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Elderly dehydration and malnutrition are very common types of elder abuse and neglect in nursing homes. Malnutrition and dehydration of the elderly in nursing homes are two of the most common health problems faced by users. They are also a leading sign of neglect and inadequate care and are often the result of negligence. It is the responsibility of the home staff to provide their users with adequate food and fluid. Staff and administrators have a legal responsibility to take reasonable care of the safety and well-being of their users and others who come to the facility. Part of this is the duty to provide adequate food and water to the users to avoid malnutrition and dehydration. In most cases, proper nutrition and hydration involves developing a diet plan and schedule to meet the individual needs of each patient. This includes considering any physical or mental health issues a patient may have, as well as any nutritional needs of that patient. Failure to meet these needs can be considered negligence or transgression. The risk of developing these conditions is much higher in the elderly, as well as the serious side effects as a result. It is therefore crucial that the staff of the establishment is appropriately trained to predict whether the beneficiary is malnourished or dehydrated. Key words: the elderly; nursing homes; dehydration; malnutrition; neglect

Alzheimerova demencija predstavlja javnozdravstveni problem te je broj oboljelih starijih osoba, sukladno demografskim trendovima, u svakodnevnom porastu. Budući da ne postoji mogućnost izlječenja, značajno je rano prepoznavanje bolesti, odgoda uznapredovalih stadija bolesti, prilagodba svakodnevnog života te održavanje kvalitete života. Uz značajnu farmakološku terapiju važnu ulogu imaju i pristupi s naglaskom na kreativne metode koje usporavaju tijek bolesti, pridonose kontroli simptoma, povećanju samopoštovanja, boljoj komunikaciji te socijalizaciji oboljele starije osobe. U radu je prikazan pregled pojedinih pristupa iz područja kreativne terapije (likovna terapija, muzikoterapija, terapija pokretom i plesom, reminiscencija, biblioterapija), njihovi učinci u radu s osobama oboljelim od Alzheimerove demencije i njihovim skrbnicima te prikaz primjena kreativnih metoda uz pomoć asistivne tehnologije. Kreativne metode prikladne su i za članove obitelji i druge osobe koje skrbe za ovu populaciju. Potrebno je približiti teoriju i praksu te zagovarati i osigurati da pristup skrbi usmjerenoj na osobu ne ostane sveden na teorijske postavke, već da se primijeni u stvarnom životu osoba oboljelih od Alzheimerove demencije.

Starije osobe predstavljaju specifičnu skupinu s vrlo različitim potrebama, ovisno o svom fizičkom i psihičkom zdravstvenom statusu. Udio osoba starije dobi u cjelokupnoj populaciji raste, što nazivamo demografskim starenjem, a posljedica je pada nataliteta i produljenja životnog vijeka uslijed napretka medicine i poboljšanja kvalitete života. Istovremeno se povećava i broj onih kojima je potrebna dugotrajna skrb ili potpora, zbog nemogućnosti samostalnog života. Ključnu ulogu u tom procesu imaju neformalni njegovatelji, koji su u većini slučajeva članovi uže obitelji. Stoga je cilj istraživanja bio utvrditi sociodemografska obilježja neformalnih njegovatelja starijih osoba te obilježja njege koju pružaju. Istraživanje je provedeno na prigodnom uzorku 342 neformalna njegovatelja na području grada Zagreba. Rezultati su pokazali da su njegovatelji najčešće udane i zaposlene žene, u srednjoj životnoj dobi. Utvrđeno je i da uglavnom njeguju svoje roditelje, koji su u dubokoj starosti, uz prisutnost multimorbiditeta. Čak trećina njegovatelja obavlja skrb 24 sata dnevno, više od 5 godina. Aktivnosti u kojima najčešće pomažu su njega oboljelog i kućanske aktivnosti. Iskazali su veću potreba za pomoći i njegom u kući, patronažnom službom, gerontološkim centrom i stacionarom. Navedeni rezultati pokazuju veliku opterećenost jednog dijela obiteljskih njegovatelja što ukazuje na potrebu promišljanja boljih zakonskih rješenja koja se odnose na socijalnu politiku prema starijim osobama kao i prema njihovim njegovateljima. ; Older people represent a specific group with very different needs, depending on their physical and mental health status. The share of older people in the overall population is growing, which is called demographic ageing. That process is a result of the decline in birth rate and increase of life expectancy due to the advancement of medicine and improved quality of life in general. At the same time the number of those who need long-term care or support is also increasing, because of their inability to live independently. Informal caregivers, who in most cases are close family members, play a key role in this process. Therefore, the aim of this research was to identify sociodemographic features of the informal caregivers of older people and the features of the care they provide. The survey was carried out on a convenient sample of 342 informal caregivers from the Zagreb city area. The results showed that caregivers are most often middle-aged married and employed women. It has also been found that they generally care for their parents, who lived to a ripe old age, with the presence of multimorbidity. Even one third of caregivers have provided care for 24 hours a day, during an average period of five years or more. Activities in which they most often provide help are care for the sick and household chores. They expressed a greater need for help and care in homes, patronage services, gerontology centres and infirmaries. The results showed that family caregivers bear a heavy burden, which points to the need to consider better legal solutions related to social policy towards old people as well as their caregivers.

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.