“The decision of placement in nursing homes is most often delayed” | EUROtoday
Get real time updates directly on you device, subscribe now.
HASU programs in his profession, Professor Claude Jeandel, geriatrician, medical advisor to the Share and Life Foundation – a acknowledged basis of public utility for non -profit which acts for the help and care of individuals weakened by age, sickness or incapacity – has seen the profile of individuals welcomed in nursing properties evolve considerably.
They are older and far much less autonomous than earlier than and combine institutions within the majority of instances when staying at residence has grow to be unthinkable. He explains the explanations for this remark and provides us keys to treatment it.
The level: Who are the folks welcomed in nursing properties in 2025?
Claude Jeandel: Their state of affairs has clearly modified over the previous ten years. They are older: immediately individuals are 85 years outdated and over when they’re welcomed. They have rather more pronounced states of dependence. It needs to be remembered that it isn’t age as such that explains dependence however power illnesses whose prevalence will increase with age, on the forefront of which neuro-evolutive illnesses, and particularly Alzheimer’s illness.
More than two thirds of residents thus have neurocognitive problems in relation to those situations. The proven fact that new residents at the moment are welcomed in much less autonomous nursing properties, in heavier medical conditions, reveals one factor: the choice of this orientation is extra typically delayed.
20 years in the past, the proportion of reception in nursing properties from the hospital was round 10 %. It is somewhat immediately between 40 and 50 %.
What is the context wherein reception in Ehpad takes place?
In the 2000s, the choice to make use of a nursing residence and the reception of residents most frequently labored in a comparatively secure and higher programmed context. Today, if such conditions stay, this recourse takes place extra typically in a context of intercurrent occasions or “crisis situation” making extra random the instruction of an early and due to this fact properly ready method.
The resolution to make use of the EHPAD due to this fact arises both on this context or within the face of a aggravated dependence state of affairs now not being suitable with residence help. People who current Neurocognitive problems Due to Alzheimer’s illness, just isn’t conscious of their lack of autonomy within the acts of day by day life. It is due to this fact most frequently the household entourage or the caregiver – the partner when he’s nonetheless alive or a toddler – who’s confronted with it.
Faced with a state of affairs of aggravated dependence, as a result of evolution of the illness, or as quickly as one of many two essential “pillars”, that represent the caregiver (s) and well being professionals concerned at residence, is now not ready to make sure in good situations the help and care of the dependent aged particular person of their place of life, it’s essential to surprise concerning the deserves of a substitute for the house so as to not expose the particular person of home accidents.
It is on this foundation that the method of anticipation, extra tailored, to respect for the precept of the free selection of the particular person should be conceived. Otherwise, it’s within the context of an intercurrent occasion or a “crisis situation” that the choice should be made. It could be a home accident (easy or sophisticated fall in fracture), an acute situation (infectious illness, corresponding to seasonal flu or covid), decompensation of a preexisting power illness (coronary heart or respiratory failure …) but in addition a break within the help as a result of exhaustion, even a hospitalization of the shut caregiver.
The most fitted response to such conditions is most frequently hospitalization on the finish of which the indication of using EHPAD can be retained as quickly because the sources having to be mobilized at residence doesn’t make it doable to make sure the help and the care of conditions which have grow to be too advanced (polypathologies, excessive dependence).
Is the entry to the EHPAD “in disaster” after a stint within the emergency room is a typical case?
20 years in the past, the proportion of reception in nursing properties from the hospital was round 10 %. It is somewhat immediately between 40 and 50 %. It is because of this that it’s essential to facilitate entry to the day care of Alzheimer’s sufferers, a number of days every week, or in all buildings, corresponding to non permanent lodging in nursing properties, which permit the caregiver to be in respite, to let go and take a step again.
Bringing the actors nearer to the house and the EHPAD should contribute to enhancing the transition between the house and the EHPAD and thus lowering the ruptures within the particular person’s life course.
Why do you assume we observe this lack of anticipation?
This resolution -making is tough as a result of it entails projecting itself right into a future that we are likely to at all times repel as a result of it’s synonymous with adjustments and losses that you’ll have to be capable of overcome. The particular person dropping autonomy as a result of neurocognitive problems just isn’t at all times in a position to anticipate a choice -making involving the integrity of their capacities for judgment and reasoning, particularly when they don’t seem to be conscious of their problems.
The monetary issue can also be to be thought of when there’s a remaining dependent for households. We can not additionally ignore the media impression of sure practices and the impression of the COVIVE pandemic on representations of the EHPAD. I’d say there may be actually a earlier than and after Cavid. We take into account the confinement of residents but in addition the separations painfully felt by their family members.
Finally, easy methods to anticipate higher?
To uncover
The kangaroo of the day
Answer
The common monitoring of medical conditions exposing to lack of autonomy is undoubtedly the measure most suited to anticipation, as quickly as it’s related to the knowledge of the particular person and their family members concerning the evolution of their state of well being and dependence. It facilitates the notice mandatory for essentially the most applicable resolution -making removed from any context of disaster. This method goals to register the particular person in an actual “health course” integrating the EHPAD as one of many options, not solely as essentially the most applicable, but in addition as chosen and higher nonetheless consented.
Memory consultations, day care and respite platforms devoted to the caregiver, the territorial sources facilities being deployed, are crucial. Bringing the actors nearer to the house and the EHPAD should contribute to enhancing the transition between the house and the EHPAD and thus lowering the ruptures within the particular person’s life course.
https://www.lepoint.fr/societe/la-decision-du-placement-en-ehpad-est-le-plus-souvent-retardee-30-04-2025-2588621_23.php