrating vulnerable people into community care schemes and widening their interests in sharing cultural activities (and even returning to part-time employment), it is hoped that the emotions of despondency, despair and a sense of being rejected by society will be alleviated.

Therefore, one can be sure that Dr. Fonseca and his team of investigators have been overjoyed to find that most of their recommendations are consolidated in the Statute of the Elderly Person which, after a delay of one year, has just been published in Diário da Republica, the official Gazette.

On a first reading of this new legislation, it seems that a genuine effort has been made to legislate for the right of the elderly to make positive choices to ensure their own protection and independence. Encouragement will be given to those who wish to remain in the comforting surroundings of their own home and participate in the life of their community. Measures will include the provision, at the expense of the State, of personal services to ensure that they will enjoy most of the facilities which one could expect to find in a nursing home.

However, a more penetrative study of the 23 Articles which make up the statute has caused some misgivings among those who have worked so hard to make this progress.

The foremost of these is demographic. In the first twenty-five years of this century the number of citizens aged over eighty years has doubled to 800,000. By year 2040 the actuarial forecast is that it will double again. Of this number, it is estimated that at least one half will be living alone often in abject conditions with an insufficient retirement income to pay rent and basic needs for living.

This will place an impossible burden on the existing stock of registered nursing homes and hospices, many in shabby condition, and upon their conscientious staff some of whom are immigrants who themselves are approaching retirement age.

From whence shall come the finance to provide public housing for such vastly increased numbers of the elderly and for the requisite number of qualified staff to give them professional attendance?

For the elite retired of means this will not present a problem. In 2025 purpose-built accommodation for students and “senior living” represented 13% of the total for newly built commercial real estate. Returns averaged 5.5% with capital investment coming from primarily foreign private equity. However, only a tiny number of Portuguese can meet fees which range from €3,500 per person per month for only basic services and board to over €10,000 where 24/7 medical attention is required.

Unfortunately, caring for the unloved ones is not an intensive industry which can benefit greatly from the new applications of AI. It has become a political football. Together with the controversial pending legislation for assisted dying, it is given little priority in party programmes and only brought out from the archives at the time of elections when there is shameful competition for capturing the votes of those whose hearts and minds may soon be neither beating or thinking.

As a nonagenarian, I have fears for the future of my generation and am ever-mindful of such words as “Covid-19 is nature´s way of dealing with old people and protects others” (from burdening expense) attributed to the conservative right of Boris Johnson´s government. Let us hope that my pessimism is proved wrong and that the good intentions of the Statute of the Elderly Person will come to fruition.

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