a) det er nødvendigt at udvide samarbejdet i EU med henblik på at forbedre sundhedsplejen, så at kravene som følge af befolkningens aldring kan blive dækket, navnlig ved hjælp af det bidrag, som programmet for Fællesskabets indsat inden for folkesundhed – som nu er ved at blive vedtaget - vil kunne give gennem følgende foranstaltninger: ∙ udveksling af informationer om befolkningens sundhedstilstand og om risikofaktorer ∙ udveksling af god praksis ∙ fastsættelse af indikatorer og behovsanalyser ∙ udarbejdelse af fælles kvalitative og kvantitative normer for kontrol med sundhedsplejen ∙ udarbejdelse af strategier for udvikling af sundhedspleje og systematiske behovsanalyser til brug for planlægning, gennemførelse og evaluering af de sundhedsprogrammer, der gennemføres på nationalt og lokalt niveau b) det er nødvendigt at etablere en database for social- og sundhedssektoren, der skal indeholde statistiske analyser og prognoser på europæisk og nationalt niveau, så de, der udformer og gennemfører tjenesteydelser, kan få indblik i situationen inden for sektoren; c) Kommissionen bør på grundlag af gennemprøvede fremgangsmåder fra medlemsstaterne udarbejde mere specifikke videnskabelige retningslinjer for sundhedsplejen og ældreomsorgen og forelægge disse for Rådet med henblik på vedtagelse heraf som en henstilling fra Rådet; d) Kommissionen opfordres til at udarbejde en generel status over den frie bevægelighed for patienter og forelægge en undersøgelse over de hidtidige erfaringer i grænseregionerne; e) det er nødvendigt på nationalt niveau og på fællesskabsniveau at gennemføre uddannelses- og informationskampagner henvendt til aktørerne på sundhedsområdet og kampagner for forebyggelse og fremme af sundheden, som f.eks. om aldersbetinget macular degeneration, i hvilken forbindelse det erkendes, at ældres sundhed i fremtiden kræver en livslang strategi og undervisning af unge om følgerne af deres handlinger for deres senere liv; f) adgangen til sundhedspleje bør være sikret de ældre, ikke kun når det gælder langvarig behandling og hospitalsophold eller rent medicinske tjenester, men også i forbindelse med forebyggende behandling, fysioterapi, genoptræning og alle andre ydelser, som vil kunne sikre uafhængighed længst muligt og forebygge eller udsætte forekomsten af sygdomme og støtte handicappede ved at forbedre deres livskvalitet; g) der bør lægges særlig vægt på en analyse af de mange risikofaktorer, især de, som har tilknytning til sociale og økonomiske forhold som det fysiske og geografiske miljø, navnlig forurening, rygning, uddannelsesniveau, beskæftigelse, indkomst, social sikring, kulturelt niveau, køn, ernæring, osv.; h) selv om det må erkendes, at sundhedsplejen ikke kan uddelegeres til familier, ngo'er eller lokale myndigheder, er det alligevel nødvendigt at udarbejde foranstaltninger med henblik på at opmuntre til, fremme og opretholde den behandling, som finder sted på dette niveau ved hjælp af: ∙ uddannelse og information af de personer, som udfører behandling ∙ etablering af særlige tjenesteydelser for ældre på lokalt niveau og fællesskabsniveau ∙ ngo’ers og brugernes egen deltagelse i planlægningen og forbedringen af sundhedstjenesterne ∙ gennemførelse af kulturelle og sociale aktiviteter for at hindre, at de ældre isoleres ∙ psykologisk, økonomisk, juridisk og social bistand til de familier eller enkeltpersoner, som plejer ældre; i) mener, at personalet i sundhedssektoren er af grundlæggende betydning for, at der kan sikres og udvikles effektive og velfungerende sundhedsstrukturer og et højt omsorgs- og sundhedsniveau, og understreger, at manglen på plejepersonale er fælles for alle medlemsstater, om end i varierende omfang; j) foreslår, at EU finansierer oplysningskampagner om de erhverv i sundhedssektoren, der er nødvendige for at udvikle tjenesterne og bevare et højt pleje-, omsorgs- og sundhedsniveau i medlemsstaterne; k) opfordrer Kommissionen til at fremlægge forslag til et særligt program for finansiering af uddannelsesprojekter, som letter adgangen til og udbuddet af videregående studiemuligheder inden for sygepleje og masteruddannelser med henblik på specialisering inde for grundlæggende områder (transplantationer, onkologi , hjertekirurgi, geriatri, akut behandling, genoptræning, telemedicin og telebehandling og neurovidenskab); l) der bør gøres en særlig indsats for efteruddannelse inden for geriatri og gerontologi af de ansatte i sundheds- og socialsektoren, ikke kun af lægerne, men også af plejepersonalet og generelt af alle, som deltager i plejeaktiviteterne; m) det er nødvendigt at undersøge muligheder for at imødegå problemet med sindslidelser hos ældre, hvor det først og fremmest er kvinder, der rammes, navnlig hvad angår forebyggelse, sporing og tidlig behandling, fastsættelse af protokoller for diagnoser, farmaceutisk pleje og psykoterapi, udarbejdelse af programmer med henblik på selvhjælp og pasning i hjemmet af personer med Alzheimers sygdom eller andre former for senil demens; n) der er behov for foranstaltninger med henblik på at forsinke eller udsætte forekomsten af handicap hos ældre og for at sikre handicappede ældre løsninger, som bidrager til, at de kan bevare deres uafhængighed (boligforhold, transport m.m.); med henblik herpå kan det være nyttigt med integrerede centre (“one stop shops”), hvor tværfaglige grupper kunne tage de ældres behov op set ud fra et helhedsperspektiv, idet der tages hensyn til alle aspekter af den pågældendes liv i nært samråd med personen selv; o) der må findes løsninger og ordninger af bl.a. økonomisk art for at garantere sikkerhed, værdighed og livskvalitet for de personer, som ikke kan klare sig selv, for at undgå, at byrderne kun belaster de pågældende familier; p) Fællesskabets forskning i ældres velfærd og opretholdelse af deres sundhed og autonomi skal uddybes og opretholdes, ligesom undervisning i og anvendelse af