Kibkom North Cyprus Forum

Hiya, my name is Selda and i currently live in the UK. I work as a care assistant for the well known company BUPA. However, due to previous personal experiences i have recently been researching opening a care/nursing to UK STANDARDS IN THE TRNC! Exciting i know! Now, you may be wondering 'what does she want feedback about??' well i want to know what YOU think of this. All staff at the care home will be trained to UK Standards and especially education in DEMENTIA CARE. I know that there is a scope for this in the TRNC as my grandma had dementia and no one in the whole country had a clue about how to look after her therefore we had to bring her back to the UK.

Starting big you may think but no i have more ideas! Home visits...not every individual or their family wants to go into a care home so providing people who go round to their houses to care for them is another area that could be filled in the TRNC. The main point i am trying to make is people need to be trained properly instead of anyone becoming a carer and potentially doing more harm than good!

So now i'm gonna shut up and hand it over to you...do you think this is a good idea? If so, what would you want to see in the care home? Or would you even be interested in working in a place like this. Anyone with previous health or social care experience your views are more than welcome! Look forward to hearing from you all!

There is certainly a need for care for the elderly, Selda, both in the mainly aging, retired, expatriate population and among the Cypriots as the traditional extended family tradition breaks down. The problem is do the people who need it and and/or their relatives have the money to pay for what is by its nature a very expensive service whether it is by way of a special facility or in their own homes.

The other problem is finding suitable carers - it is not just a matter of training, it takes a particular type of personality with imagination and emphathy to realise, for instance, that a slight movement in the position of a piece of furniture or a rug could result in a fall and serious injury for a partially sighted, confused person or one with brittle bones. It is hard enough to find a cleaner who does not turn a house into an obstacle course for someone who has even comparatively slight mobility problems.

I sat in a few discussions with people who were thinking about starting up a Sheltered Housing schme (another need you might think about) - one snag was though we could find relatively cheap land it was either isolated or very hilly - and one thing people in their declining years need is the stimulation of being able to excercise to thebest of their ability and the stimulation of live around them - as well as proximity to various types of medical services.

I wish you the very best of luck with your venture and will be pleased to give any feedback you need from one with experience from the angle of arranging care (in the UK) for elderly relatives.

Thank you very much for your reply.

I agree with every single point that you have raised and it is certainly on my list of things to tackle!
We are currently investigating what help we can get from the government etc not only for our benefit but as you mentioned for funding for those who are in need of 'specialist' care. As for staffing issues i couldn't agree with you more but i believe that even if there are very rare that there a handful of people in north cyprus who are somewhat fitting for this job

Funding and government don't seem to work KIBTEC state owned electricity company switching off the power to the councils police government offices etc for non bill payment of electricity bills

Nurseawful could be a good person to talk to about this, she is a member on here.

Hi Selda,
There is a care / old peoples home here in Lapta it might be the starting point for your research. You can e-mail me of board on trnchealthcare@gmail.com if you need any other info.

Chris

Having been contracted to Westminster Healthcare for nearly 10 years, in the provision of cost effective and safe mechanical and electrical services to care homes, I would be happy to talk to you about this small but critical matter.

vaughan@sunnycyprus.net

There are already many government and private care homes for the elderly in N. Cyprus. However, you must understand that the demand may not be quarter as much as in England and most are struggling to find people to care for. This is because putting an elderly into a "care home" - especially if they have adult children - is generally accepted as an insult by the old Cypriots. To a Cypriot mind it is a sign of rejection and "not being wanted" by the family, which can be lethal for the alderly people.

Furthermore, social culture and norms in Cyprus demand that children should take care of their elderly when they become disabled. Cypriot elderly expect the respect and care by their offspring. This is why most families in Cyprus use many "in house" care takers for their elderly - usually Turkmens, Kazaks or Uzbeks who are available in their hundreds already doing the job. I personally used a live-in young Uzbek care taker, to help my late mother move around, cook for her and clean the house. The cost was not more than what one would pay for a care-home, but she was in her own home all the time and the care taker loved and looked after her like her own mother (the poor thing cried more than my own family at her funeral). If I dared to even suggest a care home to my mum, she would have probably disowned me and not talked to me for the rest of her living days...

