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Lithuania

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

Background information

Prevalence of dementia

Alzheimer Europe estimates the number of people with dementia in Lithuania as being 47,335. This represents 1.44% of the total population of 3,292,454. The number of people with dementia as a percentage of the population is somewhat lower than the EU average of 1.55%. The following table shows the estimated number of people with dementia between 30 and 59 and for every 5-year age group thereafter.

Age group

Men with dementia

Women with dementia

Total

30 - 59

1,054

645

1,699

60 - 64

139

870

1,009

65 - 69

1,036

1,273

2,308

70 - 74

1,580

3,376

4,956

75 - 79

2,632

5,889

8,521

80 - 84

3,351

9,337

12,688

85 - 89

2,029

8,626

10,655

90 - 94

634

3,932

4,565

95+

113

820

933

Total

12,567

34,768

47,335

Where people with dementia receive care and support

The following table highlights where people with dementia live.

Place of residence

 

YES or NO

Estimated number

At home (alone)

Yes

No available data

At home (with relatives or close friends)

Yes

 

At home (with other people with dementia)

Yes

 

In general/non-specialised residential homes

Yes

 

In specialised residential homes for people with dementia

 No

 

In general/non-specialised nursing homes

 No

 

In specialised nursing homes for people with dementia

 No

 

In hospitals, special wards or medical units

 Yes

 

In psychiatric establishments

 Yes

 

No data were available on the percentage of people with dementia as a percentage of the population living in such establishments.

The general number of personnel working in elderly and disabled people care homes (included people with dementia) is 5,900. In addition, there are approximately 570 social workers and 2,121 social workers’ assistants.

The organisation of care and support for people with dementia

The Law on Social Services (dated February 20, 2006, No X-493) stipulates that the main aim of social services is to provide assistance to a person or family who, by reason of age, disability, social problems, partially or completely lacks or has lost the capability to care independently for him/herself and to participate in society.

Social services are provided to all residents in need. The need for such services is assessed according to a combination of principles of co-operation, participation, complexity, accessibility, social justice, relevance, efficiency, comprehensiveness. The provision of support is tailored to the individual’s stage of dependency and capacities to compensate for this loss of independence. 

Social services will be provided to an older person by creating the right conditions for the person to live at home, with the family and manage independently his/her household for as long as possible. The social services will organise the assistance combining personal healthcare and special assistance measures, thus maintaining social relationships with the family, relatives and society.

Social services shall be provided to a person with a severe disability by ensuring a safe and healthy environment, assistance respecting human dignity, and the coordination of personal healthcare, assistance, education to help compensate for the lost independency as well as ability to maintain social relationships with the family and society.

Social services are provided under the social assistance system.

People with dementia can benefit from informal or formal care at home care or short term care and long term care in social care institutions.

Social services can be provided by public or private providers. People have free choice of services provider.

Organisation of care in national policies

  • Action Plan of National citizens’ outcome of ageing consequences strategy

This Plan approved by Resolution of Government January 10, No 5, 2005, includes measures to ensure social care establishments offer quality activities to the elderly; to make a proper diagnosis of chronic non-communicable diseases and to improve their treatment by increasing accessibility of services, and to encourage expansion of medical rehabilitation services for the elderly. These measures include improvement of the fate of people with dementia and Alzheimer’s disease. The final implementation is scheduled in 2013.

  • Integrated Help at Home Development Programme.

The main goal of this programme started in 2012 is to ensure the accessibility and expansion of social care services (including nurse care services) and integrated home support for the elderly, disabled adults and children and for family members by consulting and involving informal carers (volunteers, neighbours and other) into the process.

The Lithuanian health system’s development framework 2011-2020 has increased funding to facilitate the integration of nursing and support care, palliative care and home nursing services.

  • Standards of care and support

The Social Care Standards were approved by the Minister of Social Security and Labour in 2007. (Decree of the Minister of Social Security and Labour dated April 20, 2007, No A1-46). The standards cover:

  • Controlling and monitoring care and support

Social care institutions are responsible for the quality of social care provided. The Department of Supervision of Social Services under the Ministry of Social Security and Labour is responsible for the assessment, control and supervision of social care, according to Licencing Rules of Social Care Establishments approved by Resolution of Government dated May 16, No 528, 2012.

