Reference Center for Healthcare of the Elderly of the Ministry of Health of the Republic of Croatia – Department of Health Gerontology WIDER Transnational Capitalisation Event: Central European Transfer Seminar Eco-Smart Housing for Elderly Prim PhD S. Tomek-Roksandić,PhD N.Tomasović Mrčela, MD Z. Šostar et all Trieste, 14 May 2015

Smart Housing for Elderly   ensure an older person to stay in his home and in his local community as long as possible Reference Center for Healthcare of the Elderly of the Ministry of Health of the Republic of Croatia – Department of Health Gerontology

GERONTOLOGICAL CENTERS (out institutional care) – CROATIAN MODEL OF SUCCESSFUL PRACTICE and SMART HOUSING FOR ELDERLY Reference Center for Healthcare of the Elderly of the Ministry of Health of the Republic of Croatia – Department of Health Gerontology

Referentni centar Ministarstva zdravlja RH za zaštitu zdravlja starijih osoba - Centar za zdravstvenu gerontologiju Izvor:

Referentni centar Ministarstva zdravlja RH za zaštitu zdravlja starijih osoba - Centar za zdravstvenu gerontologiju Izvor:

Referentni centar Ministarstva zdravlja RH za zaštitu zdravlja starijih osoba - Centar za zdravstvenu gerontologiju Izvor:

Reference Center for Healthcare of the Elderly of the Ministry of Health of the Republic of Croatia – Department of Health Gerontology Gerontology (Gr. gerōn = old man; Gr. logos = word,reason) Multidisciplinary science on biological, psychological and social aspects of aging and old age. Practical application in gerontologic-public health service. Elie Metchnikoff from Pasteur's Institute in Paris was the first to use the term in 1903 in his biological study of aging. In Croatian his Gerontology is a sub-specialization of public health specialization

Reference Center for Healthcare of the Elderly of the Ministry of Health of the Republic of Croatia – Department of Health Gerontology Centers of Gerontology Centers of Gerontology have been established at Public Health Institutes (PHI) of particular Croatian counties, City of Zagreb and Republic of Croatia, to perform gerontologic-public health service (Official Gazette 126/06), according to the Program of monitoring, studying, evaluation, reporting, health care needs and functional ability of the elderly, proposing the Program of measures and procedures in health care of the elderly and Program of primary, secondary and tertiary prevention for the elderly.

Reference Center for Healthcare of the Elderly of the Ministry of Health of the Republic of Croatia – Department of Health Gerontology Gerontologic team at the Center of Health- Gerontology, Zagreb PHI, has a standard catchment population of 30,000 elderly aged ≥65. Gerontologic-public health team consists of various professionals: specialist in public health/epidemiology – gerontologist, registered nurse/occupational therapist for the elderly, and gerontologic-health care statistician.

Reference Center for Healthcare of the Elderly of the Ministry of Health of the Republic of Croatia – Department of Health Gerontology Gerontology Center The service of Gerontology Center covers non- institutional care for the elderly. Gerontology Centers perform programs of primary prevention for the elderly; ensure daily assistance, care and rehabilitation; continuous physical, mental and occupational activities; cultural events and enterainment; recreational activities; psychological, medical, social and legal counseling; geronto-service and geronto-hosts; day-care for the elderly; meals on wheels; orthopedic and other aid rental shop for the elderly. The main objective is to enable the elderly stay at home with the family as long as possible.

 Croatia is facing a rapidly aging population - the population aged 65 and over now makes up more than 17,7 % of the population (2011)  it’s important to offer the elderly population a lot of opportunities for active and healthy ageing at the out institutional/GERONTOLOGICAL CENTERS Reference Center for Healthcare of the Elderly of the Ministry of Health of the Republic of Croatia – Department of Health Gerontology

Old people’s homes aren’t always the best solution! DO NOT FORCE an older person to live at an old people’s home if he actually doesn't want to! old people's home