However I still wish you well with your project but if you are depending on Cypriot elderly, before you think of care-nursing at UK standards in Cyprus, you should do more research on the local interest in such a service. English people living in the island, how many of them would leave their villa for a nursing home is a question mark. The only market for what you are thinking about would probably be for those currently living in UK who may wish to retire to a sunny place but cannot afford to buy a home - a nursing home in Cyprus with their fees paid by their insurance or pension may be a good proposition. But then again, they would rather not do that because they would be losing out on all the other benefits such as free home care & health service, free travel passes, free medication and better emergency services etc. in UK...

My apologies if I sounded a bit on the discouraging side, but many have lost hard earned cash on such projects because they did not do their homework properly. I am just trying to be helpful with good advice. In any case, I do not think you are addressing the correct audience for your market research by using discussion forms - used mainly by Brits or TCs from London who live in their own villas or houses in Cyprus and have no plans or intentions of residing in a nursing home themselves. Come and live here for a couple of months and learn about the local population's living habits is what I would advice.

well said Big Oz. Much better that came from you than from me. I was tempted to write, but I am but a 'yabanci' and although i think I know local culture, it is far better stated by a Cypriot!
The care of the elderly as it was in my day as a child in U.K but of ocurse it has changed. But out here, there are plenty of people in need of help, but DO YOUR RESEARCH.

Others have tried this before, and the sticking point was MONEY. Many of those out here who need help cannot afford a care home. the costs per week are more than their pensions, and there is no National health top up out here. You would need English speaking staff (which rules out the kind of carers the locals have) and you would need work permits etc, and they would expect 'English' style pay.

If you do co me up with something - great, but as I say, I think you may well find that the financial side (assuming you can overcome all the governmental hurdles) will be prohibitive to many people. However, there culd be a handful that would rejoice in having such a facility and have the money topay for it.

so how about you find out what it might cost and then ask kibKomers whether they would be able to afford it, and to ask others if they could afford it, and then you will know if it is a viable project.

I wish one existed, I really do as I can see a need for so me of th epeople I love, but saldy it is that one word - money - that is the deciding factor.

Keep us informe,d please.

While I entirely agree with Big Oz re the Cypriot traditionand it was better expressed than I could have , I didnt mention it in my post as I assumed from what she said the op is of TC origin and aware of the culture. However, sadly I have seen signs that the old order is breaking up and (particularly with greater exposure to the ways of the wider world, one way or another) and in future the elderly will no longer be able to rely on their children beingable and willing to care for them - just as Marion points out happened in England.

As for the Brits, I am aware of a few who have been forced to return to the UK for care, although they would much have preferred to stay where they had made their home and friends (apart from being literally aclimatised and cold English winters being somewhat of a shock to the system of the elderly). With an increasing expat population, the need will grow. Also good care homes are NOT available on the National Health - they are very expensive and there are many horror stories - and the situation is not improving . However in costing it is important to take into account that prospective clients' resources will be limited by the need to fund medicines, specialist medical care etc. Also it seems that Sedma was thinking particularly about special needs - particularly dementia - where with the best will in the world family care may not be adquate and specialist knowledge and training is needed and again is only available at considerable cost in the UK

I second Marion's request to keep us informed, please, Selda.

I cannot thank you all enough for your feedback. All the points you have raised in the comments are things we have raised ourselves and are our only hurdles unfortunately. However i think the potential is there! I stayed in Cyprus for 3 months last summer and every relatives/friends house i went to i heard something about dementia occurring. I completely agree with the whole cultural thing of family looking after them and providing foreign carers in their own home however i know from personal experience this is not always a good thing.

Some people may think individuals suffering from dementia are just people who have lost their memory however there is so much more to it and personally i think knowledge is imperative.

Before making such a big decision into eventually opening the care home i am first hoping to run a couple of seminars to inform the people of the TRNC about Dementia and the different methods that can be used to cope with it. You may think 'she is only a care assistant she is not a nurse or a doctor'. There are only 2-4 doctors in the TRNC that are dementia 'specialists'.May sound silly but i feel i need to do something to make a difference.

