Background information about dementia and home care services
Home help services were originally developed on a small scale by the Greek Red Cross and other voluntary associations such as the Church. The Greek Red Cross also provides training to volunteers, including training in nursing skills and personal care. Nowadays, there are many organised agencies providing home care services but this is in the private sector and they are not supervised by the State.
Some local authorities provide home care services but such services are not provided uniformly throughout the country. This is further complicated by a lack of available information on entitlement and availability of services. The majority of older people continue to live at home either with their families or alone. Families play a key role in providing care for which they receive no direct support from the State.
However, in the last two decades the State has taken measures to increase community care services for older people so that they can remain in their own homes for as long as possible thereby enabling them to maintain their independence and enhance their quality of life. These measures include the creation of open care community centres for older people (KAPIs) and the help at home programme.
Legislation relating to the provision of home care services
The transfer of responsibility for the management and operation of KAPIs to local authorities occurred as a result of article 68 of Law N.1416/84. The relevant law concerning the home help for the elderly programme is Law N.2082/92.
Invalidity is measured in terms of the percentage of disability of the whole person. Carers are not legally entitled to any benefits but there are invalidity supplements for people in need of constant care.
It is stated in the Constitution and in Civil Law that the family is responsible for the care of dependent relatives of all ages but also that the State will care for the health of citizens and will adopt special measures for the protection of young people, the elderly and invalids, as well as for assistance to the needy. Consequently, if a family is unable to care for a dependent relative, the dependent person is taken care of by the Social Security system.
For carers in paid employment, labour legislation allows them to take up to 6 days’ unpaid leave to fulfill their caring obligations.
Organisation and financing of home care services
There is no long-term care insurance in Greece. Financial assistance is mainly in the form of discretionary tax rebates to family carers. Some family carers use supplementary pensions for incapacity or dependency to help towards the costs of caring.
Some local authorities provide home help services to elderly dependent people, most of whom are poor and isolated but they are not obliged to do so. Discretionary grants and benefits are also available in some areas. However, these provisions are dependent on the financial resources of individual local authorities and are not based on an official policy.
Open care community centres for old people were set up as a pilot scheme by voluntary organisations funded by the State. In 1982, local authorities assumed responsibility for the KAPIs and the State continued to be the main financial contributor. A “Help at Home” programme for older people was started in 1992 under the auspices of the Ministry of Health and Welfare involving a number of KAPIs and local authorities. In some areas, the Help at Home programme supports family carers (mainly women) by providing supervision during part of the day so that the carer can take up or maintain paid employment.
Where community care services exist, they are free at the point of use. They are currently funded through central government. Some services are partly funded by EU special programmes e.g. some of the KAPI home care services.
Kinds of home care services available
KAPI centres aim to provide the necessary support to enable people to live independently in their own homes for as long as possible. Most offer the following services:
- Preventive medical services
- Physiotherapy programmes
- Ergotherapy programmes
- Health education
- Recreational activities
Many KAPI centres collaborate with the Help at Home project which offers a range of services to elderly people who are unable to manage on their own, i.e.:
- Social services (counselling and psychosocial support, information on rights and health issues)
- Health care services
- Family assistance (assistance with housework, personal care and eating, as well as befriending)
A few community centres are run by voluntary bodies or directly by local authorities (e.g. the centres for love and friendship in Athens). They are fairly similar to the KAPI centres but do not offer health care services. A number of day care centres have been set up since the establishment of the National Social Care System in 1998. These are closely linked to the KAPIs.
In some areas, local authorities and many parishes of the Orthodox Church provide free meals at home to people in need. In many areas, neighbours, friends and volunteers offer sitting services but the main source of respite care is still through acute admissions to hospitals. In Thessalonika and Athens, there is a 24-hour tele-alarm system linked to family, neighbours, the police or the ambulance service.
- Daniilidou, N., Economou, C., Zavras, D., Kyriopoulos, J. and Georgoussi, E. (2005) Health and social care in aging population: the case of an integrated care institution in Greece, http://www.integratedcarenetwork.org/publish/articles/000004/article.htm
- Mestheneos, E., Triantafillou, J. and Kontouka, S. National Background Report for Greece, EUROFAMCARE, http://www.uke.uni-hamburg.de/extern/eurofamcare/documents/nabare_greece_rc1_a4.pdf
- Sissouras, A., Ketsetzopoulou, M. et al. (2002), Providing integrated health and social care for older persons in Greece, (Procare report), National Centre for Social Research (EKKE), http://www.imsersomayores.csic.es/documentos/documentos/procare-providinggrecia-01.pdf#search='Procare%20National%20Report%20Greece'
Last Updated: mercredi 15 juillet 2009