The cooperation between the Association of Providers of Social Services of the Czech Republic and the Swiss association CURAVIVA Schweiz began with a visit by representatives of members of the APSS ČR presidium in Switzerland in spring 2010. Since then, this international cooperation has developed not only within a project supported by the Partnership Fund of the Swiss-Czech Cooperation Programme and its activities, but also through concrete plans to continue this cooperation. International projects of this type always lead to mutual enrichment, to the creation of partial friendships and partnerships, and to reciprocal bilateral relationships. The professional study on long-term residential care in Switzerland represents only a fraction of the results of our Swiss-Czech cooperation. Ing. Jiří Horecký, MBA Contents

  1. Primary Pillars 1.1. Health insurance

1.2. Pension and survivor insurance 1.2.1. Old-age pension 1.2.2. Survivor’s pension

1.3. Disability insurance 1.3.1. Principles 1.3.2. Benefits 1.3.3. Calculation of benefit level (entitlement) 1.3.4. Compensation for helplessness

1.4. Supplemental benefits (EL)

  1. Care Need and Long-term Care in Homes

  2. Older Adults in Long-term Residential Care Facilities and Nursing Homes

  3. Differentiated Offerings for People Requiring Support

  4. Staff in Residential Care Facilities for Older Adults and Long-term Care 5.1. General indicators 5.2. Forecasts 5.3. Increasing scope of future nursing and care service needs 5.4. Reasons for future increases in nursing staff demand 5.5. Measures Leading to Reduced Demand or Prevention of Staff Shortages 5.5.1. Measures leading to lower demand for staff 5.5.2. Measures to retain staff 5.5.3. Measures for recruiting new workers

  5. Costs and Financing of Residential Care and Institutional Nursing 6.1. Background 6.2. New care funding 6.3. Total costs of long-term residential care in Switzerland

  6. Integrated Solutions 7.1. Integrated provision 7.2. Partner institutions 7.3. Services 7.4. Degree of formalization 7.4.1. Basic residential solution 7.4.2. Basic ambulatory solution 7.4.3. Comprehensive solutions 7.5. Outcome and outlook in the field of joint solutions

  7. Quality 8.1. Quality of life in homes 8.2. Principles of responsible conduct in homes and social institutions 8.3. Basic quality in homes for older adults and nursing homes

  8. Dementia 9.1. Introduction 9.2. Care and nursing procedures for dementia illnesses 9.3. Quality of life of people with dementia 9.4. The significance of the growing number of people with dementia for the state 9.4.1. High care demands 9.4.2. Specific challenges 9.4.3. Care and nursing of people with dementia in homes 9.4.4. Housing forms for people with dementia in Switzerland 9.4.5. Insights regarding the architecture and layout of dementia units in homes

  9. Palliative care 10.1. Introduction 10.2. Framework of the national palliative care strategy 10.3. Palliative care in the context of long-term care 10.3.1. Plurality of nursing situations 10.3.2. High, individual quality of life in its final phase 10.3.3. Short length of stay 10.4. Palliative services in long-term residential care 10.4.1. Symptom management 10.4.2. Coping with death and mortality 10.4.3. Overcoming difficult communication 10.4.4. Support in decision-making in difficult situations 10.4.5. Contact with family members 10.4.6. Inclusion of volunteers 10.4.7. Farewell culture 10.4.8. Cooperation within the palliative care network 10.5. Financial compensation 10.5.1. Basic provision 10.5.2. Partly specialized palliative care 10.6. Quality assurance in palliative care

  10. Outlook 11.1. New law on adult protection 11.1.1. Introduction 11.1.2. What will change with the introduction of the new law on adult protection? 11.1.3. What does the new law on adult protection mean for the state? 11.2. Diagnosis-related groups (DRG) in the home environment 11.2.1. Introduction 11.2.2. Possible consequences for nursing homes 11.2.3. General trends 11.2.4. Risks and opportunities for nursing homes 11.3. Housing forms and options

  11. Appendix: Spitex Schweiz 12.1. Overall description 12.2. Services 12.3. Staff 12.4. Female and male clients 12.5. Finance Charter of civil society

List of tables: Table 1: Indicators of nursing homes and homes for older adults, 2000 and 2008 Table 2: Number of beds in institutions for older adults and care-dependent persons by canton, 2000 and 2008 Table 3: Share of older population living in residential care and nursing facilities (in percentages), 1970 to 2000 Table 4: Accommodation places in homes for older adults and nursing homes by canton, 2009 Table 5: Number of short-term and long-term stays in days, 2011 Table 6: Days spent in homes for older adults and nursing homes (in mil.) Table 7: Cost overview by level of required care Table 8: Total costs in the field of long-term care, 2008 Table 9: Development of costs in nursing homes, 2006 to 2008, long-term care sector Table 10: Categorization of basic quality in homes for older adults and nursing homes Table 11: Number of people living with dementia by age group in Switzerland, 2010

List of charts: Chart 1: Highest shares of costs in basic insurance, 2009 (in percentages) Chart 2: Three pillars of the Swiss social system Chart 3: Percentage share of people living in collective households by age and sex, 1970 and 2000 Chart 4: Number of short-term and long-term stays in percentages, 2011 Chart 5: Medical personnel in homes for older adults and nursing homes by education level, whole of Switzerland, 2006 (in percentages) Chart 6: Share of employees in homes for older adults and nursing homes by education type, 2009 Chart 7: Medical personnel in homes for older adults and nursing homes by education level, whole of Switzerland, 2006 (in percentages) Chart 8: Estimated additional workforce needed in 2020 by education level (compared with 2006), whole of Switzerland, 2009 Chart 9: Total operating costs by main cost bearers, 2009, in CHF Chart 10: Most common diagnoses in institutionalized seniors Chart 11: Pyramid of the national strategy

Translations of German originals used in the publication: Stationäre Langzeitpfl ege in der Schweiz – Ein Bericht von CURAVIVA Schweiz, November 2011 Zum würdigen Umgang mit älteren Menschen – Charta der Zivilgesellschaft, CURAVIVA Schweiz, Fachbereich Alter (Entwicklung Dr. Heinz Rüegger, Institut Neumünster, Zürich), Mai 2010

First edition, Tábor 2012 Translation: theBESTtranslation, Mgr. Lucie Butcher Editorial work on translations: Zdeněk Kašpárek, Mgr. Magda Dohnalová Responsible editor: Zdeněk Kašpárek Graphic design, typesetting and printing: RUDI, a. s., Komenského 1839, 390 02 Tábor