New report calls for homecare reform in Ontario

http://www.ontariohealthcoalition.ca/wp-content/uploads/home-care-the-care-we-need-report-final.pdf

Here is a excerpt from the report from the Ontario Health Coalition.

The Care We Need

A new Medicare was established when hospitals
cared for the ill and homecare for the frail. This
has changed dramatically over the last thirty
years, with much more clinical care provided at
home as well as a growing number of frail
elderly and the disabled requiring support at
home. At the same time, the commitment of
Canadians to the right to health care based on
need rather than income has not declined.
Indeed, support for this value has grown. To
modernize the system we need to recognize
the principles of the Canada Health Act and
apply them to the full range of services that
people need.
For more than two decades, Ontario
governments have pursued policies centred on
cutting hospitals. At the same time,
governments have failed to create and enforce
clear standards for accessible home care as
patients are moved to the community. In
effect, the continual failure to establish a clear
right to access medically necessary home care
amounts to an erosion in the scope of our
public health coverage. Today, the
patients find their ability to access
publicly-funded care in community
settings to be severely rationed,
poorly organized and subject to
user fees.
Ontario’s home care system is
struggling; unable to meet the
burden of the downloaded patients
from hospitals with ever more
complex needs for post-acute care
and rehabilitation, and, at the same
time, provide a wider array of
services to support longer-term care
at home for the elderly and persons
with disabilities and chronic
illnesses. ….

Demand for affordable seniors housing outstrips supply in St. John’s

Need for seniors housing will keep growing: report
DanielDaniel MacEachernPublished on March 05, 2015

Demand for affordable seniors housing outstrips supply and the problem will likely get worse, according to a report from St. John’s and the province.

The seniors housing research project grew out of a survey in 2012 that identified housing as seniors’ top concern, and last year St. John’s city council set a goal of creating 500 homes with funding partners by 2017, a fifth of those “age-friendly” homes.

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“We’re going to have about 28 per cent of our city being over the age of 60 in 2035. That’s a big chunk that are going to be living on a very fixed income,” said Coun. Bernard Davis, chairman of the city’s community services and housing committee, which reviewed the report at a meeting in late February.

Davis added the study found the average income of seniors in the city is $24,540.

“That’s not a lot to find accommodations in the city, that historically has a very high cost to find housing.”

Davis says the report’s recommendations “dovetail very nicely” with the plan the city approved last year, such as forming public-private partnerships for developments to make them affordable, including smaller units for seniors looking to downgrade from larger homes after children have moved out.

“Let’s call a spade a spade: seniors want to age at home,” he said. “If there’s a way for them to do that and afford to stay in their home, they would prefer that. They also prefer seniors-only housing.”

The city hopes to appeal to developers by making a business case to developers by noting that 75 per cent of available residential land is zoned for single-family homes.

“There’s a target market there for this aging demographic that is going to need affordable housing, and not just a little bit. There’s going to be a lot of it required,” he said. “So building more affordable options for seniors is a key piece.”

By the numbers

• 20 — percentage of St. John’s population above the age of 60 today

• 28 — percentage of population forecast to be older than 60 in 2035

• 75 — percentage of land zoned for single-family homes

• $24,450 — average income of seniors in St. John’s

Alberta to mandate sprinklers in all seniors’ homes within 3 years

Seniors minister vows to install sprinkler systems in all seniors lodges and long-term care spaces

DARCY HENTON, CALGARY HERALD
More from Darcy Henton, Calgary Herald
Published on: March 10, 2015
Last Updated: March 10, 2015 4:51 PM MDT

Seniors Minister Jeff Johnson announced approved fire system upgrade projects in seniors residences during a news conference at Hardisty Care Centre in Edmonton on March 10, 2015.
Seniors Minister Jeff Johnson announced approved fire system upgrade projects in seniors residences during a news conference at Hardisty Care Centre in Edmonton on March 10, 2015.

All seniors lodges and long-term care facilities will be upgraded with fire suppression sprinklers through an $80-million program over the next three years, Seniors Minister Jeff Johnson said Tuesday.

Johnson said the Progressive Conservative government boosted funding for the retrofit by $10 million to tackle all of the facilities in the province after announcing a $70-million first phase of the program last October.

“We want to get rolling on this immediately,” Johnson told seniors and seniors housing officials at the Hardisty Care Centre in east Edmonton.

The money allocated from the province’s social housing fund will pay for upgrades in 6,500 units in 105 facilities around the province.

