Validity Foundation - Mental Disability Advocacy Centre

Czechia: Mass institutionalisation of older persons with disabilities – new report

By Erzsébet Oláh 7th October 2021

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Validity together with its Czech partner, FORUM for Human Rights has launched a major new report on “Institutionalisation, disability and ageing”. The report focuses on the large-scale institutionalisation of older persons with disabilities in the Czech Republic, exposes the failures of government policy to implement policies that maintain dignity for older persons, and calls for a radical overhaul of the system of provision of social support services in the community. 

Click here to read the Report.  

Click here to watch the launch event. 

Large-scale institutionalisation of older persons with disabilities in Czechia reflects both demographic changes in European societies, as well as a lack of vision on how to ensure dignity and autonomy for older persons with disabilities. Despite the global shift away from institutional services for persons with disabilities prompted by the Convention on the Rights of Persons with Disabilities, older persons, as well as older persons with disabilities, have been systematically excluded from national deinstitutionalisation processes and are being left behind. 

Anna Sležková and Maroš Matiaško, Senior Lawyers at FORUM for Human Rights and authors of the report said: 

“More than two thirds of persons institutionalised in social care facilities are over 65 and the number keeps growing. The trend is clearly towards strengthening the system of institutionalisation of older persons. For instance, between 2012 and 2019 the number of persons living in one type of social care facilities designed predominantly for older persons with support needs (special regime facilities) grew by more than 10,000, but the number of persons using outreach social care alternatives (social assistance and domiciliary services) decreased during the same period by nearly 5,000. Furthermore, older persons are also institutionalised in health care facilities, especially in long-term care units. The national strategies fail to include older persons with disabilities among the target groups of deinstitutionalisation. On the contrary, this target group is often deemed as ‘unsuitable for deinstitutionalisation’.” 

Validity and its Czech partners have been advocating for a deinstitutionalisation process that is in line with the UN Convention on the Rights of Persons with Disabilities since the country ratified the Convention in 2009. For this piece of research, FORUM for Human Rights and Validity adopted an intersectional approach to investigate the multiple forms of discrimination on the basis of age and disability. 

During the launch event, Gerard Quinn, UN Special Rapporteur on the rights of persons with disabilities pointed out that a rights-based approach was necessary to improve the situation of older persons with disabilities: 

“The evolution of thinking on disability is a model of sorts that can help us analyse the situation of older persons with disabilities. We used to say that disability complicates but does not ruin lives. We need to say the same about older persons and then place the spotlight where it deserves to be – on the acceptability and adequacy of social arrangements that limit their choices and compound their segregation and isolation. The false binary between young workers and older persons is just that – a false binary.” 

Milan Šveřepa, Director of Inclusion Europe, pointed out in his presentation during the launch of the report: 

“The report that is presented today is very timely and important […]. Contrary to all strategies and declarations, access to home care services [for older persons with disabilities] is actually decreasing. That is a major failure of relevant public authorities from the Ministry of Labour to regional authorities and municipalities.” 

While this report focuses on Czechia, the implications are much broader, pointing to the need for significantly greater focus on deinstitutionalisation of services in the context of Europe’s ageing populations. Steven Allen, Co-Executive Director of Validity said: 

“This report aims to apply a human rights-lens to addressing the rights of older persons with disabilities, many of whom experience severe forms of social isolation and neglect in older age and who are faced with public administrations that view them as a ‘burden’ rather than active and valued citizens. Whereas persons with disabilities and their advocates have been strongly advocating for deinstitutionalisation for years, it is now time for us to join with older persons and their advocates to demand respect for dignity and autonomy in older age.   

Validity hopes that this evidence-based report will be a tool to facilitate changes in law and policy in Czechia, as well as at European and international levels. Our recommendations include the followings: 

  • Adopt legal changes in order to unambiguously ensure continuing deinstitutionalisation that targets all institutions, regardless of whether they institutionalise children, adults or people of age. 
  • Introduce a legal ban on new institutions and encourage the development of alternative community-based services.
  • Introduce legal changes preferring community-based services over institutions across the social and health care systems and introduce budgetary schemes clearly prioritising community-based services for people of advanced age and particularly for older persons with disabilities.