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Austria

2013: National policies covering the care and support of people with dementia and their carers

Background information

Where people with dementia receive care and support

The following table shows the type of accommodation in which people with dementia in Austria are living (e.g. at home, in various types of residential care and/or in hospitals or psychiatric institutions).

Place of residence

 

YES or NO

Estimated number/

Additional information

At home (alone)

Yes

Low

At home (with relatives or close friends)

Yes

60-80% of people with dementia

At home (with other people with dementia)

Yes

Some people with dementia live in a “betreute Wohn-gemeinschaft”

In general/non-specialised residential homes

Yes

 

In specialised residential homes for people with dementia

Yes

 

In general/non-specialised nursing homes

Yes

 

In specialised nursing homes for people with dementia

Yes

 

In hospitals, special wards or medical units

No

 

In psychiatric establishments

Yes

Very low

It is estimated that 60-80% of people with dementia live at home, most of them with female carers/family members (i.e. partners, daughters, daughters-in-law, sons and friends). People with dementia only stay in hospitals, special wards or medical units for medical treatment. They do not live there. A “betreute Wohngemeinschaft” is a place where a small group of people with dementia live together and any support or care needed is either purchased privately or supplied by the state on the basis of each individual’s assessed need and his/her right to receive such support or care according to the principle of subsidiarity (please see below). A “betreute Wohngemeinschaft” is considered as a private home and not a nursing home. Most can be found in Vienna.

Approximately two thirds of residents in nursing homes have dementia (Wancata et al., 2001). No precise data is available as to the proportion of residents in general/non-specialised residential homes who have dementia or concerning the type of nursing homes in which two thirds of the residents have dementia. 

The ratio of staff to residents in homes for older people and care homes depends on the level of care needed by the residents and also differs from one region to the next. The following table provides an overview of the different ratios of staff to residents in three different areas according to the level of care needed (expressed as categories ranging from 0 to 7). In addition to these ratios, the proportion of staff with different levels of specialisation/training is also specified and varies from one region to the next.

Care level

Steiermark region

Oberösterreich region

Vienna region

0

 

1: 24

1: 20

1

1: 12

1: 12

1: 20

2

1: 6

1: 7.5

1: 7

3

1: 3.7

1: 4

1: 2

4

1: 2.6

1: 2.5

1: 1.75

5

1: 2.5

1: 2

1: 1.5

6

1: 2.3

1: 1.5

1: 1.25

7

1: 2

1: 1.5

1: 1

            Source: Tupy (2011)

The organisation of care and support for people with dementia

The overall organisation of care and support

The Federal Ministry for Social and Consumer Protection (Bundesministerium für Soziales und Konsumentenschutz - BMSK) and the regional states are responsible for the organisation of social support to people with dementia/dependent older people. In regional areas, due to inadequate structures, there is some overlap between the healthcare and social welfare systems. The State, the private sector, the voluntary sector and NGOs all provide services.

The long-term care allowance (Pflegegeld) is granted to people whose disability necessitates a permanent need for personal care (at least 6 months). There are seven levels of disability and private physicians are responsible for deciding on eligibility and the level of disability. Level 1 is the lowest level and intended for people whose disability necessitates between 50 and 74 hours of care per month, whereas levels V to VII, are for people who require 180 hours of care or more. This benefit is intended to enable people to stay at home for as long as possible and to promote self-determination and family support.

In Austria the principle of subsidiarity (Subsidiaritätsprinzip) is applied which means that financial responsibility for care follows a set order: 1st the family, 2nd the commune, 3rd the “Land” (provincial state) and 4th the state.

The long-term care allowance is financed through general taxation, not through social insurance contributions. It is not means tested and is tax free. The amount that service users have to pay for services not covered by the long-term care allowance is based on their available financial means (Eigenleistung). This is, however, dependent on income and assets, including that of close relatives. According to Blaha (2006), the conditions for calculating people’s available financial means are still governed by regional state legislation despite efforts to harmonise these laws in the last 10 years.

People who have been judged eligible for the long-term care allowance are paid a cash benefit on a monthly basis independent of their income and assets or the reason why they need care. This is exempt from tax and can be spent in any way that therecipient sees fit e.g. to pay for services or to pay an informal carer.

Social rights are not mentioned in the Austrian Constitution which dates back to 1857. However, the European Convention on Human Rights was ratified by Austria in 1958 and this has the same status as the Constitution (BVG 1964 BGBI Nr.59).  Paragraph 15a of the Constitution (B- VG) covers general measures taken by the State and the provincial states with regard to long-term care needs and an agreement regarding the overall aims and principles of long-term care throughout the whole of Austria (BGB1. Nr.866/1993, entered into force on 1 January 1994).

There are no limits governing access to support on the grounds of age or type of dementia. On the other hand, insufficient attention is paid to the specific needs of people with dementia, although this is gradually improving. In rural areas, there is a lack of support both quantitatively and qualitatively. There is no specific support for people with different types of dementia or for younger people with dementia. Similarly, there is no support that is specifically designed to meet the needs of people with dementia and their carers from ethnic minorities in Austria.

How specific aspects of care and support are addressed

The provision of care and support to people with dementia in residential and home care is covered in some national policies. There is government legislation, for example, covering:

 

  • Standards of care and support,  
  • Controlling and monitoring care and support,
  • Continuity of care and support,
  • Staffing levels,
  • Funding and control bodies,
  • Complaint procedures (the Nursing Home Law, “Bewohnervertretung”/representation of residents and the Guardianship Law),
  • Promoting well-being and autonomy (the Nursing Home Law, Guardianship Law and Care Allowance Law),
  • Involving people with dementia in decisions about care and support   (the Guardianship Law).

Training

Which social and healthcare professionals provide care and support

The following social and healthcare professionals are involved in the provision of care and support to people with dementia in residential care or living at home.

