Implementation Strategy

forOlder PersonsLegislation

CONTENTS

1.Foreword

2.Definitions

3.Background

4.Legislation and Policy Framework

4.1.Legislation

4.2.Policies

4.3.Instruments

5.Situational Analysis

5.1.Number of Older Persons

5.2.Vulnerabilities of Older Persons

5.3.South African Context

5.3.1.Fact Tables

5.3.1.1.Older Persons aged 60 – 85+ per Gender per Province

5.3.1.2.Older Persons aged 60 – 85+ per Race per Gender per Province

5.3.1.3.Older Persons aged 60 – 85+ Receiving Pension per Race per Gender per Province per District

5.4.Focus Areas

5.4.1.Rights

5.4.2.Abuse

5.4.3.Poverty

5.4.4.Health

5.4.5.Food and Nutrition

5.4.6.Housing and Living Environment

5.4.7.Family

5.4.8.Social Welfare

5.4.9.Employment and Income Security

5.4.10.Crises, Emergencies & Epidemics

5.4.11.Migration

5.4.12.Education and Training

5.4.13.Gender

6.Strategy

6.1.Vision

6.2.Objectives

6.3.Stakeholders of the Strategy

6.4.Responsibilities contained in the Act

6.5.Potential Risks

7.Proposed Delegations

7.Implementation

7.1.Develop Community-based Programmes

7.1.1.Process

7.2.Prescribe National Norms & Standards

7.3.Make regulations

7.3.1.Process - Consultations

7.3.2.Process – Invite Comments

7.4.Develop Uniform Approach

7.4.1.Process

7.5.Delegate Power and Authority

7.5.1.Evaluate Act Application

7.5.2.Evaluate Proceedings

7.6.Register Provision of Community-based Care and Support Services

7.7.Provide Financial Awards

7.7.1.Process

7.8.Protect older Persons

7.9.Provide Ministerial Consent

7.10.Account for Assets

7.11.Account for Caregivers

7.12.Monitor a Registered Residential Facility

7.13.Monitor a Registered Facility other than a Residential Facility

8.Provincial Implementation

Definitions

Abuse - Any conduct or lack of appropriate action, occurring within any relationship where there is an expectation of trust, which causes harm or distress or is likely to cause harm or distress to an Older Person; constitutes abuse of an Older Person. This includes physical, sexual, psychological and economic abuse.

Act –Means the Older Persons Act (13 of 2006)

Care - Means physical, psychological, social or material assistance to an older person, and includes services aimed at promoting the quality of life and general well-being of an Older Person.

Caregiver - Means any person who provides care.

Community-based Care and Support Services - Means services within the programmes below.

(i)Prevention and Promotion programmes, which ensure the independent living of an older person in the community in which the older person resides; and

(ii)Home-based Care programmes, which ensures that a Frail Older Person receives maximum care within the community through a comprehensive range of integrated services

Department - Means the Department of Social Development in the national sphere of government.

Director-General - Means the Director-General of the Department.

Frail Older Person - Means an Older Person in need of 24-hour care due to a physical or mental condition which renders him or her incapable of caring for himself or herself.

Health Care Provider - Means a health care provider defined in section 1 of the National Health Act, 2003 (Act No. 61 of 2003).

Home-based Care - Means care provided or services rendered at the place where a Frail Older Person resides, excluding at a residential facility, by a caregiver, in order to maintain such Frail Older Person’s maximum level of comfort, including care towards a dignified death.

Magistrate - Includes an additional and an assistant Magistrate.

Manager - Means the person responsible for the day-to-day management of a residential facility.

Minister - Means the Minister of Social Development.

Older Person - Means a person who, in the case of a male, is 65 years of age or older and, in the case of a female, is 60 years of age or older.

Older Person in need of Care and Protection - means an Older Person who –

(a) Has his or her income, assets or old age grant taken against his or her wishes or who suffers any other economic abuse.

(b) Has been removed from his or her property against his or her wishes or who has been unlawfully evicted from any property occupied by him or her.

(c) Has been neglected or abandoned without any visible means of support.

(d) Lives or works on the streets or begs for a living.

