P-420: The place of elderly disabled people in nursing homes: French experience

摘要

Introduction: The life expectancy of people in France continues to increase and old people with disabilities and physical dependence too. French Nursing home are not enough trained to welcome old people with disabilities. In our nursing home we welcome 120 elderly disabled people (out of 310 hosted) in two specialized departments with dedicated staff. The aim of this study is to share our care model in order to help other nursing home to take care of disabled old people. Results: Older people with disabilities come from: home for 30.2% psychiatric hospitals 27%, social homes 9%, mixed 18.3%. The profile of the person entering in the nursing home is a disabled person whose physical dependence increases at the average age of 63 years old; (versus 84 years old for a regular nursing home), requiring care provided by FDI and qualified caregivers (FDI, caregiver, medi-copsychological aid). Our model is: (1) prepare the entrance, (2) personalize the daily support (disabled people will stay 10 years in the NH) on (3) create a reassuring framework, with qualified care-giver for psychological support, to ensure the clothing needs, hygiene, outings (birthdays, social life) in order to supply the lack of family presence, (4) adapt activities to the age and disability with a rehabilitation team (occupational therapist, psychomotor therapist, psychologist), (5) evaluate the environment and equipment with the occupational therapist during all the stay, (6) network is important in order to help the care access, (7) use tutelary representation for all. Discussion: The limits: taking care of disabled elderly is more costly 130 euros per day versus 56 euros per day for elderly people. Conclusion: The nursing home must be a place to live for the elderly disabled people. But the institution must be adapted to the specific needs of these people (quality of life, emotional dependence, social life). This care is poorly valued by current pricing and requires specific budget recognition. This represents a major public health issue today.