informationsteknologien skal udvides og forbedres, da forebyggelse og uddannelse kan bidrage til en længere levetid; q) det er nødvendigt at sikre en permanent koordinering af en lang række tjenesteydelser, som skal omfatte forebyggelse, fremme af sundheden, primære sundhedstjenester, intensiv behandling, genoptræning, langvarig behandling og pleje af døende; r) man må være mere opmærksom på at hindre, at ældre overlades til sig selv, eller udsættes for mishandling, og bekæmpe fysisk, psykisk, seksuelt og finansielt misbrug af ældre, der begås af familiemedlemmer, plejepersonale, sundhedspersonale eller socialarbejdere i de ældres eget hjem, på plejehjem og på hospitaler, både gennem oplysningskampagner, der er rettet mod den brede offentlighed og brugerne af sundhedstjenesterne og de sociale tjenester, og ved at oprette særlige tjenester for ofre for mishandling ved at iværksætte efteruddannelsesprogrammer; glæder sig over, at der er udført forskning på dette område; anmoder Kommissionen om at opfordre Det Europæiske Agentur til Forbedring af Leve- og Arbejdsvilkårene til at samordne udveksling og udbredelse af viden og politikker på dette område; mener, at der er et presserende behov for at etablere et netværk af kontrolsystemer i de forskellige medlemsstater, således at en person, der flytter til en anden medlemsstat og søger et job med ældre, underkastes en sikkerhedskontrol i den medlemsstat, som han eller hun kommer fra; s) der bør endvidere lægges særlig vægt på plejebehovene for personer i landdistrikter; t) der bør også tages tilstrækkelig højde for kvindespecifikke aspekter i forbindelse med alle sundhedsrelaterede foranstaltninger; u) fremtiden for sundhedsplejen og ældreomsorgen bør i fremtiden indgå som en fast del af Kommissionens arbejdsprogram;
(a) Community cooperation should be stepped up in the sphere of improving health services in order to tackle the ageing of the population, not least by means of the contribution which may be made by the action plan for public health now being adopted, covering: - the exchange of information on the population’s state of health and risk factors, - the exchange of good practice, - the establishment of indicators and an analysis of needs, - the drawing up of common qualitative and quantitative standards to monitor the health services, - the drawing up of strategies for developing health services and for the systematic analysis of needs with a view to the planning, execution and assessment of health programmes carried out at national and local level; (b) a data bank should be established covering the social and health care sector, and containing statistical analyses and projections, both at European and national level, to enable anyone involved in planning and setting up services to understand the situation in the sector; (c) on the basis of proven practices used in the Member States, the Commission should, to a greater extent, draw up specific scientific guidelines for health care and care for the elderly and submit these to the Council with a view to adoption as a Council recommendation; (d) the Commission should carry out a general assessment of patient mobility and submit a study on experience in the border regions to date; (e) provisions should be made for organising, at national and Community level, training and information campaigns for operators and prevention and promotion campaigns in the field of health, such as on age-related macular degeneration, including recognising that the future health of older people requires a lifelong approach and educating young people as to the consequences of their actions in later life; (f) elderly people should be guaranteed access to health services not only as regards long-term care and hospitalisation, or strictly medical services, but also as regards preventive care, physiotherapy, rehabilitation and any other service designed to ensure their independence for as long as possible, in order to prevent and delay the onset of diseases and to support disabled people in a way which improves their quality of life; (g) particular attention should be devoted to studying multiple risk factors, in particular those linked to social or economic conditions, such as the physical and geographical environment, and in particular pollution, smoking, level of education, profession, income, social support, culture, gender, nutrition, etc.; (h) whilst bearing in mind that the provision of health care services cannot be delegated to families, NGOs or local communities, it is necessary to identify measures designed to encourage, facilitate and support the care activities provided by such bodies or individuals, by means of: - training and informing the persons providing the care, - the creation of specialised services for elderly people at local and Community level, - the participation of NGOs and users themselves in the planning and improvement of health services, - the development of cultural and social activities to prevent the isolation of elderly people, - psychological, economic, legal and social support for families or individuals caring for an elderly person; (b) a data bank should be established covering the social and health care sector, and containing statistical analyses and projections, both at European and national level, to enable anyone involved in planning and setting up services to understand the situation in the sector; (c) on the basis of proven practices used in the Member States, the Commission should, to a greater extent, draw up specific scientific guidelines for health care and care for the elderly and submit these to the Council with a view to adoption as a Council recommendation; (d) the Commission should carry out a general assessment of patient mobility and submit a study on experience in the border regions to date; (e) provisions should be made for organising, at national and Community level, training