The first priority will be given to facilities housing seniors with mobility issues and those served by volunteer fire departments in rural areas, Johnson said.

The minister said he hopes to announce additional money to pay for the installation of fire suppression sprinklers in seniors’ assisted-living complexes in the near future.

Most of the province’s 24,000 seniors housing units aren’t fully equipped with fire suppression sprinkler systems because they weren’t required under the building code until 1990.

Ministry documents obtained under freedom of information legislation reveal that 455 of the province’s 657 seniors facilities are not fully equipped with sprinkler suppression systems.

Several provinces, including Ontario and Quebec moved to make sprinkler systems mandatory in seniors facilities after a fire at a nursing home in Quebec last year killed 32 seniors.

Sprinklers installed in the living units of seniors facilities suppress fires and give seniors with mobility issues more time to evacuate.

Joe Patterson, 79, whose wife has been residing in the 48-year old Hardisty Care Centre for four years, applauded the announcement.

“This is an old building and if you got a fire in it … it would go up in no time,” he said. “It’s a very good idea. It should have been done years ago.”

But NDP critic David Eggen pointed out that five months have passed since the government set aside funds for the sprinkler program, and so far not one has been installed.

Eggen said “for the sake of safety,” he wished the Tories had started installing sprinkler systems when they first announced the program in October.

“Considering the tragedy that happened in Quebec … we know that it’s incumbent on all of us to act in the most expeditious way,” he said. “Let’s not forget this announcement now will cover only about half of the facilities that require retrofitting.”

Johnson said it was important to survey the facility operators to determine their needs in order to plan for the upgrades.

“We want to be thoughtful about how we’re going to do this,” he said. “We could have been rash and just thrown money out the door. It might have cost us three times as much and we might not have had the impact that we really want to have.”

Johnson also rejected calls to make sprinkler systems mandatory, saying most of the buildings constructed before 1990 are owned or operated by the province anyway and it’s the government’s responsibility to upgrade the fire suppression systems.

Doug Mills, president of Alberta Senior Citizens Housing Association, said he was pleased the government was tackling all long-term care facilities and seniors lodges immediately.

“This has been a fruitful, collaborative effort,” he said.

John Pray of the Alberta Continuing Care Association said he appreciated the government is proceeding with the sprinkler program despite the fiscal crisis triggered by the collapse of oil prices.

“I think today’s announcement is just the start,” he said.

dhenton@calgaryherald.com

Twitter.com/darcyhenton

Why this Ontario pension plan can afford to boost its benefits:

Mayers While many plans are struggling, nurses and other hospital staff can cheer. Their Healthcare of Ontario Pension Plan has just increased its benefits for its 295,000 members. Here’s why.

http://www.thestar.com/business/personal_finance/retirement/2015/03/04/why-this-ontario-pension-plan-can-afford-to-boost-its-benefits-mayers.html

By: Adam Mayers Personal Finance Editor, Personal Finance, Published on Wed Mar 04 2015
Ontario’s nurses, social workers, lab technicians and other hospital staff have a lot of reasons to smile today.
At a time when most pension plans are cutting benefits, their Healthcare of Ontario Pension Plan (HOOPP) has just increased inflation protection for its 295,000 members. Instead of covering 75 per cent of the annual increases in the cost of living, HOOPP is raising the bar to 100 per cent.
While many plans struggle with underfunding, Ontario’s third-largest pension fund has $1.15 on hand for every $1 it must spend. Stocks on the Toronto market returned 7.4 per cent on average in 2014, while HOOPP returned a record 17.71 per cent. The plan’s average return in each of the last 10 years is 10.27 per cent.
CEO Jim Keohane seemed almost embarrassed Wednesday as he discussed his annual results. He noted somberly, “We have the highest 10-year return of any global pension plan.”
Hey, let me in. Where can I get a pension plan like that? Well, in the private sector, nowhere.
The surest way to rouse readers from slumber to red hot anger is to suggest that anything in the public sector can be better than the same thing done privately. The profit motive is the only way to breed efficiency, some say. Let the market decide. Government and quasi-government agencies are fat, wasteful and largely corrupt. You can add lazy, unproductive and incompetent.
But when it comes to pensions, that’s not true. Ontario’s big public-sector funds are the top of their class. While companies want 110 per cent of our effort, they’ve largely rewarded workers by abandoning the sort of pension plans that provide security and let people sleep easy in retirement.
Some 76 per cent of private-sector employees don’t have a pension of any kind. Of those who do have a pension, less than half have defined benefit plans. When you do the math, only about one in 10 people working in the private sector has a defined benefit plan.