  • Interdisciplinary cooperation and coordination

According to the law on Social Services, the management, granting and provision of social services is based on co-operation and mutual assistance between a person, family, community, the organisations defending the interests and rights of social groups of people, social services establishments, municipal and state institutions;

  • Needs assessments

Individual needs are assessed and should be provided in a timely, fair and appropriate manner according to the specific needs of the person.  

  • Staffing levels

Personnel working in social care establishments and providing home care is  regulated by the Social Care Standards of Work Time for Workers Providing Social Care  (Decree of the Minister of Social Security and Labour dated November 6, 2006, No A1-317).

  • Funding and control bodies

State, municipality budgets, EU Structural Funds are the funding and control bodies for the implementation of the various programmes.

  • Complaint procedures

According to the Law on Social Services dated February 20, 2006, No X-493, the Department of Supervision of Social Services under the Ministry of Social Security and Labour investigate complaints of social care establishments, common interest and social attendance services. All clients (users, carers) are informed that they have the right to appeal against decisions and to make complaints about their care. Also, user forums, councils of residents of social care establishments give them the opportunity to appeal or to raise a variety of issues with a view to influencing and improving their stay. Municipalities control and investigate complaints toward

  • Involving people with dementia in decisions about care and support

Legislation addressing the provision of care in residential care homes is regulated by the Law on Social Services dated February 20, 2006, No X-493, Social Care Standards (Decree of the Minister of Social Security and Labour No A1-46, 2007), Licensing Rules of Social Care Establishments approved by Resolution of Government dated May 16.

Social services are provided to a person (family) taking into consideration the individual interests and needs of the person (family) of this Law and continuously assessing the efficiency of the social services provided in respect of development or compensation for the person’s (family’s) possibilities and abilities to care for his private (family) life or to participate in society.

Services and support for people with dementia and their carers

  • Help at home

People in need of home help are regularly visited by social workers or social workers’ assistants. Local municipalities estimate the need for social care. Social attendance or social care at home includes performance of housework and care by home helpers.

Social care services include services which are provided by a team of specialists (social workers, social workers assistants, healthcare, assistants and others depends on the need) at a person‘s home.

Elderly and disabled people can receive day care services at home from 2 hours till 8 hours per day up to 7 times per week, short - term care (respite care) up to 8 hours per day till one month at person‘s home.

In some cases, when it is impossible to organise social services in monetary form, services may be changed into a cash allowance. This target benefit is paid for foster families, people with disability, elderly and their families in order to ensure social assistance. Cash allowance financed from the municipal budgets.

  • Day care and short-term care

Elderly and disabled people can receive day care services in day care centres from 3 hours per day up to 5 days per week in institutions.

Short-term social care (respite care) for elderly and disabled people not less than 12 hours per day till 6 months per year or 5 days per week or termless in institution.

Day care and short-term care is financed from the State or municipal budgets or special targeted subsidies of the state budget to municipal budgets.

  • Residential care

Residential care is provided for children and adults with disabilities and elderly people in social care homes (old age homes, specialised social care homes, social care homes for disabled people, independent living home, etc.)

Residential care is financed from the State or municipality budgets or special targeted subsidies of the State budget to Municipality budgets.

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

Services for people living at home, in social care establishments and others can be provided by social workers, assistants of social workers, individual care personnel, nurses, nurses, assistants, etc.

The type of training that social and healthcare professionals receive

According to the Social Workers and Social Workers’ Assistants Qualification Law (Decree of the Minister of Social Security and Labour dated April 5, 2006, No A1-92) social workers should have trainings (16 academic hours) every year and receive a certificate. Also, Social Workers’ Assistants should have trainings (16 academic hours) every year.

The ‘Methodological Centres’ are responsible for the preparation of specific training programmes for the social workers and their assistants. These centres are social care organisations, which provide residential care, home care or day care centres. They use their own experience or invite other professionals to prepare the programmes and provide training. The programmes must be evaluated by the Department of Supervision of Social Services under the Ministry of Social Security and Labour (the ‘Department’). An Evaluation Committee with evaluate the programme before receiving approval by the director of the Department. The number of hours of the training is specified by the programme. The social workers who have followed the training will receive a certification recognised at state level.

Dementia is included in the programmes provided by the Methodological Centres. There are 206 programs for the social workers and 107 for their assistants. Themes such as care of people with dementia, changing behaviour and other themes in relation to gerontology are included in the programmes.

