Ageing in Lebanon Research and Policies Long Term Health Facilities Bristol Hotel Beirut September...

Ageing in LebanonResearch and Policies

Long Term Health Facilities

Bristol Hotel Beirut September 2007

September 2007 1Dar Al-Ajaza Al-Islamia Hospital in Beirut

Azzam Houri

Director

of

Dar Al-Ajaza

Al-Islamia

Hospital

in Beirut


Definitions (1/3)

• Old age: The last stage in life.

• Senility: Weakening of the physical and mental faculties due to elderly.

• A third age person: A person who is above 64 but is still independent.

• A fourth age person: A person who is above 64 but is dependent and needs aid physically and/or psychologically.


Definitions (2/3)

• Dependence is defined as:

The situation of an individual needing, to accomplish his/her daily life activities, (to feed himself/herself, move around, put clothes on, assure his/her hygiene) some form of human or technical aid at home or in a care institution.


Definitions (3/3)

• Social insurance: insurance coverage in case of illness or social situation.

• Social legislations: is the group of laws and regulations intervening in favor of individuals and homes.

• Elderly insurance law: a project that is part of the social security law. This project was initiated for the first time in 1963.


Hospitals and Elderly Home care Institutions in Lebanon

Why? For whom?

• To ensure medical services, infirmary services and a social protection.

• To protect the society and citizens of certain risks.

• To reduce the pain of the elderly.• To welcome the ill.• To protect, monitor, and re-educate the

handicapped and the elderly.• For students and researchers.


I invite you

I invite all the citizens,the different organizations,

from Lebanon, the Arab world and the international community

to visitthe elderly care institutions

to be up to date on their activitiesand to recognize the importance of their

services to the society September 2007 7Dar Al-Ajaza Al-Islamia Hospital in Beirut

Institutions provide the following services to the elderly (1/2)

• Medical services– Geriatric cabinet// dental cabinet.– General medicine cabinet// Others

• Sanitary and therapeutic services– pharmacotherapy// physiotherapy.– Psychotherapy// ergotherapy.

• Diagnostic services– Laboratory// radiology// echography.– E.E.G. // E.C.G// psychological tests.


Institutions provide the following services to the elderly (2/2)

• Infirmary services• Social services:

– Entertainment (TV, music, garden, etc..).– Intellectual activities (chess, reading, etc.).– Sport// drawing// crafts.– Ceremonies and anniversaries.– Excursions.

• Hotelier services– Dietetic and kitchen section – Laundry and tailoring section


Financial resources (1/2)

• Elderly care institutions depend essentially on two resources to assure their continuity:– Contracts with official institutions:

• Ministry of Health.• Ministry of social affairs.• Municipalities.• Others.

– Donations, contributions and aids.


Financial resources (2/2)

• The ministry of health pays 15,600 LBP per day per dependent elder, whereas the expenses vary between 40,000 and 50,000 LBP per day depending on the elder’s needs and his/her physical or mental situation.

• The ministry of social affairs pays 4,100 LBP per day per independent elder.September 2007 11Dar Al-Ajaza Al-Islamia Hospital in

Beirut

1. A coherent family.

2. Services provided: by elderly care and socio-medical care institutions.

3. Legislations and necessary laws related to the elderly subject.

In order to grow older decently,with acceptable standards of living

and socio-medical guarantees,3 conditions need to be satisfied:


– Residential Institutions: offering socio-medical or care services.

– Day Care Centers: offering social activities services.

– Home Care: offering services in the home of the elderly.

The number of elderly care institutionsin Lebanon is around 40

and which according to their services are:


Classification

• The ministry of health and the ministry of social affairs have never classified the elderly care institutions even though all the hospitals in Lebanon are classified and are submitted to accreditation.

• There are no specific criteria to classify or evaluate the institutions in Lebanon . Each institution has a different way of practice.


The Work Team with the Elderly

must be Specialized:

– Geriatrics.– Specialized infirmary.– Social assistance.– Physiotherapy.– Ergotherapy.– Dietetics.– Psychometrics.– Others. Very few institutions have

complete specialized teams


• In the early 20th century, the foundation of elderly homes started. But the role of these institutions was very limited, covering food services, meals and housing along with some fixed medical consultations.

• Later, the different Lebanese religious communities took care of this layer of the society (both the dependent and independent elderly) and they founded the specialized institutions.

History (1/2)


• The services of these institutions continued to grow till they reached a satisfactory medical level in addition to specialized hospitality services and infirmary care services.

• At the end of the 20th century, Lebanon already has developed and specialized institutions along with the foundation of day care centers.

• It is important to mention that most of these institutions are non-governmental.

