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Introduction and Objectives The geriatric population over the age of 65 has a high malnutrition prevalence and an increased risk of malnutrition. In addition to malnutrition, multi-morbidity, inadequate physical activity and the worsening of acute illness also lead to reduced performance and reduced body function. Appropriate nutrition and malnutrition detection in the sense of screening must, therefore, be considered in modern treatment planning to achieve the desired goals. Our study aimed to determine the incidence of malnutrition in elderly patients over the age of 65 years. Materials and Methods This study included 1159 patients older than 65 years (maximum age of 101 years) who were admitted to the geriatric department at the Luzerner Kantonsspital Wolhusen (Switzerland). To assess nutritional status, we applied the Mini Nutritional Assessment-LF, according to the recommendation of the European Society of Clinical Nutrition and Metabolism (ESPEN). The subjects were divided into several different age groups, and the data obtained were then statistically processed. Results The analysis confirmed the high incidence of malnutrition in the geriatric population. A total of 751 patients – 64, 8% were malnourished or in the risk for malnutrition. The malnutrition was confirmed in 27, 9% of the patients, while the next 36, 9% were in the category of a high risk of malnutrition. The higher incidence of malnutrition was confirmed in the age group of 71-80 years. A lower MNA score also implies a significantly longer time of hospitalization. Conclusion Malnutrition and high risk of malnutrition are very common in patients over the age of 65, suggesting the need for regular and timely nutritional screening of geriatric patients to reduce the incidence of complications and improve prognosis in acute and rehabilitation medicine. At the same time, it can improve the efficiency of the treatment and shorten the duration of hospitalization, which also has significant economic implications.

Introduction and Objectives Depression is the most common mental disorder in the elderly population with a major impact on the quality of life and mortality. Depression has a significant impact on the treatment outcome of chronic non-infectious diseases, such as cardiovascular and neurological diseases or tumors in their acute and chronic phases. There are several tests available to detect a suspicion of depressive disorder. One of the most used tests is the Geriatric Depression Scale-15 (GDS-15). The goal of our research was to determine the incidence of depressive symptoms in people hospitalized in the geriatric department. Materials and Methods A total of 1159 patients were included in the retrospective analysis (421 men and 738 females), in the age between 65 and 101 years. All subjects were tested with GDS-15 (positive test implies a GDS-15 value of > 5). The results were analyzed by Statistica 13.3 Tribco, USA. Results In a total of 266 (23%) patients the test confirmed the existence of depressive symptoms (90 men and 176 females). In women, symptoms are mostly present in women who are widows, divorced, or unmarried (121 women-68, 7%). In the male population, the majority are married men or men who live in a partnership (59 men– 65, 6%) Conclusion Depression is present in a high percentage of elderly patients. Although patients are hospitalized for some other disease, early detection of depressive symptoms may contribute to greater success in treating the underlying disease. GDS-15 is a simple method that can detect the presence of depressive symptoms in patients applicable on any hospital ward Routine screening is necessary for timely recognition of depressive symptoms, conducting further tests in the detection of depression and initiation of therapy. This can achieve greater success in the treatment of basic illness.