and information campaigns for operators and prevention and promotion campaigns in the field of health, such as on age-related macular degeneration, including recognising that the future health of older people requires a lifelong approach and educating young people as to the consequences of their actions in later life; (f) elderly people should be guaranteed access to health services not only as regards long-term care and hospitalisation, or strictly medical services, but also as regards preventive care, physiotherapy, rehabilitation and any other service designed to ensure their independence for as long as possible, in order to prevent and delay the onset of diseases and to support disabled people in a way which improves their quality of life; (g) particular attention should be devoted to studying multiple risk factors, in particular those linked to social or economic conditions, such as the physical and geographical environment, and in particular pollution, smoking, level of education, profession, income, social support, culture, gender, nutrition, etc.; (h) whilst bearing in mind that the provision of health care services cannot be delegated to families, NGOs or local communities, it is necessary to identify measures designed to encourage, facilitate and support the care activities provided by such bodies or individuals, by means of: - training and informing the persons providing the care, - the creation of specialised services for elderly people at local and Community level, - the participation of NGOs and users themselves in the planning and improvement of health services, - the development of cultural and social activities to prevent the isolation of elderly people, - psychological, economic, legal and social support for families or individuals caring for an elderly person; (i) healthcare staff are of fundamental importance in ensuring the maintenance and development of efficient and functional health facilities , and a high standard of care and health, while the nursing shortage is a phenomenon experienced by all the Member States – albeit to varying degrees; (j) the European Union should fund campaigns to raise awareness of the care professions needed to develop services and maintain a high standard of care and health in the Member States; (k) the Commission should therefore propose a specific programme to fund training projects to enable people to gain access to and attend nursing courses and undergo specialised higher training in important areas (transplants, oncology and heart surgery, geriatrics, emergency medicine, rehabilitation, telemedicine, telecare and neuroscience); (l) particular attention should be given to ongoing training in geriatrics and gerontology for healthcare and social service professionals, to include not only doctors, but also nurses and, more generally, care workers; (m) possible responses to the problem of mental illness in the old, which affects women in particular, should be analysed, in particular as regards prevention, detection and early treatment, the establishment of protocols for diagnosis, pharmaceutical treatment and psychotherapy, the devising of programmes aimed at self-help and home care for people suffering from Alzheimer’s or other forms of senile dementia; (n) measures are needed aimed at delaying the onset of disabilities in elderly people and providing solutions to allow disabled elderly people to maintain their autonomy (accommodation, transport, etc.); to this end, "one-stop shops", where multidisciplinary teams could look at the needs of the older person in a holistic approach, taking on board all aspects of his/her life in a close consultation with the person can be very useful; (o) efforts should be made to devise solutions and instruments - including economic ones - aimed at assuring the safety, dignity and quality of life of people unable to live self-sufficiently with a view to ensuring that the burden does not fall solely on the families involved; (p) Community research aimed at ensuring the welfare and maintaining the health and autonomy of elderly people should be developed and maintained and educational approaches and information technology should be developed and improved so that prevention and education help achieve improved life expectations; (q) provision should be made for coordinating a vast range of services in a comprehensive framework covering disease prevention and health promotion, primary health services, intensive care, rehabilitation, long-term care and palliative care; (r) particular attention should be devoted to combating the maltreatment, physical, psychological, sexual and financial abuse and neglect of elderly people in their own homes, in residential care and in hospital, by family members, carers and health or social care professionals, both by means of awareness-raising campaigns aimed at the general public and those working in the health and social services, and by creating services specifically designed for victims of maltreatment and programmes to re-educate those guilty of such acts; welcomes the research being carried out into elder abuse and calls on the Commission to ask the European Agency for Living and Working Conditions to co-ordinate the sharing and dissemination of knowledge and policies in this area; believes there is an urgent need to establish a network of vetting systems in the respective Member States so that a person who moves to another Member State, and seeks a job with elderly people, can be subject to security checks with the Member State from which he or she has come; (s) particular attention should also be paid to the care needs of those in rural communities; (t) adequate account should be taken in all health-related measures of aspects specific to women; (u) the future of health care and care for the elderly should from now on form a permanent part of the Commission’s work programme;