Once again i thank you all and always welcome your feedback. I have done a lot of research in the past few days and will continue to do so.

With personal experience of a family member with Altzheimers Disease, I entirely endorse what Rose has said and support her endeavours. It is not just the confusion and memory loss, these unfortunate people often suffer complete personality changes, and relatives (particularly if close - a spouse who may themsellves be suffering physical problems or a child) themselves need support to cope with the emotional and physical demands arising from this.

If one is disabled and they decide to live somewhere warm like Cyprus after working all their lives and paying their Nat. Ins. contributions, do they get any help besides their pension or do they lose all other benefits with regards to medical help?

There has been a lot of discussion on this Big Oz. As I understand it , if you move permanently and full time (and are therefore not "domiciled" in the UK) you lose the right to access to the National Health System even if you have paid contributions all your life and are still paying UK tax on your pension and other UK based income. If you return permanently you may be allowed back in but only after six months (but I am not quite sure aboutthat) and of course you may have problem getting back onto the lists of doctors, and particularly dentists! I dont know about Social Services - obviously many, such as home helps etc. can only apply if you live in the country, as they are provided by Local Authorities rather than NHS. Probably OK if you retained a house in the UK you can return to, but probably a problem otherwise.

Very unfair since most permanent residents pay for routine treatment and medicines locally rather than face flight costs and waiting time in the UK and probably save the NHS a lot of money, not to mention things like free bus passes! And the point you make that the climate itself may be beneficial to certain conditions. There are anomolies - for instance if you received winter fuel allowance in the UK you get it here, but if you were too young when you left the UK you dont when you get older.

Bearing in mind that UK Care Homes are not free anyway, nor is care in your own home though it may be subsidized there is a lot of sense in Sedma's ideas.

When I was in NC in Dec I met a couple who have lived there 12 years and never returned to the UK in all that time, the woman had 2 knee replacements she had to pay for herself but applied for attendence allowance from the UK just by filling in the application form, this allowanc e is not means tested, no GP assessment and nothing to get signed by anyone saying is was disabled in fact she isn't now she has the new knees, she does have other illness's but nothing that she needs help with personal care which is what the allowance is supposed to be for, she gets the full attandence allowance she applied early Dec and it was backdated to October.

To continue from my first post and to make a few points clear...this is not something we are thinking of doing immediately without doing our FULL research.
From research i have carried out this week we have decided on our nursing home being a Specialist DEMENTIA unit not a care home. There is more need for a dementia unit than for an average care home this is because of the previously mentioned cypriot traditions. I currently have someone in Cyprus researching rules and regulations and will continue to do my own research.

More feedback please!:D

I have been following this with great interest, but the one thing that ha snot been mentioned, or seemingly touched upon, is what this might cost for a patient for a week. I know it will depend on staff costs etc, etc, but can you give any idea at all as to what this might be, for it will give many of us an idea as to whether it might be a viable option . as has been mentioned, there is no top up here from a National Health Service, so all costs would have to be met form pensions or relatives who unable to cope with care of those nearest and dearest who suffer from dementia'alzheimers.

It is almost exciting to think that there could be an answer here, but for many ,many would like to have an idea as to whether they could even begin to get excited, as cost is everything.

I know you have not done your research, but on emust assume you have given due consideration to the practicalities.

so any ideas - within say a range - as to what it might be. I think also that it could possibly help in your planning if you knew how many people thought they might be able to afford it for themselves or loved ones .

Marions. I would hazard a guess that it would cost as much as here in the UK, I have a friend with both parents in a private nursing home paying over £1,200 a week for the 2 of them, as Mum has Alzheimers and has been assessed as needing nursing care she does get some of her fee paid by the NHS otherwise it would cost a lot more. I should think that pay for Home Care assistants is in the region of £6-£7 per hr here so charged more than that to a client. The staff costs would also include paying Managers. As I worked as a Manager with Home Care in Local Government I know it is important to get the right kind of carers and the right training .

