Why this story matters:
"Thank you" -- these are two words which the care service workers at East Tallinn Central Hospital's Nursing and Support Clinic (Support Clinic in short) seldom hear. At least not from their patients' relatives.
The families mainly complain.
"Why are you giving my mother painkillers? She's not in pain."
"Why did my mother die? She was fine in the summer!"
..are just a few examples of what a health care worker interviewed by Eesti Ekspress (article below), is used to hearing.
There are five follow-up treatment clinics like this one in the capital of Estonia, Tallinn. These are the very few facilities most Estonians need to turn to in order to get care for their elderly relatives, for lack of other affordable options. One day here costs around 10 euros and the rest is covered by the Public Health Insurance Fund.
The only problem is that those centers are not meant to be nursing homes and most people seem to ignore that.
The clinics have a very different purpose -- they are follow-up treatment centers for the patients of public hospitals. The idea is that, during their recovery, they should get a bit of extra care at the Support Clinic and then leave. The maximum stay is 60 days.
However, often relatives don't pick up their parents after this period or the clinic simply cannot reach them. So the staff ends up taking care of people who don't actually belong there. And they already are swamped with work.
Most of those patients live out the rest of their life in the care center.
On the other hand, you can also understand the relatives who have no other option. Where can they place their parents suffering from dementia, if the queues for the public nursing homes are two to three years long?
Private nursing homes don't accept people with dementia, since they need more specific care. Quitting work to take care of your loved one is also not an option for most people. So they are looking for loopholes in the system.
For instance, they call an ambulance and ask their elderly relative to be taken to a hospital. From there, the patients are sent to the follow-up treatment center where they spend 60 days. After that period, the relatives call the ambulance again and the cycle continues.
It's a messy, expensive system, and blameless health care workers are stuck in the middle of it all -- between the government's inability to tackle the problem and angry, desperate relatives.
Details from the story:
- At the beginning of December, the World Health Organization warned that the number of people suffering from dementia will triple in the next 30 years, reaching 152 million by 2050.
- Estonia does not have a good system to accommodate the growing need for care and support services.
- A lot of tension is put on the care workers, who look after patients that often shouldn't even be in the care center.
- Most people, who end up at a care center, die there.
- There are five care centers in Tallinn for the so-called follow-up treatment of patients in need of extra care after hospitalization. Two other facilities are located near Tallinn. They offer care, nursing, hospice and boarding services.
- One day at the public care center costs 96 euros. The government covers 85.15 euros and the rest -- 10.17 -- is paid by the patient or the relatives.
- Sometimes relatives simply refuse to pay or they cannot be reached.