(e) Abuses or is addicted to a substance and without any support or treatment for such substance abuse or addiction.

(f) Lives in circumstances likely to cause or to be conducive to seduction, abduction or sexual exploitation.

(g) Lives in or is exposed to circumstances which may harm that Older Person physically or mentally.

(h) Is in a state of physical, mental or social neglect.

Operator - Means a person who operates a residential facility.

Police Official - Means a member as defined in section 1 of the South African Police Service Act, 1995 (Act No. 68 of 1999, or a member of a municipal police service established under section 64A of that Act.

Prescribed - Means prescribed by regulation.

Regulation - Means any regulation made under section 34 of the Older Persons Act (Act 13 of 2006).

Rehabilitation - Means a process by which an Older Person is enabled to reach and maintain his or her optimal physical, sensory, intellectual, psychiatric or social functional levels, and includes measures to restore functions or compensate for the loss or absence of a function, but excludes medical care.

Residential Facility - Means a building or other structure used primarily for the purposes of providing accommodation and of providing a 24-hour service to Older Persons.

Respite Care - means a service offered specifically to a Frail Older Person and to a Caregiver and which is aimed at the provision of temporary care and relief.

Service - Means any activity or programme designed to meet the needs of an Older Person.

Service Provider - Means any Person registered in terms of the Act to provide social service to Older Persons, and includes an operator of a Residential Facility.

Shelter - Means any building or premises maintained or used for the reception, protection and temporary care of an Older Person in need of care and protection.

Social Worker - Means a person registered as a social worker under section 17 of the Social Service Professions Act, 1978 (Act No. 110 of 1978), and in the employ or service of government or a registered welfare organisation.

1.Background

The purpose of the Department of Social Development is to create a caring and integrated system of social development services that facilitates human development and an improvement in the quality of life of the Person the Department serves. Central to this is the provision of developmental social services to ease the burden of poverty and other socio-economic challenges on vulnerable Persons such as Children, Women, Persons with disabilities and Older Persons.

Whilst traditionally respected, Older Persons are becoming increasingly marginalised as a result of social change and economic pressure. The growth in the elderly population has not been accompanied by great economic development.

Government has recognised the need to increase focus on Older Persons in terms of the development of legislation, service delivery, awareness and advocacy campaigns and to assess the relevance and effectiveness of the programmes and services that are being provided to Older Persons in South Africa.

South Africa has ratified the United Nation’s Madrid International Plan of Action on Ageing (2002), the African Union’s Policy Framework and Plan of Action on Ageing (2003) and promulgated the Older Persons Act (13 of 2006) in order to –

  • Deal effectively with the plight of Older Persons by establishing frameworks aimed at their empowerment, protection and at the promotion and maintenance of their status, rights, well-being, safety and security.
  • Facilitate accessible, equitable and affordable services to Older Persons
  • Empower Older Persons to continue to live meaningfully and constructively in a society that recognises them as important sources of knowledge, wisdom and expertise

This document is an articulation of the Department’s approach to fulfill its legislative mandate

2.Legislation and Policy Framework

2.1.Legislation

  • The Constitution of the Republic of South Africa, 1996. Act 108 of 1996.
  • Aged Persons Act, No. 81 of 1967.
  • Aged Persons Amendment Act, No. 100 of 1998.
  • Older Persons Act, No. 13 of 2006
  • Human Rights Commission Act, No. 54 of 1994.
  • Domestic Violence Act, No. 116 of 1998.
  • Promotion of Equality and Unfair Discrimination Act, No. 4 of 2000.
  • Mental Health Act, No. 18 of 1973.
  • Health Act, No. 63 of 1977.
  • Criminal Procedure Act, No. 51 of 1977.
  • Criminal Procedure Second Amendment Act, No. 85 of 1996.
  • Public Protector Act, No. 51 of 1977.
  • Social Assistance Act, No. 45 of 1994.
  • Recognition of Customary Marriages Act, No. 120 of 1998.
  • Social Assistance Act, No. 59 of 1992. (Proclamation No. 8 of 1996)
  • Housing Development Schemes Act for Retired Persons, No. 65 of 1988.