Nurses, doctors and other health specialists should have continuous training. Once a year, nurses must follow 60 academic hours of training, and doctors 120 hours. For specialists who work directly with older people and people with dementia or Alzheimer’s disease, the Methodological Centres organise special qualification training courses. For instance, nurses are trained in psychosocial rehabilitation of people with mental health problems, older people with mental health problems, care features and similar themes.

How the training of social and healthcare professionals is addressed

The ‘Social Workers and Social Workers’ Assistants Qualification Law’ of 2006 also stipulates that every social worker and their assistants should enhance their qualification with no less than 16 academic hours per year.

The ‘Social Service Staff Competency Training Programme’ (Decree of the Minister of Social Security and Labour dated April 28, 2012, No. A1-303) aims to enhance the quality and level of knowledge and competence of the social workers and their assistants who are working in social settings. The programme also aims to identify the need for trainings.  The programme’s training themes are related to the basic/elementary knowledge about dementia, care and support of people with dementia, behavioural and psychological symptoms of dementia and the assessment of capacity.

The competency of social workers, their assistants is supervised by the Department. The Department organises seminars for the qualification for social workers and their assistants.

The training of the staff working in social work area (such as social workers, social worker’s assistants, for instance) is regulated as follows:

  1. The competence of social workers is regulated by education restrictions. From 1 of July 2011, only people who have the acquired higher (university or non-university) education in social work or equivalent education shall be entitled to the position of a social worker.
  2. The competence of social workers is periodically assessed during the certification.  Certification of social workers is obligatory and ensured by the Senior Certification Commission of Social Workers and territorial certification commission.
  3. In 2013-2015 The Programme of Competence trainings for the employees of social services establishments are implementing. According to it new evaluation of competence, competence development, oriented to development of organisation and strengthen forms of team are checking.
  4. In 2012, the ‘Integrated Help Development Programme’ included support by consulting and involving informal carers (volunteers, neighbours and other) into social care process (including nurse services) process. The aim is to offer better quality social care services at home and increase the knowledge of all team workers (social and health sector).
  5. Social workers are not only providers, they are often mediators towards policy makers, ministries, municipalities, NGO‘s and also make proposals.  

The health professionals are restricted by requirements to provide healthcare services:

Specialisation

Duration

Healthcare Professional

(Medical doctor – General Practitioner) *

 

Basic medical studies 3 years

Doctor therapist  *

Basic medical studies 6 years + 5 years specialisation

Doctor in general medical practice *

Basic medical studies 6 years + 5 years specialisation

Neurologist *

 

Basic medical studies 6 years + 4 years of specialisation

Nurses responsible for general care

3,5 years (in College)

4 years (in University)

Assistant Nurse

 

360 h courses

Masseur 

 

2 years (in vocational training school) or

160 h of specialisation after training as a masseur, nurse, midwife, physiotherapist and other health professional specialists

Physiotherapist

 

3 years (in College)

4 years (in University)

Occupational therapist

3 years (in College)

4 years (in University)

*These 4 professions are involved in care process

Support for informal carers

National policies support carers in the field of respite care, training, consultation, counselling and support, case management.

  • The National social integration for disabled 2013-2019 programme defines implementation measures for people with disabilities and their families. Care givers are involved into the projects of social integration for people with disabilities: taking part in self-help groups, sociocultural activities, recreation camps activities and other special events for disabled and their families.
  • A reform of the Conception of Special Needs System Reordering and the Conception on Development of Services for Disabled – independency and social abilities will be evaluated and expanded. The aim of conception is how to change cash allowances into social services.
  • The National Demographic Strategy of Family Welfare Policy was implemented between 2011 and 2013. One of the target priorities was to consult caregivers facilitate return to the labour market. 

The aim of this measure is to ensure safe environment and high quality of services provided to elderly people, the disabled and children in stationary social care establishments by modernising current and establishing new institutions of stationary social services. Current support structures were refurbished and newstationary institutions of social services constructed, reconstructed and repaired as well as provided with necessary equipment and furniture. It is invested to small, cosy social care establishments, groupware living homes in the communities. All this was made possible thanks to the European Structural Funds.

Acknowledgements

Nijole Bieliniene, Health Ministry

Genovaite Paulauskiene, Health Ministry

Eglė Savuliene, Health Ministry

Agne Uogintiene, Ministry of Social Security and Labour

 

 
 

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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