Ostvarivanje ljudskih prava u starosti znači prije svega skrb za kvalitetu života osoba oboljelih od Alzheimerove bolesti i sprječavanje diskriminacije na osnovi starosti i bolesti. U ovome radu analiziramo najkvalitetnije instrumente zaštite ljudskih prava oboljelih od Alzheimerove bolesti, a koji se temelje na načelima autonomije, samoodređenja i najboljeg interesa oboljele osobe. Takvi se zahtjevi najbolje mogu ostvariti u sustavima koji predviđaju više različitih modaliteta zaštite oboljelih od Alzheimerove bolesti. Pravni status skrbnika i odlučivanje o pravima, interesima i potrebama osoba oboljelih od Alzheimerove bolesti uz podršku, informirani pristanak oboljele osobe na medicinski tretman i/ili istraživanje o samoj bolesti kao i mogućnost sklapanja anticipirane naredbe instrumenti su zaštite njihovih ljudskih prava. Život osoba treće dobi reguliran je zakonskim mjerama i politikama koje nisu posebno okrenute njihovim potrebama, te u svojoj suštini krše temeljna ljudska prava, osobito kada je riječ o osobama oboljelima od Alzheimerove bolesti. Palijativna skrb jedna je od tih mjera koje treba smatrati temeljnim ljudskim pravom oboljelih od Alzheimerove bolesti., The management of human rights in old age primarily refers to providing care related to the quality of life of people suffering from Alzheimer’s disease and preventing discrimination on the basis of age and illness. This paper analyses the best instruments for the protection of human rights of those suffering from Alzheimer’s disease based on the principles of autonomy, self-determination, and the patient’s best interests. Such requirements can best be met in systems providing several various forms of protection for people suffering from Alzheimer’s disease. The legal status of caregivers and making decisions regarding the rights, interests, and needs of people suffering from Alzheimer’s disease with the support, informed consent of the patient to medical treatment, and/or research of the disease itself, as well as the option of anticipated disposition, are all instruments for the protection of their human rights. The life of the elderly is regulated by legal measures and policies which are not directly focused on their needs and inherently violate basic human rights, especially in the case of people suffering from Alzheimer’s disease. Palliative care is one of the measures which should be considered a basic human right of people suffering from Alzheimer’s disease.

The authors of this paper present the two studies conducted by the Foundation Zajednički put, published in the period from 2012 to 2016, and compare the results with international studies into the same area. The results of the quantitative study Rights of the Elderly in the City of Zagreb showed that the category in which the participants reported the greatest occurrence of rights violation is the category of safety and personal dignity: every fifth participant was cursed at, insulted or ridiculed, one in seven was mugged, and one in eight was physically threatened to. However, the most worrying finding is not the rights that are violated or the number of the elderly whose rights are denied, but the general passivity of the institutions when a senior citizen seeks protection: the results indicate that the elderly whose rights are violated extremely rarely report the discrimination because, as it has been the case, their report usually has no effect whatsoever. The results of the qualitative study Narratives of Dignity in Old Age have shown that the elderly are most discriminated against in health institutions, public spaces (squares, streets, public transportation) and in public and private institutions. The discrimination most often includes inappropriate treatment and improper communication, ignoring, objectivization, ridicule, insults, fraud, physical threat and mugging. Although older people have equal rights and liberties as every other citizen, the studies conducted at the Foundation Zajednički put have shown that they, compared to the rest of the population, find themselves in an unequal position when it comes to the enjoyment of their rights. The enjoyment of rights presupposes creating proper conditions for an effective implementation of international standards, which in return necessarily includes educating and informing the individual about the rights belonging to them, as well as about the ways they can enjoy and protect them.

Excessive alcohol consumption and the exposure of the elderly to family violence are in close connection. They represent both a general and social problem from a legal, medical and social aspect. The objectives of this study were to 1) test the frequency of alcohol consumption in older persons with respect to certain social and demographic characteristics; and 2) test the correlation between alcohol consumption and family violence towards the elderly. The sample used in this study was constructed as probabilistic with a random selection of participants in order to ensure representativeness for the City of Zagreb population over 65 years. The study included 1000 persons older than 65, among which 38% were male (N = 380) and 62% female (N = 620). The results showed a significantly more frequent consumption of alcohol among older men aged between 65 and 74, elderly people with life partners (unmarried), and financially independent older persons. A correlation between alcohol consumption frequency and exposure to violence was also established, as well as that older persons who consume alcohol are more likely to commit acts of violence. Further research is needed on the risk and protective factors for specific forms of family violence so as to detect the causes of violence within families as well as mechanisms that al- leviate coping with violence.