Thanks for that. And that is what frightens me, and I am suree others here who would like to think there was somewhere for them to go if they reached the point of not being fully compus mentis. But (and I would like the opinions of others here), I strongly suspect that there are many ageing pensioners here who could never afford that , short of a Lottery win. If they sold their properties here, the value would be such that they might get one or two years' money. I know of several who love being here but as managing on British pensions which of colurse 'shrink' as inflation means that their income is like a piece of overstretched elastic.

the other aspectof this that concerns me is that if such a home were opened would there be enough people to make it a viable commercial proposition.

we were shown one in U.K a few years ago which was £1000 a week each(!) and I could have not have gone there unless I was in a state of dementia (long story as to why we were shown it), and I could have hoped tohave died within a year or two as my money would have run out, assuming I had sold a property to pay for it.7

Not being negative - I am a realistic, but I am really concerned as to how many people here could afford sch a 'home' or how many of their offspring could afford it for them. having said that it really is needed, but...... as i say, I have my reservations. Hope I am proved wrong.

The other problem is in many cases you will be dealing with two people, only one of whom suffers from dementia. Are you to separate them or do you condemn a person who is still mentallly alert to live with those who arent? And the partners will still need somewhere to live, income, and possibly a degree of physical help themselves.

I would also have thought that most families who were able and willing to give a degree of care to a dementia sufferer (as opposed to one who only needs physical help) would prefer the dementia sufferer to be repatriated so that even if they had to go into a home they would be able to visit regularly, and where there other resources and a legal system (albeit very inadequate perhaps better than nothing).

Rose. In the case I have mentioned only Mum has Alzheimers, my friend coped with Mum & Dad by taking them to live with her, now she as breast cancer and having chemo so reluctantly has had to let them go to the nursing home, Dad did go into an OAP home first but he couldn't cope with not being near his wife so he moved to be with her, it is heartbreaking for him to see her but it is his wish to be there, so upsetting for the family but it is the best they can do in the circumstances.

This is an interesting proposal . I have read with great interest , however the reality of providing such a service here would
I am sure be problematic. I was a matron in the private care sector in UK , in a specialist Alzheimer Care Home.
The fees alone would defy most of the population here. Specialist medical support, which we had at our fingertis in UK would
be difficult to access and , doubtless very costly . From the legal viewpoint , a client with dementia is in an extremely vulnerable
state , needing a proxy to make informed decisions . Often the partner is equally vulnerable.
The responsibility and workload on any employee is huge. It is certainly to be considered a vocation . Finding suitable staff can be not unlike searching for a needle in a haystack. keeping them , even more difficult.
I intend this to be an honest reflection , wish you every success , you sound like a wonderfully dedicated person. Bless you.

As someone who visits the Lapta Old Peoples Home on a fairly regular basis I would like to correct one misconception about the "local" extended family. This is beginning to break apart at great speed. There are people in there who rarely if ever receive visits from their families and are, to quote one of the managers " dumped" She said "maybe once a month somene comes for a hour and think they have done a good job". Cyprus is changing and the extended family appears to be changing also.

Mimi makes an extremely good point. It is not just a matter of a "proxy". In the UK to take over the decisions about financial and lifestyle decisions of someone who is unable to do it for themselves, you need to get a"Lasting Power of Attorney" and register with with the Court of Protection. If there is no one able and willing to do so, the Court of Protection may appoint someone - usually a Solicitor - and all this takes money which will then not be available towards the care of the sufferer. You also need the sufferer to sign the Power of Atorney while they are still legally competent to do so - ie before the disease has progress so far that they are not able to make the decision to let someone else make the decisions!

The relevant legislation was updated inthe UK in 2005. I dont know if such legislation and a Court even exists inthe TRNC and a can foresee a Care Home becoming entangled in wrangles about who is entitled to , for instance, sell a sufferer's property and allocate the money to a "Home". And think of the opportunitites for misappropriation!

I dont think the UK has adequately understood and addressed the problems of these very vulnerable people and their families and I seriously doubt the TRNC had done so.

If you were involved in the sharp end, rather than management, Sedma , you really do need to get first class legal advice and study the management implications.

Just a thought! Why not start with "care in the community" offering relatives assistance with personal care, and providing sufferers with with interests and stimulation, and relief care for carers. That would also give you an opportunity to assess the needs and rescources and possibly build up a client base for if and when you felt able to consider residential care.