In Malta the Civil Code clearly places the responsibility of caring for a spouse or parent with family members. According to the Maltese Civil Code (Book first of persons, art. 2), a married person who is in need of help with daily living can rely on maintenance from his/her spouse provided that they still live together. Maintenance is defined in article 19, paragraph 1 as including food, clothing, health and habitation. Children are bound to maintain their parents or other ascendants that are indigent. However, neither of the spouses can claim maintenance from their children if such maintenance could be provided by the other spouse (art. 5.3). No one is legally obliged to care for unmarried people or widows/widowers with no children. The State would be responsible for their care.
There is little interaction between state, private and voluntary providers but Forum Malta in Europe works to strengthen the interface between government and NGOs.
In 1987, the Government set up the Department of Elderly and Community Services (within the Parliamentary Secretariat for the Elderly and Community Care) which is responsible for taking care of the special needs of the elderly. The aim, in providing these services, is to enable elderly people and those with special needs to remain living within the community for as long as possible. Community services for the elderly and for people with special needs are heavily subsidised by the State. People receiving such services pay a nominal fee based on their in- come (Ministry of Health, 2002). Following the change in government in March of 2013, the Parliamentary Secretariat for the Elderly and Community Care was renamed as Parliamentary Secretariat for Rights of Persons with Disability and Active Ageing under the remit of the Ministry for the Family and Social Solidarity.
Services are not targeted specifically for people with dementia and they are slow to respond especially in times of crisis. Entry to a long-stay government home may take months to arrange due to long waiting lists.
As mentioned above, social support, when provided, is organised through the Department of Elderly and Community Services. Social Workers are responsible for conducting assessments for people in state hospitals or in the community. Requests for the homecare help service must be accompanied by a medical report. This is sent to the Department for the Elderly and Community Services, which then arranges for a social worker to visit the applicant in their home in order to assess their needs. The number of hours granted is dependent on each person’s needs.
Healthcare and services are funded through general taxation. The healthcare system is publicly financed through general taxation and is free at the point of delivery although users may have to make out-of-pocket payments (for example to purchase medicine that is not reimbursed under the National Health System). Private healthcare is fair- ly common (Ministry of Health, 2002). National (social) insurance serves to fund pensions.
There is no problem with accessibility to services and support, even for people living in rural areas, although many services need to be up-graded. Services for individuals with dementia in the community such as day care, respite care and community psychiatric nurses are scarce. There are associations for people with conditions that mean they are at a higher risk of developing dementia e.g. Huntington’s disease or Down’s syndrome. There are no special provisions for people with dementia and carers from minority ethnic groups.
Gerry Griffiths, Information & Support Co-ordinator
Taken from Council News – October 2016
Editor’s Note: the above is an extract from a very thorough and detailed report produced by Gerry on this vital subject. Unfortunately, space presents me from printing the full report which runs to several pages. For a full copy of the report or for further information, please contact us.