Following an audit and survey conducted regarding the country's municipal nursing homes, the National Audit Office has expressed concern that there is no national level legislation on provision of nursing home services in Estonia, where the elderly have increased in number even against declining overall population.
The audit of the Estonian eldercare system found that the number of elderly receiving nursing home services has grown about 80 percent in the last 10 years, while the number of those receiving such services at home has increased by only 10 percent, the agency said today.
"Significantly more attention should be devoted to services that allow the elderly to continue living at home longer," it said in a statement. "Not only is this the psychologically preferable option, it is also many times less costly than providing care in nursing homes."
Local governments have spent about 40 million euros a year on eldercare in recent years, most of it as funding for nursing-home-based eldercare. Many new nursing homes have been opened and the number of elderly in them has grown rapidly. Local government nursing homes have around 4,500 open spots, and private nursing homes offer approximately 1,900 spots. In 2012, there were a total of about 350 open spots at local governments’ nursing homes.
"Most of the local government nursing homes are full, however. If a need arises, there may not necessarily be a spot at a family’s preferred nursing home or one that is close to their home," the office said.
Living conditions in nursing homes can be considered generally good, the office said, although many nursing homes did not manage to comply with all health code requirements. The National Audit Office found that none of the shortcomings constituted a major obstacle to the organization of care. "Nevertheless, they do undoubtedly affect people’s privacy, comfort and programmes for keeping the elderly active."
The National Audit Office said it found a number of problems related to funding of services. It said there should be more uniformity in the amount of taxpayer support for the cost of nursing home spots, and that the financial situation of requesting families must be examined more closely; the audited local governments did so in only 14 percent of cases approved for benefits.
Instead of negotiating terms with individual cities and municipalities, there should be national-level requirements.
"The office [...] finds unsatisfactory a situation where there is a lack of a state-level agreement on important social services as well as no absolute minimum level of quality that must be provided. The legal framework laid down by the state is not sufficient, as there are a lack of requirements on content of service, service provider, provision process and the persons eligible to receive the service."