The EHPA residents are still more dependent

Structures of accommodation at December 31, 2007, it accounted for 10 305 accommodation for elderly facilities: 6 504 retirement homes, 2 786 housing homes, 903 long term care units and 112 homes for temporary accommodation and experimental facilities. All of these structures offers 684 000 installed seats and welcomes 657 000 residents, or an overall rate of 96 occupancy and rates of average equipment of 127 places per 1,000 persons age 75 and over. Retirement homes offer the largest number of seats, or 69 of the capacity of all institutions, housing homes to offer 21, care of long-term, 10 and the residences of temporary accommodation and experimental facilities, 0.3. In all these institutions, the places specifically devoted to the home of day or night reception represent respectively 1 and 0.1 of capacity (i.e., respectively, 6,000 and 500 seats). Temporary accommodation is also only a small portion of the support. December 31, 2007, only 1 of the clientele was allowed temporarily. In implementation of the reform of the pricing, all institutions allowing dependent elderly people gradually become accommodation for elderly dependent (EHPAD). They are in 2007, 6 850 (67 of the total) 515 000 places (75 of the total). The EHPA residents are still more dependent. Indeed, the proportion of very dependent elderly persons was 47 in 2003, and rises to 51 end 2007. More than 397 000 people (340 000 full-time equivalents) are employed in the EHPA, either 52 000 higher than in 2003. The framing rate, which expresses the number of jobs (FTES) to 100 seats, is always higher and higher in the EHPAD. It is also in the EHPAD, as well as in long term care (USLD) units, from medical or paramedical staff is the highest. It represents 62 of FTE in USLD non-EHPAD and 43 in EHPAD. The average size of settlements increased slightly compared to 2003, 63 and 66 seats. The average capacity of retirement homes passes of 68 and 72 seats, and varies with the status. The largest settlements are retirement homes public with an average capacity of 84 beds, while private retirement homes have an average capacity of 66 non-profit private beds and 61 for the non-profit private. Long term care units have an average capacity of 75 seats and accommodation-homes of 51 seats. Institutions become EHPAD have an average capacity greater than that of other institutions (75 seats against 49). Half has a capacity of 70 seats or more, and 25 have at least 88 seats. The median size of retirement homes non-EHPAD is significantly lower: 27 seats. 58 of the capacity of all institutions within the public sector, 26 of the private sector to non-profit and 16 of the lucrative private sector. -Retirement homes are places of collective providing a decision-making in overall charge of the person, including accommodation in a room (or housing), meals and various specific services. They constitute the largest category of EHPA in numbers and in terms of capacity (471 000 seats in total). Each unit offers an average 72 seats. It may be noted the important role of the sector private (non-profit or non-purpose) which holds about 60 of retirement homes and provides a little more than half of the seats available. -2 786 Homes housing represent 21 of the offer of accommodation, with 143 000 places. These are groups of autonomous housing (sometimes rooms) equipment or collective services. They are intended primarily for the independent elderly people, more than half of them home with specified in their regulations do not admit of dependent persons. There are places on average 50 per unit. -Long term care (USLD) units are the wards and are particularly aimed at the home of the more dependent persons. These units are largely dependent on hospital services. USLD 903 together 68 000 beds, or 75 per establishment. -More marginally, 112 residences of temporary accommodation offer 2,000 beds. These homes enable the elderly to cope with transitory difficulties such as the temporary absence of the family, isolation, recovery, or even the inadequacy of housing in winter. Between 2003 and 2007, the overall number of EHPA places increased by 1.4, but this figure conceals dynamic contrast depending on the type of establishment. Indeed, while the number of places in retirement homes had substantial growth ( 8.4), the number of places available in the other types of structures has decreased over the same period (-7,7 for housing homes,-17,2 for the USLD and -31 for the residences of temporary accommodation). It may be noted that this contrast is especially marked for the private for-profit sector: housing-sector homes lost 38.2 of their capacity, but private-for-profit retirement homes increased their number of beds of 17, 4. A sector carrier, but difficult an increasingly aged population, whose revenues improve and whose accommodation requirements are expected to grow considerably in the years to come, beyond the capacity of home actuelles At first glance, the sector of the third age presents all the characteristics of a carrier market. But these appearances have already proved misleading, even fatal to short-sighted entrepreneurs. In recent years, the land became economically carrier; the wealth of economic data delivered on the subject has coincided with a certain medical and paramedical sector being evil. Number of nurses liberal or private, physiotherapists or doctors to unemployment or dissatisfied with their working conditions have thought find an exit door in the creation of centres for the third age. But most of them are left