Caring for the elderly in Austria
Experience in caring for the elderly in Austria is based on the model of their service by relatives.
Practice shows that, in general, care for elderly relatives is mainly done by daughters or nieces. About 59% of relatives of the elderly are people aged between 40 and 60, 1/3 are people over the age of 60, and 15% are under 40.
Since there is no special program in Austria to provide long-term leave for an elderly relative, over 25% of family caregivers during the study period were forced to work part-time or do not work at all. About 40% of relatives of the elderly would like to find a new job or return to the old one. However, the more they were engaged in such unofficial work of the nurse, the more difficult it was for them to return to the labor market again.
There is an opportunity to take a sick leave (five working days) to care for a sick family member living with you on the same area.
Social policy aimed at facilitating the work of relatives of the elderly provided for an increase in the range of services (only 15% of family nurses combine their work with the services of a professional social worker), in particular the development of temporary care services.
Other social measures included raising the level of consciousness in relation to relatives of the elderly and providing advisory services. The amendment to the legislative act on the provision of social benefits from 1998 facilitated the inclusion of home caregivers-the relatives of the elderly-in the social security system. Relatives caring for the elderly, requiring intensive care (sixth and seventh degree), were entitled to contribute to the pension insurance fund (using the care allowance), and the state accepted the contributions paid to the employer.
Thus, the situation of unskilled social workers in Austria remained uncertain, as systematic measures of support and assistance to relatives of the elderly were not carried out. Family ethics were the most important factor that makes family nurses the most popular and common form of providing services for caring for the elderly.
Providing elderly with social services with permanent residence. The policy regarding old people's homes in Austria during the period studied was largely dependent on the fact that long-term social security was controlled by regional authorities. The state strategy in this sphere was absent. There were regional differences in the number, quality and scope of service delivery. Nevertheless, the main tendency in the activity of the authorities was the continuation of the development of long-term social care structures, but with some modification of their functions.
From the point of view of the recipients of such services, there was an interesting trend: older people move to such institutions, if only they need help and care. Thus, the average age of patients in these institutions increased on average to 80 years, and overall health indicators deteriorated significantly.
Faced with the phenomenon of aging residents of nursing homes, such boarding schools began to re-equip rooms designed for people in good physical shape, into wards for patients requiring additional care.
Implementation of long-term care development policies, financing structures and organizations providing services. As mentioned above, regional authorities and municipalities are developing a new social policy of collective residence. In many cases, the right to provide such services has been transferred to voluntary non-profit organizations. However, in politics and the attitude of elderly homes, public organizations play a more important role than in the sphere of state and municipal social security. About 25.7% of the total number of boarding schools for the elderly belongs to non-profit organizations, and 69% is owned by public organizations (49% of all institutions for the elderly). The commercial sector is of little importance in this area, however, commercial organizations have more influence here than in the sphere of social welfare.
The procedure for admission to boarding schools and nursing homes. The Austrian long-term social security system provides clients (service users and their relatives) with complete freedom to choose the type of social services and way of care. In general, the recipient of services decides in which institution he wants to live. Therefore, many, having reached a certain age, automatically queue up in a nursing home as a general precautionary measure ("just in case"). Therefore, similar waiting lists are constantly growing, despite the fact that most of the applicants registered in these lists are not yet going to move to boarding schools for the elderly.
Despite this, waiting lists were often used as the main argument for planning and building new boarding schools for the elderly. In Vienna, a similar policy was discontinued in 1993, when the Municipal Council decided not to build institutions for the elderly (1993).
The practice is as follows. Usually, if there is a free place in the shelter, the supervising organization turns to the waiting list for confirmation of his desire to move to a boarding school. Medical chambers in such institutions are designed for patients who are unable to stay in ordinary apartments or rooms anymore because of a sharp deterioration in their health.
In all cases, municipal authorities intervene in such procedures only if the service provider organization, the potential patient or his relatives - is unable to pay for his maintenance in the institution.
Consider types of institutions for the elderly and their potential.
Boarding schools, shelters and nursing homes. As mentioned earlier, there is almost no difference between nursing homes and boarding schools. In particular, most of the nursing homes at the time considered had both living rooms and specially equipped wards. In general, such institutions offered about 60,000 seats.
Joint living arrangements. Offered a large communal apartment for 4-8 people (each has its own room, bathroom, kitchen and dining room common). In one and. such apartments can accommodate a social worker (or a doctor-geriatrician), but usually quite active people live in similar apartments (there are no more than 50 such organizations in Austria), and they do not need constant support.
Social apartments. This type of service was a relatively new aspect of social services. Such a service allows customers, on the one hand, to live in their own apartment, and on the other, to be supervised by social workers. There were different models of such programs. So, in Lower Austria and Vorarlberg, organizations operated. They provided social apartments, located in the same building with the Center for Social Welfare. Thus, nurses and social workers, in addition to serving the area, visited residents of social apartments (their number was usually from 6 to 12). Residents were offered some joint activities, but on the whole, everyone led an independent life. However, in the event of deterioration in health, residents had to move to the orphanage, since in such apartments only buttons for calling a doctor at night were provided.
In addition, in Austria in the period 1980-1990-ies. services for temporary inpatient care and partial inpatient care for the elderly were provided. For example, in some nursing homes special places were allocated for temporary patients. However, this type of services was not very common, as the directors of boarding schools tried to fill vacant places in institutions, rather than leaving one or two places vacant in anticipation of potential temporary patients. Such type of short-term security services was offered mainly in Vienna. At the same time, the number of allocated places to provide such services does not exceed 100. The idea of caring for patients during the day, especially for patients suffering from senile dementia, proved to be more successful. Such services were invaluable support for relatives caring for patients.
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