PRESENTATION BY ACADÉMIE DE CRÉTEIL

Marie-José Côme

Nadine Mundinger

Véronique Ponchaux

Claire Vivant Le Calonnec

DEPENDENCY AND DISABILITY

ALZHEIMER AND UNDER 60-YEAR-OLD PEOPLE

In France more than 8000 people under 60 years suffer from Alzheimer’s disease.

The person can ask the Committee for the rights and autonomy of handicapped people ( Commission des droits et de l’autonomie des personnes handicapées – CDAPH)

Actually the clause « l’article L.241-6 » of social action and family law considers that « CDAPH » has the authority

to decide on the placement of a handicapped person

To say in which establishments of rehabilitation or personalized retraining the adult disabled should be sent.

OBLIGATION TO GIVE WORK TO DISABLED PEOPLE :

A RIGHT TO WORK AND HAVE AN OCCUPATION

References Employment law :   the 5th part is devoted to employment / Book 2 « Measures concerning certain categories of workers / Title 1 : Handicapped workersLaw n°2005-102 11 February 2005 : equal rights and chances, the participation and citizenship of handicapped people

  Principal concept

Every employer who has employed at least 20 full-time workers for 3 years should employ 6 % of handicapped people of the total number of staff.

 

The organizations which don’t employ disabled people or not as many as they should have to pay AGEFIPH (private companies) or to FIPHFP (public organizations), to finance the funds of professional integration of the disabled.

The obligation to employ disabled people concerns all workers, in private or public sectors, those who have a permanent or temporary contract, who work full-time or part-time, who are doing an apprenticeship or a professional training.

Some aids can be given to employers who employ handicapped workers.

Payments to public funds of integration of disabled workers (AGEFIPH or FIPHFP) if the quota of 6% is not respected

According to number of employees and missing handicapped employee

From 20 to 199 employees: 400 times the minimum hourly salary (3676€)

From 200 to 749 employees: 500 times minimum hourly salary (4595€)

Over 750 employees: 500 times minimum hourly salary (5514€)

THE ORGANISATIONS WHICH DEAL WITH DISABLED PEOPLE AND THEIR INTEGRATION

FINANCIAL AID FOR DEPENDENCY OF PEOPLE

UNDER 60 IN FRANCE

Autonomy benefits (APA)

THE LAWS CONCERNING DISABLED PEOPLE ARE COVERED BY ALL TRAINING COURSES

10 years of existence

The objective is to reinforce aid to old people who are losing their autonomy, by having the necessary help in their daily routines

TERMS OF AWARDING

To be 60 years old or older, to miss or to be losing one’s autonomy due

to physical or mental conditions , To be in need help to accomplish

essential tasks in every day life or to be in need of surveying

To be French and live in France ,or to be a foreigner legally living in France.

For information : APA benefits don’t depend on revenue.

ASSESMENT TOOL TO ANALYSE THE LOSS OF AUTONOMY National grid AGGIR

(Autonomie Gérontologie Groupes Iso-Ressources)It serves to evaluate the degree of autonomy loss or the degree of physical or psychological dependency

Assessment is done according to 17 criterias (variables): Ten variables called "distinguishing criterias" which define the

loss of physical and psycholocal autonomy and which are used to calculate GIR (groupe iso-ressources) : coherence – sense of direction - washing – getting dressed - eating – going to toilet- transfers (getting up, going to bed, sitting) – moving around inside a house- moving around outside – communicating at distance ;

Seven variables called "illustratives", concerning the loss of household and social skills, they are not included in the calculation GIR but they give useful information for the care plan : handling of one’s budget and goods- cooking - cleaning - transports -shopping – following the treatment – leisure activities.