Such plans pay a monthly amount for life, putting the onus on companies to come up with the money. Corporate Canada doesn’t like that idea and has been bailing out, moving to defined contribution (DC) plans where they can throw some money in the pot to match workers’ contributions (if they’re lucky) and then wash their hands.
That leaves workers with all the risks and stress of investing and managing the money on retirement. These are skills most people don’t have.
The public sector still believes that collective effort can give a better outcome. So, 86 per cent of workers for provincial and local governments — people such as firefighters and police, those at universities and colleges and workers in health care — are covered by pension plans, mostly the defined benefit kind.
Related:A closer look at our public sector pension envy
Pensions provide a broader social benefit beyond the cash in a pensioner’s pocket. According to HOOPP, 7 per cent of all income in Ontario comes from defined benefit pensions, which pay out about $27 billion a year, money that supports the communities where people live.
Keohane says 20 per cent of all income in Collingwood, for example, comes from pensions.
He says it’s a myth that taxpayers are footing the bill. In HOOPP’s case, 80 cents of every dollar in the $61 billion fund come from investment returns.

There are several reasons why an individual can’t hope to match the performance of a big fund with an RRSP. Big funds bring investing expertise and economies of scale to bear in a way that individuals cannot. It is precisely because they lack a “for-profit” motive that such funds can keep fees low and returns high.
Think of how many fees you might pay along the way when investing — for advisors, buying and selling stocks and funds, trailer fees, management expense ratios, fees you can’t see.
Big funds are also “patient money”, which means they can weather market ups and downs and not be forced to sell. The next “quarter” for HOOPP is 25 years, not three months.
Related:Who’s in and who’s out of Ontario’s pension plan
OMERS, Ontario’s largest pension plan, also reported strong results last week. OMERS manages the assets of 450,000 municipal employees and earned a 10 per cent investment return in 2014.
The fund stumbled during the financial collapse of 2008 and has been working its way out of a hole. In 2014, OMERS made more progress, increasing its funding level to 91 cents per dollar needed, up from 88 cents a year ago. There’s still a long way to go to catch HOOPP, but it’s going the right way.
Our frayed faith and anger with our public institutions is well-deserved, and that general discontent spills over to public pension envy.
But a better target would be private-sector employers who have abandoned their workers because it’s expedient, leaving them to make financial decisions in retirement they are often ill-equipped to make.
More columns by Adam Mayers
Adam Mayers writes about investing and personal finance. Reach him at amayers@thestar.ca
What is HOOPP
– Healthcare of Ontario Pension Plan is the 8th largest pension fund in Canada.
– It cover 295,000 people who work at hospitals, community care facilities, labs, clinics and addiction centres.
– Nurses are its largest membership group.
– Fifty of its pensioners are over 100 years old.
– HOOPP earned a 17.71 per cent return in 2014, adding $9.1 billion to its assets, which now stand at $60.8 billion.
– Its average annual return over the past 10 years is 10.27 per cent, its 20-year return an average 9.98 per cent a year.

Source: HOOPP
More on thestar.com

Poorest B.C. seniors not getting help, advocate says

Many don’t know about government subsidies available, survey finds
http://www.vancouversun.com/Poorest+seniors+getting+help+advocate+says/10861395/story.html

BY ERIN ELLIS, VANCOUVER SUN MARCH 6, 2015

B.C.’s seniors advocate says the first survey conducted by her office surprised her by revealing that many of the people who are in most need of help don’t know how to get it.

Isobel Mackenzie says the next step is to find out how to get the message to seniors and to make it easier to apply for subsidies, some of which must be renewed each year.

The survey conducted in the fall of 2014 interviewed 506 seniors throughout B.C. by telephone.

Here are some of its key findings along with a reality check from the front lines.

Getting a break from Medicare premiums

“Something that really jumped out was MSP (Medical Services Plan) premium assistance,” Mackenzie said in a telephone interview. “It’s a sliding scale so you get full premium assistance at $22,000 or less. And absolutely everybody with a household income of $30,000 or less would benefit in some way.”

It adds up to a savings of $864 per year for the lowest income group.

Sixty per cent of respondents living on less than $30,000 a year said they didn’t know they could get help with Medicare premiums.

“That tells me there are people out there who could be getting cost relief and increase their disposable income, but they are not being connected to these programs,” Mackenzie said.

