The fifth meeting of ELTECA advisory board and the second ELTECA conference was held on 25 and 27 April 2013 in the Hotel Grand Majestic Plaza in Prague. ELTECA (originally the working title) is the acronym for Exchange of Experience in Long-Term Care. The theme of the conference focused on the issues of dementia and pain in long-term care.
The impetus for this initiative came from expert discussions, especially within the geriatric medicine community. While the long-term care (LTC) system in some countries, particularly in the western and northern parts of the European Union, is very well developed and relatively generously funded, some countries, including countries of the former Eastern Bloc, significantly lag behind in the provision of LTC services and the allocation of resources in this area.
Moreover, this fact was again highlighted in the documents of the European Commission issued in February this year. While the expenses on long term care in the EU stand on average at about 1.8% of GDP, in the Czech Republic, for example, it is about half of that (Note: nevertheless, the comparability of data on LTC financing still remains problematic as countries’ definitions of what is part of long-term care may differ.)
Besides inadequate funding and underestimation of the issue, the countries of the former Central and Eastern Europe face many other common challenges in this area. These include fragmentation of services, lack of communication and co-operation of health and social services, etc. On the other hand, there are many examples of good practice at level of organizations or municipalities to which counter-balance this.
We agreed that the initiative to exchange experience and to improve the situation in long-term care, at least at the expert (medical and nursing) level, should come from these countries. Therefore, we are pleased that experts, especially geriatricians, nurses, physiotherapists, psychologists, pharmacists, health care organizers and other members of interprofessional teams from various countries have been participating in the ELTECA meetings.
Currently, countries involved include (in alphabetical order) Albania, Austria, Bulgaria, Czech Republic, Estonia, Germany, Hungary, Lithuania, Norway, Poland, Romania, Slovakia, Slovenia, Turkey, UK, and the USA: other countries are joining in gradually. Another goal of ELTECA initiative is to improve communication between experts from Central and Eastern Europe and other countries, to better connect them at both professional and informal level so that they can more easily cooperate and participate in European research projects where the representation of these countries is still very low.
The first ELTECA meeting took place in late 2011 in Prague, followed by the first conference in March 2012 and the first Advisory Group meeting in December 2012, where the issue of quality of long-term care was discussed and recommendations for the care of patients with dementia were produced. Documents and instruments of the Czech Alzheimer Society which serves as the basis for evaluation of quality of care for people with dementia and awarding of the “Dragonfly” certification of quality were presented and very positively received as examples of good practice.
The next meeting of the ELTCA working group was held within the symposium “Inter-professional Aging Issues in a Global Society”, which was organized by Geriatric Educational Centre (GEC) at NOVA University Medical School Ft. Lauderdale, Florida.
The 2013 ELTECA conference focused on the issues of pain and dementia. In opening lecture, Professor Alexander Kurz from TU Munich focused on diversity of dementia syndrome, which is manifestation of Alzheimer’s disease and other diseases causing dementia. In the following lecture Robert Rusina (Czech Republic) focused on the possibilities of therapy for Alzheimer’s disease.
Sigurd Sparr from the city of Tromso, Norway spoke about the needs of older people with dementia and Iva Holmerová (Czech Republic) focused on the consequences of dementia on society and caring family. Debbie Tolson from the UK stressed the need for and importance of person-centred care, especially in people with dementia. Helgi Kolk from Estonia dealt with the problems and needs of patients with dementia who underwent orthopaedic surgery.
Hana Vaňková, Czech Republic presented data from a survey of long-term care and emphasized that up to two thirds of patients in long-term care facilities suffer from pain and that with systematic management, education and support of care staff this share can be significantly reduced. Naushira Pandya, vice president of AMDA (American Medical Directors Association) has addressed the issue of pain in long-term care and presented the recommendations of AMDA.
Ladislav Kabelka of Hospice Rajhrad, Czech Republic, spoke about symptoms management in the wider context of palliative care. Brigitte Hermann from Austria opened the panel discussion with presentations of case studies.
The discussion panel, moderated by Cecilia Rokůsek of GEC NOVA University, Ft Lauderdale, included Rasa Ruseckiene (Lithuania), Katarzyna Wiecorzowska Tobis and Marzena Dubiel (Poland), and Agnes Egervari (Hungary). Ms Nina Baláčková, a patient suffering from Alzheimer’s disease, who as a result of good therapy is still very active and also involved in the activities of the working groups of patients with Alzheimer’s dementia in Europe, spoke about her experiences and drew attention to problems and risks in care of patients with dementia.
Iva Holmerová is past president and current vice-president of Czech Geriatric Society