THE SIX GROUPS OF THE GRID AND THEIR INFLUENCE ON FINANCIAL AID

The group iso-ressources 1 includes people in bed care or in a wheel chair, whose mental functions are badly damaged and who need permanent assistance ;

The groupe iso-ressources 2 , includes people in bed care or in a wheel chair whose mental functions are not completely damaged but whose condition obliges them to have assistance in most everyday activities. This group also includes those elderly people whose mental capacities are diminished but who can move independently;

The groupe iso-ressources 3 gathers the elderly who have mental independence, are capable of moving up to some point, but who need daily assistance and need to be helped several times a day;

The groupe iso-ressources 4 consists of people who can’t get up alone but who, once up, can move around their apartment. They sometimes need help for washing and getting dressed. This group also includes those elderly people who don’t have problems moving about but need help in physical activities and meals ;

The groupe iso-ressources 5 is formed by elderly people who only need help in specific situations such as preparing meals or cleaning, or washing ;

The groupe iso-ressources 6 is composed of elderly people who have not lost autonomy in their everyday activities.

Only the first 4 groups of the national grid give rights to APA. The benefactors can be at home or in an institution. They can get help if their age and residency correspond to criterias.

The elderly people of groups GIR 5 et 6 can ask for financial assistance to help with cleaning corresponding to their social health insurance category.

THE ADVANTAGES

A measure based on universal and objective means to standardize fees and national scales. This measure favours diversified payment. It aims to improve the quality of services. It garanties a double solidarity in its financing: local solidarity by local organisations and the general council (Conseil Général)

DIFFERENT CATEGORIES OF PROFESSIONALS IN CHARGE OF DEPENDANT PEOPLE

Home aide

Family care assistant

Home family assistant

Home assistant in rural areas

Social family assistant

Nursing assistant

Medico-psychological assistant

Gerontology assistant

Social and family technical assistant

ACADEMIE DE CRETEIL OFFERS CERTIFICATES WHICH SPECIALIZE IN KNOWLEDGE OF DEPENDENCY

Nursing assistantSocial family assistant Home care assistantMedico-psychological assistant Gerontology assistant

THE TRAINING COURSE CONTENTS

Each training course has an objective to: - Give the necessary knowledge of the disease and the ability to help the patient and family in need . - Give the assistants the information and means to better help the family and handle its needs, but also know the structure and functioning of the health network in order to help the family to deal with it.

Course Modules Contents

Assistant (e)de vie aux familles

Home care assistant

CCP1 -Helping people in their essential every day activities

Aide soignant (e)

Nursing assistant

Modules 1 à 3 -Helping people in their every day activities-Clinical condition of the person -Healthcare

Auxiliaire de vie

Social family assistant

Modules 2 à 4

- Assisting people in their every day activities - Helping with social life and relationship - Helping with ordinary activities

Course Modules Contents

Aide médico-psychologique

Medico –psychological assistant

Modules 1 à 5

-Knowledge of a person -Rehabilitation activities and helping with every day activities -Helping with social life -Medico-psychological support -Setting up personal care plans and following them up

Assistant (e)en gérontologie

Gerontology assistant

Modules 1 à 5

-Creating and executing individualized care plans respecting the person  -Helping and supporting people in their every day life considering their needs and their degree of autonomy  -Leading activities which stimulate social and cognitive capacities collaborating with psychomotricists, ergotherapists or psychologists -Understanding and analyzing principal symptoms related to state of health  -Dealing with every day care by appropriate acts

EXAMPLES OF TRAINING COURSES PURCHASED BY PROFESSIONALS

Assisting dependent peopleSupporting a person who is at the end of his/her lifeTaking good care of a person/ dealing with cases of bad treatmentErgonomy , gestures and postures professionals The aging processAlzheimer's diseaseStimulating physical or intellectual capacities which favor the autonomy of dependent people

HUMANITUDE , TO TAKE CARE OF ALZHEIMER PATIENTS IN A NEW WAY:A PHILOSOPHY SERVING ELDERLY PEOPLE

Objective: rehabilitating a person in taking into consideration one’s dignity and improvement of relationships between the patient and the assistants

THE FOUR PILLARS OF HUMANITUDE

This method relies on a global changement of caretakers’ behaviour

Eye contact: the caretaker should talk to the patient face to face on the same level

Speech : one should explain every gesture and announce it beforehand

Touch : one should touch the patient with « tenderness » instead of « practicality »

Verticality : no more washing patients in the bed which they never leave. Elderly person is adequately taken care of, she /he can or should function standing up. Verticality is one of characteristics which distinguishes us from animals , therefore it’s very important for us.