Cilj ovog rada je širenje spoznaja o nasilju nad osobama starije životne dobi. Zlostavljanje starijih odnosi se na svako ponašanje u sklopu ljudskih povjerenja, koje na neki način šteti starijoj osobi. Zlostavljanje starijih podrazumijeva psihičko zlostavljanje, tjelesno zlostavljanje, seksualno zlostavljanje, financijsko (ekonomsko) zlostavljanje i zanemarivanje. O fenomenu nasilja u trećoj životnoj dobi nema mnogo podataka kako u svijetu tako ni u Hrvatskoj. U radu se sažeto prikazuju teorijska objašnjenja, uzroci i oblici zanemarivanja i zlostavljanja starijih osoba, čimbenici koji tome doprinose te prevencija istog. Također su prikazani neki rezultati istraživanja s područja zlostavljanja i zanemarivanja starijih osoba. S obzirom na demografske trendove i sve veći broj osoba starijih od 65 godina u ukupnoj populaciji, realno je očekivati da će fenomen zlostavljanja starijih osoba tek zaokupiti pažnju i interes kako stručnjaka tako i šire javnosti., The aim of this paper is to broaden the awareness of violence towards elderly persons. There are not many data on the neglect and abuse of elderly persons in Croatia, nor in the world. That does not mean that it does not exist. The current system pays more attention to violence towards children and women. The paper concisely presents causes and forms of neglect and abuse of older persons, the factors that contribute towards them and the prevention of the same. It also presents some results of the research in the area of abuse and neglect of older persons. Considering the demographic trends in the aging of the population and the increasing number of elderly persons, it is realistic to expect that violence towards older persons is yet to reach »an expansion«.

The main goal of non-institutional forms of care is to enable the individual that is in social protection need to remain in their social environment, where she/he will get all necessary care depending on their specifi c needs. One of the possibilities of non-institutional care for adults, elderly and disabled person is a foster care that is regulated by the Foster Care Law. Benefi ts of foster care over institutional care are family environment, shorter waiting lists for accommodation, lower cost of care, easier adaptation to new living conditions, greater opportunities to provide quality care in relation to the specifi c needs of users. One of the priorities of social policy in the Republic of Croatia is to fi nd new, economical way and form of social care for adults and elderly people that could meet their needs in the way that fi nancial burden of care do not jeopardize the economic stability and social development. The purpose of this paper is to provide a description of legal framework of foster care for adults and elderly people and to show statistics data from 2003 till now. Finally, there is an evident absence of research in this fi eld and lack of development models and programs to improve this form of care. Understanding the situation of foster care and improving the current professional standards of quality, contributes to improving the quality of foster care and protect the dignity of persons in care.

The term violence refers to violence and neglect that a person may experience from their social network members (spouses, caregivers, family members, medical and other professionals). Violence usually affects vulnerable groups: children, women, elders and women with disabilities. Researches on violence against women with disabilities in the last decade are more and more present. This was preceded by giving information, punishment but also alarming data on violence against women in general. Studies indicate that women with disabilities are exposed to a greater risk of violence, not only from family members, but also from friends, medical professionals and personal assistants, and they are exposed to violence over a longer period of time. The aim of this study was to determine: what are the forms of violence, who are the perpetrators of violence, what support is available to victims and what is an attitude of society toward violence that was perpetrated. The study sample consists of women with disabilities (N=29). This is a qualitative survey using semi-structured interview constructed for the project "The social status of people with disabilities in the Republic of Croatia". Qualitative data analysis showed that women with disabilities have experience with various forms of violence (physical, psychological, sexual) and that very often the perpetrators of violence are members of the immediate entourage (spouse, colleagues at work). When reporting violence, women with disabilities encounter many difficulties (lack of understanding of the social entourage, disregard). From the results of the research one can conclude that women with disabilities are more exposed to the risk of violence due to: their dependence on the caregivers, difficulties encountered when reporting and proofing the violence, lack of education and information on acceptable and unacceptable behavior. All mentioned above indicates the need for empowerment of women with disabilities, education about violence and forms of support in case of violence. Equally, it is necessary to educate the professionals (doctors, social workers, police and the head of the assistance program for women with disabilities) and to develop the network and support services at local and national level.

