December 15, 2011

MACEDONIA: Who should care for the elderly?

BITOLA, Macedonia / Southeast European Times / December 13, 2011

In response to a growing elderly population, Macedonia's government is in the process of creating a legal framework to govern elderly services and encourage the establishment of private nursing homes.

By Klaudija Lutovska for South European Times in Bitola

A new policy announced earlier this year aims to develop legal institutions for social protection and encourage the establishment of private nursing homes, but some still question the morality of leaving their loved ones in the care of others.

Labour and Social Policy Ministry spokesperson Davor Poitov told SETimes nine private institutions have been established so far under the initiative, while seven others are in the process of being established.

Residents at the Sue Raider Home for the Elderly in Bitola. 
Klaudija Lutovska/SETimes

"The ministry is also reviewing opportunities for public-private partnerships," Labour Minister Spiro Ristevski told SETimes.

The nursing homes tend to attract elderly who have lost their spouses, suffer from chronic diseases, have no family or a family that is abroad, but also a growing number of socially disadvantaged individuals.

According to experts, the need for the homes and the services they provide is acute.

"There are four state homes in Skopje, Prilep, Kumanovo and Bitola, with a total capacity of 500 beds [each]," Blagoja Ilievski, manager of the Sue Raider Home for the elderly in Bitola, toldSETimes.

It should be ten times that figure, he added.

Proper care and accommodation at nursing homes has increased the quality of life for the elderly, causing waiting lists to grow by 40% in the last three years.

"The elderly receive professional care 24 hours a day and their lifespan is extended for several years," Ilievski said.

The conditions at all facilities must be adjusted to EU standards, which have required some nursing homes to seek financial assistance. Sue Raider, for example, obtained a grant from the EU's IPA1 fund administered through the Bitola municipality.

"We received 600,000 euros to completely reconstruct the home's two pavilions. With the reconstruction, our elderly will enjoy conditions according to the EU standards. The Bitola municipality will participate by providing 3.5m euro," Bitola Mayor Vadimir Talevski told SETimes.

Despite changes in modern lifestyle, some families find it hard to accept residency at nursing homes.

"Tradition calls for the elderly to be taken care of by their family," social worker Marika Gjorgoski told SETimes.

"Only in very exceptional cases the Muslim elderly are sheltered in these homes. Their number is 1% of the total residents," she said.

Many Muslims say parents should not be left without their family when they are old and powerless.

"My mother raised me and my children; there is no place for her in a home for the elderly. Her place and home is with us," 25-year-old Shpresa Chkiponja, an ethnic Albanian, told SETimes.

General practitioner Fanche Talevska told SETimes, however, that the increasing interest indicates practical need overcoming social taboos.

"The best models to extend the quality of life and life-span are urged [and being implemented]," she said.

Some, like Menka Bozhinovska, an 84-year-old mother of nine from the village of Puturus near Bitola, decided to try an elderly home after her husband died.

"The children have their own life and taking care of old people is not useful for their lives. It is hard to live together; elderly people want peace. Here I work in the kitchen, and the pension and the money that I earn is enough so that my children will not have to finance my residency at the home," Bozhinovska told SETimes.

"In a nursing home they can socialise with peers and take medication regularly. Sometimes one has to choose the lesser evil: whether to think of the psychological trauma that can be caused in young children in development, or respecting the wishes of the elderly who are not [themselves] because of unbearable pain, dementia, or Alzheimer's," Tale Klimeski, 28, told SETimes.

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