History (2/2)


18

74

19

04

19

20

19

23 1

93

6 19

49

19

50

19

51

19

52

19

54 1

96

51

96

71

96

71

97

11

97

31

97

91

98

21

98

41

98

51

98

51

98

91

98

91

98

91

99

01

99

11

99

21

99

21

99

31

99

41

99

51

99

81

99

81

99

91

99

92

00

12

00

1

1850

1870

1890

1910

1930

1950

1970

1990

2010

2030

2050

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38

Series1

Chronological sequence of founding the institutions in Lebanon


0 0 0 0

8 10

10 1

8 28 32 35

35

35 4

5

45

45 50 6

0

60

60 65 70

70

70 75

75 80 85

10

0

10

0 11

0 12

01

50

40

04

50

45

0

0

50

100

150

200

250

300

350

400

450

500

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38

Series1

Number of beds per institutions


9 8 4 7 1 4 5

760

1220

217

379

70

145

255

84

153

54 54 7036 51

0

200

400

600

800

1000

1200

1400

Beyrouth Metn Chouf Nord Sud Bekaa Kserouan

Institutions/lits/moyen

institutions

lits

moyen


Chronological sequence of founding the institutionsin Lebanon (1/4)

1.Foyer St. Georges - Beyrouth 1874

2.Beit Sayidat Al-Alam - Guedras 1904

3.Hôpital Assaydeh – Antelias 1920

4.Association Kahel - Bourj Hammoud 1923

5.Association Hamilat At’tib 1936

6.Hôpital Dar Al-Rahmeh – Ain Saadeh 1949

7.Ma’wa Al-Ajaza Al-Marouni – Fourn Chebbak 1950

8.Association des services sociaux - Tripoli 1951

9.Dar Jesus le Roi – Zouk Mosbeh 1952

10.Hôpital Dar Al-Ajaza Al-Islamia - Beyrouth 1954September 2007 21Dar Al-Ajaza Al-Islamia Hospital in

Beirut


11.Maison de vieillard malade – Mansourieh 1965

12.Dar Al-Istiraha Mar Cherbel – Khahaleh 1967

13.Dar Diafet Sami Al-Kodsi – Al-atchana 1967

14.Hamline - Hammana 1971

15.Deir Mar Youssef - Jrabta 1973

16.Têtes Blanches – Baabdat 1979

17.Beit Al-Inaya al-Ilahiya – Zgorta – Arjes 1982

18.Beit Al-Chaykhoukha – Tripoli – Almina 1984

19.Dar Al-Karama - Beyrouth 1985

20.Dar Al-Raha – Mejdlaya 1985September 2007 22Dar Al-Ajaza Al-Islamia Hospital in

Beirut


21.Dar As-Salam - Saida 1989

22.Markaz Ri’aya Al-Moussinine - Ain wazen 1989

23.Longue Vie - Bhersaf 1989

24.Hôpital Dar As-Sahel linnakaha 1990

25.Association Mar Mansour –Ozanam –Batroun 1991

26.Mabarrat Al-Imam Al-Mahdi – Baalbeck 1992

27.Al-Omr Al-Madid 1992

28.Beit Assindianeh – Shayleh 1993

29.Sayedat Om Al-Marahem – Meziara 1994

30.Hôpital Bhanness – St. Florian – Bhanness 1995September 2007 23Dar Al-Ajaza Al-Islamia Hospital in

Beirut


31.Association Crechendo – Achrafia 1998

32.Association Riaayat Al-moussine – Verdun 1998

33.Dar Assaada Lil-Mousinine – Ksara 1999

34.Association Rahbat Assalib – Shlifa 1999

35.Darouna – Fourn Achoubak 2001

36.Centre Medico-Social – Baytouna 2001

37.Association Catholique – Zahle

38.Association Dar Al-inaya – Jbeil - Hboub


• The Permanent National Committee for the Elderly was founded in 1997 and is composed of representatives from the governmental, non-governmental, private sector institutions and experts in the elderly area.

• On October 1st, 2003, the committee initiated 33 day care centers in all Lebanese regions to provide activities, social relations, medical care and family relations.


Difficulties faced by the institutions

• Despite the limited resources of these institutions, the costs are high:– Electricity bills– CNSS fees– Drugs prices– Salaries– Installments paid by the concerned ministries

cover only 40% of the fees.


Numbers and Ratios

• The number of institutions in Lebanon is around 40

• The number of residents in these institutions is around 3400.

• The number of personnel in these institutions is around 1450.

• The ratio (personnel/resident) (1/ 2.34)

• The ratio (institution/resident) (1/ 85)


To improve the quality of care in geriatric services:

• Daily cost paid by the ministries need to be revised in function of the services offered by each institution.

• Demographically, the population in our society is growing older and we are reaching the 13% threshold in few years, which necessitates a radical change in the command of this population.


Thank you

Merci� شكرًا


Ageing in Lebanon Research and Policies Long Term Health Facilities Bristol Hotel Beirut September...

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