BIOETYKA / WPROWADZENIE

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Position Statement on the rights and needs of older patients – EPF (European Patients Forum) 2013

Background s. 2

As the general population is ageing, many chronic diseases become more prevalent. Patients with chronic diseases developed at a younger age are living longer, thanks to modern medical treatments. As persons with chronic diseases age and older people acquire chronic diseases and co-morbidities, they develop specific needs and are confronted with unique difficulties in addition to facing obstacles common to patients of all age. These difficulties can be socio-cultural (discrimination, lack of respect, isolation), structural (lack of involvement of older people in clinical trials resulting in inadequately evidenced treatment), linked to patient safety (polypharmacy), or in other areas.

Eurostat has estimated that by 2050, people aged 65 + will represent 30% of the population in the EU.2 Chronic conditions currently affect 80% of people over 65 and often involve multiple morbidities. More than half of all older people have at least three chronic conditions, and a significant proportion has five or more.

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What are the rights of older patients? s. 3

Older patients’ rights are derived from two sources: fundamental human rights among which is the right to health; and patients’ rights, which have been defined as a result of the development of a patients’ rights movements and have led to considering patients as active partners in healthcare. These rights are developed in the following instruments:

• The WHO defined the right to health as an inclusive right, which gives entitlements among which figure the availability and access to good quality services, goods and facilities, without discrimination. It also adopted a policy framework on active ageing.
• The UN Human Rights Council adopted the right of everyone to the enjoyment of the highest attainable standard of physical and mental health, and focused particularly on its realization for older people through a thematic study.
• The Political Declaration and Madrid International Plan of Action on Ageing of the Second World Assembly on Ageing (2002) puts an important emphasis on access to healthcare services.
• The Charter of Fundamental Rights of the EU states that “Everyone has the right of access to preventive health care and the right to benefit from medical treatment under the conditions established by national laws and practices (article 35) and prohibits discrimination on the grounds of age and disability (article 21).
• The European Charter of Patients’ Rights defines 14 essential rights for patients, and also highlights their right to participate in decision making.
• The European Charter of the rights and responsibilities of older people in need of long-term care and assistance also details essential rights for patients.
• The European Parliament adopted the resolution of 8 March 2011 on reducing health inequalities in the EU, with a specific call for action at EU level on inequalities related to age (recommendation 24). 11 It also called on the European Commission and Member States to address the impact of the crisis on access to care for vulnerable groups in its resolution 2013/2044/INI.

The EU needs to take action to implement and uphold these rights s. 4

EPF believes that, complementing the European Innovation Partnership on Active and Healthy Ageing, further work is needed to uphold these common rights for older patients in the EU, as the EU population is ageing but at the same time important flaws have been identified by patients organisations in the care for older people.

This paper provides recommendations for the EU institutions, Member States and stakeholders (including healthcare professionals, researchers, scientists and industry) to further cooperate and work towards achieving the changes that are needed to meet the needs of older patients and uphold their rights across Europe. It centres around the following priorities that were identified by EPF and our members:

1. Integrated, holistic approach to health and social care
2. Promoting the rights of older patients and tackling discrimination and stigma
3. High-quality information and health literacy addressing the specific needs of older patients
4. Ensuring patients have access to the services they need throughout the care continuum
5. Shared decision-making and empowerment for older people and their carers
6. Development of innovative therapies and technologies to meet older patients' needs
7. Making meaningful involvement of older patients in health policy a reality