In mid-June the Ministry of Labour published its annual report titled Carta Social which gave statistics for the year 2022 in respect of Social Security and Solidarity.


Of the 1,8 billion euros budgeted, 44% was spent in support for the aged and 38% for minors. For the disabled and disadvantaged of all ages the amount was 14%. The total number of users benefiting from this distribution is given as 1,027,600 which is an increase of 8.5%.over 2021. It is not clear if the value of this wealth increased proportionately or was decreased by the effect of inflation but it is claimed that all three sectors showed positive achievements.

However, the report concludes that if all persons over the age of 65 were to need access to social services at any one time only 12% would have access to a slot in the system. This troubling information is enhanced by the report that, in twenty years of the 21st century the number of people aged over 80 has doubled from 377,000 to 720,000. More frightening, is the demographic forecast that by year 2040 this is likely to double again while, at the other end of the graph, the birth/fertility rates will diminish. The effect is that of an inverted hour glass with the sands of time flowing upwards. Of all European countries, Portugal is assessed at being in fourth place for its proportion of older ones in the populace and is likely soon to move up into third place even with the counter balance of young immigrant workers arriving with large families.

Before 25 April 1974, there was little supervision of social needs by the State which considered that traditional care for the aged was adequate in family circumstances with support from charitable institutions, hospitals and asylums. The revolution rapidly brought about social changes in many fields not least of which was a response to the needs for accommodation to meet the requirements of elderly parents many of whom had been left behind in rural locations after their children had emigrated or moved to urban locations. Initially, the demand was fulfilled by the adaptation of dilapidated hotels and “residenciais” but later extended to large houses and apartment buildings.

Four years ago, at the peak of the Covid-19 epidemic, the deplorable state of health care for the elderly and the disabled was revealed with disturbing accounts of the restrictions imposed by the institutions to which they had been committed. Many care homes and their poorly paid staff were found to be wanting in the requisite standards of hygiene and nursing and the prison-like morale which was imposed on the inmates. Some of the worst were closed while others received emergency repair. In all cases there was the dilemma of what to do with a large number who had nowhere to go. And, perhaps more important, there was the problem of recruiting trained nursing staff to replace the unskilled but often dedicated workers who carried on with great difficulty due to their own sickness and ageing.


At the top end of the private sector, the wealthy aged have a choice of excellent care/nursing homes many of which were new constructs with a range of in-house medical facilities and leisure amenities which public sector institutions cannot hope to emulate due to lack of finance. However, with pressures mounting due to the overcrowding of hospitals and the threat of impending pandemics, some of the private space may soon have to be rented by the SNS until such time as its budgets are substantially increased to provide the new buildings which are so urgently needed.


The present dire predicament for the placing of the elderly in care has been likened to moving the deckchairs on the sinking Titanic!


Last year, 575,000 elderly people were found to be living alone. With increasing longevity, the average age at which serious illnesses commence has moved from 80 to 83 so there may be a short respite before some of these people are forced to enter an institution which can provide palliative attendance for diseases such as cancer or secure accommodation for patients with dementia.


After the census of year 2021, units of the GNR visited “loners” to provide advice concerning security and how to obtain urgent aid in the event of accident. The Radar Social Project, launched in 2023, also intends to contact these aged ones but with the deeper purpose of encouraging integration into community care schemes as promoted by local authorities. Both of these enquiries found an overwhelming desire to remain at home until the inevitable occurs and a determination to remain independent but with self-sufficiency being supported by care workers. In some districts, mobility for the disabled is provided with mini-buses carrying cheerful ones on shopping expeditions and for participation in the community. It is comforting, even inspiring, to be greeted personally by the local pharmacist, butcher, baker and candle-stick maker.


The immense benefits of such schemes and the overall savings which can be obtained by freeing space in hospitals and hospices were expertly summarized in the research paper Aging in Place in Portugal which was undertaken by Dr António Fonseca of the Universidade Católica of Lisboa in 2020. I recommend a reading to all who may be involved in this matter of urgent national interest.

Roberto Cavaleiro (nonagenarian) Tomar 24 June 2024