Our Speakers

David developed a strong management team and staff who were encouraged to explore and grow, and empowered to work together to create and implement innovative programs and services. They developed successful care partnerships which provided the Elders living in the affordable housing setting with one of the strongest supportive service programs in the country. Over half of David's staff were certified Eden Associates. This is yet another sign of his commitment to the person-centered philosophy. David has been featured in the "Wisdom" section of the national magazine, "FutureAge", for making a difference through servant leadership.

As a managing partner of WD International, LLC, David is committed to the mentoring and coaching of individuals with a focus on their professional and personal development. David has a demonstrated ability to connect with people from diverse backgrounds and cultures.

He has presented various workshops for such organizations as The Eden Alternative International, Pioneer Network, LeadingAge (National), National Affordable Housing Management Association, LeadingAge Georgia, Georgia Gerontology Society, and South Carolina's State Conference on Aging. David has served on the Board and public policy committee of LeadingAge Georgia. On a national level, he has served on the LeadingAge National House of Delegates, Public Policy Congress, Nominations & Awards Committee and the LeadingAge National Ethics Commission. In addition, he has served on the national Board of Directors of CCAL – Advancing Person-Centered Living.

As part of his commitment to individual/staff development, David has served as guide/instructor for the LeadingAge Georgia Leadership Academy. On a national level, he has served as a Leader-in-Residence for the LeadingAge national Leadership Academy, where he shared his experience and advice to emerging leaders from a variety of organizations from across the U.S.

Over the course of his career, David has held the position of V.P. of Members Services for LeadingAge Georgia, Program Analyst for the Office of Inspector General for Health and Human Services, and various positions with the IBM Corporation. His last position with IBM was as Central Operations Team Leader for Latin America.

David holds a Bachelor of Arts in Spanish/Business Administration and a Master of Public Administration (MPA) with a concentration in nonprofit management. His other credentials include Certified Aging Services Professional (CASP), Certified Professional of Occupancy (CPO), Certified Eden Alternative Associate, and Certified Eden Educator. Most recently, David completed Dispute Mediation training and is registered with the Georgia Office of Dispute Resolution (GODR). He is fluent in both written and spoken Spanish.

Akhmeteli Ramaz Otarovich was awarded with a Medal  of "Honor and Benefit" and "Medal of the Russian Red Cross."
The topic of the report "Challenges of population aging and answers to them: the Russian perview field".
Theses:

• Demographic data
• Understanding call options
• Practical measures
• Methodological failure and  the European context
• Development activity

Topic of report

Aspects of long-term care and factors determining the loss of autonomy in older adults in Russia

Sharashkina NV, Merkusheva LI, Runikhina NK.
Russian Gerontology Clinical Research Center, Pirogov Russian National Research Medical University of   Ministry of Healthcare  of the Russian Federation, Moscow,Russia

Background: Since chronic diseases potentiate the adverse effects of each other, their effects may eventually lead to new clinical phenotypes, increasing susceptibility to pathology and loss of autonomy. The complexity of the assessment and the lack of clear criteria for comorbidity make it one of the main problems for clinicians and researchers
Purpose: The purpose of our study was to determine the prognostic significance of the main geriatric syndromes and age-related diseases for long-term care. 
Methods: 5678 patients aged 60 years and older (mean age 71 ± 0.1 years, 72.3% women and 27.7% men) were included in the prospective study (3-years follow up). We estimated the presence of any chronic diseases and geriatric syndromes. To identify the main geriatric syndromes, we used the questionnaire validated in Russia. Primary end-points were all-cause mortality, and Kaplan-Meier analysis was applied to evaluate 3-years total mortality.
Results: During 3-year follow-up, 1332 (23.5%) patients developed functional deficits: mobility and functional activity decreased; as a result, patients passed under long-term care at home. Among age-related diseases which determined the loss of autonomy chronic obstructive pulmonary disease (COPD) and myocardial infarction (MI) were noted significantly (p< 0.05). While diabetes mellitus and smoking were found as independent predictors of 3-years mortality. Patient with a history of weight loss falls, depressed mood and cognitive impairment more often end up in "low mobility" group at the end of evaluation compared to the main group (p < 0.05). The number of patients with frailty syndrome among patients who have transferred to a "low mobility" group was almost twice higher than in the main group, 42% and 26%, respectively (p <0.0001). 
Conclusions: COPD and MI are factors determining the loss of autonomy in older adults patients in Russia. Diabetes mellitus and smoking are independent predictors of 3-years total mortality in these pts. Among geriatric syndromes: malnutrition, falls, depression and cognitive impairments were noted significantly.  

