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Disability and Ageing in the Canton of Basel-Stadt – Services and Services Development

Background and aims

Demographic changes apply also to people with disabilities. Today, people with disabilities live quite a bit longer than they did even 20 years ago. Many facilities for adults were established in the 1970s as socio-educational residential and work facilities. For them, the demographic change is a great challenge. It will occur more often that persons that have lived for many years in a residential group also enter retirement there and perhaps also die in the facility. With advancing age, chronic illness and multimorbidity are more frequent, care needs increase, and palliative care will be increasingly required.

The facilities for people with disabilities in the Canton of Basel-Stadt face the question as to whether they can themselves provide the residents with support, care and nursing up to the end of their lives, even if they have serious chronic degenerative diseases like multiple sclerosis or dementia. What is more, there is also uncertainty as to how many ageing persons who have previously lived on their own with or without assistance will also need to move to a facility for people with disabilities or a nursing home.  

This study aims to capture the existing situation with disability and ageing in the Canton of Basel-Stadt. The results will provide the bases for planning in this area in the Canton of Basel-Stadt.

Questions

The study will address the following questions:

  • What nursing and care services do persons with a lifelong disability in the Canton of Basel-Stadt need?
  • In the Canton of Basel-Stadt, what specific experience do the facilities for people with disabilities, the organizations for home nursing and care (Spitex), and the assisted living  facilities and nursing homes have with support, care and nursing of people with disabilities who are ageing, entering retirement and have changing care needs?
  • What models exist that endure high-quality nursing and care up to the end of life for people with lifelong disabilities in the Canton of Basel-Stadt? Can any examples of good practice be described?

Methods

The need for nursing and care services for people with lifelong disabilities in the Canton of Basel-Stadt will be determined through questionnaire surveys of directors of residential facilities for people with disabilities, directors of assisted living facilities and nursing homes, and family relatives as well as through guided interviews with persons with disabilities themselves.

Results

In residential facilities for adults with disabilities in the Canton of Basel-Stadt, 47.4% of the residents are older than age 50. Each year, 5% of the available places for adults with disabilities are filled by new residents who are older than 50. The need for care increases significantly for persons with a lifelong disability starting at age 65.

Many persons move to residential facilities from different forms of independent living or from living with relatives. An increasing need for care and nursing often leads to a move into an inpatient facility. But many facilities do not admit persons with aggression towards others, persons with complex or severe and multiple disabilities, or persons with addictive behaviour. This makes it very difficult to find a suitable residential facility for them.

Residential facilities reported that the greatest challenges in caring for persons with lifelong disabilities and with high care needs were communication, challenging behaviour, organization of daily life, and identifying pain and symptoms. The organizations rate the quality of their care and nursing of persons with disabilities as good-to-very good. This was largely confirmed by the persons themselves and by relatives. All those surveyed reported that the following were helpful: the presence of medical and social pedagogy specialists, good cooperation with relatives and guardians, clear arrangements for cooperation, day-structuring measures, and interdisciplinary cooperation.

Kontakt

Forschung und Entwicklung
Tel: +41 44 317 11 81

zfe[at]hfh.ch zfe