Due to current demographic trends and the expected increase in the population of elderly people in Croatia, the increase of elderly social work clients is expected as well. Therefore, it is necessary to provide the social workers with additional training in the field of gerontology and include them in supervision, as a professional support method incorporating the learning process and supporting the professional and personal growth. International experience shows that supervision of gerontology and geriatrics professionals has certain characteristics resulting from the population these professionals work with. Social workers working in retirement and nursing homes face specific problems and needs of the elderly, as well as illnesses and deaths of clients. The obstacles that professionals, especially the younger ones, can encounter in their work with the elderly also include prejudice and stereotypes. In Croatia, supervision is a relatively new method of professional support to social workers. Supervision refers to specific professional guidance, training and development of professionals aimed at ensuring and developing quality communication and cooperation in the professional context. The ultimate aim is providing clients with quality services. This type of supervision is not obligatory for social workers in Croatia, but it is very popular among professionals in the social welfare sector working with children, young people and families. In contrast, initial initiatives for introducing supervision for social workers into residence homes were not successful and social workers were not eager to join the offered supervision groups. Therefore, a qualitative research was conducted aimed at examining to what extant social workers were familiar with supervision, their experience, motivation, expectations and obstacles for introducing supervision of social workers in retirement and nursing homes. The research has been conducted by interviewing all female social workers (11 of them) employed in retirement homes in Zagreb, the capital city of the Republic of Croatia. The results indicate that the social workers, although they do not have direct experience with supervision, are informed and recognize the purpose and aims of supervision as a professional help to professionals working in caring professions. They consider the management to be responsible for the absence of supervision in retirement and nursing homes. The social workers have expressed their professional needs and reasons for inclusion into supervision (for instance, death of clients, lack of willingness to cooperate and accusation of clients' families, unpleasant feelings associated with the work, etc.), as well as reasons for reluctance to join supervision (for instance, presence of their superiors and lack of trust). They expect that the supervision would reduce the level of their professional stress. Also, the means of organizing supervision (time, place and freedom to decide whether to join) have proved to be crucial for their involvement. Since social workers in retirement and nursing homes are in general rarely included into lifelong learning programmes, the further motivation for their participation in supervision should be included as a part of the necessary lifelong professional development programmes.

Although awareness about the need for supervision in social work in Croatia has a tradition of 40 years, the supervision was introduced in social work practice only recently. The first article about supervision was published in the journal Social Work (1973) and the book Supervision in social work was published in 1977. The influence of American approach to supervision was recognizable, but emphasizing that supervision is not an administrative measure and thus not based on hierarchy and administrative structure. The contextual and political reasons for neglecting the need for supervision in social work will be discussed (Pregrad and Ajdukovic, 2003 ; Ajdukovic and Zizak, 2007). In year 2000, a group teachers from the Department of Social Work, University of Zagreb started the three year project Introducing supervision into the social welfare system in Croatia" in cooperation with the departments for social work of the University of Stockholm and University of Goteborg and financial support from Swedish International Developmental Agency (Sida) (Ajdukovic and Cajvert, 2003: Ajdukovic, 2005)). The project was based on "training of trainers" model and included: (1) advanced one year training for trainers in supervision for a group of ten professionals with significant experience in supervision but without previous systematic training and (2) training of 35 professionals for supervisors in social work. Additional project outcomes were the first university textbook in Croatian on supervision Supervision of the psychosocial work (2004). As well, the course Methods of supervision was introduced to undergraduate and later on to graduate students of social work (Ajdukovic and Urbanc, 2010). The two and half year long university Postgraduate program in supervision was designed and offered since 2006. The postgraduate program is carried out in accordance with ANSE standards for education of supervisors (www.supervison-eu.org/anse ). It is aimed for already licensed professionals in the social welfare field. The contents of the program will be presented in detail. The focus of the program is on development of supervision skills (i.e. reflections, Socratic dialog, collaborative learning) through interactive teaching and educative meta supervision of carefully planed supervision groups that are led by postgraduate students. The evaluation of the program (scale from 1 – poor to 5 – excellent) showed that participants highly evaluated experience in educative meta- supervision groups (4.8), their personal experience with planning and leading supervision groups (4.60), interactive lessons (4.6), writing of essays about dynamic of supervision group (4.3) and reading and discussing new literature in the field of supervision (43). As additional benefits of participating in the postgraduate program in supervision the students emphasize improved organization of their regular work, better insight into relations among colleagues, increased recognition of clients' needs, improved evaluation of own collaboration with clients. The program will be additionally discussed from the perspective of personal and professional growth of participants. The final part of the paper will present analysis of final research papers of postgraduate students in supervision with the focus on selection of research topics and methods, and impact of further development of the knowledge base in supervision relevant for Croatia and the South East Europe region.