Curriculum vitae

Aurora Carmen Bărbat, M.D. University for Medicine and Pharmacy "Victor Babes", Timişoara, Romania / Dipl. in Caritas Science and Christian Social Work (Albert Ludwig-University, Freiburg i. Br., Germany), works as senior lecturer at West University of Timisoara, Faculty for Sociology and Psychology, Social Work Department. Has published 3 books, ca. 50 articles & chapter books in scientific (inter)national volumes and journals, covering areas such as coping with illness, social work, addictions, spirituality as coping. Has also a lot of participations at national and international socio-medical and psycho-spiritual trainings, research programs and conferences, has organized scientific events, being member of Romanian and international scientific organizations including  BCE (Association of Bioethicist in Central Europe), ESCT (European Society for Catholic Theology), Institute for Social and Political Research, Romania, CONEM (Romania Biotechnology and Environmental Sciences Group), and Romanian Association for Gemotherapy and Homeopathy.
Email:
carmen.barbat@gmail.com
aurora.barbat@e-uvt.ro

Ars moriendi: end-of-life challenges and the request for communitarian therapy

The study attempts to highlight the bond between natural sciences such as epigenetics and humanities when analyzing the complexity of end-of-life (EOL) challenges. The main aim of the paper is to underline that combining the collective wisdom of science and building solid transdisciplinar therapeutical teams, is actually the key toward a fully understanding of EOL challenges. The qualitative method used for this task is based on a thematic synthesis using an body of (electronic) researches.
We conclude that:

• keeping high standards in educational health implies a sine qua non balance between personal responsibility during the lifetime and the societal therapeutically response;
• the EOL education is based on certain (forgotten?) human needs such as genuine and appropriate dialogue with care specialists, truth with regard to the principle of subsidiarity of  therapeutically teams and religious freedom.

Key words: end-of-life, coping, communitarian therapy, holistic approach.

Paul-Teodor Hărăguș este conferențiar universitar la Departamentul de Asistență Socială a Facultății de Sociologie și Asistență Socială. Este sociolog (cu studii de doctorat încheiate în 2008, în Sociologie, cu titlul ”Folosirea timpului și distribuția sarcinilor domestice în familia din România”). Este interesat de teme de cercetare din domeniul studiilor familiei din România, populație, politici sociale și probleme ale tinerilor. Cu o experiență de peste 18 ani în activitatea didactică predă cursuri de Introducere în Sociologie, Sociologia Copilăriei, Evaluarea Politicilor și Programelor Sociale, Statistică Avansată, Proiectarea și Analiza Bazelor de Date Sociale.

The effect of economic wellbeing on the exchange of intergenerational support

Haragus Paul Teodor; Haragus Mihaela

Family solidarity has distinct motivations and manifestations in different social strata and the socioeconomic status influences the intensity of intergenerational solidarity. From the reciprocity and altruism approaches, working class families are more involved in intergenerational exchanges than the upper-class families. We can approach downward intergenerational solidarity from the perspective of status reproduction: parents invest in their children through intergenerational transfers to avoid their downward social mobility. Consequently, working class parents offer less financial support to their adult children, compared with upper class parents. Most approaches (altruism, reciprocity, or status reproduction) suggest more instrumental support in families with lower socioeconomic status.

We have followed the link between offering financial, instrumental, and emotional support, both from the parents to their adult children and vice versa, and the level of economic wellbeing of the provider. Our intention was to investigate how social class and mobility are constructed through intergenerational relations.

To fulfil our intention, we used the data from Generations and Gender Programme (GGP) Wave1, for two eastern-European countries (Bulgaria and Romania), focusing on three forms of support provided to family members: financial, emotional and instrumental. We have constructed a synthetic index of material wellbeing, using several items from the GGS questionnaire, combining income and expenditure approach: total household income, two indicators of the ability of household to make its ends meet, one indicator that captures evaluation of the household ability to overcome financial difficulties and one indicator regarding the satisfaction with the housing.

For the support from parents to their adult children we have selected from the original samples those respondents that have at least one child over 18 years, while for the support from adult children to their parents we have selected those respondents that have at least one parent alive.

Analysis of data for Romania and Bulgaria shows that intergenerational solidarity seems to function distinctly in different social strata. We have shown that a high level of material wellbeing (coupled with a high level of education) increase the odds of providing financial support to an adult child, both in Romania and Bulgaria, but for the emotional support the effect was found only in Romania. Regarding instrumental support offered to adult children, we found a statistically significant effect only in Bulgaria: those with a higher level of material wellbeing are less likely to offer instrumental support to their descendants. This confirms the idea that persons with a high socioeconomic status (linked with high economic wellbeing) offer less downward intergenerational instrumental support; this appears to be a form of support for lower social classes. Same effects were found regarding upward intergenerational transfers: a high level of material wellbeing is associated with higher odds of providing financial and emotional support to their parents and with lower odds of providing instrumental support (only in Bulgaria). We have found that both downward and upward financial support is more intense in case of persons with higher economic wellbeing.

Este dezvoltarea serviciilor de îngrijire la domiciliu în mediul rural fezabilă? Studiu de caz judeţul Cluj

Adina Rebeleanu, Universitatea Babeş-Bolyai, Facultatea de Sociologie şi Asistenţă Socială

Paula Nicoară, Agenţia Judeţeană pentru Plăţi şi Inspecţie Socială, Cluj

Responsabilitatea APL pentru organizarea serviciilor sociale destinate persoanelor vârstnice este consacrată legal prin legea cadru a asistenţei sociale. Disparitatea urban - rural în acoperirea cu personal de specialitate, organizarea spas-urilor, existenţa serviciilor destinate vârstnicilor este o realitate.

