How to live old and better in Monaco
From 2025 to 2050, the senior population will explode. In Monaco, as elsewhere, the post-war baby boom gave way to a grandpa boom and the age pyramid was reversed. Some observers even speak of “gerontogrowth”.
“When we consider that 75 is the average age of dependency, we understand that the issue of care for the elderly is essential.explains Philippe Migliasso, administrator of the Gerontological Coordination Center of Monaco. It is also faced with the scourge represented by neurodegenerative diseases, which are expected to double in the coming years, in particular Alzheimer’s disease, which is the most representative. Faced with this, the more we will have anticipated, the more we will have acted on all the inherent factors, the less we will have the risk of a tipping point.”
This is the role of the CCGM, created in 2006, which this health executive coordinates alongside a multidisciplinary team made up in particular of a geriatrician, Dr Pascale Porasso, nurses and social workers.
A one-stop shop wanted by the Prince’s government in the heart of the city and easy to access. He is the privileged interlocutor of any elderly person living at home over the age of 60 with a loss of physical or cognitive autonomy, as well as caregivers.
It tends to facilitate their access to the information and aid available in principle. It also defines an individualized assistance plan corresponding to the identified needs of each person. Lastly, it has implemented a home care policy, bringing together all the public and private players who can intervene with the elderly.
“In 50 years, life expectancy has increased by 15 years thanks to health progress. The challenge of our society, and our mission at the CCGM, is to increase life expectancy in good health and at his home. We are in a support process to move towards aging well.”
“We are also at the side of family caregivers”
With the aging of the population, the category of “caregivers” appeared. “Everyday heroes”, non-professional people who come to the main aid, partially or totally, to an elderly person who is dependent on those around them, for the activities of daily life. From child, spouse or friend, they have suddenly switched to the world of caregivers. “We know how much the family caregiver is a key part of home care and in the case of a neurodegenerative disease. We also know that this role is a burden because these people are exhausted in the face of the task. It is therefore important to support them”, explains Philippe Migliasso.
“Unfortunately, they very rarely ask us, admits geriatrician Pascale Porasso. What they experience, however, has an impact on their life expectancy: on illnesses, depression, cancer and family caregivers who sometimes die even before the person they care for. »
“Advice, no judgment and a real listening”
Cathy was able to count recently on the support of the CCGM for her parents, including her dad who has Alzheimer’s disease. “Here I received a real listening, never judgment and real advice. It helped me more than the doctors”.
Support that takes nothing away from day-to-day management and anxiety for the future, “but which facilitates the process. I was surprised, for example, to discover thanks to them that my parents had the right to assistance for maintaining them at home. I am an only child and I really feel less alone with my aging parents. »
Philippe Migliasso, administrator of the CCGM: “Do not rush anything, advance step by step. And anticipate”
Concretely, what is the role of the Gerontological Coordination Center?
As its name suggests, we centralize medical and social information in one place. Whatever question a person over the age of 60 has at home or a carer, whether health or social, we are able either to answer it or to direct the person to the service concerned.
You have moved there on Avenue Princesse-Florestine. Was being in the heart of the city important?
Yes to reach as many people as possible. So that there is no obstacle for an elderly person who feels the need to come and push our door. We are in the heart of La Condamine, which is the district where the highest rate of elderly people live, which makes things easier. Not counting caregivers, we have an active file of 800 people out of the approximately 7,500 people who represent the over 60s residing in Monaco. There are still people who don’t know who we can help.
“There are still people
who does not know and whom we can help”
How is the contact made?
It is a process that must be voluntary, either on the part of the beneficiary or of a caregiver… Then a diagnosis is set up to identify the needs of the person by means of a Standardized Gerontological Assessment carried out by the medico-social teams at the person’s home. This assessment makes it possible to establish an appropriate protocol and a personalized assistance plan.
What was this assessment?
It allows a global approach of the person concerned with four components: the medical aspect, the psychological aspect, the social aspect and finally the environment. These four factors are precisely those which intervene in the loss of autonomy. With a whole series of questions we will determine his autonomy but also detect if there are cognitive disorders. We also use nutrition, which is one of the pillars of prevention. Then we recommend in place a support plan based on recommendations. Do not rush anything and go step by step. This is why we must be in anticipation.
Anticipate to postpone entry into Ehpad?
Yes. Anticipate to promote home care, but also to avoid neurodegenerative diseases. When we set up support, we also prevent social isolation, depression, malnutrition… These are factors that can aggravate the onset of a neurodegenerative disease such as Alzheimer’s.