2.2.Policies

  • SA Policy for Older Persons – 2005

2.3.Instruments

  • Protocol on Management of Elder Abuse – 2005
  • Protocol on Victim Empowerment
  • Draft Older Persons Regulations – 2010
  • Human Rights Charter
  • Department of Health: Strategy on Elder Abuse
  • UN Principles and Resolutions
  • Vienna International Plan of Action
  • IFA position on Elder Abuse
  • Department of Health: Patients’ Charter
  • DSD Strategic Plan - 2009-2012
  • Norms and Standards for developmental social welfare services
  • African Union Policy Framework & Plan of Action on Ageing – Help Age International
  • Madrid International Plan of Action on Ageing – United Nations
  • African Population Studies Vol. 21 No. 1 - Ferreira, M & Kowal, P
  • The Status of Older Persons in South Africa - CASE
  • Addressing Older Person’s Rights - Help Age International
  • Nutritional status and risk factors for vulnerability of Older Person in Africa - Help Age International

3.Situational Analysis

3.1.Number of Older Persons

The world population aged 60 years and above is increasing rapidly.Whereas in 1950 it was200 million, by 2000 it had increased to nearly 606 million. It is projected that by 2025, the World population of Older Persons will reach 1.2 billion and by 2050, 2 billion.

The Older Population of Africa, currently estimated to be slightly over 38 million, is projected to reach between 203 and 212 million by 2050; a six-fold increase in five decades.

The 1996 South African census determined that 6.9% of the country’s population was aged 60 years and older. This proportion increased to 7.8% (3.28 million) of the total population (44.8 million) by 2001. The Community Survey conducted by Statistics SA in 2007 puts the figure at 3.77 million; approximately half a million more than projected.

3.2.Vulnerabilities of Older Persons

Older Persons, specifically in developing countries, have particular vulnerabilities which are exacerbated by social, economic, cultural, political and environmental factors.

  • Poverty is widespread and the majority of countries lack formal social protection; Older Persons are consistently among the poorest of the poor.
  • Natural and man-made disasters impact Older Persons’ livelihoods, security and well-being.
  • Health systems struggle to grapple with the elimination of communicable diseases, and seem unable to expend sufficient resources on treatment of an increasing prevalence of non-communicable diseases; the direct and indirect consequences of the HIV/AIDS epidemics being the most severe.
  • Changes in family structures as a result of urbanisation and other forces diminish kin support for Older Persons.

3.3.South African Context

The largest proportions of Older Persons per Province are found in the Eastern Cape and KwaZulu-Natal. The majority of Older Persons in South Africa are black African females. In addition, the 2001 census estimated that over half of Older Persons in South Africa had not had access to education; and that older females tended to have more limited access to education than older males. There is also a “considerable diversity in ageing patterns due to differences in their fertility, mortality and accessibility to resources.”

  • The number of Older Persons who are the main care givers in their households remains very high.
  • The increasing number of young and middle-aged adults who die due to HIV and AIDS, often leaving behind Orphans in the care of Grandparents tend to increase the burden of care placed on the Older Person.
  • Most of the household members depend on the Older Person financially.
  • A substantial proportion of Older Persons still do not have access to basic services like running water, flush toilets and refuse removal.
  • Even though the majority of the Older Persons were receiving social grants or private pension, a very small proportion of them reported that their households are receiving any subsidy to help pay for basic services.
  • Very few Older Persons benefited from the government subsidized housing program even though the policy stipulates that recipients of the old age grant are eligible for the housing subsidy scheme.
  • A very low percentage of the Older Persons had ABET but a substantial number reported that they had no formal education.
  • The majority of Older Persons use government hospitals or clinics for medical care. The South African Policy for Older Persons stipulates that Older Persons should be eligible for Primary Health Care services at no cost at all. However some of the Older Persons had to pay for registration, consultation and medication.
  • Some Older Persons are travelling long distances to get to the centers and have to join long queues to be attended to.
  • A lot of Older Persons are on treatment for chronic illnesses which could be prevented through good health practices at younger ages. Knowledge of Dementia and Alzheimer’s was very low even though a large proportion of Older Persons have memory problems.
  • Some of the elderly did not know what abuse to Older Persons refer to. There were Older Persons who knew of someone who was being abused but did not know what to do about it.