Help with rent or deferred property taxes

About 17,500 people — or one in five seniors — use the Shelter Aid for Elderly Renters (SAFER), which can provide $180 per month to people with incomes below $22,000.

This is only available to those who pay rent for their homes, which is an estimated 20 per cent of B.C. seniors, according to Mackenzie’s office.

The median income for seniors in this province is $24,000, meaning half of B.C.’s 820,000 seniors earn more than that and half earn less.

Seniors in Metro Vancouver were more likely to know about the grant, but it’s used most within the boundaries of the Interior Health Authority, where half of the seniors surveyed received the SAFER grant.

Those who are homeowners can defer property taxes until their home is sold or until their death through the province’s Property Tax Deferment Program.

Yet only 40 per cent of senior homeowners with household incomes below $30,000 were aware of the program, compared with 75 per cent of homeowners with incomes greater than $60,000.

“These low-income senior households are the ones that could potentially benefit the most from a tax deferment program, yet are the least aware of its existence,” states the report.

In real life

Susan Moore, director of an information and referral centre run by the West End Senior’s Network in Vancouver, said she sees people scrimp on food and medications because they have never asked the government for anything and they don’t know there is help available.

“They did plan, they had money in the bank, they had investments, then they stayed healthy and they outlived their savings,” Moore said Wednesday. “And they will have exhausted every personal resource before they ask for help.”

Seniors make up 17 per cent of the population, a figure that’s expected to double during the next two decades.

The B.C. Seniors survey, conducted in conjunction with BC Stats and HealthLink BC, says its margin of error is plus or minus 4.38 per cent.

The full report is available at seniorsadvocatebc.ca

Where to go for help

• 411 Seniors Centre Society, Vancouver, 604-684-8171, 411seniors.bc.ca

• Seniors Services Society, New Westminster, 604-520-6621, seniorsservicessociety.ca

• BC Centre for Elder Advocacy and Support, 604-437-1940 or 1-866-437-1940 (toll free), http://bcceas.ca

bc211.ca: Free confidential, multilingual information and referral assistance for government, community and social services for seniors. Dial 211 24 hours a day, 7 days a week.
eellis@vancouversun.com

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Why we need a national seniors’ housing strategy

Seniors’ Housing: the Need for a National Strategy                                      

John Anderson

March 2015 

While the huge increase in the number of seniors that is coming over the next years in Canada is generally well known, the implications of this growth for seniors’ housing are rarely mentioned. There is no national seniors’ housing strategy, and conditions and programs vary greatly in provinces and territories.

Massive increase in seniors’ population

As of July 1, 2014, Statcan estimated that 15.7% of Canada’s population (nearly one in six Canadians) was aged 65 and older. In 1984, the proportion of Canadians aged 65 and older was 10.0%. By 2016, the number of seniors aged 65 and older would be greater than the number of children under the age of 15. The absolute numbers of seniors will double from 5 million in 2011 to 10.4 million in 2036.[i] By 2051 roughly one in four Canadians is expected to be 65 or over.[ii]

CMHC notes, from Census data, that “In 2006, senior households were more likely to live in unacceptable housing than non-senior households, especially if they were single-person households.”[iii]

Also it is important to underline that there is generally a much higher percentage of seniors in small town Canada than in the large cities, and, yet, it is in these small towns that seniors’ housing and seniors’ services are less available than in big cities.

Most seniors remain in their own homes but need programs and supports

For the vast majority of seniors, who remain in their own homes and wish to do so, there are many issues that need to be addressed to make this option more viable. For example, many seniors live in rental housing and have serious affordability issues. A study of BC seniors housing estimated 50% of seniors who rent have affordability issues.[iv] As well many seniors need to have their homes adapted to assure they can continue to live in them and age in place.

Very little seniors’ housing, and, in general, very expensive.

As for purpose built seniors housing, CMHC says that in Canada there were in 2014, “219,052 spaces in seniors’ housing residences in 2014, with the majority (76.5 per cent) being standard spaces. (note: that roughly 50% of these spaces are in Quebec) The vacancy rate of standard spaces in seniors’ housing residences in Canada decreased slightly over the past year, reaching 9.7 per cent in 2014”.[v]  But with over 5 million seniors right now, and the number growing rapidly and doubling over the next 20 years, not only is this number of units very small and the spaces represent housing for only roughly 4% of seniors, but just to provide the same access in the future, some 200,000 spaces would have to be built over the next 20 years.