Cilj rada bio je dobiti uvid u strategije suočavanja kojima se koriste njegovatelji člana obitelji osobe oboljele od Alzheimerove bolesti obzirom na spol njegovatelja i duljinu skrbi o oboljelom. Metode: Broj sudionika istraživanja bio je 38, a raspon dobi kretao se od 26 do 88 godina (M=61, 1 ; SD=14, 2). Prema bračnom statusu, 65, 8% ispitanika je u braku, 2, 6% je razvedeno, 2, 6% su udovci/ice, 7, 9% živi s partnerom/icom, te 21, 1% ispitanika su samci. Obzirom na radni status, 42, 1% ispitanika su umirovljenici, 42, 1% je zaposleno, 15, 8% nije u radnom statusu. Prosječna duljina njegovateljske skrbi je 4, 5 godina, a dob oboljelih kreće se od 55 do 99 godina Za prikaz rezultata korištene su mjere deskriptivne statistike, dok su razlike testirane Hi kvadrat testom. Podaci su prikupljeni tijekom 2008. godine na području Hrvatske anketiranjem njegovatelja u Udruzi za osobe oboljele od Alzheimerove bolesti i poštanskim putem u suradnji s liječnikom specijalistom. U istraživanju je korišten Upitnik strategija suočavanja obitelji u krizi (F-COPES) koji sadrži 30 čestica kojima se ispituju strategije suočavanja i rješavanja problema korištenih od strane člana/ova obitelji. Rezultati: Nema statistički značajnih razlika u odgovorima muških i ženskih njegovatelja, međutim zamjetan je trend da žene u nešto većoj mjeri nego muškarci kao strategije suočavanja koriste socijalnu podršku i duhovnu potporu. Nije utvrđeno postojanje statistički značajnih razlika u strategijama suočavanja obzirom na duljinu skrbi, iako je zamjetno da se s povećanjem godina skrbi povećava korištenje strategije traženja duhovne potpore, a smanjuje pasivno/izbjegavajuća procjena situacije. Utvrđeno je da njegovatelji s povećanjem duljine skrbi sve više koriste adaptivne, problemu usmjerene strategije suočavanja nastojeći pronaći rješenje koje će im omogućiti prevladavanje postojeće krize. Zaključak: Najčešće korištena strategija suočavanja njegovatelja u procesu skrbi za osobu oboljelu od Alzheimerove bolesti je redefiniranje situacije u cilju praktičnijeg načina prihvaćanja situacije dok je najmanje korištena strategija mobilizacija obitelji. Dobiveni rezultati ukazuju na potrebu aktiviranja resursa obitelji, zajednice te društva u cilju unapređenja kvalitete skrbi i života oboljelog i njegove obitelji.

Researches show that there are a number of social circumstances, making it harder on caregivers, and increasing responsibilities of caregivers, at the same time pointing out need for ensuring quality and professional responsibility of our occupation. Although many aspects of care are mainly covered with number of studies in past decade, not many of them deal with effect of different sorts of social support on the decreasing caregivers stress and the quality of life of caregivers. Studies show that availability of help at home services and other that provide support for caregivers effects decreasing feeling of burden put upon caregivers, postpones institutionalization of sick ones which increases quality of care. Since there are no scientific knowledges on mentioned issue in Croatia, goals for this study are: to determine used forms of rights and forms of help for families that provide care for person with Alzheimer's, to examine perceived need of caregiver for formal sorts of help and determine caregivers satisfaction with understanding and support they get from formal service providers. This research shows results of pilot study provided on pattern of caregivers of individuals affected with Alzheimer disease. Based on mentioned, aim of this work is to provide recommendations in making standards in social care for families and individuals affected with Alzheimer disease.

The coping strategies according to Lazarus model of stress have significant role in decreasing some of negative effects (etc. burnout, turnover, absenteeism) of prolonged exsposure to occupational stress. The objective oft his research was to determine the relationship between coping strategies , burnout and its' consequences. Self-report instruments provided data from 174 mental health workers employed in psychiatric hospital and clinics in Croatia. The results give partial support to the basic hypotheses on role of coping int he relationships among particular components of the stress and coping model. The findings suggested that mental health workers who use dan problem-focused strategy were more likely to display low levels of personal accomplishment. Furthermore, emotion-oriented coping strategies were found to be positively associated with the depersonalization and emotional exhaustion. Considering consequences of burnout, problem- focused coping strategy exhibit less frequent physical consequences. The results are discussed in a context of providing suggestions for implementing stress training to teach appropriate use of coping skills and finally, monitoring particularly vulnerable groups of mental health staff.

