Background information

Where people with dementia receive care and support

The following table provides estimates of the number of people with dementia living at home, in various types of residential care and in hospitals or psychiatric institutions.

It is estimated that about 10% of residents in general/non-specialised residential homes have dementia. In Turkey residential homes do not usually accept people with dementia. However some of the elderly people staying in residential homes develop dementia. In general/non-specialised nursing homes, the number of residents who have dementia is about 50%

The ratio of staff to residents in different types of accommodation is as follows:

• 1:8 in general/non-specialised residential homes,  
• 1:5 in general/non-specialised nursing homes,
• 1:5 in specialised nursing homes for people with dementia.

The organisation of care and support for people with dementia

The overall organisation of care and support

The majority of people with dementia live at home with their relatives or they live in the house of their children. Care is provided mainly by the members of the family. Some families especially from the upper-middle class can employ professional caregivers in their houses but this is very limited.

A few nursing homes (both private and state-run) are also available. Day care centres are a new emerging trend. These are run by the municipalities in urban areas but there are not many of them.  There are also some special care units like “decubitus ulcer treatment teams” which are supported by municipalities in a few major cities.

In the last two years, home visits by GPs have been initiated. In any case, GPs visit bedridden patients in their own house. In addition, a few state-run hospitals organise homecare teams including specialists. These teams are starting to visit bedridden patients at home.

How specific aspects of care and support are addressed

The State supports families financially. For example, depending on the disability scores of the patients, families receive funding or some financial benefits.

If people with dementia cannot be cared for at home, there are some state-run nursing homes and people with dementia can be transferred to these places. 

Codes linked to nursing homes and residential homes are available. Also, there is a draft document with minimum standards for nursing homes.

The Alzheimer Association of Turkey is aware of a (draft) national ageing plan which includes medical and social issues linked to dementia. 

Training

Which social and healthcare professionals provide care and support

The following social and healthcare professionals are involved in the provision of care and support to people with dementia in residential care or living at home.

* Only if they are linked to the provision and organisation of care and support (i.e. not with regard to their role to provide medical treatment).

There are special high schools called “health occupation high schools” and graduates of these schools can work as nurses in Turkey. Also people who have graduated from normal high schools can apply for places on special graduate programmes in universities and after this education, they can work as nurses. 

No special training is needed for auxiliary staff. People need to complete a 4-year special graduate programme to become language therapists and physiotherapists in Turkey.

The type of training that social and healthcare professionals receive

Nursing staff receive education about dementia in their primary training. They may have additional training but this is their choice. The Alzheimer Association of Turkey annually organises a training course where majority of the attendees are nurses. It does not organise a special training programme for auxiliary staff.

Social sector professionals receive education about dementia in their primary university training. No additional special training is required. Allied health professionals (e.g. language therapists, physiotherapists, dieticians, podiatrists) are not required to have special training in dementia.

How the training of social and healthcare professionals is addressed

The training of neurologists, psychiatrists and geriatricians includes specialised knowledge about dementia and about the behavioural and psychological symptoms of dementia. That of GPs, other specialists and nurses includes basic/elementary knowledge about dementia 

All medical doctors (MD) have a 6-year formal education in Turkey. In this period they receive a special education related to dementia in their Neurology and Psychiatry rotation. After 6 years of education, MDs can apply for residency programmes where they need to pass a qualification exam. In the residency programmes for neurology and psychiatry there is a special training about dementia.  It is not known if nurses and social sector professionals receive any special training about dementia.

Support for informal carers

There are no national policies addressing support for informal carers (e.g. respite care, training, consultation/involvement in care decision counselling and support).

National Alzheimer Association

The Turkish Alzheimer Association provides the following services.

Acknowledgements

Başar Bilgiç, Member of the Executive Committee of the Turkish Alzheimer Association