A social security system aimed at helping seniors in Belgium

Social Security Assistance System oriented to aid Seniors in Belgium

INTRODUCTION

Belgium is a founding member of the European Union and its capital, Brussels, is home to several international organizations, most European institutions and NATO headquarters. Belgium is a federal state divided into three main regions, namely Flanders (the north of the country), Wallonia (the south of the country) and the capital Brussels (a bilingual capital with French and Flemish as official languages). In 1830, Belgium achieved its independence and became a constitutional monarchy. [1] The National Social Security Office (Office national de Sécurité sociale) can be defined as a public institution focused on the field of social security. This institution is primarily responsible for collecting contributions (with the exception of occupational accidents) and for allocating funds to individual central institutions administering the various areas of social security through the so-called global management. Social security in Belgium is a federal matter that falls under the competence of the Minister of Social Affairs (Ministre des Affaires socials), the Minister of Labor (Ministre de l'Emploi), the Minister for Public Service (Ministre de la Fonction publique), the Minister for Pensions and Large Cities (Ministre des Pensions et des Grandes villes), the Minister for Small and Medium Enterprises (Ministre des Classes moyennes), the State Secretary for Social Affairs entrusted with persons with disability (Secrétaire d'Etat aux Affaires sociales chargé des personnes handicapées), to the State Secretary for Social Integration and the Fight against Poverty (Secrétaire d'Etat à l'Intégration sociale et à la Lutte contre la Pauvreté). [2] The costs of health care in old age can be high, so the Flemish government introduced social care insurance in 2001 for this reason. This form of insurance does not exist in Wallonia. From the age of 26, every person who resides in Flanders is forced to contribute 25 euros per year to finance the system. Social care insurance provides contributions that apply only to medical expenses. The allowance can be used for home and community care, compensating individuals providing regular help to another person, support measures that a person dependent on care needs. [5]

SENIOR

By the term senior, we understand an older or old person who has reached retirement age (that is, from the age of 60 and above). This age is characterized by changes in the field of psychological, physical and mental health, which cause, to varying degrees, signs of the gradual aging process. Currently valid Act No. 448/2008 Coll. on social services, the term recipient of social services is used to denote a senior citizen. The senior population shows some characteristic features and is also heterogeneous to a certain extent. This fact is conditioned mainly by:

• unique abilities and personality traits that do not disappear with age,
• different rate of development of unique abilities during the period of youth and middle age,
• interindividual variability of involutional biological events,
• different degree of disease changes,
• events of a long life,
• experiences and habits including education, professional career and lifestyle,
• value system and life views,
• socio-economic background, such as property, housing conditions or housing situation. [3]

SOCIAL SECURITY

According to the Service Public Fédéral Sécurité Sociale, the social security system in Belgium is based on solidarity between:

• employed and unemployed,
• people of productive age and pensioners,
• healthy and sick people,
• people with higher incomes and the unemployed,
• families with children and families without children.

Social security in Belgium provides three main guarantees for its citizens, namely:

• in case of loss of wages (unemployment, retirement, disability), the citizen will be provided with a replacement income,
• in the case of some 'wages' (supplements), such as children's education and health care expenses, citizens will receive a supplement to their income,
• in the absence of any type of income, a citizen has the right to social benefits. [4]

The Belgian social security system includes sickness and maternity benefits, insurance against accidents at work and occupational diseases, death benefits, invalidity benefits, old-age and survivors' benefits, unemployment benefits and family benefits. Belgium provides all kinds of social services for seniors, but their government is trying to strengthen social assistance oriented to seniors in order to ensure that seniors can stay as long as possible in their family home environment. There are various options for helping seniors in the home, financial assistance and assistance in various types of medical facilities. Help for seniors is divided into three basic levels, namely:

• guaranteed income

The guaranteed income for the elderly (Grapa) represents a minimum income. The government will allocate this guaranteed income to seniors who have reached the retirement age of 65. [5] Entitlement to this financial assistance is automatically reviewed if you receive a pension, disability allowance or integration allowance. If this is not the case, you must apply yourself to the municipal office or the national pension office. The National Pension Office (Office national des pensions ONP) based on an investigation of the financial situation of the applicant and the persons who live with him in the same household, will assess whether the given person is entitled to receive this financial assistance. [2] Seniors with reduced independence and ability to take care of themselves are entitled to financial support. These seniors are provided with a senior aid allowance (APA), which is, however, part of the disability allowance. This allowance can be provided if a medical opinion confirms that the senior suffers from a lack or reduced independence. The contribution is divided into five categories, and when assessing the category, the actual degree of independence of the senior is taken into account, such as his ability to move, receive liquids and food, the ability to prepare food independently, the ability to maintain personal hygiene, the level of self-service activities, the ability to run his own household, the ability to lead an independent life without the supervision of another person, or the level of social contacts. [6]

Tab. 1: Contribution amount in individual categories valid from 1 February 2012

Source: available online: https://www.socialsecurity.be

According to the Federal Public Administration of Social Security (Service Public Fédéral Sécurité Sociale), persons with disabilities are provided with an integration allowance. To calculate the contribution, the income of the disabled person is assessed, but the income of the person with whom the disabled person shares a household is also assessed. Any person between the ages of 21 and 65 with a permanent residence in Belgium and must have one of the nationalities covered by the legislation is entitled to the allowance. The application must be submitted to the mayor of the municipality where the disabled person is registered in the register of residents or in the register of foreigners. The Belgian social security system provides various social and tax benefits for disabled people, such as a parking card, priority access to social housing, social tariff for gas, electricity or telephone, reduction of transport costs. [5]