To identify independent predictors of burnout syndrome among mental health workers, based on job satisfaction and manifestations of occupational stress. The study included a convenient sample of 174 mental health workers in the Republic of Croatia. During data collection, the following measurement instruments were used: Maslach Burnout Inventory, Manifestations of Occupational Stress Survey, and Job Satisfaction Survey. Multiple regression analysis used three components of burnout syndrome: emotional exhaustion, depersonalization, and personal accomplishment. Stepwise multiple regression analysis showed that pay and rewards satisfaction (β =-0.37), work climate (β =-0.18), advancement opportunities (β =0.17), and the degree of the psychical (β =0.41) and the physical manifestations of occupational stress (β =0.29) were significant predictors of emotional exhaustion (R=0.76 ; F=30.02 ; P

Demographic circumstances in Croatia demand constant investment and efforts towards settling needs of older people throughout social system, healthcare and pension system. New models that include multidisciplinary approach in care for elderly, throughout net of institutions, associations, private, profitable and non profitable sector, are essence of satisfying care of older people. Aim of this work is to present nowadays, and to emphasisze necessity of creating new one, models of care that are suitable to needs of older people and to concept of "active aging".

The purpose of this paper is to provide a general overview of current knowledge about elderly abuse in Croatia. The analysis covers two field of research: (1) prevalence and correlates of elderly abuse and (2) attitudes toward elderly abuse. The research on prevalence of elderly abuse has been carried out on the convenient sample of 303 elderly men and women. On average, in the last year they have experienced some forms of psychological violence (24.1%), economic violence (6.4%), physical violence (4.4%) and sexual violence (2.1%) in the family. Most often, abusers are husbands (30.15%), sons (16.64%) and daughters (14.01%), wives (9.21%), grandsons (8.60%) and granddaughters (5.40%). Further analyses show that 44% of women and 35% of men have experienced at least some form of violence in the partner relationship. Victims of partner abuse and abuse by other family members have poorer mental and physical health. Results indicate alcohol as one of the factors of victimization, unrelated to sex of the perpetrator. The research of attitudes toward elderly abuse was carried out on the sample of 334 social welfare professionals and students. Generally, they have a sensitive attitude toward elderly abuse. Nevertheless, data indicate that further education regarding different forms of elderly abuse and the negative effect of ageism on sensitivity toward elderly abuse should be planned.

Caring for a family member with Alzheimer’ s disease and related dementias (ADRD), as many authors describe, is one of the most devastating and challenging experiences one person can endure. The care for people with AD requires complete commitment and drastically changes the life of entire family, according to the stage of disease. Family constitutes the major caregiving response to the needs of the elderly who are no longer self-sufficient (Aguglia et al., 2004). As many studies confirmed, three-quarters of the caregiver’ s day is devoted to the patient, that proportion tends to increase linearly as the disease progresses (Aguglia et al., 2004). The burden of performing various tasks, affect all spheres of the caregiver’ s life— psychological, professional, financial (that caregivers are often obliged to reduce the number of hours worked or even to leave their jobs to be able to look after their relatives), and relational (Aguglia et al., 2004, Shua-Haim et al., 2001 ; Juozapavicius & Weber, 2001). Therefore, taking care of family member with Alzheimer’ s disease is very demanding and stressful roll for caregivers, who also become a victim of disease, and who need to find better ways of coping with and managing the progressively deteriorating stages of Alzheimer’ s disease (Juozapavicius & Weber, 2001 ; Feeney et al., 2003). The aim of this research was: identification of the common problems that caregivers are facing in dealing with care for Alzheimer, to take the wider social-demographical context of the caregiver, stressors, mediators, consequences and the possible facilitators of the care giving process. This research puts focus on the caregiver’ s experience, on understanding the difficulties which they are facing in everyday care for the family member, taking into consideration feelings, distress sings (depression, grief, care giving stress), care giving influence on the caregivers physical health and the quality of the support from the family members, institutions and wider community.