3.3.1.Fact Tables

All information contained in the Tables has been extracted from information obtained during the Community Survey conducted by Statistics SA in 2007.

3.3.1.1.Older Persons aged 60 – 85+ per Gender per Province

Province / Spread per Province / Number of Older Persons per Province / Older Persons Across All Race Groups
Male / Female
Eastern Cape / 16.62% / 626 610 / 232 987 / 393 623
Free State / 5.89% / 222 244 / 86 003 / 136 241
Gauteng / 19.05% / 718 234 / 304 646 / 413 588
KwaZulu-Natal / 19.18% / 723 003 / 250 233 / 472 770
Limpopo / 11.77% / 443 700 / 146 653 / 297 047
Mpumalanga / 6.32% / 238 099 / 93 190 / 144 909
North West / 6.63% / 250 097 / 102 384 / 147 713
Northern Cape / 2.53% / 95 226 / 39 832 / 55 394
Western Cape / 12.01% / 452 881 / 19 6558 / 256 323
Country Total / 100.00% / 3 770 094 / 1 452 486 / 2 317 608

Table 1

3.3.1.2.Older Persons aged 60 – 85+ per Race per Gender per Province

Province / Race
Black African / Coloured African / Indian or Asian African / White African
Male / Female / Male / Female / Male / Female / Male / Female
Eastern Cape / 189850 / 337350 / 13294 / 21369 / 808 / 1067 / 29035 / 33837
Free State / 60400 / 105477 / 2315 / 3331 / 6 / 126 / 23282 / 27307
Gauteng / 150932 / 224422 / 8284 / 14707 / 9618 / 11591 / 135812 / 162868
KwaZulu-Natal / 167391 / 364459 / 4080 / 7008 / 33461 / 47548 / 45301 / 53755
Limpopo / 137455 / 287036 / 321 / 532 / 310 / 534 / 8567 / 8945
Mpumalanga / 78489 / 126710 / 360 / 966 / 453 / 827 / 13888 / 16406
North West / 84971 / 124987 / 1174 / 1952 / 413 / 672 / 15826 / 20102
Northern Cape / 12445 / 18702 / 17847 / 25407 / 119 / 155 / 9421 / 11130
Western Cape / 24086 / 29691 / 73884 / 108464 / 2320 / 2675 / 96268 / 115493
Country Total / 906019 / 1618834 / 121559 / 183736 / 47508 / 65195 / 377400 / 449843

Table 2

3.3.1.3.Older Persons aged 60 – 85+ Receiving Pension per Race per Gender per Province per District