Also the cost of seniors’ housing is today very high. “The average rent for bachelor units and private rooms, where at least one meal is included in the rent, rose from $1,995 per month in 2013, to $2,043in 2014. Prince Edward Island posted the highest average rent at $2,782, while Quebec had the lowest at $1,497.”[vi] The highest average rents in cities were: Toronto ($3,206), Regina ($3,105) and Ottawa ($3,017). [vii]  In most provinces, the average rent levels are far above the maximum of $1328 per month which a single person with only OAS and GIS would receive.

Because, in part at least, due to these high rates, the rate of seniors’ population aged 75 years and over in seniors’ homes was quite low, at 8.9%. The highest rate was in Quebec (18.6 %), while the lowest rate of occupancy was in Nova Scotia (2.0 %).[viii]

Canada has no national housing strategy and no seniors’ housing strategy

Canada is the only major G8 country without a national housing strategy and is also without a national seniors’ housing strategy.  The present and growing number of seniors will require different kinds of housing, and each kind of housing choice must have programs attached to it to assure its availability for seniors. We need a national seniors’ housing strategy, developed with the federal, provincial and territorial governments as well as with aboriginal governments and municipalities.  A housing strategy for seniors needs to be co-ordinated with the healthcare services such as homecare. A national seniors’ housing strategy would include:

1. Development of comprehensive programs to help seniors stay in their own home. Most seniors today remain in their own homes but many need programs that will help them with aging in place.

a) Assuring that low income Canadians can remain in their own home with subsidies to units, home tax deferrals and other programs to assure b) Making improvements to help them make their homes seniors friendly. While some provinces have home improvement tax credits or grants, these kinds of programs are generally very limited.c) Providing the home care and other health services that will allow seniors to stay in their own homes and not be forced into long term care facilities which for many seniors are not the right place for them and are extremely costly as well as blocking services that could be used by others who really need this kind of care.d) While many seniors live with others in their own home, many do not and live alone. Of these seniors, many are increasingly isolated and alone. Networks need to be created that will keep all seniors in contact with sources of help, friendship and activity.e) Creating programs to allow seniors who want to share housing with other seniors This can help some seniors stay in their own home by providing a new source of income and allow other seniors to remain in a home environment with other seniors.

2. Creation of more purpose built seniors’ housing, including more affordable seniors’ housing, and the upgrading of existing seniors’ housing.

The reasons why seniors want or have to move into seniors’ housing are very varied, and, thus, we need different kinds of seniors’ housing and care. As much as possible, we need to provide a wide range of seniors’ options:a) independent living rental and purchase housing options in seniors and mixed age buildings or in plus 55 developments (including Life Lease and Equity co-operatives) b) subsidized rental accommodation for low income seniors in municipal, not for profit, and co-operative housing c) all forms of supportive and assisted living to meet the health needs of seniors from physical

[i] http://www.statcan.gc.ca/daily-quotidien/140926/dq140926b-eng.htm

[ii] http://www4.hrsdc.gc.ca/.3ndic.1t.4r@-eng.jsp?iid=33

[iii] CMHC 2011 Housing Observer https://www.cmhc-schl.gc.ca/en/corp/about/cahoob/upload/Chapter_8_EN_W.pdf

[iv] BC Non-profit  Housing  Association, The Need for Non-Profit Seniors’ Housing

in British Columbia, 2010 http://www.bcnpha.ca/media/Research/SENIORS%20REPORT%20-%20FINAL.pdf

[v] CMHC, Seniors Housing Report, 2014, http://www.cmhc-schl.gc.ca/odpub/esub/65991/65991_2014_A01.pdf?lang=en

[vi] http://www.seniorszen.com/blog/2014/08/12/seniors-housing-report-cmhc-canada-highlights

[vii] ibid

[viii] Ibid

 

Which are the best countries in the world to grow old in?

