Human Rights of the Elderly: Lacking Systemic Protection

A-care-home-for-the-elder-007According to the 2013 data, there are 48 state-run homes for the elderly in the Republic of Serbia. Besides the duly registered nursing homes founded and run by individuals as private welfare enterprises, there are also a number of illegal ones, the capacities of which are still unknown.

Visiting elderly and nursing homes run as private enterprises and duly registered with the relevant authorities of the Autonomous Province of Vojvodina, the Provincial Ombudsman has determined that the rights of the elderly are being systemically violated on several grounds. Their rights are often being violated by their relatives because they keep placing the elderly into nursing homes contrary to their own will. This indicates that cases of the elderly being coerced into placement within these homes are a common practice, along with the completely unstandardized and non-transparent admission practices varying from one facility to another and not monitored by any relevant inspection authority whatsoever.

The living condition of these elderly people is most often revealed during the visits of the National Prevention Mechanism (NPM), an independent human rights inspection body the Provincial Ombudsman is a part of. The elderly are frequently placed in inadequate housing, often in higher floors of private houses, though they have limited mobility and are using bulky orthopedic aids. Their open-air time is often just sitting around unsafe terraces or semi-open spaces. The home property is mostly surrounded with high fences, with gates locked as a rule. Often lacking a proper yard and free time space, the beneficiaries of these homes are practically deprived of their freedom of mobility.

The local welfare centers, all a part of the state welfare system, usually know nothing about the existence and capacities of private enterprises providing housing and/or nursing to the elderly people. As if by rule, the local welfare centers fail to refer the elderly to properly registered private welfare enterprises even in cases when the state-run homes are full. This puts the legally operating private nursing homes in an unequal position. On the other hand, there are also abuses of office in cases when employees of the local welfare center are at the same time owners of illegal nursing homes. This is a conflict of interest and it opens a vast space for abuse.

NPM Findings

Prior to placement into a nursing home, it is important to ensure that the elderly person has undergone a monitoring procedure with the relevant local welfare center because the state is bound to provide the minimum of human rights exercise to the elderly and prevent any inhuman or degrading treatment. Private nursing homes are profit-driven, so it often happens that the rights of the beneficiaries are neglected and more attention is paid to the relatives or other people placing the elderly people into homes. Therefore, placement of persons suffering from dementia or the Alzheimer’s disease, particularly if they are to be placed in the so-called closed wards of welfare facilities, needs far better legal regulation. The official placement ruling must state the initial placement period, as well as the times and deadlines of beneficiary welfare evaluation in order to consider its extension.

The authorities in charge do no quality control or monitoring of the private nursing homes, while the Provincial Ombudsman has limited opportunity to investigate on individual beneficiaries’ complaints due to the fact that the elderly are too frightened and powerless to address anybody for help. The NPM observed that some homes disregards even the most basic human rights of their beneficiaries, so there is a most urgent need of involvement of all relevant social actors aimed at resolving this problem.

The Ministry of Labor, Employment, Combatants and Welfare, as well as the Provincial Secretariat for Healthcare, Welfare Policies and Demography, must monitor and supervise the work of private nursing homes, while the rulings on closing down unlicensed homes must be implemented consistently. Unfortunately, the experience so far has shown that the wider public is not interested in elderly people’s issues, including those concerning nursing homes, unless there have been some incidents, such as abuse, malnourishment, fire or other situations jeopardizing the lives of the elderly.