on a distorted calculation basis, building on the elderly home relatively valid. However, seniors are reluctant to leave their homes as long as they can stay, and accept the solution of collective accommodation to a more advanced age. So home structures found themselves confronted with a clientele far more dependent that they could not think. "Those who believed find a vein in the area of the third age are mistaken," find a professional. Of course, for a business leader, a retirement home offers some undeniable advantages: on the one hand, it is a stable area, where you can, provided you ensure impeccable service, be sure display full permanently, which is most always the case in the restaurant or in the hotel. On the other hand, all the operating costs are covered by the first week of the month. Well functioning practice, at a time where service providers are more and more often facing intractable problems of deadlines. "Whatever the activity chosen, take charge of the elderly is a complex activity, that cannot reasonably deal without some prior experience and a willingness to personal investment. Create a home for the aged structure assumes quite individuals with skills in management, catering and hospitality. Indeed, the social dimension of this activity involves a device legal and administrative complex and compelling, especially since the reform 2000-2001. Finally, "customer" third age or fourth age presents compelling features: such a structure of home management application of the psychology of human heat, certain ethical requirements without which it is best to choose another activity. Can be read, in this regard, the Charter of rights"and freedoms of the old dependent person, established in 1997 and revised in 2007 by the Ministry of employment and solidarity. Finally, given the financial means to mobilize and the professionalization of a sector increasingly monitored by public authorities, the selection becomes unforgiving of those who want to create a home for the elderly. And approvals are issued in dribs and drabs by General advice. All these conditions pose a significant advance in the future creator: mounting of a record from A to Z application for two to four years of hard work. And, from the opening of the institution, the creator must provide appropriate publicity: the rate of occupancy of the residence must be maximum. This must be approaching hospitals, advertising in the specialized press, seduce pharmacists, associations of mutual assistance for the elderly, the Ddass, etc. The rights of the elderly class accommodation for the elderly gave rise to certain abuses, or to various facts. Institutions where elderly people were malnourished, mistreated, still exist and are anecdotal. Awareness of

abuse of older persons is an emerging phenomenon that is changing rapidly and leads unquestionably to take a new look at the older person and re-evaluate most attitudes, behaviors, procedures and structures on. It was probably to prevent the ill-treatment the national Gerontology Foundation enacted, with the Ministry of employment and solidarity, the "Charter of rights and freedoms of the dependent elderly people", defining the fundamental principles of respect for the elderly, who has taken value of reference in all places of life of older persons: "the physical and moral security against all assaults and abuse must be saved." The entry into public or private institution or placement in a foster home, residence conditions must be guaranteed by an explicit contract, the dependent elderly person may have recourse to the Council of his choice. Any change of place of residence or even House must be the subject of a consultation with the interested party. When implementing protections provided by the civil Code (protection of justice, curatorship or guardianship), should be considered with attention that: the need for protection is not necessarily total, or final; the protected dependent elderly person must be able to continue to give its opinion whenever this is necessary and possible; psychological dependence does not exclude that the elderly can express directions of life and must always be informed of the acts performed in his name. "The retirement home by its residents in September 2005, the members of the association VEDIBE, aging with dignity and well-being, developed a synthesis of the wishes and the releases expressed by people living in retirement home, to define what would be the"ideal"retirement home Here are some extracts which future creators would do well to consider. The "ideal" Home - A home close to the shops and services and as close as possible children or my family. -When he knocks on my door, staff must expect that I would say "enter". I am in my home. -Respect the adult who is in each one of us, with his past, his experience and his history, and we call our name and not "papi and mami", especially when it did not have the chance to be grandparents. -Not to impose me the hour of sunrise. Block certain schedules aberrations. Meet my pace! -Provide a room where residents can take advantage of the movements of the street. -A true home spacious to make some personal furniture and to move in a wheelchair. -Me to maintain a role social in the family and, if possible in the neighbourhood. Do not be suddenly abandoned by those who shared with me an activity. -The retirement home should help me to feel useful until my death, and not hindering assistance that I could make to the disabled. -To have a small square of garden, a balcony to grow flowers or vegetables, or at least power