Pensions and healthcare benefits vary widely across the globe as do people’s perception of their happiness

http://www.theguardian.com/society/2015/mar/03/which-best-countries-grow-old-in-pensions-benefits-happiness

Three women on beach with surfboards in Australia.
Three women on beach with surfboards in Australia. Photograph: Michael Hall/Getty Images

Australia
Australia’s notoriously labyrinthine $150bn (£75.8bn) welfare system last week underwent a major review, which essentially recommended an overhaul. However the Commonwealth-funded age pension was conspicuously absent. A politically sensitive topic, it was not in the scope set by the conservative Abbott government, despite it being the largest and most expensive part of Australia’s social security.Australians are living and working for longer. By 2013 the number of Australians aged 65 and over had increased by 533,000 from five years previously, and 17% of people aged 45 and older expected to work beyond the age of 70. In 2012-13, more than half of all retired men and a quarter of retired women named the government pension/allowance as their main source of income, a 45% increase on the number who told the Australian Bureau of Statistics they relied on it when they first retired. Superannuation payments (9.5% of a salary contributed by an employer) have been compulsory since 1992.State pensions are available to Australian residents over the age of 65 (67 by 2023) who have lived in Australia for at least 10 years (with some exceptions such as refugee status) and who meet income and asset requirements. In 2011, that translated to 60% of Australians of qualifying age. People who work past the pension age can still receive partial benefits or a lump sum under incentive schemes.Each fortnight pension recipients get a maximum payment of A$776.70 (£392) for singles, or A$585.50 (£296) if you are part of a couple. A payment supplement of up to A$63.50 (£32.13) a fortnight covers a pharmaceutical allowance, on top of Australia’s publicly funded universal healthcare benefit scheme, and utilities allowances. Each state and territory also offers cheaper travel and retail discounts to people over 60.

Additional services, which are means-tested and partly financed by contributions from a recipient’s pension after a departmental assessment of what is needed, include the Home Care package, and the Home and Community Care package. People over the age of 65 can apply, or from 50 if they are Aboriginal or an Torres Strait Islander.
Helen Davidson, Darwin

Germany
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At the core of the German welfare benefits system is the comprehensive social insurance system into which most workers pay, which includes healthcare provision, unemployment insurance and pension insurance. Once you pay into all these parts of the system, (about 15.5% of your salary for healthcare, 3% for employment insurance, nursing care insurance, 2.2% or 1.95% for those with no children, 18.9% for pension insurance – most of these shared with an employer) you are entitled to a range of benefits, including healthcare for older people. Prescriptions and glasses are covered by that system so don’t have to be applied for separately, and are not classed as benefits.

A person continues to pay into the health insurance system once they are drawing a pension, unless they don’t have the means. Roughly speaking, on retirement, individuals receive half to two-thirds of net income as a pension. About 85% of the workforce is enrolled in the system. There is no legally set minimum or maximum pension.

The normal retirement age for everyone born after 1964 is 67 years. Women who take time off to have children have their contributions topped up by the state. But an OECD report published this week shows that Germany has the widest pension benefits gap between men and women in Europe and the US. The average monthly pension received is around €1,052 (£767.46) for men in the old West German states, and €1,006 (£733.9) for those in the old East German states, while for women the figures are €521 (£380) and €705 (£514).
Kate Connolly, Berlin

Japan
Roughly one in four Japanese are 65 or over – that proportion is expected to rise to one in three by 2025. Pride that life expectancies for Japanese men and women are among the highest in the world is tempered by concern over how to pay for welfare in the coming decades, when there will be fewer people of working age to foot the bill. In 2012, the full basic pension was ¥786,500 (£4,342) a year, 16% of average earnings of 4.79 million yen (£26,443) a year, according to OECD figures.

Everyone aged between 20 and 59 is expected to enrol in the basic national pension scheme, but only those who have paid in for a minimum of 25 years are eligible to draw a pension when they retire at 65. Full-time company employees and their spouses are automatically included in the employees’ pension scheme, which provides additional contributions to the basic state pension, proportional to an individual’s salary. The government estimates that about 85% of Japan’s workforce draw from the employees’ pension scheme. The fuel allowances for low-income residents will be cut by about ¥3bn (£16.2m) in this financial year. People aged 75 or older only need to shoulder 10% of their medical costs unless they have a high income. Everyone else pays 30% of the total cost. Some cities offer reasonably priced annual passes that enable elderly passengers unlimited travel for a year.
Justin McCurry and Chie Matsumoto, Tokyo

