Budapest, Hungary

The survey was conducted under the direction of Mrs. Edina Reviczky of the Florence Nightingale Association, which provides home care services to older people in Budapest. The area selected is one of the poorest and oldest districts in the City, comprising 1,253 Ha. with a resident population of 72,000. The density is high at 5638 persons per square km.

From 1960 to 1990 the population has aged considerably with marked declines in the age groups below 60. The population over 70 includes twice as many women as men. 15% of those interviewed were 60-69, 40% were 70-79, and 45% were 80 or older. 80% had walking disabilities, 40% use crutches, and another 40% have sight and hearing difficulties. 80% have always lived in Budapest, and 20% for more than 35 years.

Intensive industrial development took place in this area during the 19^th century and dwelling conditions deteriorated. The old houses had toilets in the corridors for group use. The City government has improved conditions and the apartments though small are comfortable. Many of the older residents were former factory workers in the district. An urban redevelopment project from 1958-1966 replaced a large portion of one of Budapest’s worst slum areas with a large housing estate with extensive parks and central heating. Nevertheless, a large portion of poor older housing remains.

The Social Welfare Act of 1993 requires the City to provide health and family services, day care centres and clubs for the elderly. Rent subsidies are given to the poorest residents and district heating and hot water supplies are provide to ensure that these people can stay in their homes. The local government also provides medicines to those over 70. Some of the twenty older people in the district interviewed were clients of the Florence Nightingale Foundation whose volunteers bring them meals, assist them in getting medical care and medicines, take them shopping, etc.

All people taking part in the Survey live in apartments made of brick with no gardens. 30% live in 1-room apartments, 50% have 2 rooms and the remainder 3 rooms. 45% live alone; 35% with their spouse; 15% live with 1-3 persons, and 5% with 4 to 6 persons. All are home owners and their housing costs as a percent of pension income was as follows: 20 to 30% of income for 55% of the households; over 30%-50% of income for 35% of those interviewed; and over 50% for one-fourth of the respondents.

Piped water is available in all dwellings, and all now have private toilets and baths. They heat with gas and 75% consider the price excessive. Streets are kept clean by the City. The area has a health clinic, park, elderly centre, churches, shops, schools and home meal delivery. The schools have intergenerational programmes. Most of the elderly use public transport, which is free for those over 65. Communications services are good.

Twenty five percent of those interviewed had part time jobs, working on average 10 hours a week. Their sources of funds for housing included savings, family, and pensions. Their greatest living problems were safety and security, except for disabled people who need vehicles or assistance in order to leave their apartments.

Evaluation by Edina Reviczky: “Age is, in fact, used simply as a proxy variable for a variety of biological and psychological factors that are the proximate causes of age trends in physical health and disease. The chances of living to old age have increased as life expectancy has improved. The study shows that older people’s social, psychological, or even physical functioning does not inevitably decline with age. The data gave a real picture of the needs of old people, many of whom had lived in this district before retiring, and consider this their home. Their problem is that they have very low income and can hardly live on their pensions. Those on minimum pensions can ask the local government to help with supplements for their electricity, gas and heating bills. Whilst this case study proved to be interesting and worthwhile for all those involved, it nevertheless did not produce any surprising results. An overwhelming conclusion was that the central and local governments should offer more financial assistance to the elderly to ease their living conditions”.