• assistance in home care

Belgium provides its seniors with various types of help in home care, such as services for maintaining a senior household, cleaning and taking care of housework, a sanatorium for seniors (a medical institution, a facility used for remedial treatment of certain diseases, or for the treatment of protracted illnesses), physiotherapy, social loan, care, palliative care, social assistance, daily meal delivery, alarm systems for senior households, provision of hairdressing services, etc. Seniors have at their disposal an extensive network of social centers for local and regional assistance in home care. A large part of the costs for many of the services is covered by the finances of the local regions. CPAS (1) provides a number of services for seniors, but private organizations also participate in social assistance to seniors. In both cases (public and private sector), payment for assistance usually depends on the senior's income. Community care for seniors can be provided by a responsible person, volunteer, partner, parent, child, friend or neighbor. Caregivers are entitled to help from their insurance and CPAS. [7]

• institutional facilities and care

In Belgium, within the framework of institutional care for the elderly, day centers, day care centers or centers for short-term stays are available. In the event that home care for a senior is not sufficient, it is possible to place the senior in a day care center or inpatient facility. In the aforementioned centers, services are organized for seniors, such as personal supervision of seniors throughout the day, medical supervision and organization of leisure activities. These centers are suitable for seniors after a hospital stay who need support during their recovery before returning home. It is also possible for seniors to be temporarily placed in these facilities for a short-term stay, at intervals of three months in one year. A nursing home or seniors' home offers a safe and stable environment for the life of seniors. [8] These institutions ensure quality care for seniors. Services are provided to seniors regardless of their degree of disability by a multidisciplinary team, and the staff of the facility has a personal approach to each senior. Entering a nursing home should not be seen as a resignation to life without any activity, as these facilities provide many activities adapted to seniors (for example, trips, parties, shows and many daily activities). More detailed information about nursing homes can be obtained from your doctor, your local insurance company or your local CPAS. In Belgium, each city or municipality has its own CPAS and they have their own institutional facilities for seniors. As an example, we present CPAS Charleroi, which operates a network of nine facilities with a capacity of 917 beds and 591 nursing beds in home care.

Tab.2: List of nursing homes (maisons de repos et de soins)

Source: available online: http://www.cpascharleroi.be/maisons-de-repos-et-de-soins/maisons-de-repos-et-de-soins.html

CONCLUSION

Seniors, not only in Belgium, but also within the Slovak Republic, have the right to participate in decisions about their own lives, they have the right to legal protection and the best health and social services available in their country. As seniors get older, they absolutely need a spectrum of health and social services, especially timely and accurate diagnosis, elimination of curable diseases or symptoms, availability of common medical therapy, specialized neurological and psychiatric care, day care centers, home and institutional care, sensitive and adequate palliative care. The work of a social worker with seniors in institutional facilities is undergoing many changes. Currently, the traditional understanding of the roles of helping workers is gradually changing, and at the same time, new paths are being sought that would lead to greater client autonomy.

Author: Mgr. Mária Heverová

LITERATURE

[1] European Union: Information on the functioning of the EU, Member countries - Belgium [online]. 2012. Internet portal of the European Union. [cit. 03.12.2012]. Available online: http://europa.eu/about-eu/countries/member-countries/belgium/index_sk.htm [2] European Commission: Employment, Social Affairs and Inclusion. [online]. 2012. Your social security rights in Belgium. [cit. 04.12.2012]. Available online: http://ec.europa.eu/employment_social/empl_portal/SSRinEU/Your%20social%20security%20rights%20in%20Belgium_sk.pdf [3] MUHLPACHR, P.: Basics of gerontology. Brno: MSP, 2008, 203 p. ISBN 978-80-7392-072-2. [4] Service Public Fédéral Sécurité Sociale : Sécurite Sociale en bref [online]. 2012. Autres informations et services des autorités fédérales. [cit. 01.12.2012]. Available online: http://www.socialsecurity.fgov.be/fr/over-de-fod/sociale-zekerheid-kort/sociale-zekerheid-kort.htm [5] Public Fédéral Sécurité Sociale : Allocation d'intégration [online]. 2012. Autres informations et services des autorités fédérales. [cit. 01.12.2012]. Available online: http://www.handicap.fgov.be/fr/vos_droits/alloc_ph/ai.htm [6] Informations et services officiels: Aide sociale, seniors, Allocation pour l’aide aux personnes agées [online]. 2012. Portal Belgium. [cited 30.11.2012]. Available online: http://www.belgium.be/fr/famille/aide_sociale/seniors/revenus_garantis/ [7] Informations et services officiels : Aide sociale, seniors, Aide et soins à domicile, Types d'aide et de soins à domicile agées [online]. 2012. Portal Belgium. [cited 30.11.2012]. Available online: http://www.belgium.be/fr/famille/aide_sociale/seniors/aide_et_soins_a_domicile/ [8] Informations et services officiels: Aide sociale, seniors, Maisons de repos et maisons de soins [online]. 2012. Portal Belgium. [cited 30.11.2012]. Available online: http://www.belgium.be/fr/famille/aide_sociale/seniors/maisons_de_repos_et_de_soins/

(1) CPAS is a public center for social action, it provides a range of social services to ensure the well-being of every citizen. Each city or municipality has its own CPAS.