HOME CARE: THE DANISH WAY I Q 2017 Red Deer, Alberta Eva Pedersen, Copenhagen, Denmark
Denmark in one page 5.5 mio people (+65, approx. 20%) Life expectancy increasing Birth rate: 1.8 One central Government/Parliament 5 Regions (primarily hospitals) 98 Municipalities (elected local government) Health care and social services tax financed and free of charge Universal access (no previous contribution required) (Income)Tax burden among the highest in the world
Life Expectancy
Social expenditure Elderly
Core Elements in Danish Elder Care Preventive home visits Rehabilitation, restorative care Home care Day center activities Temporarily relief schemes Residential care, nursing homes (temporarily or permanent)
Preventive home visits Offer one visit per year to people 80+ (obligatory) Offer one visit the year a person turns 75 (obligatory) Targeted offers to people 65-75, based on risk assessment Alternatives to home visits is possible, grouped sessions, outreach measures to vulnerable people The municipalities have the obligation to offer home visits. The citizens are free to decline the offer. Home visits are carried out by nurses, specially trained in preventive measures and how to trace early signs of impairment e.g. Alzheimer's.
Preventive Home Visits
Restorative Care Rehabilitation Reabling Municipalities are obliged to provide rehabilitation or training measures when a person applies for home care. The purpose is to re-able the person live as independently as possible Measures may be Physical training Cognitive Use of technology Social activities Re-ablement is based on active involvement and a holistic, individualized approach. The intervention must be structured, coordinated and interdisciplinary
Home Care Types of assistance Practical assistance (e.g. cleaning, shopping, laundering) Personal assistance (e.g. bathing, shaving, dressing, getting in or out of bed) Meals on wheels Vouchers which provide limited access to assistance of your own choice e.g. visit to relatives, museum, hairdresser Day centre and relief measures aimed at relatives or informal cares Home care is granted based on an individual assessment of the recipients needs. The decision is made by the local government (administrative level)
Recipients of home care, Percentage of 65+
Home Care Referral Hours by Gender
Referral Hours per Week
Different Types of Home Care
Residential Care
How is elder care organized Care for elderly is a legal obligation for the public sector, almost entirely financed by taxes, free of charge Universal system with equal access for all legally residing in Denmark Since 2015 elder care has been integrated in health care in a Ministry for Health and Elderly. However, from 2016 there was appointed a minister specifically for elder care. Previously elder care had been seen more as a social intervention. In many municipalities primary health and elder care are organized in the same department. Local governments have by law the responsibility to deliver elder care and primary health care Within the legal framework local governments have freedom to decide organization and level of service Local governments have the right to collect taxes
Who Provide Home Care Local Governments are responsible for providing the service and decide the level and the quality standards and allocate the financing necessary to meet these standards. Providers may be Public, private for profit or non profit All providers must be treated equally and all must full fill the required standards For home care the municipalities are obliged to offer a free choice of provider either by contracting with at least one private provider or by issuing a voucher Local governments are obliged to regularly oversee that service is provided according to the decision and the quality standard
TAKEAWAYS Home care can not stand alone. Closely integrated with other services Primary health service (local GP, home nurses, outreach medical teams) Available 24/7 Infrastructure and ICT Qualified staff, life long learning Family and network in the community Involvement of civil society Strong organizational support Political anchoring
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