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Czech Republic

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 provides estimates by the Czech Alzheimer Society of the number of people with dementia living at home, in various types of residential care and in hospitals or psychiatric institutions.

Place of residence

 

YES or NO

Estimated number/

Additional information

At home (total)

Yes

100,000

At home (with relatives or close friends)

Yes

Not available

At home (with other people with dementia)

Yes

Not available

In  homes for seniors

Yes

25,000

In homes with "special regime" including dementia

Yes

10,000

In specialised nursing homes for people with dementia

 No

-

In special hospital wards or units:

- Long-term care hospitals

- Psychogeriatric departments

- Post-acute and aftercare hospitals

Yes

7,000 total, of which:

3,000

2,000

2,000

 

In total, an estimated 42,000 people with dementia are currently in various types of social care, long-term care and post-acute care institutions.

An estimated 68% of residents in general/non-specialised residential homes have dementia. This is based on a Czech Alzheimer Society survey of eight such establishments.

There is no information available about the ratio of staff to residents in social care institutions.

32,000 people with dementia were treated in outpatient care facilities in 2011 (UZIS - Czech Institute of Health Information and Statistics, 2012).

8,493 people with dementia diagnoses were hospitalised in 2011, including all hospitals, “nursing homes” and psychiatric units (UZIS - Czech Institute of Health Information and Statistics, 2012).

The organisation of care and support for people with dementia

There are three levels of government: the parliament, the regions and the municipalities.

The parliament enacts legislation and the 14 Czech regions are responsible for registering healthcare and social care providers. Both public and private providers receive funding from the general health insurance system. This funding is based on tenders: the Ministry of Health organises tenders for hospitals and other types of in-patient care, while the regions organise tenders for other care providers. Czech municipalities do not play a role in health and social care provision.

There is a draft Czech Alzheimer plan for 2014-2017 but it is not official. As a result, there are very few specific provisions for the care and support of people with dementia.

However, people with dementia and their family caregivers can use social services, even without a formal dementia diagnosis. They can get personal assistance, home respite care, consulting and day care centre or residential home services for elderly and specialised residential homes. There is a care allowance, which, to some extent, promotes the acceptance of people with a greater need of help to the social facility. This allowance is automatically paid to the social facility that provides care.

All social services, irrespective of the founder (city, county, religious, NGO, private), may apply for a grant. Grants are given on a regional basis as a redistribution of state resources. Grants can only be obtained by social services that are registered with the regional government. Clients of these services must co-pay to use the service, up to a limit defined by law.

People with dementia have full access to healthcare. In theory, GPs are meant to act as gatekeepers but their recommendations are not always needed or sought. It is possible to see a specialist without prior referral and people with dementia can be treated by neurologists, psychiatrists and geriatricians.

Within the healthcare system, there are currently long-term care hospitals or departments, and in psychogeriatric departments that provide long-stays of “healthcare type”.

In the social care system there are two types of homes for seniors, namely those for people with severe disabilities and homes with a "special regime” for people with chronic health conditions including dementia. Despite the fact that the health status of these people is often very complex, healthcare issues - according to the Social Services Act - are not part of the formal system of quality control in these institutions.

People with special needs may move into a residential home or a home with special regime. Residents at these homes have to pay for their accommodation and "mandatory" services that include food and assistance with activities of daily living. These two items will generally consume their entire care allowance and up to 85% of their pension. Healthcare, drug co-payments and other services are paid for separately by residents. Municipalities are responsible for hiring and paying staff that includes care workers, social workers and others. Some homes also employ medical staff such as nurses or physiotherapists, but this is not required by law.

There are very few private care homes and the quality of their services is very often questionable.

The system of long-term care provision in the Czech Republic is very fragmented and thus difficult to describe as a whole. The main problem is the separation and discontinuity of healthcare and social care services. Social care services do not consider the complex health needs of residents, while healthcare services do not reflect the fact that some health conditions are long-term and patients with these conditions need continuous healthcare and long-term care and support. This problem will likely persist even after legislative changes that are currently being envisaged.

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. However, in some cases there are currently very few such professionals.

Social or healthcare professional

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

Nursing staff

Yes

Auxiliary staff

Yes

Allied health professionals

Yes

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

No

General practitioners*

No

Other

Yes (Physiotherapists, occupational therapists)

*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

There is currently no official dementia-specific training for nursing staff, auxiliary staff or allied health professionals that work in residential or home care. However, there are some educational programmes accredited by the Ministry of Social Affairs.

How the training of social and healthcare professionals is addressed

There is currently no official dementia-specific training for social and healthcare professionals.

The Ministry of Education, Youth and Sports is responsible for setting standards for educating and training physicians towards their first degrees. University medical studies consist of six years of study.

The Ministry complies with European Directive 36/2005/EC, which sets conditions for obtaining and recognising medical degrees and specialised postgraduate training for physicians and non-physician health professionals.

Medical school graduates must complete an accredited training programme in a selected medical specialty and pass a state licensing exam in order to be allowed to work independently as physicians. Similarly, nurses must complete an accredited Bachelor's degree programme and may also obtain specialisations (Bryndová L., et al., 2009).

Support for informal carers

There is no official support for informal carers in the Czech Republic. They have access to personal assistance, home respite care and similar services, but in reality these services are rare or non-existent.

National Alzheimer Association

The Czech Alzheimer Association offers the following services and support.

Helpline

x

Information activities (newsletters, publications)

x

Website

x

Awareness campaigns

x

Legal advice

 

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

 

Respite care at home (Sitting service etc)

x

Holidays for carers

 

Training for carers

 

Support groups for carers

x

Day care

 

Residential/Nursing home care

 

Palliative care

 

References

Bryndová, L., Pavloková, K., Roubal, T., Rokosová, M., Gaskins, M., & van Ginneken, E. (2009). Czech Republic health system review.Health Systems in Transition, 11,1, 1-122.

Czech Alzheimer Society (n.d.).Survey of eight facilities.Czech Alzheimer Society.

CZSO - Czech Statistical Office. (2012).Statistical Yearbook of the Czech Republic.CZSO - Czech Statistical Office,

www.czso.cz/csu/2012edicniplan.nsf/t/9A002AD9E0/$File/0001120402.xls.

UZIS - Czech Institute of Health Information and Statistics (2012). Healthcare of patients treated for dementia in out-patient and in-patient facilities in the Czech Republic in 2007–2011.UZIS - Czech Institute of Health Information and Statistics, www.uzis.cz/system/files/66_12.pdf.

Wija, P. & Holmerová, I. (2013). Vybrané údaje o dlouhodobé péči a sociálních službách (Selected data on long-term care and social services).Praktický lékař,93,4, 176-180.

Acknowledgements

Martina Mátlová, Executive Vice President, Česká alzheimerovská společnost (Czech Alzheimer's Society)

 

 
 

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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