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National Background Report: Professional and Informal Carers in Luxembourg. C ontent m A terials to R aise E mployability and R einforce S kills of carers - CARERS . Dieter Ferring Martine Hoffmann Thierry Ries University of Luxembourg. Contents.
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National Background Report:Professional and Informal Carers in Luxembourg Content mAterials to Raise Employability and Reinforce Skills of carers - CARERS Dieter Ferring Martine Hoffmann Thierry Ries University of Luxembourg
Contents • General Informations about the Situation in Luxembourg • Slides 3-4 • Dependency Insurance • Slides 5-14 • Training programme • Slides 15-20 • Bibliography • Slide 21 L
General Informations about Luxembourg • Luxembourg Population: N=476.200 • 67.6% active population (15-65 years) • 41.6% foreign population (Portugal, Italy, France, Belgium, Germany) • GDP/capita 69.900 $ (2005) • Life expectancy 77.3 years (♀81; ♂74.9) • Installation of the „dependency insurance“ („Assurance Dépendance“) in June 1999 Statec, 2006
General Informations about the Situation of Informal Carers in Luxembourg • Total number of recipients (1999-2006): • N=8.354 (June 2006); • N=2.918 cared for in aninstitution, • N=5.436 cared for at home. • Population between 60-109: • N=2.869 institutional care; • N=3.811 at home care (Total: N=6.680). Inspection Generale de la Securité sociale, 2005
Dependency Insurance (DI) Dependency Insurance (DI) Aims and Conditions • Aims: … compensation of costs generated by the need of assistance and care by a third person, who helps to maintain the basic acts of living in a state of dependency. • Dependency is defined as “a living condition, where a person – due to a physical, mental or psychiatric illness or deficiency of a similar nature regularly needs a considerable amount of assistance from a third party in order to carry out basic daily tasks (at least 3.5 hours per week)” Ferring & Weber, 2003
Dependency Insurance (DI) • “Cellule d’évaluation et d’orientation” • Estimation of the need for care and the corresponding attribution of benefits by the dependency insurance. • “Union of Sickness Funds” (“Union des caisses de maladie”) • the individual classification of dependency, as well as the attribution, reduction, and suppression of the different benefits and services • the payment of nursing services, the elaboration of nursing contracts, and the negotiation of the monetary value of nursing services, • the negotiation with services for the provision of nursing aids.
Dependency Insurance Most Common Diseases Covered by the DI 1999-2005 • Diseases of the Musculoskeletal System and Connective Tissue (DMSC) • N=1.995 (23.9%; 1.574♀, 421♂) • Dementia and Cognitive disorders (DCD) • N=1.708 (20.4%; 1.360♀, 348♂) • Diseases of the Nervous System (DNS) • N=1.533 (18.4%; 785♀, 748♂) Inspection Generale de la Securité sociale, 2005
Dependency Insurance Most Common Diseases Covered by the DI (1999-2005) DMSC: Diseases of the musculoskeletal system and connective tissue DCD: Dementia and cognitive disorders DNS: Diseases of the nervous system
Dependency Insurance Institutional care vs. Home Care Diseases of the musculoskeletal system and connective tissue • Institution (N=683); • At Home (N=1.312). • Mean care needed: 22.7 hours/week Dementia and cognitive disorders: • Institution (N=1.109); • At Home (N=599). • Mean care needed: 41.6 hours/week Diseases of the nervous system: • Institution (N=377); • At Home (N=1.156). • Mean care needed: 27.1 hours/week Inspection Generale de la Securité sociale, 2005
Dependency Insurance Institutional care vs Home Care DMSC: Diseases of the musculoskeletal system and connective tissue DCD: Dementia and cognitive disorders DNS: Diseases of the nervous system
Dependency Insurance Informal Caregivers in Luxembourg (1999-2005) • Informal caregivers: N=3.765 (1.124♂; 2.641♀) • „Typical“ informal caregiver: 45 year old women Inspection Generale de la Securité sociale, 2005
Dependency Insurance Costs Total Costs in 2004: 256.6 Million € Care - Woman: 180.7 Million € Care - Man: 75.8 Million € Institutional Care Costs: 129.9 Million € Home Care Costs: 124.4 Million € Inspection Generale de la Securité sociale, 2005
Dependency Insurance Costs: Institutional versus home care Number of persons: institution versus home care
Dependency insurance Cost Evolution Inspection Generale de la Securité sociale, 2005
Training programme Specificities of Luxembourg Multilingualism • Luxembourgish, • French, • German, • Portuguese • and others Multicultural society • Differing socio-economic backgrounds • Differing educational background and employment status • Differing family structures and family values • … NO private help networks – two networks „Help“ and „Hellef dohéem“ - Tight collaboration between networks and ministries in charge