Red.br. ŽUPANIJE I GRAD ZAGREB Old people’s home / DOMOVI ZA STARIJE – 2014.g. DRŽAVNI (OSNIVAČ RH) DECENTRALI- ZIRANI DRUGI OSNIVAČI UKUPVNO DOMOVA UKUPNO DOMSKIH KORISNIKA PO POJEDINOJ ŽUPANIJI** postotak korisnika po pojedinim županijama 1 GRAD ZAGREB ,27 2 ZAGREBAČKA ,08 3 BJELOVARSKO- BILOGORSKA ,36 4 BRODSKO-POSAVSKA ,84 5 DUBROVAČKO- NERETVANSKA ,91 6 ISTARSKA ,69 7 KARLOVAČKA ,99 8 KOPRIVNIČKO- KRIŽEVAČKA ,55 9 KRAPINSKO-ZAGORSKA ,52 10 LIČKO-SENJSKA ,32 11 MEĐIMURSKA ,88 12 OSJEČKO-BARANJSKA ,19 13 POŽEŠKO-SLAVONSKA ,55 14 PRIMORSKO-GORANSKA ,27 15 SISAČKO-MOSLAVAČKA ,78 16 SPLITSKO-DALMATINSKA ,65 17 ŠIBENSKO-KNINSKA ,11 18 VARAŽDINSKA ,42 19 VIROVITIČKO-PODRAVSKA ,75 20 VUKOVARSKO-SRIJEMSKA ,45 21 ZADARSKA ,42 HRVATSKA UKUPNO STRUKTURA UDJELA KORISNIKA DOMOVA ZA STARIJE PO ŽUPANIJAMA HRVATSKE (N= / 2%), 2014.G.*

AIM Maintain functional ability of elderly people to ensure them to stay at home / ECO SMART as long as possible  GERONTOLOGICAL CENTERS (outinstitutional care) Reference Center for Healthcare of the Elderly of the Ministry of Health of the Republic of Croatia – Department of Health Gerontology

 Basic aim: keep an old person in his home and so in his local community as long as possible and to ensure him an active way of life and therefore also active and healthy ageing

1. Gerontological center ensures immediate care in health protection of functionally active and functionally disabled elderly in the local community /ECO SMART Housing for elderly where old people live and create. Reference Center for Healthcare of the Elderly of the Ministry of Health of the Republic of Croatia – Department of Health Gerontology

2. Gerontological center is a center of coordinative multiprofessional activities in choosing measures from the Programme of primary, secondary and tertiary prevention for the elderly in the local community where old people live and create. Reference Center for Healthcare of the Elderly of the Ministry of Health of the Republic of Croatia – Department of Health Gerontology

3. Gerontological center is the central meeting place of the elderly for the promotion and prevention of risk factors for sick aging, place of constant physical, psychical and working activities of the elderly, teaching, reeducation and reintegration of older and younger people in the care for the elderly. Reference Center for Healthcare of the Elderly of the Ministry of Health of the Republic of Croatia – Department of Health Gerontology

4. Gerontological center ensures interdisciplinary approach and coordinate activity, efficacy, rationality, systematics and programming in integral activity of various carriers of health and social care for the elderly. Reference Center for Healthcare of the Elderly of the Ministry of Health of the Republic of Croatia – Department of Health Gerontology

5. Gerontological centers are centers of gerontological continuous education for older and younger people about old age and ageing as well as mini-educational and creative institutions for the preparation of people for retirement and old age. Reference Center for Healthcare of the Elderly of the Ministry of Health of the Republic of Croatia – Department of Health Gerontology

 Gerontological centers ensure everyday help, care and rehabilitation for the elderly living in their own homes  the provide daily stay, offer adequate services according to the Programme of primary, secondary and tertiary prevention for the eldery Reference Center for Healthcare of the Elderly of the Ministry of Health of the Republic of Croatia – Department of Health Gerontology

 permanent physical recreation, creative working and cultural activities together with health, psychological and economic advisory services  professional teams carry out all the necessary actions for detection and systematic care of the elderly Reference Center for Healthcare of the Elderly of the Ministry of Health of the Republic of Croatia – Department of Health Gerontology