Nordic countries
Unlike Sweden and Finland, in Norway pensions are holding up, and poverty among pensioners is actually falling dramatically, despite rising average wages. The official pension age has been 67 for both men and women since the 1970s, but it is possible to draw a full old-age pension from 62 and continue to work full time, while there is a range of options to draw a partial pension. But 67 remains the age when most people aim to retire – and the age at which people on disability benefits are transfered to pensions. Norwegians can continue to accrue pension entitlement until they are 75. Norway’s pension system is in transition, and currently two versions are in operation as the old one is phased out. The outgoing one is a defined benefit scheme comprised of a flat-rate universal benefit, an earnings-related second tier and a minimum benefit floor of almost 50% of average earnings after tax. It is a strongly progressive, egalitarian system due to the comparatively generous level of minimum protection and a decreasing replacement rate for earnings above the average annual wage. Marginal tax rates on pension income rise rapidly. A worker in Norway with 40 years’ contributions on an average wage can expect to enjoy a pension of about 67% of their previous income after tax. A new system is gradually taking over that consists of a defined contribution scheme, plus a minimum guaranteed pension. The payouts from this scheme are subject to a life expectancy adjustment, implying that old-age benefits for each new cohort of pensioners will be reduced in proportion to increases in longevity compared to 2010. Employment among older people is high in Norway, with more than 70% of people aged between 55 and 64 still working – well above the EU average of around 50%.

In Sweden, pensions used to be more generous than in Norway, but the average pension is now just above 50% of wages, and it is expected to dip below that level if life expectancy increases and the retirement age is not postponed. The guaranteed minimum pension is about one-third of the net average wage. Pensioners in Sweden and Norway get discounts on public transport, entry to museums and an income-tested housing allowance is available. Pensioners – like other people in need – can also apply for social assistance to cover one-off payments and special needs.

David Crouch, Gothenburg
Russia
The legal retirement age in Russia is early by European standards: 60 years for men and 55 for women. There has long been talk of raising the age, but given that male life expectancy is only just above 60, the move would be deeply unpopular. Russia’s finance minister said in a recent interview that the pension age should be increased gradually until it is 63 for both men and women. There is also talk of introducing an income test for pensioners – currently none exists and working pensioners or those receiving money from investments or other sources can still claim their pension.

Workers involved in certain categories of hard labour, those who have spent more than 15 years working in Russia’s far north, and mothers of more than five children, are entitled to begin receiving their pensions earlier.

A new points-based system is being phased in that will determine how much money pensioners receive based on how many years they worked. Currently, the basic state pension is around 4,000 (£40) roubles per month, but almost all pensioners receive a number of add-ons, and the average pension across the country is around 11,000 roubles (£110) per month, which is a little under one-third of the average salary. Some regions have particular allowances, for instance pensioners who have been registered living in Moscow for more than 10 years have their pensions topped up to at least 12,000 roubles by the Moscow city government.Pensioners also have a number of travel subsidies, discounted medicine, as well as small savings in certain supermarket chains, usually offered on particular days of the week.

There is no guarantee of the security of Russia’s pension fund further down the line, and indeed it was recently admitted that 243bn roubles (£2.4bn) had been redirected from the pension fund to pay for costs associated with annexing Crimea.
Shaun Walker, Moscow

United States
As the country ages there is no shortage of local, state, national and not-for-profit initiatives that cater to older citizens’ needs. From prevention of elder abuse to ageing awareness to help with nutrition, assistance programmes are a common feature in many communities. Take the “Campus Kitchens Project”, which along with the older persons’ organisation, AARP Foundation announced in 2014 a three-year renewal of its outreach effortsusing student volunteers to combat hunger and isolation among older people. With an estimated 9m older Americans at risk of hunger and the number of hungry people over 50 up by 80% in a decade the initiative harnesses a number of student-run kitchens at colleges across the country to help tackle food insecurity.

Meanwhile in Pennsylvania, one project, “Coming of age”, under the auspices of a collection of organisations, including the state branch of AARP has trained administrators in methods to revamp “seniors centres” to make them more appealing for older people to spend time in with numerous benefits including reducing social isolation. While there are plenty of examples of inventive community-based initiatives, there are wider challenges not least of which is funding retirement.

Exactly what income and benefits an individual receives when they reach 65 depends on a host of factors including which state they live in, whether they continue working past retirement age and in what capacity, the level of private or public sector employment-based pensions and other savings or investments.

The Pension Rights Center in Washington DC and the Pension Policy Center report that of the 44.7 million Americans over the age of 65 in 2013, half had a total annual income of less than $20,380 (£13,271) – from all sources.

Most US retirees receive income from social security, a federal social insurance programme to which people contribute via direct taxation. In the absence of a national state pension, it is the primary source of income for many and widely regarded as the foundation of retirement income. In 2013, 85% of older Americans received monthly social security benefits. The average annual benefit from social security for retired workers in 2013 was $15,132 (£9,852). According to the Social Security Administration, the national average wage in the same year was $44,888.

