Dansk Gerontologisk Selskabs Årsmøde 2009 Hvordan kan kronisk syge’s livsverden forbedres? -et 3 årigt EU projekt Lis wagner, Dr.PH, Professor Enheden for sygeplejeforskning, Syddansk Universitet

Titel: Sundhedssystemer og long term care (LTC) for ældre i Europa. Udvikling af en model der beskriver berøringsfladene mellem forebyggelse, rehabilitering, kvalitet i ydelserne og uformel pleje

Baggrund: EU’s 7’ende Rammeprogram •Second Call Health: Health systems and long-term care for older people in Europe 2006 •Ansøgningen blev placeret som nr. 1 ud af 18 •Forberedende første møde i Wien primo 2007 Presented by Kai Leichsenring • Vienna,

Deltagere: 16 fra 14 lande •European Centre for Social Welfare Policy and Research,(A) Coordinator •Ecole d'études sociales et pédagogiques (CH) •University of Southern Denmark •Institut de Recherche et Documentation en Economie de la Santé - Irdes (FR) •National Research and Development Centre for Welfare and Health – Stakes (FI) •Institut für Soziale Infrastruktur (DE) •Wissenschaftszentrum für Sozialforschung, Berlin (DE) •CMT Prooptiki ltd. (EL) •University of Valencia – Polibienestar (ES) •Studio Come S.r.l. (IT) •Vilans (NL) •Institute for Labour and Family Research (SK) •Institute of Public Health (SI) •Forum for Knowledge and Common Development, Stockholm County Council (SE) •University of Kent (UK) •University of Birmingham (UK)

Mod et integreret system for LTC ? Integreret LTC system Brugere/klienter/ patienter/borgere Sundheds- væsnet Social- væsnet Ydelser Hjemmepleje Institutioner Proffessioner Udbydere Metoder Regelsæt Politik Ydelser Hospitaler Professioner Udbydere Metoder Regelsæt Politik Vision – Kultur Strategier – Politik Financiering Mennesker - Processer Metoder - Kvalitetskriterier Forskning - Udvikling Træning

Mål ( ) •At udvikle en metode til at beskrive og analyserer LCT og forløbs- koordineringen mellem sundheds- og socialvæsnet og eget hjem. •At sammenligne LCT forløb over grænserne •At udvikle praktiske værktøjer til at måle og støtte fremgang, med udgangspunkt i kronisk syges livsverden og eksempler på god praksis •At identifiserer god praksis, som kan hjælpe med at guide og forme politik og praksis i andre medlemslande i retning af at: •Fremme forebyggelse og rehabilitering •Vurdere kvaliteten af plejen •Støtte pårørende •Forbedre ledelse og finansiering

Design: PHASE 2 PHASE 1 PHASE 3 Modelling 1 WP 7 Prevention and Rehabilitation WP 3 Quality of service WP 4 Informal care WP 5 Sounding Board 2 Quality of service WP 4 Informal care WP 5 Modelling 2 WP 7 Modelling and Validation by WPs 3-6 Final Conference Governance and Financing WP 6 Sounding Board 1 Prevention and Rehabilitation WP 3 Modelling 3 WP 7 Kick-off meeting WP1 - WP2

Nøglespørgsmål i forskningen: •Hvordan kan effektivitet, ydeevne og finansiel bæredygtighed i sundhed og LTC, for kronisk syge ældre, - planlægges og sikres i et internationalt perspektiv? •Forebyggelse og rehabilitering •Kvalitet i plejen •Støtte pårørende •Ledelse og finansiering •Hvilke elementer, strukturer og organisatoriske aspekter kan føre til et succesrigt samarbejde over grænserne ?

Første opgave: Vignettes To historier om kroniske patientforløb blev beskrevet af alle landene og blev drøftet ved “Kick off” mødet i Wien, Østrig, Marts 2009

Vignette #1 Mrs. L.T. Care, an 83 year old woman, had an acute stroke, was admitted to hospital and is now discharged with partial hemiplegia (a paralysis affecting one side of the body). She is incontinent and living alone in a relatively large apartment owned by herself (second floor, with small lift). She receives an average widows-pension. Her daughter and her son-in-law are living and working in a nearby town (20 km).

Vignette #2 Mr. L.T.C. Dementia is 87 years old. His wife died recently and, during the past few months, he started to become confused and the neighbours found him several times already out in the road not knowing where he was (onset of Dementia of the Alzheimer type). His family lives (average income, both son and daughter-in-law are close to pension age but still working) in the same town and is increasingly worried about his behaviour. He is living with a small pension but owns the small house he is living in. Please describe how Mr. L.T.C. Dementia and his family would access and use the services that might be appropriate to their needs in your area, using the following questions as a guide. Mr. L.T.C. Dementia is 87 years old. His wife died recently and, during the past few months, he started to become confused and the neighbours found him several times already out in the road not knowing where he was (onset of Dementia of the Alzheimer type). His family lives (average income, both son and daughter-in-law are close to pension age but still working) in the same town and is increasingly worried about his behaviour. He is living with a small pension but owns the small house he is living in. Please describe how Mr. L.T.C. Dementia and his family would access and use the services that might be appropriate to their needs in your area, using the following questions as a guide.

Hvad National Expert Panel, kan gøre for INTERLINKS •Støtte den nationale del i Danmark •Udveksle forskning med nationale forskningspartnere •Hjælpe med informationer om politik, kultur og organisation •Inspirere og motivere •Læse og evaluere publikationer •Deltage i endelige konference: INTERLINKS 2011