Development dynamics of health and social infrastructure for the long-term care – The case of the Posavje region

Abstract

Background and purpose The populations of rural areas across Europe, especially Slovenia, are ageing rapidly and the areas themselves are becoming depopulated. Therefore, this study aims to contribute to our understanding of the population dynamics and provide a method for forecasting housing and other long-term care needs. Method The surveys questioned those responsible for long-term care, the caretakers in institutional care, and current and potential homecare users in rural areas of Slovenia. We wanted to discover what they considered as crucial in the process of long-term care deinstitutionalization. Our 2020–2050 projections are based on the surveys conducted across 38 municipalities in the Eastern Slovenian region and an in-depth empirical study in Posavje. The results are embedded in the demographic projections and the multistate transition model of the declining functional capacities to forecast the needed housing facilities and human resources. Results The results are the time series of required capacities. Around 60% of respondents in Slovenian rural areas believe that even a better organization of homecare would not allow them to stay at home until death due to inadequately built housing and the absence of a continuous presence of caregivers. These findings were included in the projections. Therefore, community care in the network of Smart Silver Villages was proposed. Discussion Investments are needed to renovate the housing stock of older adults and construct sheltered, assisted living housing and specialized households in the community. Moreover, proper education and training of human resources would increase the output. In addition, financial solutions are advised to develop Smart Silver Villages.

What palliative patients and their carers need at home and what a primary health care team can offer – first pilot study in Slovenia

“…Some patients needed to be hospitalised due to complex conditions that could not be resolved at home (e.g., severe dyspnoea-related pleural effusion and ascites, pain resistant to therapy). Based on years of regional experience (28)(29)(30)(31), Slovenia has been expanding the network of specialised mobile palliative teams that provide specialist consultation and specialist palliative care at home. Further progress in home-based palliative care is expected, especially for patients with complex palliative needs (30).…”