Lazio Regional Authority strategy to support people with Alzheimer s

Transcription

1 Workshop presented by: Regione Lazio, Italia Social and healthcare integration Lazio Regional Authority strategy to support people with Alzheimer s

2 CONTEXT Alzheimer s in Europe 7.3 million people with dementia in EU27 numbers expected to at least double by billion: the total estimated cost of dementia disorders in EU27 in % of which were costs of informal (unpaid) care per person per year: the average cost with dementia in EU27 Source: Anders Wimo, 2008 in Alzheimer Europe Diapositiva 1 di 16

3 CONTEXT Alzheimer s in Italy In Italy, more than 1 million people are affected by dementia affected by Alzheimer's disease Total cost of dementia is estimated beyond 29 billions The cost per demented is about Source: Alzheimer Italia, 2011 e Alzheimer Europe, 2008 Direct costs are 15% of the total, i.e per demented Informal care costs are 85% of total cost, i.e per demented Source: Alzheimer Europe, Informal care cost Direct cost Diapositiva 2 di 16

4 CONTEXT Alzheimer s in Lazio Total inhabitants of Lazio: Inhabitants aged 65+: Estimated dementia incidence: (6% of population aged 65+) Estimated Alzheimer s incidence: (55% of all dementias) Actual patients in care affected by dementia: Direct costs Costs incurred by families (80%) Costs incurred by public sector (20%) Direct share of health and social service costs Costs for assistance personnel and aid tools Informal care costs Loss of productivity (for both demented and family members) Psychological and physical stress and pain for informal caregivers Direct costs Medical exams, hospital stays, medicines Formal care: home care, day care centers Nursing homes Financial support to demented and families: disability pensions, vouchers for assistance, etc. Diapositiva 3 di 16

5 CONTEXT World Report on Alzheimer s 2013 The 2013 World Report on Alzheimer s outlines the following main Recommendations: Governments around the world should make dementia a priority by implementing national plans Monitor the quality of dementia care in all settings Autonomy and choice should be promoted at all stages of the dementia journey Health and social care systems should be better integrated Need to train caregivers and to provide them with financial reward Quality of life at home can be as good, and costs are comparable The quality of care in care homes should be monitored through the quality of life and satisfaction of their residents Diapositiva 4 di 16

6 National level CONTEXT L. 104/1992 National law on assistance, social inclusion and rights of the disabled Regulatory framework in Italy Lazio Region L.R. 6/2012 Regional Plan for people affected by Alzheimer-Perusini s and other dementias A national plan on Alzheimer s is to be approved It defines the service network, access procedures, some governance tools such as the Dementias Information System and the Dementias Regional Register. Services are designed as follows: Centres for diagnosis and medical treatment Semi-residential/Residential services (both health and social care) Home care Financial support to families and to volunteering associations Training courses for caregivers + information for demented and families Register and Information system Diapositiva 5 di 16

7 REGIONAL POLICY Overview on the Regional Plan National and regional resources in 2012 Fund for disability (non self sufficient persons, LSA, dementias, etc.) ,00 Specific fund for Alzheimer's ,00 (DGR 504/2012) Objectives To foster a multidimensional approach to Alzheimer's disease To realize and integrated network of health and social services for demented and their families To even out the services offer on the whole of regional territory ,00 National resources Regional resources Diapositiva 6 di 16

8 REGIONAL POLICY Health New social units Social Health units (ASL) Social Districts and new social scope units 8 new social units coinciding with health units and formed by social districts Diapositiva 8 di 16

9 REGIONAL POLICY Social & healthcare integration Health Social New social services units: coinciding with health units Shared methodology between social services and health sector Shared design of Individual Assistance plan (PAI) Shared services delivery with health sector Diapositiva 9 di 16

10 REGIONAL POLICY Resources destination Residential / semi-residential Daycare centres and short-term residential Direct and indirect home-care Information and training Alzheimer's Café, self-mutual help, caregivers' training Diapositiva 10 di 16

11 RESULTS AND PERFORMANCE Residential & semi Day care centres for Alzheimer's Short term residential service Outcome Service offer in 2012: 19 day care centres with 400 places Increase of service offer in 2014: 8 new day care centres and 140 places Service offer in 2012: 120 short term residential places Increase of service offer in 2014: 30 short term residential places Criticalities High start up and management costs Uncertainty about level of financial resources through different years Territorial diversity in service offer: 17 day care centres in Rome Diapositiva 11 di 16

12 RESULTS AND PERFORMANCE Home-care Direct and indirect home-care Outcome Current offer: users Increase of: 500 new users who will receive home-care Criticalities Uneven service supply: from six months to one year from 12 to 44 hours per month from 100 to 800 per month Home care is the most requested service in non-metropolitan areas Diapositiva 12 di 16

13 RESULTS AND PERFORMANCE Information & training Information to families Self-mutual help of informal care-givers Alzheimer Cafè Care-givers training Outcome New places for socialization (Alzheimer Café) Development of family networks Training for 130 formal and informal caregivers Criticalities Uneven use of financial resources and kind of service delivered Care-givers often get little Alzheimer s specific training Diapositiva 13 di 16

14 RESULTS AND PERFORMANCE Conclusions Summing up on the positive side Widening of type and quantity of supplyed services Guidelines in service supplying Online application for monitoring and financial reporting Diapositiva 14 di 16

15 RESULTS AND PERFORMANCE Conclusions Summing up the critical sides Uneven territorial distribution of service supplying (cultural and social differences, infrastructure, etc.) Lack of specific standards for services (access procedures, fruition, territorial characteristics, functions, costs) Diapositiva 15 di 16

16 Themes for working groups 1. Informal care: choice or necessity? 2. Quality of services: the point of view the supplier Vs the point of view of the user 3. A look at the future: what services for Alzheimer s? Diapositiva 16 di 16