Ehpad: Denmark, this country where seniors are kings

The French scandal of abuse in French nursing homes has crossed borders to reach the ears of Bjarne Hastrup, in Denmark – an exemplary nation in terms of “old age” policy, to the point that it is nicknamed “the country where seniors are kings”. “Tell Emmanuel Macron to come see how we manage things in Scandinavia because, if I understood correctly, France needs a New Deal for the third age”, launches, in Copenhagen, the president of Aeldre Sagen (or DaneAge, in English), a powerful organization for the defense of the rights of the elderly created in 1986. And the dashing septuagenarian drives the point home: “It is obvious that France needs a new approach, new practices and new laws”, he adds, holding in his hand an article on the scandal of French retirement homes, unveiled by The Gravediggers (Fayard), the book of revelations signed by independent journalist Victor Castanet.

In this regard, Denmark has a lot to teach us since this country of 5.8 million inhabitants is the one which, in Europe, has set up the most efficient and best thought out system. And this largely thanks to the Aeldre Sagen association. Co-founded by Bjarne Hastrup, it has… 900,000 members, or 15% of the Danish population, and constantly puts pressure on the government and the deputies so that the laws passed in parliament improve the lot of the elderly. “We are the spokespersons of the old, explains this silver-haired man who speaks daily in the media and influences public policy.” He adds: “For almost forty years, we have been working to create a society in which everyone can live long and well; a society where we look at the individual rather than his age; where it is possible to live and thrive until the end of life; and where support and care are available to all who need it.” And it works !

The dream ? Yes, but a very concrete dream based on a few good practices based on common sense. To begin with, the small Scandinavian kingdom has implemented a policy for decades aimed at delaying the age of entry into retirement homes as late as possible. On the contrary, the elderly are kept at home for the longest time, where they benefit from assistance and care coordinated at the level of the municipalities and often implemented by small private structures acting in the field of “care”.

In thirty years, the number of people admitted to nursing homes has been divided by three. And today, residents of retirement homes (41,000 in all) are three times less numerous than people cared for at home (125,000). “Being at home is both more pleasant for the people concerned and five times less expensive for the community.” However, another danger awaits the elderly at home: isolation. This is why the municipal services, but also the 20,000 volunteers of Aeldre Sagen, regularly visit seniors in their homes.

“An advice to Macron: raise the retirement age, as in Denmark”

Everything is managed at the municipal level which is, according to Bjarne Hastrup, the most appropriate administrative level. “When an elderly person asks for help, he takes a capacity test, he says. If he is still able to cook on his own, then meals are not provided to him. Same thing for the household The services are à la carte and are based on the idea of ​​keeping people independent for as long as possible: this keeps them active and healthy and, therefore, reduces the cost of their care,” adds our septuagenarian activist, who advocates the creation of a Ministry of Solitude as there is in the United Kingdom. “Do you know that in England, he says, a general practitioner can prescribe home visits to the elderly rather than medication? Great!”

The welfare state, in Denmark as in other Scandinavian countries, is based on sound finances. “Of course, any social policy is expensive. But if I have any advice for Macron, it’s to do what we did in Denmark: raise the retirement age.” It went from 65 to 67 years ago ten years ago and will soon increase to 68 years, then to 70 years, in order to accompany the lengthening of life expectancy. “This allows the government to generate more tax revenue (collected from taxpayers who have remained in the labor market) while reducing the cost of financing pensions”, explains Hastrup, according to a liberal logic which guarantees the sustainability of the Scandinavian model. “Our country has thus been able to release 2 billion euros – a significant sum on the scale of Denmark – dedicated to the care of retirees“, welcomes Hastrup, whose organization also ensures that the level of all pensions is sufficient for everyone to live on.

In the same vein, the Nordic countries have long popularized the use of the “rullator”, in other words the walker – a Swedish invention dating back to 1978. Far from being considered an alienating object, this tool which, in its most complete version, including brakes, a basket and a stool to sit on, is seen as a liberating factor. In all the countries of the North, its generalization has increased the autonomy of the elderly, limited the number of falls and, therefore, that of fractures of the limbs – in other words, it has reduced the number (and the cost) of hospitalizations. This has resulted in the reduction of social security expenditure in each of the Scandinavian countries, whose accounts are balanced.

The presence of the elderly in public space is visible to the naked eye. Riding their rullators, or in their wheelchairs, they are much more numerous and independent than in France. Just as death is not hidden behind the high walls of cemeteries, old age is displayed without complex. The municipalities, and the Aeldre Sagen association, also organize meetings, activities and networking for seniors in order to maintain a social life. “In 2021, our locals organized more than 90,000 activities, from Nordic walking and pétanque to internet initiation, foreign languages, card games, dance lessons, etc.”

Particular attention is paid to the decoration

All this delays the moment of admission to a retirement home – the last stage of life where, in Denmark, the average length of residence is two and a half years. But here too, every effort is made to ensure that the stay takes place in dignity, even joy. It is not uncommon to see seniors put to work cooking, doing the dishes, their beds, sweeping the yard, gardening, etc. It is still and always the same idea: to maintain the capacities of autonomy. “In some cases, this is not possible, because some residents have dementia. However, I have in mind the example of a nursing home in Odense (north of the country), where a patient with dementia had to cook once a week. A real challenge that he took up, and which turned into a small success story in the establishment in question.

Some nursing homes have created “reminiscence workshops”, where participants recount their childhood memories. The interest? Intellectually stimulate patients, as this contributes to the improvement of the general state of health. Most establishments practice daily gymnastics (sitting) or implement sports rehabilitation workshops (also sitting), so that a simple fracture of the wrist or a minor domestic accident does not lead, for lack of appropriate care, to weakening widespread. Everything is led by caregivers whose training, in Denmark, lasts three years.

“The important thing is that they have fun”

In the land of design, particular attention is paid to decoration. Retirement homes strive to erase, as much as possible, all aspects that evoke a hospital environment. For twenty years, residents of retirement homes and their families have been encouraged to furnish their rooms in the most personal way possible with their furniture, books, paintings, photos and wardrobes, so that they really feel at home. Another, more recent trend: more and more bedrooms are being enlarged and transformed into two-room apartments, with a bedroom and a lounge area, not to mention a kitchenette, always with the same idea: to make the home straight the life.

“The right to happiness has no age”, proclaimed a few years ago Thyra Frank, a figure in Danish public life and director of a retirement home met by L’Express in her establishment, which looked like a banquet hall. . In the canteen of his Ehpad, we ate well and drank French wine, while listening to jazz at full throttle. Patients were even allowed to smoke Cuban cigars and drink whiskey! And everyone was happy. “The important thing is that they have fun,” she repeated tirelessly about the patients, some of whom had become friends. All smiles, she added: “We cannot impose living conditions on the elderly that we would not accept for ourselves.”