Centre Hospitalier Camille Guérin Hospital « Camille Guérin » Châtellerault Docteur / Doctor Eric Desforges Nouvel EHPAD: quel projet médico-social ? New EHPAD (nursing home for dependent elderly people): what kind of medico-social project ?

What kind of medico-social project? The demographic ageing concerns first of all the age group over 80 (in the district, between 2006 and 2020: + 40% of the persons over 80 years old) The average age of the inpatients in EHPAD is above 85 years old (for the hospital Camille Guérin: 88 years old) The highest rate of Alzheimer and similar troubles occurs after 85 years old (25% of this age group is concerned) The stay at home for elderly people is often endangered when the persons are suffering of disorientation and behaviour troubles For the EHPAD sector of the hospital Camille Guérin, 85% of the inpatients do have disorientation problems (spatiotemporal)

What kind of medico-social project? Definition of a socio medical project for an EHPAD – Who will be concerned by the medico social project ?

Who will be concerned by the medico social project ? An old person and his/her family, with a home that he/she’s going to leave >>How is it possible to keep the links with the family, the friends, the society ? »Which place to reserve to the family and relatives ? »Which activities or previous centres of interest to preserve ? »How could the family be concerned with those activities ? A weaken old person –An old person in a situation of breaking-off: to leave the own house and to arrive in an old people’s home often means for the person a worsening of the health state, a loss of intimacy/freedom, a group life with other persons considered older, sicker and more disoriented.

Who will be concerned by the medico social project ? A confined old person –Confined at home and in a situation of insecurity (loneliness creating fear, inadequate reactions, state of disorientation creating inappropriate behaviours, more anxiety) An old disoriented person –With various troubles : behaviour, identification of the persons, the places, of the person him/herself, of his/her history (creating anxiety) A dependent old person –Important loss of autonomy for the daily tasks; the person is depending on community care workers or the children (if existing and close). The person often shows opposition or denies the help

Who will be concerned by the medico social project ? An old person with several diseases –Necessity of a regular follow up visits to prevent the risks of falling and undernutrition Which solution ?

Creation of real living areas Because of their architecture, organisation, but first of all a reassuring place where the person is welcomed individually and with a personalized project Taking into account the following characteristics: –To act against loneliness –To act against idleness –To act against insecurity, anxiety and fear –To act against the confinement

Creation of real living areas With natural light With a direct access to a garden or a patio With a really welcoming space in the building With an easy access to the city life for the person and his/her family (shuttle, city busses)

Creation of real living areas and true care places Thanks to a quality of food (precise thought about this topic and about the time dedicated to the meals) Thanks to a quality of the medical cares, the treatments and thanks to doctors in geriatrics and trained care workers Thanks to the quality of medical care in case of acute decompensation or at the end of life Thanks to easier accesses to other medical units

Which consequences in terms of space arrangements ? To create : –Human size units (25 persons) –Individual rooms to preserve the intimacy –Special user-friendly living areas –A building open on the outside –A place mixing freedom and safety –A place with dedicated rooms for leisure activities –A place open to the families and relatives –A place open on the city –Specific units (Alzheimer living units, unit of adapted cares) linked with the rest of the medical structure –Places adapted for future evolutions (increasing number of beds...)