Invest in older people’s health to preserve independence

Investing in older people’s health can help them remain independent for longer and reduce the need for institutional care, Björn Bjarnason argues in a column published by Morgunblaðið. He says the debate should look beyond how many nursing home places are needed and consider how people can maintain their abilities. That could improve quality of life and make better use of public funds.

Janus Guðlaugsson, a sports and health scientist, has long advocated targeted health promotion for older people, with an emphasis on strength training, regular exercise and nutrition. He argues that investment should come before illness and declining ability require extensive care, so people can continue daily activities, hobbies and social relationships on their own terms.

Janus has cited an annual operating cost of about ISK 20 million for each person in a residential or nursing home. For 1,000 people, that would amount to ISK 20 billion. If the need for such care were delayed by a year, he says, the potential benefits would be considerable. But that would not automatically mean a saving of ISK 20 billion, since other services cost money and fixed costs would remain.

Finance Minister Daði Már Kristófersson stressed the importance of investing in older people’s health promotion in an interview with RÚV on October 21. He said the government’s five-year planning horizon might be too short for investments that could take decades to deliver results. When budgets are in deficit, prevention work may be tempting to cut, even though doing so could increase the problem. That, Bjarnason writes, reflects how short-term savings can lead to long-term costs.

On October 22, Progressive Party parliamentary group chairman Stefán Vagn Stefánsson questioned the health minister about health promotion for older people. Referring to Janus’s work, he pointed out that the rehabilitation pool run by the Health Institution of North Iceland in Sauðárkrókur had closed. He said the pool needed about ISK 20 million a year to operate and asked what social costs its closure could bring in the short and long term, beyond the institution’s own expenses.

Health Minister Alma Möller said she was familiar with Janus’s work and would look into the pool issue. She referred to cooperation between the Directorate of Health and municipalities, and said health promotion and prevention were responsibilities shared by society. Bjarnason adds that ministers remain responsible for decisions within their remit.

The Directorate of Health supports health promotion for older people through guidance, education and cooperation with municipalities. Work has also been carried out to improve access to information about exercise options. But people must be able to use the services regardless of their finances, where they live or their level of ability. Information alone is of little help to those who cannot leave home without assistance.

Housing and the surrounding environment also matter. In Morgunblaðið on November 2, Aflvaki managing director Sigurður Stefánsson noted that more people live alone as they grow older and that their housing needs change. He called for suitable housing, support, rehabilitation and nursing care to form a continuous service. Accessible homes, walking routes and nearby services can help people stay active and maintain social ties.