For three out of five people over 65 who receive social security benefits it accounts for half of their total annual retirement income but it is particularly important for lower income Americans. In 2012 one in four people over the age of 65 received all of their income from social security. According to the Global Age Watch Index 2014 the modest nature of social security payments and the high reliance on it means that the US has a higher incidence of elder poverty than most other countries One of the most valued public services available to older Americans is Medicare, a national health insurance system with almost universal coverage. According to Global Age Watch the programme provides “good access” to medical services and preventative care. However wWhen it comes to access to services for older people with long-term care needs, however, there are many barriers to obtaining affordable, quality provision because most adults don’t have separate insurance coverage for these.
Mary O’Hara, Los Angeles

South Africa
Old age pensions are provided to people above the age of 60 earning below R49,920 (£2,763) if single and R99,840 (£5,527) if married, and whose assets do not exceed R831,600 (£46,041) if single and R1.7 million if married. Beneficiaries must not be maintained or cared for in a state institution, and should not be in receipt of another social grant. An elderly person is typically eligible for a grant of 1,350 rand (£75) per month. Government guidelines state: “It should be noted that social grants for adults are paid on a sliding scale – the more income and applicant has, the less he/she will receive for the grant.” They can turn to extended families and NGOs for help. The services NGOs offer include social support groups, training and education, income generating projects, frail care services, transport to health facilities and luncheon clubs and home based care, according to the Older Person’s Forum. But most of these services are non-existent in rural areas.

Nearly three million people were old age pension recipients in 2013/14. There are private companies that offer these benefits to pensioners – such as Specsavers with spectacles and some bus companies regarding travel. South Africa has one of the largest voluntary retirement funding systems in the world (and for the large proportions of people in employment, these arrangements are mandatory conditions of service). There are programmes of support in provincial social department for old age homes. There is broadly free healthcare in public health facilities. Public housing and transport also benefits many elderly people. Those retiring early have their pensions cut by 3.6% for each year, except those forced into early retirement, whose pensions can by cut by a maximum of 10.8%.
David Smith, Johannesburg

Italy
The state pension is €219-€230 (£159-£167) per week for people under 80 and €240.30 (£175) for over-80s, depending on Older people, like all other Italians, receive free healthcare under the national health system. The services are either delivered free of charge, or patients pay for them and are reimbursed.

Other benefits differ from region to region. For example, residents in Rome over the age of 70 are offered free bus and metro passes.
Stephanie Kirchgaessner, Rome

France
The legal retirement age in France now stands at 62 for people born between 1955 and 1973. However a full state pension is only awarded for those who have worked 40-43 years. Those born after 1973 will have to work for 43 years to obtain a full pension at 62. In certain cases, including those who have taken time out for parenting or taking care of a disabled person, it is possible to claim a full pension at the age of 65 (or 67 depending on the date of birth) regardless of how long the individual has worked. For private sector workers, the full pension takes into account the 25 best years worked, with an allowance for inflation, and can total half their monthly salary. Civil servants have a more generous scheme: they can retire on a state pension of 75% of average income, calculated on the basis of their last six months in work (minus bonuses). However under reforms announced last year, civil servants will have to work an extra two years – 43 instead of 41.5 – to receive a full pension, bringing them into line with the work period requirements of the private sector, even though the calculation remains different.

For unemployed pensioners, a single person with less than €9,600 (£6,988) per year or a couple with less than €14,904 per year can claim an allowance called the allocation de solidarité aux personnes agés (Aspa), or elderly persons solidarity benefit. In the case of a single person surviving on €7,000 a year, the Aspa allowance would be €2,600 (£1,893) – calculated according to the €9,600 benchmark figure minus the €7,000. A couple with €13,000 would receive €1,904 per year.
Anne Penketh, Paris

Ireland
The state pension is €219-€230 (£159-£167) per week for under-80s and €240.30 (£175) for over-80s, depending on social insurance contributions while working, regardless of any income from private or occupational pensions.

Pensioners, like those in receipt of long-term social welfare payments or those who can prove they cannot provide their heating needs during winter, are entitled to a means-tested weekly winter fuel allowance of €20 (£ 14.54) per household. Those over 70 receive a free TV licence and in some cases are eligible for means-tested free electricity and gas depending on their fiscal circumstances. All pensioners receive free bus and rail travel, not only in the Irish Republic but across the border in Northern Ireland.
Henry McDonald, Dublin