Ms. Drahomíra lived alone in Ústí nad Labem for years. Apart from his son and daughter-in-law, he has no close relatives. And her health was steadily deteriorating. “She didn’t take care of herself, but absolutely refused to move to us in Prague. Then she applied to a home for the elderly, but delayed the move. She kept saying: One more Christmas,” recalls daughter-in-law Aneta.
As Seznam Zprávy has already described, even according to a survey by the Ipsos agency, a minimum of Czechs want to spend their final years in a home for the elderly or other institutional care. But the reality is often different. Mainly because of poor health, people often end up “on the waiting list”. They often wait years for a new home.
Where is the greatest need for homes for the elderly
The following map was created on the basis of CZSO data and shows how essentially the whole of the Czech Republic is dealing with a lack of places, but at the same time large regional differences are also evident. As of 31/12/2022, the Statistical Office records approximately 61,000 places in total, of which less than 36,000 beds are in homes for the elderly and less than 25,000 in homes with a special regime. It’s not nearly enough either. “The lack of beds is a big problem. 10,000 to 12,000 applicants are currently applying for admission,” says Alice Švehlová, executive director of the Association of Social Service Providers.
How to handle the map: you can switch according to the type of facility (homes for the elderly, homes with a special regime, but also homes for people with disabilities or asylums). The map is shaded according to the relative conversion of places in the given facility per inhabitant in this municipality with extended scope (ORP). The right menu then shows specific municipalities where the device is located. The size of the point corresponds to the capacity of the device. Click on the ORP or a specific municipality to view details.
When converting the population of the regions to places in homes for the elderly, the worst situation is in Prague. Over 1.3 million people live in the capital, and there are 4,374 beds in homes for the elderly and in homes with a special regime. “The average waiting time is in the order of one to two years,” calculates Vít Hofman, spokesperson for the Prague municipality. He adds that the health status of the applicant can shorten the wait to several months in urgent cases.
Not good in Prague (also in Brno, Karviná, Pilsen and elsewhere)
A more detailed look at municipalities with extended jurisdiction shows significant differences even within individual regions. Go through all the regions of the Czech Republic step by step – just switch the slides.
The family of 76-year-old Drahomíra also experienced the stress of the search. The turning point came before Christmas 2022. “The mother-in-law had a medical complication. She was diagnosed with Alzheimer’s disease in the hospital. The situation was much worse than we had previously thought. They told us that they wouldn’t let her go back home alone,” recalls Aneta, who was shortly before giving birth at the time. He does not want to give his full name, the editors know him.
At the hospital, due to the advanced stage of pregnancy, they were not advised to take a sick elderly woman into an apartment in Prague. The search began. “But we found nothing and after 4 days she was taken from the hospital to a psychiatric hospital. Terrible experience. It was clear that he could not stay there,” adds Aneta. He says that he began a “carpet raid” on various facilities within driving distance of Prague, as well as in the surrounding regions.
Pavel from Brno also describes similar concerns. His father used to be a successful lawyer, but now, at the age of 77, he forgets his son’s name due to advancing Alzheimer’s disease. “We’re looking for something close so mom can walk to it. Everywhere they tell us to apply to as many facilities as possible, because the waiting period is easily 4 to 5 years in homes with a special regime,” says the man, who does not want to publish his full name. The editors know them.
In the Czech Republic, the number of beds in residential facilities for the elderly has been increasing over the last decade. The proportion of places in homes with a special regime, where people with senile dementia, after brain injuries and other non-self-supporting clients live, is gradually increasing.
According to experts, it will be necessary to continue to strengthen. There are currently up to 140,000 people living with various forms of dementia in the Czech Republic, and by 2050 this number may increase by up to a third. “Today, we hardly find a family where someone at an older age does not have Alzheimer’s disease,” says Robert Rusina, head of the Neurological Clinic of the 3rd Faculty of Medicine of Charles University and Faculty Thomayer Hospital.
Waiting periods are difficult to ascertain
The editor’s search for how long the waiting periods are in homes for the elderly is not easy. Individual regions record the number of beds in these facilities, but only some have accurate records of the status of applications or waiting periods. For example, the South Moravian regional office uses an online system for this. There are less than six thousand beds available in the mentioned facilities in the region, and about 2,300 people are waiting for a place.
“Unfortunately, due to the many variables that affect the length of the waiting time, it is not possible to determine the average waiting time for one bed. In some facilities, it can take weeks, in others it can take several months,” explains regional spokeswoman Alena Knotková. He adds that each device registers at least dozens of requests.
“The worst thing is the uncertainty. They bluntly told us that they were waiting for someone else to die. It’s hard that you have to wait for someone else’s death for your parent to get there,” reflects Pavel.
We want field service
Experts emphasize that one cannot blindly focus on the number of beds in homes. “The state must continue to focus on field services. It declares that it does so. Most of us will age at home. The only question is how much quality and dignity. This also includes the right to a dignified death,” explains sociologist Lucie Vidovićová from the CERA Center for Aging Research at Masaryk University.
He adds that most Czechs die in a hospital or other institution, but they could also die in the comfort of their homes if their loved ones had the security of a mobile hospice in the so-called “every village”. “But the call for more beds is always somehow louder than the call for more well-paid people and social services,” responds the sociologist.
Aneta and her partner spent a month looking for a place for a 76-year-old senior woman with acute problems. “The partner flew between the maternity ward and the psychiatric hospital. At one facility I was told that nothing might happen for months and years. That’s when we realized how big a problem it is,” he reports.
He notes that there are no comprehensive lists of quality-rated homes. “Sometimes it’s hard to find out more details about homes, they don’t have an up-to-date website. The requirements for applicants’ application forms differ,” he adds.
Crisis beds for the most vulnerable seniors
Counties, which are frequent home founders, approach the lack of places in different ways. For example, in Vysočina, four homes have been pilot testing the crisis bed program since February. “It is a completely new service, unique in the Czech Republic. It has nothing to do with emergency beds for the homeless or mothers in need,” explains regional spokeswoman Jitka Svatošová.
Clients like Drahomíra will temporarily be put on the bed. “Perhaps people whose caregiver suddenly falls ill or for some reason cannot stay in their home environment. However, the rule applies that the client must vacate the bed within three months. For example, by switching to a regular bed in a home for the elderly, a suitable solution will be found for him or he will return to the home environment,” explains councilor for social affairs Jan Tourek (KDU-ČSL). In Vysočina, they estimate that after the pilot version it will be adopted in other regions as well.
Prepare your monthly salary
After a month of urgent searching, Aneta’s mother-in-law found a place in a private home in the Pilsen region. However, the worries do not end there either. “In Prague, they want 40,000 to 45,000 crowns a month for a senior citizen’s monthly stay, in Pilsen it is of course less, but even there they have raised the price by 4,000 crowns since the beginning of the new year. We live on one salary now, I’m on parental leave. It’s no joke,” says Aneta.
This is also why they are looking for a place in a cheaper state institution. “It’s been over a year since I’ve been trying to get my mom there. We’re just as adamant about it as before, and it’s completely useless.”
Sociologist Vidovićová points out that the increased need for beds is not due to “old age”. “This is due to a lack of housing for young people, seniors giving them their apartments, poor health prevention, but also a lack of care for relationships. From childhood, no one teaches us to solve conflicts constructively. We also often build houses in which, due to various obstacles, it is not possible to grow old,” he adds.
With the contribution of Daniela Krásenská.
