Prevention policy of French National Pension Insurance Fund - Cnav Eu Falls Festival 2016 Bologna, Italy
Prevention policy of French National Pension Insurance Fund - Cnav Eu Falls Festival 2016 Bologna, Italy
Demographic ageing challenges Dependency costs 34 billion euros in 2010 About 8 to 10 billion euros more in 2040 Life expectancy vs disability-free life expectancy Stratregic issue : to gain 2 years of DFLE from now to 2020 (France: 61,9 years old VS Sweden: 71,7; Bulgaria: 63) Housing adaptation for the ageing population Only 6% of adapted housing in France (16% in Netherland) 3
A overall approach strategy Frailty detection Regional frailty observatories (cartographies) Operational research projects to identify fragile populations Frailty objectification Overall needs evaluation tool used at home Experimentations of evaluation through different partnerships (Postman) Adapted answers Information and advice Collective actions Personalised action plan (basket of services for fragile elderly) 4
Frailty observatories Data from national health insurance and national pension insurance fund Identification of at-risk territories Field for social prevention policy 5
Frailty observatories Example of action Normandy: 31 at-risk territories identified Financial frailty Isolation situation Limited health care offers Results: Actions led with the French post office on these territories : frailty objectification through questions and tailored services provided. 6
Frailty objectification Overall needs evaluation: analysis of all living conditions and the environment surrounding the retiree in order to determine: His/hers need for aids; the exact nature of his/hers needs Financial aids that can be granted The evaluation is realised at home by a social worker A new frailty-screening instrument to accurately predicts the risk of frailty in older adults (FRAGIRE), based on expert consensus and psychometric analysis. Multidimensional analysis of living conditions and the environment surrounding the person Integration of a risk prevention dimension (GIR 5 and 6 as well as risks related to a breach in life) 7
A 3 level strategic orientation Prevention website INFORMATION AND ADVICE IN ORDER TO LIVE A SUCCESSFULL RETIREMENT SOCIAL SERVICE PREVENTION PROGRAMMES ALLOWING THE ELDERLY TO AGE WELL PERSONALISED SOCIAL ACTION PLANS (PAP) AIMED AT PRESERVING THE AUTONOMOUS WELL-BEING OF THE ELDERLY Booklets, web serie Self-evaluation of needs for prevention Common lectures and work shops Partner programmes on social participation and cross-generational cooperation Daily life and security Preservation of a social link Information and prevention advice Housing and living conditions 8
Level 1 : Information and advice 9
Level 2 : Collective prevention programs for healthy aging Objective : progressively industrialise collective actions for the entire territory Reinforcing their visibility and accompanying the retirees (in 2014: more than 190 000 participants) Financially contributing to services and ensuring a part of the costs for the retirees Accompanying the professionals training Collective actions include: Conferences, collective workshops based on national frames of references, approved by scientific experts, and organised through a Prevention Process Collective events focusing on social relationships 10
Level 2 - Collective prevention programs 11
Level 3 : Personalized Action Plan (PAP) : ensuring support to elderly people at home Objectif : personalized follow-up to manage "crisis episodes" Two-step system: Comprehensive evaluation of needs If agreed and validated by local pension fund, Personalized Action Plan implemented Key points: - Daily life and security - Support to socialization - Information on prevention - Housing environment Priority: take up temporary crises in a swift and accurate way Exemple: returning home after hospitalization 12
Level 3 - Personalised Action Plans 3 baskets of services are experimented since 2014 to improve adapted answers Frailty risk 1000 (12%) Frailty 2000 (55%) Increased frailty 3000 (33%) -Daily life help: 62% -Mobility aids: 37% -Assistance and security: 36% -Shopping aids: 21% -Well-being: 21% -Prevention workshops: 17% -Minor works: 14% -Home meal deliveries: 13% -Leisure aids: 3% 13
Future perspectives and ongoing work Since December 2015: new law of adapting society to the aging of the population Reinforcement of prevention policies: Reinforcement of assistance to fragile persons together with the CNAMTS Housing Coordination of partnerships Targeting of actions based on a frailty analysis Public authorities reflexion themes: Individual cross-referring of data within the Social security organisations Information and prevention related to the period between working life and retirement Industrialisation of collective actions Identification of frailty/frailties Coordination of actors 14