Training programme Institutions in Charge with Care for the Elderly • ALA (Association Luxembourgeoise Alzheimer; Luxembourg Alzheimer Association) • ALGG (Association Luxembourgeoise Gérontologie / Gériatrie; Luxembourg Gerontology / Geriatric Association) • Conseil Supérieur des Personnes Agées (Higher Council for Older People) • COPAS (Confédération luxembourgeoise des Prestataires et Ententes dans le Domaine de Prévention , d´Aide et de Soins aux Personnes dépendantes; Luxembourg Confederation of Service Providers and Associations of Prevention, Assistance and Care for Dependent People) • EGIPA (Entente des Gestionnaires des Institutions pour Personnes Agées; Association of Managers of Old Peoples Homes Institutions) • OMEGA asbl (Service for Training in Palliative Care) • Service socio-familial RSB (RSB Socio-Family Service) Ferring & Weber, 2003
Training programme Institutions in charge with Care for the Elderly (continued) Organisations of older people • AMIPERAS (National Association of Older Citizens) • LRIV (Letzebuerger Rentner- an Invalideverband; Luxembourg Association of Retired and Invalid People) • „Clubs Senior“ – „Centres Régionaux d´Animation et de Guidance pour Personnes Agées“ (Regional Centres Offering Animation and Guidance for Older People) Service providers • „Hellef Doheem“ (Help at Home) • „HELP“ (support; care) Policy makers • Ministere de la Famille et de l´Intégration (Ministry of Family Affairs and Integration) • Ministere de la Santé Nationale (Ministry of National Health) • Ministere de la Sécurité Sociale (Ministry of Social Security) • Conseil Supérieur pour Personnes Agées (Higher Council for Older People) • Conseil Supérieur pour Personnes Handicapées (Higher Council for Handicapped People) • Conseil Supérieur du Bénévolat (Superior Council for Volunteer Activities)
Training programme Services for the Elderly and/or Caregivers Offered in Luxembourg • Needs assessment • Counselling, assistance and training for care recipients: • Assistance on call (Tele-Alarme, Senioren Telefon) • Medical care at home • Support for care • (home delivered meals, palliative care at home, home help) • Assistance for activities of daily life • (nutrition, hygiene, mobility) • Individual assistance • (psychologists, occupational therapists, physiotherapists, social workers) • Technical adaptations • Lending of materiel (e.g., wheel chairs, special bed, prosthetics) • Haircut • Pedicure • Social assistance • Other services (garden, repairs, walking the dog) • Coordination of services
Training programme Services for the Elderly and/or Caregivers Offered in Luxembourg Couselling, assistance and training for caregivers: • Assistance on call (SOS Alzheimer) • Medical care at home • Assistance and counselling • (problems in activities of daily living ADL: nutrition, hygiene, mobility) • Palliative care, Supervision • Protecting physical and mental health • Relaxation • Crisis Management • Social assistance • (information about dependency insurance, health insurance, legal assistance) • Coordination of services • Self-help groups • Caregiver training (dementia)
Training programme Services for the Elderly and/or Caregivers Offered in Luxembourg Respite care services: • Specialised day centres • „Holiday placement“ • Over night „hotel“ • Weekend breaks • „Granny-Sitting“ Monetary transfers Integrated planning of care for elderly and families Special services for family carers of different ethnic groups
Hellef Doheem : Help at home 48A, avenue Gaston Diderich L-1420 Luxembourg Tél: (+352) 402080-600 FAX: (+352) 402080-619 e-mail : fondation@shd.lu http://www.shd.lu HELP : care and support 54, rue Emile Mayrisch L-4240 Esch-sur-Alzette Tél: (+352) 26.70.26 FAX: (+352) 26.70.26.70 e-mail : info@help.lu http://www.HELP.lu OMEGA 90 : Association for Training in Palliative Care 138, rue A. Fischer L-1521 Luxembourg Tel:+352 29 77 89 1 Fax:+352 29 85 19 e-mail:omega90@pt.lu http://www.omega90.lu RBS : socio-family service 20, rue de Contern L-5955 Itzig Tel. (+352) 36 04 78-1 Fax (+352) 36 02 64 e-mail : akademie@Rbs.lu http://www.internetsenioren.lu ALA : Luxemburgish Alzheimer Association L-1050 Luxembourg Tel: 42 16 76 -1 Fax: 42 16 76 – 30 e-mail : info@alzheimer.lu http://www.alzheimer.lu/ Training programme Potential Partners for Training Programmes Addressing Informal Carers
Training programme • Complementary Projects at the University of Luxembourg • Caring for the Elderly in Luxembourg: On the Psychosocial Situation of Family Carers • TEMPUS_TACIS 2007-2009: Training Courses for Oncology Services in the Omsk Region. Development of training courses and traning of oncology services to implement modern methods of diagnosis and treatment. • Technologies de l’information pour accompagner le vieillissement de la population luxembourgeoise
Questions • Target groups • Semi-professional • Non-professional • Family carers • working • no-working • Aspects of Psychosocial and Medical Care to be Covered • ….
Bibliography Web resources http://www.alzheimer.lu/ http://www.omega90.lu/ http://www.shd.lu/ http://www.help.lu/ References Ministere de la sécurité sociale. Inspection générale de la sécurité sociale (IGSS). (2006). Rapport général sur la sécurité sociale au Grand-Duché de Luxembourg 2005. Luxembourg. Statec (2006). Luxemburg in Zahlen 2006. Luxembourg Ferring, D. & Weber, G. (2005). Services for Supporting Family Carers of Elderly People in Europe: Characteristics, Coverage and Usage, EUROFAMCARE, National Background Report for Luxembourg. • http://www.uke.uni-hamburg.de/extern/eurofamcare-de/publikationen.php?abs=2