maintain some flower beds. -Participate to the choice of menus and culinary activities. -An animation which is necessary but whose purpose is to promote the relationship between the residents. -In room dining each must choose his table according to their affinities. -Able to eat foods with flavours of the past, and prohibit a too strict health regulations. -Volunteers who spend in the rooms must have a real exchange with residents. -More involvement of families: lunch between families, family permanently to working capital for the weekend, allowing to better understand and know the residents. -Facilitate exchanges between the families of the residents and make a sort of large family which includes the isolated of the retirement home. -Freedom to go and come, even in a wheelchair, including in the city. Zero risk does not exist and there is nothing worse than to be cloîtré. -Have the guarantee that everything will be done for my well-being life, through, inter alia, a team formed to end of life support and appropriate palliative care. -Telephone in a direct line to allow the choice of the operator and a less prohibitive cost. The retirement home which they don't want - House isolated, unrelated to the outdoor life. -A Director without qualification, or qualities of heart, never shown outside major holidays, and incompetent staff, without vocation to work with the elderly. -Be treated as an object that is washed in the same way as the bathroom or the furniture of the House, and not as a human being needs to communicate and to be respected. -I refuse that it alienates my freedom by a too strict regulation. -I refuse that imposed safeguards while it would be that it helps me to go to the toilet so I become not incontinent (e). -We refuse to be treated as children. -A House that will let me die alone, without any attention, and worse still, in the suffering. Other forms of hosting other accommodation structures beyond the generic term of retirement home, due to some particularities. The Cantous These natural animations from useful Occupational Centres have been created in 1977, under the auspices of the France Foundation, to help the elderly suffering from mental disorders more or less serious. Each of these small autonomous units includes 12 single rooms, with, for each of them, an ensuite bathroom with washbasin, a toilet, a shower, distributed around a common room. The residents live with House Mistresses (four by Cantou) and a versatile staff accompanying avoiding substitute them for the actions that they can still perform only. The day price is around 55 euros. It includes the support of all benefits, and does not supplement. A deposit equivalent to two months in pension is seen for admission. It is refunded at departure or death. Residences with services developed by private developers, the residences with services cater to a wealthy population. Formula: apartments clustered around PPV services (laundry, catering, household, custody... nurse). Located in the downtown shops and green spaces, residence services offers an environment that is secure and reassuring. A large part of these residences are condominiums (from the studio in three parts), but rentals also exist. The prize is divided into rent (or reimbursement of credit to the Bank for the purchase of the apartment) and services, charged back by the trustee or the management company according to the degree of services. Accommodation at home Act of 10 July 1989 clearly developed the framework of the family home to a number of abuses. In effect, taking advantage of the vagueness of the Act of 30 June 1975 on the social and social institutions, number of retirement homes have developed on the grounds of their "family"... character only to avoid the procedure for administrative authority claimed by the Act. To put an end to these abuses, the 1989 Act set a threshold. Two or, exceptionally, three persons received, any accommodation long-term elderly under the legislation of 1975 on retirement homes. An individual can take pension only one or two seniors (except where a derogation by the President of the General Council). The 1989 Act requires the allowed and the welcoming to complete contract their relationships by a contract and strictly framed the remuneration of the welcoming. It has three distinct components: compensation, representative compensation of the cost of maintenance (heating, electricity...), and finally the rent. The remuneration is fixed by Decree. The General Council for its part will set a ceiling of total compensation that no one shall exceed, except "specific constraints. Thus, an additional element of availability of the welcoming to take into account the State of the elderly person, or to assist it to carry out certain acts of everyday life, may open the door to a markup. Representative compensation of the cost of maintenance (food, heating...) is also determined by Decree. It includes a daily minimum set at two times the guaranteed minimum and a maximum fixed at five times the guaranteed minimum. "Boarding" this term corresponds to a formally illegal reality for the accommodation of elderly people. If everyone is free to transform its spacious Pavilion Hotel structure, on the other hand no hosting persons self-employed or likely to lose their autonomy. Clearly, any establishment hosting a person unable to meet the needs of daily life - itself moving, feeding, washing without assistance - is liable to a charge of penalizing anyone in danger if the slightest problem his tenant. However, a few guesthouses remain far out of control.