1. SPF SANTE PUBLIQUE, SECURITE DE LA CHAINE ALIMENTAIRE ET ENVIRONNEMENT 1 USA – Be : Same problems, different solutions The growth of aging populations : a challenge for health systems Caring for the elderly : Elements of Policy making in Belgium Muriel QUINET coordinatrice de la cellule soins aux personnes âgées et soins chroniques du SPF Santé Publique.

2. SPF SANTE PUBLIQUE, SECURITE DE LA CHAINE ALIMENTAIRE ET ENVIRONNEMENT 2 Strategic approaches to meet and manage the future challenges 1. The protocol 3 2. The geriatric care programme 3. The RAI -tool

3. SPF SANTE PUBLIQUE, SECURITE DE LA CHAINE ALIMENTAIRE ET ENVIRONNEMENT 3 1. The Protocol 3 a joint policy statement between Federal, Communities and Regions Defining a number of common goals concerning the care for ederly people 174 million budget spread over a six-years period Communities and Regions are free to make use of this budget according to their choices BUT 20% of this budget should imperatively be used to enable care- depending elderly people to stay at home as long as possible

4. SPF SANTE PUBLIQUE, SECURITE DE LA CHAINE ALIMENTAIRE ET ENVIRONNEMENT 4 2. Geriatric care programme Elderly people, and very old people in particular, require a very specialized, multidisciplinary and intensive approach. A royal decree is in preparation. 5 elements : the geriatric service (G index), the geriatric consultation, the geriatric day hospital the internal liaison function the external liaison function. The geriatric care programme will be implemented gradually

5. SPF SANTE PUBLIQUE, SECURITE DE LA CHAINE ALIMENTAIRE ET ENVIRONNEMENT 5 3. RAI-tool To stimulate the collaboration and coordination of the different actors in this new holistic and integrated approach for geriatric care. To allow an adequate exchange of information between the concerned actors To provide a support for the evaluation and organisation of appropriate care planning for the patients.

6. SPF SANTE PUBLIQUE, SECURITE DE LA CHAINE ALIMENTAIRE ET ENVIRONNEMENT 6 3. RAI-tool RAI/MDS - tool has different versions : home-care, acute care and long term-care, but has always a common basis. before a wide implementation asked for a further evaluation of the following items : - budgetary needs - level of acceptance of the tool by the users - facilitators and constraints for implementation - possible objections from the field regarding the changes this tool provokes - adaptation of the tool to the Belgian context - implementation of a helpdesk

7. SPF SANTE PUBLIQUE, SECURITE DE LA CHAINE ALIMENTAIRE ET ENVIRONNEMENT 7 Conclusions The organisation of care and service, and all the treatments, health care and care support should all function in an integrated network. The different treatment possibilities for dependent people should be seen as a continuum. This implies an adaptation of the traditional financing mechanisms and the development of the tools allowing a rapid exchange of information A coherent policy can only be realised through a broad dialogue with the communities and the regions