IWA 18:2016

INTERNATIONAL IWA
WORKSHOP 18
AGREEMENT
First edition
2016-06-15
Framework for integrated community-
based life-long health and care
services in aged societies
Cadre de travail pour les services de santé et de soins communautaires
à vie intégrés dans les sociétés âgées
Reference number
©
ISO 2016
© ISO 2016, Published in Switzerland
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ii © ISO 2016 – All rights reserved

Contents Page
Foreword .iv
Introduction .v
1 Scope . 1
2 Terms and definitions . 1
3 Principles and social issues . 5
3.1 Principles . 5
3.1.1 General. 5
3.1.2 Human dignity . 5
3.1.3 Productive ageing . 5
3.1.4 Community-based services . 5
3.1.5 Systemization with people at the centre . 5
3.1.6 Pursuit of innovation for sustainability . 6
3.2 Social issues . 6
3.2.1 General. 6
3.2.2 Future provisions for aged societies . 6
3.2.3 Challenges and barriers to creating new approaches. 9
3.3 Basic approach .10
3.3.1 Health and care in relation to ageing .10
3.3.2 Healthy ageing .12
3.3.3 Approaches to ageing, implementation and services .13
3.3.4 Guidance for maintaining the quality of services .16
4 Holistic framework of services .18
4.1 General .18
4.2 Integrated health services .18
4.3 Integrated care services .21
4.4 Social infrastructure .23
5 Recommendations .25
Annex A (informative) Workshop contributors .26
Bibliography .29
Foreword
ISO (the International Organization for Standardization) is a worldwide federation of national standards
bodies (ISO member bodies). The work of preparing International Standards is normally carried out
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ISO collaborates closely with the International Electrotechnical Commission (IEC) on all matters of
electrotechnical standardization.
The procedures used to develop this document and those intended for its further maintenance are
described in the ISO/IEC Directives, Part 1. In particular the different approval criteria needed for the
different types of ISO documents should be noted. This document was drafted in accordance with the
editorial rules of the ISO/IEC Directives, Part 2 (see www.iso.org/directives).
Attention is drawn to the possibility that some of the elements of this document may be the subject of
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as well as information about ISO’s adherence to the World Trade Organization (WTO) principles in the
Technical Barriers to Trade (TBT) see the following URL: www.iso.org/iso/foreword.html.
International Workshop Agreement IWA 18 was approved at a workshop hosted by the British Dental
Association (BDA), in association with the British Standards Institution (BSI), held in London, United
Kingdom, in July 2015.
iv © ISO 2016 – All rights reserved

Introduction
This International Workshop Agreement defines principles, social issues and approaches related
to aged societies in order to address the shortcomings in social infrastructure. The contents of this
International Workshop Agreement, which are supported by the holistic framework of services (see
Clause 4), need to be highlighted on a global platform in order to share knowledge. Countermeasures
to cope with insufficiencies in social infrastructures to adapt to a global ageing society need to be
addressed today.
[3]
According to projections based on the UN DESA report on World Population Prospects by the year
2050, many countries are projected to become super-aged societies, with people aged 65 years or older
exceeding more than one in five of the population.
NOTE The terms “ageing society” (where more than 7 % are 65 years or older) and “aged society” (where
more than 14 % are 65 years or older) are derived from past UN population reports. The term “super-aged
society” (where more than 21 % are 65 years or older) is an extension of these terms. It is used in the academia
and government of Japan and is gradually spreading into use in international news arenas.
In addition, developing countries and regions with rapid economic growth will be subject to changes to
their ageing population over the next few decades. A well-supported infrastructure of an aged society
includes a comprehensive, holistic view covering diverse generations and their lifestyle, economic
status, cultural backgrounds and much more. As life expectancy increases, governments, health care
providers, service providers and the community need to adapt to enable members of the younger
generation to maintain their health and active participation in society, and to support the desire for
people to continue to live independently as they age. This International Workshop Agreement covers
key concepts that support certain on-going social changes. It aims to promote further deliberations
from service providers and standards bodies, among others, of these aspects that will not only address
existing issues, but also help to prevent potential future problems.
This International Workshop Agreement recognizes the wide range of global efforts to define social
infrastructure for aged societies and to offer consistent, personalized lifelong care. A common factor
in academic research and national/international guidelines is the promotion of the individual as an
equal partner in controlling his/her health care. This relates to all aspects of a person’s life, including
planning, decision making and day-to-day living, leading to a user-centred approach. The following five
key principles have been identified as the core elements for future investment:
a) human dignity;
b) productive ageing;
c) community-based services;
d) systemization with people at the centre;
e) pursuit of innovation for sustainability.
Guidance on these key principles is given in 3.1.
Consideration needs to be taken in delivering person-centred services. Care needs to be provided
ethically and respectfully, with the flexibility to meet the needs of diverse generations. Both the
individual and the wider society benefit because the individual experiences greater satisfaction with
his/her care and the social infrastructure that supports health care delivery is made more cost-
effective. The focus of this International Workshop Agreement is not to provide clinical guidance, but to
encourage health care service providers to drive for a shift in thinking. Harmonizing the concepts and
methodology internationally will streamline the market environment of providers and users of health
and care services, and build the basis for fair competition and development of related industries.
Establishing a common goal for standardization activities will help to provide life-long support for
aged societies in the most efficient and productive way, by addressing common challenges. There will
be closer examination on where standards can be used to bring about change. There is an increase in
global awareness of the need for a sound social infrastructure to support ageing populations. There
are already some established platforms for knowledge sharing, but more needs to be done to align the
language used and to outline proven good practices that may influence new behaviour and practices.
This International Workshop Agreement aims to encourage:
— sharing of knowledge and best practices at global level, relating to a gradual increase over time of
aged societies;
— minimizing repetition and duplication of efforts, through the development of common approaches
to the challenges associated with societies that are not able to adapt to an increase in the older
population;
— improved realization and understanding of aged societies for policy makers, providers and the
general public;
— creation of innovative solutions, across multiple service sectors, that will allow people to remain
within their communities and outside of institutionalized care, where possible and for as long as
possible;
— economic benefits for governments and the general public, through the provision of better products,
services and systems.
Supporting material to accompany this International Workshop Agreement is available at the following
website: shop.bsigroup.com/iwa18.
vi © ISO 2016 – All rights reserved

International Workshop Agreement IWA 18:2016(E)
Framework for integrated community-based life-long
health and care services in aged societies
1 Scope
This International Workshop Agreement provides a framework for addressing challenges faced by
societies that have been unable to adapt to an ageing population. It can also be used by stakeholders as
a useful reference at regional or global level.
This International Workshop Agreement addresses health, care and social challenges (including health
...