Zagreb - According to reports for 2024, as many as 37% of people over the age of 65 in Croatia live at risk of poverty. Institutional care and home assistance remain unavailable to many, and care homes have capacity for only 3.5% of the elderly population.
"Care homes for the elderly have capacity for only 3.5% of this population, which is lower than the EU average. At the same time, the cost of accommodation in 2024 increased by up to 40%, including in decentralised homes, making them increasingly unaffordable, especially for people with lower incomes," said Ombudswoman Tena Šimonović Einwalter.
She added that only Romania and Bulgaria have lower accommodation capacity than Croatia.
Home care services, which should allow the elderly to remain in their own homes, are also not widely available. The Ombudswoman pointed out that these services are mostly funded through the "Make a wish" project, but due to a lack of workers and low wages, many citizens still go without them.
Showering once every two weeks
"The shortage of staff is a huge problem when it comes to homes for the elderly and infirm. It's difficult to precisely determine the number of such complaints, because the lack of employees - primarily medical personnel and caregivers - directly or indirectly affects a whole set of problems we receive complaints about," said Šimonović Einwalter.
During field visits, she encountered alarming examples of treatment toward care home users.
"In one of the homes, the elderly were bathed only three or four times a month, and in another only once every two weeks," she noted.
"According to the standards of the European Committee for the Prevention of Torture and Inhuman or Degrading Treatment or Punishment (CPT), users should be showered at least twice a week, and more often if necessary, to avoid inhumane treatment," she explained.
She also mentioned cases of users who do not go outside for weeks because there is no one to take them out for fresh air, as well as those who lie in wet bedding, with unhealed wounds, without adequate care.
Serious human rights violations
In addition to physical care, privacy is also seriously neglected, such as when immobile individuals are cared for without privacy screens or with the room doors open.
"All of this points to serious violations of the human rights of elderly persons," said Šimonović Einwalter.
The Ombudsman for Persons with Disabilities, Darijo Jurišić, also confirmed that the problem of a lack of caregivers is widespread, especially in rural areas.
"The lack of staff limits the independence of people with disabilities, their access to services, and their inclusion in the community," he warned. He noted that many users with legally binding decisions wait for months for a personal assistant.
Jurišić also emphasised that the Personal Assistance Act urgently needs to be evaluated, as an increasing number of users are elderly with complex health needs, for whom personal assistance is not enough.
"A combination of services is needed, including healthcare, and more precise targeting of actual needs," he said.
Measures launched
The Ministry of Labour, Pension System, Family and Social Policy stated that it recognises the importance of improving long-term care and that it is working intensively on it.
The Operational Plan for the Development of Integrated Long-Term Care for the period 2025-2030, created in cooperation with the World Bank, includes a series of measures, from mapping workforce needs to training and employing caregivers through a voucher system.
So far, more than a thousand people have started training to become caregivers, and wages have increased by about 70% compared to 2023, the ministry said.
The plan also includes the establishment of a national intersectoral body to monitor the implementation of the measures, as well as support for informal caregivers through training, psychosocial support, health care, and the "Respite from Care" service.
Implementation delays
Despite these developments, the competent institutions warn that changes are too slow given the growing needs.
The Ombudswoman emphasised that recommendations on employment and strengthening the workforce have been made years ago, but that a systematic policy has yet to take hold.
She especially warned of a legal gap in complaints and the fact that users in most homes, especially private ones, do not have a clearly defined procedure for filing complaints or appeals.
"The rights of older persons are still largely unrecognised," said the Ombudswoman.
She added that although there are many conventions relating to human rights, there is still no international convention on the rights of the elderly. The good news is that the UN is now beginning preparations for one, which could bring a number of new obligations for member states, she added.
Šimonović Einwalter also expressed her belief that the vast majority of elderly people in Croatia would prefer to stay in their own homes until the end of life. She believes the state should enable this through adequate pensions, a strong social welfare and healthcare system, as well as improved transport infrastructure and other strategic priorities.
Report (in Croatian)