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In my contribution, I will discuss the issue of the oldest population; specifically, I will focus on the issue of the recognition of older peoples’ care needs, preferences and spending of everyday life. In the case of the Czech Republic, there is very little information on the oldest-old or the specific population in need. Generally speaking, the oldest-old population is a population seriously underrepresented in research, being one which is often neglected in surveys and qualitative research. The interviewing of people of advanced age brings specific problems and interviewing by proxy is often used. Nevertheless, an improved understanding of the needs and preferences of this population is a precondition for improving both the provision of care and its quality of life. Unhelpfully, such populations are surrounded by various myths and stereotypes. According to Czech statistics, only 16 % of older people are the oldest-old (i.e. 80+), which is a little more than 400 000 people. Of these oldest-old, only 43 % of women and 25 % of men receive care allowance. These relatively low percentages and studies of centenarians – indicate that although health generally deteriorates with age, the oldest-old are not generally regarded as people in need. The other ambiguity relates to the living conditions of older people, as we know that only a small minority live specifically in “old people’s homes”. There are various types of residential care for older people, and standard residential homes for older people are, in many cases, substituted by primarily medical facilities, there is no accurate knowledge of the number of older people no longer living in their own home. For defining older people in need, the fourth age concept seems useful. Fourth-agers might be characterized in particular by their loss of agency, especially by their inability to care for, and make decisions about themselves. In this respect, it is not an inevitable stage of life and affects only a proportion of the population. The combined effects of ageing, chronic illness, and disability which are all characteristic of the fourth age irreversibly change an individual’s customary way of life and call into question his/her sense of self. Indeed, the fourth age is conditioned by institutional practice, and contact with the health and welfare systems. Older adults, however, are not passive elements in this process; they actively negotiate and maintain a fragile sense of self in the face of increasing disability and frailty. In the context of fourth agers, the following important question arises: When does a person lose enough of his/her autonomy or agency in order to be labeled as a fourth ager? In other words, what kind and degree of help tend to make an older person a fourth-ager? I will address these questions and issues in my presentation.
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