Gerontological centers as noninstitutional care for elderly can be within old people's homes (but not necessarily) Reference Center for Healthcare of the Elderly of the Ministry of Health of the Republic of Croatia – Department of Health Gerontology

Zagreb started in 2004 with 4 Gerontological centers. In the meanwhile there are, because of the big success and demand for it, 13 Gerontological centers in Zagreb and in the entire Croatia there are 116 Gerontological centers. Reference Center for Healthcare of the Elderly of the Ministry of Health of the Republic of Croatia – Department of Health Gerontology

Development of gerontological centers, promotion of outinstitutional care for the elderly in their local community and infrastructure connection with old people's homes allows resistance to the present passivity and social isolation (loneliness) of the elderly to healthy active and productive ageing of Croatian old population. Reference Center for Healthcare of the Elderly of the Ministry of Health of the Republic of Croatia – Department of Health Gerontology

GeroS / CEZIH (Central Health Information System of the Rebublic of Croatia) SUBSYSTEM FOR MONITORING AND EVALUATION OF HEALTHCARE NEEDS AND FUNCTIONAL ABILITY OF GERONTOLOGIC INSUREES AND GERIATRIC PATIENTS Reference Center for Healthcare of the Elderly of the Ministry of Health of the Republic of Croatia – Department of Health Gerontology

Source: Croatian Institute of Health Insurance and Department of Health Gerontology, Dr Andrija Štampar Institute of Public Health Teaching Unit (CIHI and DHG, Dr Andrija Štampar IPHTU)

GeroS  computerization of the geriatric healthcare at all three levels of primary healthcare for the elderly  enables rationalization of the rising geriatric healthcare cost and upgrading of healthcare for the elderly  enables monitoring, study, evaluation, reporting and planning of the healthcare needs and functional ability of the elderly (institutional as well as outinstitutional care) Reference Center for Healthcare of the Elderly of the Ministry of Health of the Republic of Croatia – Department of Health Gerontology

GeroS includes the following entities:  primary health care  specialist consulting healthcare  hospital healthcare and long term/paliativgeriatrics treatment  old people's homes and social and health care centers Reference Center for Healthcare of the Elderly of the Ministry of Health of the Republic of Croatia – Department of Health Gerontology

 GeroS allows regular revision of the list of drugs used by a geriatric patient (age 65+)  GeroS enables gerontologic NONduplication (NONoverlapping) and differentiation of healthcare procedures  Nutritional gerontologic standards for the elderly are also included as a link in GeroS Reference Center for Healthcare of the Elderly of the Ministry of Health of the Republic of Croatia – Department of Health Gerontology

 GeroS will detect gerontologic problems and geriatric difficulties in healthcare of the elderly via link to healthcare system and social welfare system  Rationalization through GeroS enables development of focused gerontologic public health programs Reference Center for Healthcare of the Elderly of the Ministry of Health of the Republic of Croatia – Department of Health Gerontology

IMPORTANCE OF CONTINUING EDUCATION in gerontology, geriatrie and geriatrics nursing health care Reference Center for Healthcare of the Elderly of the Ministry of Health of the Republic of Croatia – Department of Health Gerontology

THE WORLD BELONGS TO THE YOUNG PEOPLE, BUT IT EXISTS THANKS TO THE OLDER PEOPLE ! NA MLADIMA SVIJET OSTAJE A NA STARIJIMA OPSTAJE ! Die Gegenwart der Welt ruht in den Armen der Älteren, die Zukunft der Welt liegt in den Händen der Jugend !

AIM Maintain functional ability of elderly people to ensure them to stay at home / ECO SMART HOUSING for ELDERLY as long as possible  GERONTOLOGICAL CENTERS (outinstitutional care) Reference Center for Healthcare of the Elderly of the Ministry of Health of the Republic of Croatia – Department of Health Gerontology

OLD AGE IS NOT A DISEASE but a normal physiological phenomenon and definitive perspective of every human, dependent on the genome of ageing acquiring favorable health behavior during the process of ageing. Reference Center for Healthcare of the Elderly of the Ministry of Health of the Republic of Croatia – Department of Health Gerontology

83-year-old gymnast