Israel

Awareness of needs of the large and rapidly growing group of elderly population intensified in the 1980s. Israel responded to these needs by passing new welfare laws and developing new services. Israel ensures by law a minimal level of income to its older population. In addition to a pension received from the workplace, Israeli citizens above the official retirement age (women at the age of 60 and men at the age of 65) are eligible to receive an old-age pension from the National Insurance Institute (NII). In 1998, about one-third of the elderly population received a supplementary income because this was their only income, or because their overall income was lower than the poverty line. In general, elderly Israelis have lower socioeconomic status than younger age groups. This situation is expected to change in the twenty-first century as younger and better-educated cohorts reach old age.

Since the establishment of Israel, health care services have been available to the vast majority of the population. In 1995, Israel passed the National Health Care Law, under which all Israeli citizens have health care coverage, regardless of income. This insurance covers ambulatory and hospitalization services, including medications which are provided by four sick funds. Elderly Israelis consume more than 30 percent of the national expenditure on health services.

The dominant orientation that has guided Israel's health and welfare policies in meeting the needs of frail and disabled persons is to enable them to continue living in their own homes and communities as long as possible. Accordingly, a wide network of welfare and long-term health services has been established throughout the country by public and private agencies.

For independent elderly persons, many municipalities have opened social clubs. Public and private sheltered housing units have been built in many settlements for persons who want to live independently and for those who need limited services.

The needs of disabled elderly persons have been addressed in part by the Nursing Law, which was passed in 1988. Under this law, people who live in the community and who have difficulties in performing activities of daily living (ADL) are eligible to receive up to sixteen hours per week of help at home, providing for personal needs as well as cooking, house cleaning, and shopping. These trained care providers are paid directly by the state through private manpower agencies.

Community services for the disabled elderly are also provided in numerous public day-care centers. These centers provide a variety of services to people who need assistance in ADL. Services include transportation, meals, nursing surveillance, dentistry and physiotherapy, workshops, social activities, and help in bathing, foot care, and hair styling.

Large municipalities provide subsidized hot, nutritionally balanced meals to the home through the Meals on Wheels service. In addition to regular welfare services, many localities have also developed a wide range of voluntary community services including home visits to ill or lonely persons, information and counseling services, loan of medical equipment and devices for disabled persons, supportive neighborhood programs, and home repair projects. Due to this network of community services, only 22.4 percent of the elderly people who were defined as disabled lived in institutions in 1999.

Long-term institutional care is provided by a variety of public and private organizations such as nursing homes for independent, frail, and nursing-care elderly. These services are financed partly by the government and partly by the patient and the patient's children, depending on their income. Long-term, institutional complex nursing care is financed by the sick funds. The total number of beds for elderly persons in long-term care institutions in 1998 was 43 per 1,000 elderly persons. Only about 5 percent of the elderly population lived in institutions in that year.