In this project we will use 3 scenarios as a tool to stimulate debate about the future of elderly care. Scenario analysis is a process of analyzing possible future events by considering alternative possible outcomes. The scenario analysis does not try to predict the future, neither is it a coherent analysis of all aspects of a possible future. Instead, it presents consciously several alternative future developments.
Participants in scenario workshops are typically people who have a stake in the future of elderly care. In the present case this can be representatives for the senior citizens themselves and their relatives, people working in the health care sector, local politicians, people from industry, research and development and volunteering organisations. Stakeholder involvement is a way to make the decisions more robust and socially acceptable. Involving relevant stakeholders in the process can give them ownership to the process. This in turn can make implementation in society easier.
The scenario workshops in the PACITA project will produce visions for what kind of elderly care services the Europeans (through the expressed and confronted views of a divers range of stakeholders) want and policies needed to achieve these visions.
A vision in the context of the PACITA scenario workshop is a picture of a desirable future in the elderly care. It can reflect ethical, social and/or legal challenges, which were identified during the workshop procedure.
Our 3 scenarios
The quality of life of a senior citizen in the future will be influenced by a number of factors, like their family situation, whether they live in an urban or rural area, their religion, their ability to participate in social life etc.
This project is concerned with choices that the politicians can take for improving the future care services for the senior citizens – and the dilemmas they are faced with.
The two main concerns in our scenarios are:
- Is it the public or private health care providers who are providing future elderly care?
- How do the senior citizens and other groups in the society organise themselves in order to meet the needs for care?
In the PACITA project, we have chosen to look at these two main concerns as two axes. On the horizontal axis the one extreme is that the government decides which technologies everybody will be entitled to, and the other extreme is that people can choose freely themselves from an open marked. On the vertical axis, the one extreme is that the senior citizens themselves, their relatives and the community cooperate and help out, and constitutes the major resource in the elderly care. The other extreme is that each senior citizen has to find and choose his or her own care services.
In reality, the solution will be somewhere between these extremes. To illustrate the consequences that might follow different decisions three scenarios have been developed. The three scenarios are not the aforementioned extremes but they include a combination of them. The way they address the main concerns is illustrated by where they are located in the coordinate system (see figure below):
The three scenarios illustrate different ways the community can develop. They show in particular how the health care services may develop, how the municipalities may be affected by increased government control, a stronger private sector or a better organised voluntary community. The scenarios also illustrate what municipalities can do to tackle the different reality models.
Scenario 1: One size fits all is based on the assumption of lack of labour in the future, and it describes a large-scale governmental initiative using technologies to make people more self-reliant.
Scenario 2: Freedom of choice is based on a new political system where [incentives for care recipients] go directly to the user, and this scenario furthermore describes a society where you can buy a great variety of care services from the open market. Everyone in need for care is entitled to [incentives and financial support] depending on his or her health condition.
Scenario 3: Volunteering community is based on volunteering people as the key resource for the community and for each other. This could include the senior citizens themselves, their relatives, charities, neighbours, school children etc. The [council/municipality’s] main role is to mobilize coordination of the volunteering organisations.
To create awareness of the choices we make today and make them more tangible, we develop user stories. These are three stories about four individuals how they live their lives in 2025 in the given scenarios. You will meet George, Annabelle and the couple Laura and Kevin on page 3 Personnas.
 The year 2025 is chosen because the population projections show a clear increase in the ageing population. 2025 also makes room for several years of technology development.