Old and sick: the double penalty Trivalle Christophe, L'Harmattan




"For now, writes Christopher Trivalle in his introduction, our society as a whole, including our politicians, believes that old people are good at throwing." In this short book, he denounces force significant examples of the French health policy committed for over 10 years and provides some ideas to change that.

"Our consumer society no longer repairs, no more back, she throws," said Christophe Trivalle. It is the same for the old, says that the geriatrician Hopital Paul Brousse Hospital (APHP). For him the fact of associating cessation of activity in old age led to a negative perception of older people. Those who no longer work or who are not considered easy-to senior-capable-of-use, including health spending (see the declaration of A. Minc on France Info), are costly to society. This is an age discrimination, says the author. See also our article.

To illustrate this practice to the work of rejection of the old, Christophe Trivalle said that in response to the law "Hospital, patients, health and Territories" (HPST)-l '-APHP to save farm services. As part of the consolidation of the hospital and Bicêtre Hospital Paul-Brousse, the first step was to close / transfer the geriatric ward of Bicetre.

While the need for appropriate structures will increase from 30 to 50% by 2025, we continue to close beds in long-term care. The author cited many examples in support.

At the hospital, business and pricing activity which according to the report of the UMP Flajolet, said Christophe Trivalle has exacerbated inequalities since the goal of profitability means to remove as soon as possible ( less than 40 days) sick, what will he of elderly patients with Alzheimer's disease whose length of stay is counted in months
For these patients also depending on whether you consider they are of psychiatry or neurology pricing ranges from 4800 to 7800 euros, he said.

The hospital is a hostile environment for the elderly indicates the author. They clutter. When permitted, often after long hours spent in the ER on stretchers and parked it in the best service unsuitable for their condition. "In the end many become dependent and never recover, but many patients to écèdent in very poor conditions." Christophe Trivalle refers in this respect to the lette February 7, 2009 Professor Pfitzenmeyer the President of the Republic denounced any "inhumanity" of the situation.

These statements are supported distressing complaints from families of elderly patients, volunteers and testimonies of caregivers, the economic adjustment variables, which express their shame. Their ratio is the lowest in Europe. It is in the long-term care that he was the highest, just where, since 2006, the number of beds is reduced drastically. Decision, however, slowed by the petition "worthy old" and the association of Dr. SOSLD Pradines in Albi.

The under-medicalization of nursing homes residential homes for the frail elderly, said the transfer of patients to ER. But the very name of the establishment is telling is the author, noting the role of physicians coordinator indquei "they have many responsibilities but little scope to apply them."

"But even if we tend to treat the sick and old dependents as waste, it is very profitable to build homes." "And the large private groups that own 35% of carrying capacity have understood."

To change this and that modern society no longer ruled over a quarter of its population, Christophe Trivalle suggest some ideas. General principles first, then proposals for the hospital, institutions, aid and finance. Among the general principles, there are particular: "A civic education from an early age on the wealth of older people."



Contents

Discussion of old age and geriatrics - Seniors also become old / Geriatrics: medicine of old
Alzheimer's disease: patients and families - Patients / Lyrics of patients / family or caregivers / A obstacle course / Home or institution?
The old and the hospital - The hospital business / pricing to the business / How to become bedridden and dependent in a few days? / Words of families / volunteers / Volunteer Lyrics
Caregivers - Fewer nurses and auxiliary nurses / caregivers Shame / The black sheep / caregivers Lyrics
Of long-term care and residential facilities for elderly dependents (EHPAD) / In the interest of long-term care / Back to the hospital / medical difficulties EHPAD / White gold
About Money - The cost / The long-term illness / How to spend less?
And ethics? - Sort sick as it sorts the waste / Euthanasia: the final solution?
Some thoughts in conclusion


Dr. Christopher TRIVALLE is a geriatrician at the Hospital Paul Brousse (AP-HP) since 1997. He is responsible for Alzheimer's unit and the unit
of Long-Term Care. He is also coordinator of the university degree for the Prevention of pathological aging, Faculty of Medicine Paris-Sud. Editor of the journal NPG (Neurology, Psychiatry, Geriatrics) he led the book preventive gerontology.
Elements of Prevention of pathological aging, the second edition appeared in 2009.

Old and sick: the double suffering!
Christopher Trivalle, 136 pages
L'Harmattan Edition Collection: The Gerontology in action
To order online Old and sick: the double suffering!