Social or healthcare professional

Involved in the provision of care and support to people with dementia in residential care or at home

Nursing staff

Yes

Auxiliary staff

Yes

Allied health professionals

Yes, if organised privately

Specialists (e.g. psychiatrists, gerontologists, neurologists)*

No

General practitioners*

No

Other

Yes (validation therapists if privately organised; also voluntary visiting services)

* Only if they are linked to the provision and organisation of care and support (i.e. not with regard to their role to provide medical treatment).

The type of training that social and healthcare professionals receive

With regard to nursing staff, knowledge about dementia is included in the special training of psychiatric nurses. This is covered in the Law on Health and Nursing Care (Law: “Gesundheits- und Krankenpflegegesetz). Auxiliary staff (who provide general assistance, usually with no medical or nursing training) are state recognised but there are different levels of training (i.e. varying from ten weeks to one year and provided by official or private schools). Social sector professionals, such as social workers, are educated to degree or Masters (BA or MA) level at state recognised “Fachhochschulen” (which are equivalent to universities). Allied health professionals (e.g. language therapists, physiotherapists, dieticians, podiatrists) have specific training which leads to a state recognised qualification.

How the training of social and healthcare professionals is addressed

The training of social and healthcare professionals in the residential or home care, which covers or includes dementia, is addressed in some national policies.

According to the “Gesundheits- und Krankenpflegegesetz”, health and nursing care education must include basic/elementary knowledge about dementia. In some social services, specialised nurses and carers for older people (Altenpfleger) provide specialised knowledge about dementia to home help staff and visiting services (e.g. people who sit with the person with dementia and talk but do not carry out any care tasks).

Certain groups of social and healthcare professionals such as psychologists, psychiatrists, psychotherapists and validation therapists receive training in the behavioural and psychological symptoms of dementia. This is covered in national guidelines.

Certain groups of social and healthcare professionals who are responsible for providing palliative or end-of-life care to people with dementia have guidelines and professional codes.

Case managers and care managers receive training in the assessment of capacity.

Support for informal carers

Some forms of support for informal carers are addressed in national policies.

Respite

Carers who are caring for a person with level 3 care needs are entitled to three weeks per year respite from caring, which is financially covered by the Federal Social Office (the “Bundessozialamt”).

Training

There is no national policy covering the training of informal carers.

Consultation/involvement in care decisions

Carers who are the legal representatives of a person with dementia are consulted and involved in care decisions in accordance with guardianship legislation.

Counselling/support

There is no national policy covering counselling/support for informal carers.

Other

As of 1 January 2014, people caring for a person with needs defined as care level 3 will be entitled to three months’ break from work (“Pflegekarenz”) or three months’ part-time work (“Pflegeteilzeit”). For the three-month break, carers will receive a payment based on their last wage but up to maximum of EUR 1,400 per month. For the part-time work, carers will be able to reduce their working time by a minimum of ten hours per week and the payment they receive will be calculated on the basis of their reduced income. These two measures are designed to make it easier for carers to combine work and care responsibilities during difficult periods without fearing losing their jobs. However, the request for a carers’ break must be approved by each person’s employer.

Support for carers is also provided by private organisations such as the carers organisations (“Interessensvertretung pflegender Angehöriger), Alzheimer Austria; MAS-Alzheimerhilfe, Bad Ischl, the Red Cross and Caritas. The communities and regions also provide support through projects.

National Alzheimer Association

Alzheimer Austria provides the following services and support

Helpline

 

Information activities (newsletters, publications)

x

Website

x

Awareness campaigns

x

Legal advice

x

Care coordination/Case management

 

Home help (cleaning, cooking, shopping)

 

Home care (personal hygiene, medication)

 

Incontinence help

 

Assistive technologies / ICT solutions

 

Tele Alarm

 

Adaptations to the home

 

Meals on wheels

 

Counselling

x

Support groups for people with dementia

x

Alzheimer cafes

x

Respite care at home (Sitting service etc)

 

Holidays for carers

x

Training for carers

x

Support groups for carers

x

Day care

 

Residential/Nursing home care

 

Palliative care

 

References

Anonymous Internet article (2013).Pflegekarenz ab 2014 geplant: Bis zu 1.400 € monatlich. Accessed online on 26 July 2013 at:

http://www.krone.at/Oesterreich/Pflegekarenz_ab_2014_geplant_Bis_zu_1.400_Euro_monatlich-Wichtiger_Schritt-Story-359579

Blaha, M. (2006). Information provided for Alzheimer Europe report on home care services in Austria. Alzheimer Europe

Österreichisches Statistisches Zentralamt (2013).Bevölkerung(as of 1.1.2013)

http://www.statistik.at

Tupy, G. (2011), Im Gespräch mit… ExpertInnen aus den Alten- und Pflegeheimen. Lebenswelt Heim, 49,5-7. Accessed online on 26 July 2013 at: http://www.lebensweltheim.at/cms/dv/images/lwh%2049-expertinnen.pdf

Wancata, J., Kaup, B. und Krautgartner, M. (2001). Die Entwicklung der Demenzerkrankungen in Österreich in den Jahren 1951 bis 2050,Wien Klin Wochenschr,113/5–6, 172–180, Springer Verlag

Acknowledgements

Antonia Croy, Chair, Alzheimer Austria

Margarethe Blaha, Legal Advisor, Alzheimer Austria

Monika Natlacen, Vice Chair, Alzheimer Austria

 

 
 

Last Updated: Tuesday 25 February 2014

 

 
  • Acknowledgements

    The above information was published in the 2013 Dementia in Europe Yearbook as part of Alzheimer Europe's 2013 Work Plan which received funding from the European Union in the framework of the Health Programme.
  • European Union
 
 

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