Province / Race
Black African / Coloured African / Indian or Asian African / White African
Male / Female / Male / Female / Male / Female / Male / Female
Eastern CapeTotal / 117440 / 302255 / 6248 / 17678 / 216 / 587 / 4517 / 7393
DC10 - Cacadu / 4254 / 8273 / 1788 / 5631 / 31 / 31 / 875 / 1656
DC12 - Amatole / 36946 / 89592 / 557 / 1424 / 65 / 22 / 1046 / 1533
DC13 - Chris Hani / 22027 / 52987 / 409 / 1121 / 0 / 0 / 329 / 367
DC14 - Ukhahlamba / 7392 / 18443 / 74 / 584 / 0 / 0 / 194 / 410
DC15 - O.R. Tambo / 31462 / 85647 / 0 / 70 / 0 / 132 / 0 / 0
DC44 - Alfred Nzo / 7797 / 26895 / 0 / 50 / 0 / 0 / 72 / 24
NMA - NelsonMandelaBay Metro / 7562 / 20418 / 3420 / 8798 / 120 / 402 / 2001 / 3403
Free State Total / 32842 / 94558 / 1238 / 2928 / 0 / 67 / 3855 / 7735
DC16 - Xhariep / 1639 / 5192 / 437 / 761 / 0 / 0 / 225 / 614
DC17 - Motheo / 8920 / 26850 / 603 / 1430 / 0 / 67 / 1245 / 1732
DC18 - Lejweleputswa / 7217 / 20401 / 60 / 82 / 0 / 0 / 790 / 1615
DC19 - Thabo Mofutsanyane / 9691 / 26809 / 0 / 279 / 0 / 0 / 636 / 1101
DC20 - Fezile Dabi / 5375 / 15306 / 138 / 376 / 0 / 0 / 959 / 2673
Gauteng Total / 61191 / 176430 / 3867 / 10445 / 2996 / 6559 / 20141 / 39061
DC42 - Sedibeng / 7665 / 19101 / 64 / 46 / 158 / 373 / 2102 / 3537
DC46 - Metsweding / 1194 / 1779 / 0 / 0 / 0 / 26 / 406 / 813
DC48 - West Rand / 3310 / 8382 / 164 / 383 / 114 / 354 / 1085 / 1831
EKU - Ekurhuleni Metro / 15168 / 41952 / 168 / 1814 / 549 / 1056 / 6977 / 13542
JHB - City of Johannesburg Metro / 19778 / 67508 / 3037 / 7086 / 2054 / 4034 / 5380 / 10973
TSH - City of Tshwane Metro / 14076 / 37708 / 434 / 1116 / 121 / 716 / 4191 / 8365
KwaZulu-Natal Total / 88721 / 324556 / 1391 / 4693 / 13462 / 37158 / 8652 / 15596
DC21 - Ugu / 8738 / 32727 / 46 / 79 / 419 / 1234 / 910 / 1355
DC22 - UMgungundlovu / 7863 / 27676 / 331 / 1575 / 1421 / 3011 / 1230 / 2168
DC23 - Uthukela / 7636 / 28454 / 0 / 84 / 689 / 961 / 140 / 110
DC24 - Umzinyathi / 5123 / 23064 / 0 / 133 / 30 / 441 / 0 / 264
DC25 - Amajuba / 4198 / 13799 / 0 / 0 / 339 / 1004 / 652 / 846
DC26 - Zululand / 11550 / 35410 / 0 / 0 / 0 / 0 / 168 / 313
DC27 - Umkhanyakude / 7917 / 24461 / 0 / 0 / 0 / 0 / 42 / 149
DC28 - Uthungulu / 9677 / 32101 / 0 / 72 / 201 / 209 / 308 / 551
DC29 - iLembe / 6559 / 20550 / 0 / 55 / 599 / 1542 / 246 / 355
DC43 - Sisonke / 5711 / 22635 / 30 / 265 / 0 / 68 / 52 / 67
ETH - eThekwini Metro / 13749 / 63679 / 984 / 2430 / 9764 / 28688 / 4904 / 9418
Limpopo Total / 86211 / 267230 / 157 / 530 / 201 / 295 / 2427 / 3768
DC33 - Mopani / 14360 / 49352 / 0 / 0 / 0 / 0 / 349 / 344
DC34 - Vhembe / 19073 / 63640 / 0 / 119 / 0 / 0 / 130 / 261
DC35 - Capricorn / 23467 / 69450 / 119 / 336 / 0 / 0 / 464 / 987
DC36 - Waterberg / 8407 / 26195 / 0 / 75 / 173 / 231 / 1365 / 2014
DC47 - Greater Sekhukhune / 20904 / 58593 / 38 / 0 / 28 / 64 / 119 / 162
Mpumalanga Total / 42666 / 113633 / 103 / 796 / 94 / 483 / 3782 / 6077
DC30 - Gert Sibande / 8507 / 23430 / 56 / 273 / 0 / 39 / 1669 / 3012
DC31 - Nkangala / 15048 / 38458 / 47 / 197 / 60 / 75 / 1323 / 1645
DC32 - Ehlanzeni / 19111 / 51745 / 0 / 326 / 34 / 369 / 790 / 1420
North West Total / 45235 / 112320 / 610 / 1778 / 121 / 301 / 4169 / 7963
DC37 - Bojanala / 19189 / 48339 / 78 / 357 / 51 / 15 / 821 / 1844
DC38 - Central / 13307 / 31708 / 181 / 451 / 0 / 163 / 544 / 819
DC39 - Bophirima / 7502 / 16863 / 169 / 462 / 0 / 55 / 496 / 1169
DC40 - Southern / 5237 / 15410 / 182 / 508 / 70 / 68 / 2308 / 4131
Northern CapeTotal / 6898 / 16916 / 10223 / 22234 / 69 / 133 / 1812 / 3610
DC6 - Namakwa / 53 / 0 / 2527 / 6135 / 0 / 61 / 156 / 430
DC7 - Pixley ka Seme / 560 / 1660 / 1777 / 4633 / 0 / 12 / 174 / 543
DC8 - Siyanda / 886 / 1230 / 3182 / 5911 / 0 / 30 / 280 / 768
DC9 - Frances Baard / 2681 / 7923 / 2244 / 5036 / 69 / 30 / 1141 / 1578
DC45 - Kgalagadi / 2718 / 6103 / 493 / 519 / 0 / 0 / 61 / 291
Western CapeTotal / 10236 / 22763 / 33237 / 84803 / 925 / 1539 / 13044 / 23449
DC1 - West Coast / 178 / 127 / 2660 / 6033 / 0 / 0 / 727 / 1195
DC2 - CapeWinelands / 1780 / 2948 / 5557 / 13569 / 0 / 65 / 1430 / 3631
DC3 - Overberg / 284 / 344 / 1861 / 4059 / 83 / 116 / 1466 / 1847
DC4 - Eden / 966 / 2021 / 3851 / 9133 / 0 / 47 / 2249 / 3087
DC5 - Central Karoo / 163 / 307 / 625 / 1684 / 0 / 0 / 77 / 223
CPT - City of Cape Town Metro / 6865 / 17016 / 18683 / 50325 / 842 / 1311 / 7095 / 13466

Table 3

3.4.Focus Areas

The recommendations from the Madrid International Plan of Action on Ageing are encompassed in these areas:

  • Older Persons and development;
  • Advancing health and well-being into old age; and
  • Ensuring enabling and supportive environments.

The African Union Policy Framework and Plan of Action an Ageing recognises that apart from children, Older Persons are the social group most vulnerable to the numerous ills facing Underdeveloped Countries; specifically in Africa (poverty, food insecurity, civil strife, armed conflict, migration, violence, inadequate social welfare services).

The recommendations from the AU Policy Framework and Plan of Action address the areas contained in the Madrid International Plan of Action on Ageing and include others that establish the Continental context for addressing the needs of Older Persons.

The Older Persons Act (13 of 2006) instructs the following:

  • Deal effectively with the plight of Older Persons by establishing a framework aimed at the Empowerment and Protection of Older Persons and at the Promotion and Maintenance of their Status, Rights, Well-being, Safety and Security; and Provide for matters connected therewith.
  • All organs of state must co-operate in the development of a uniform approach aimed at co-ordinating and integrating the services delivered to Older Persons.

The Focus Areas of the recommendations from the Madrid International Plan of Action on Ageing and the African Union Policy Framework and Plan of Action an Ageing integrated with the stipulates of the Older Persons Act is depicted in Figure 1.

Figure 1 - Focus Areas

3.4.1.Rights

  • The rights that an Older Person has in terms of this Act supplement the rights that an Older Person has in terms of the Bill of Rights. [Section 4. (1)]
  • All proceedings, actions or decisions in a matter concerning an Older Person must respect, protect, promote and fulfil the older person’s rights, the best interests of the Older Person and the rights and principles set out in this Act, subject to any lawful limitation. [Section 5. (2)(a)]
  • Older Persons enjoy the rights contemplated in section 9 of the Constitution of the Republic of South Africa and in particular may not be unfairly denied the right to –
  • Participate in community life in any position appropriate to his or her interests and capabilities
  • Participate in inter-generational programmes
  • Establish and participate in structures and associations for Older Persons
  • Participate in activities that enhance his or her income-generating capacity
  • Live in an environment catering for his or her changing capacities
  • Access opportunities that promote his or her optimal level of social, physical, mental and emotional well-being

[Section 7]