Pentru a veni în întâmpinarea nevoilor de îngrijire la domiciliu a persoanelor vârstnice, în 2018 ministerul de resort a lansat un program de interes naţional al cărui scop declarat este creşterea calităţii vieţii persoanelor vârstnice dependente prin dezvoltarea serviciilor publice comunitare de îngrijire la domiciliu.

Prezentul demers analitic vizează realizarea unei radiografii la nivelul unităţilor administrativ teritoriale din mediul rural, Judeţul Cluj. Sunt analizate modul de organizare/reorganizare a serviciilor publice de asistenţă socială conform prevederilor legale, calificarea personalului angajat şi modalitatea în care la nivelul acestor comunităţi rurale se gestionează problematica persoanei vârstnice dependente.

Ne situăm în logica abordării calitative din perspectiova analizei critice. Utilizăm analiza de documente legislative ce pregătesc demersul implementării măsurilor preconizate prin PIN, analiza bazelor de date existente la nivel local cu privire la numărul persoanelor vârstnice, evaluarea acestora, existenţa personalului de specialitate, organizarea/absenţa SPAS-urilor în unităţile admnistrativ teritoriale ale judeţului, intenţii de accesare a PIN în vederea organizării serviciilor comunitare la domiciliu, obstacole în calea înfiinţării acestora.

Sharing experience of the main problems of the elderly care system in Germany with proposal of further possible development

Multidisciplinarity and Longevity

Physiological, psychological, social and cultural approach shows a heterogeneous old population.
Ageing involves an individual functional decline modeling stress adjustment and “frailty” is addressed to older persons with high vulnerability. A research concerning frailty as a physical, psychological, cognitive, functional, social and environmental interaction result is essential for a better understanding Ageing. 
Although frailty of older people can be associated with less capacity in normal systems, clinic conditions and geriatric syndromes are very complex.
Comorbidity, disability and frailty may be apart or simultaneous entities to older person and, a multidimensional evaluation or a comprehensive geriatric assessment directing a decision making in geriatrics is crucial.  There is a geriatric challenge for this complexity including many medical and social interaction concerns.
Geriatric services are able to respond to this complexity by assessment approaching, multidisciplinary team, and multidimensional interventions.
There is no always clear how specific interventions or care approaches “make the difference” for a patient or a group. Clinic complexity and comorbidity make the older person to be excluded from many clinic trials.
Although is seen as common, frailty at longeviv people should be carefully approached. A multidisciplinary approach takes us out of the routine when decreased functional capacities are even within normality.  
To stimulate restant capacities should be the main care plan objectiv even for a longevity person; the premise of personalised, specialised care with impact on the longevity is created.
Frailty prevention with its impact is a challenge for an Ageing society and many barrieres we expect to overcome.

Unităţile de asistenţă medico-sociale (U.A.M.S.) au apărut ca răspuns la nevoile medicale, sociale şi de îngrijire ale unui segment populațional în continuă creștere. Viața socială din cadrul U.A.M.S. are o dimensiune colectivă explicită. Ea presupune existența unei largi diversități relaționale deoarece implică o mare varietate de interacțiuni între diferiți actori. Creșterea calității vieții persoanelor instiuționalizate în cadrul acestor unități este dată de ingredientele unei vieți bune, având în permanență în centrul atenției persoana instituționalizată, cu nevoile și așteptările sale, și cu modul în care aceasta poate să–și depășească propria condiție.

Studiu de față își propune să evidențieze câteva strategii care să permită o sporire a calității vieții persoanelor instituționalizate, prin intervenții care operează la mai multe niveluri. Semnificația rezultatelor si implicațiile pentru reconceptualizarea organizării și funcționării UAMS vor fi analizate integrativ în vederea formulării unor soluții eficiente.

THINKING THE NURSING HOME OUTDOOR SPACE AS THERAPEUTICAL GARDEN FOR ELDERLY WITH DEMENTIA. INTERDISCIPLINARY DESIGN PRINCIPLES

GÂNDIND CURTEA CĂMINULUI CA GRĂDINĂ TERAPEUTICĂ PENTRU VÂRSTNICI CU DEMENȚĂ. PRINCIPII INTERDISCIPLINARE DE DESIGN
Zamfir (Grigorescu) Mihaela¹, Zamfir Mihai V², Moglan Maria³

¹Lecturer PhD Arch., Department "Synthesis of Architectural Design", Faculty of Architecture, "Ion Mincu" University of Architecture and Urbanism; MMZ – Individual Architecture Studio- Bucharest,  Romania;
²Assist. Prof. PhD Md. Geriatrics-Gerontology, Psychiatry, Physiology II-Neuroscience Division, Faculty of Medicine, "Carol Davila" University of Medicine and Pharmacy; Medicover, Bucharest, Romania;
³Psych. PhD, Vice-President of Romanian Alzheimer Society, Bucharest, Romania.

Correspondent author: Zamfir (Grigorescu) Mihaela, e-mail: mmg_architecturestudio@yahoo.com

BACKGROUND: The environment, both built and natural, plays a significant role in increasing the quality of life and well-being of institutionalized older persons. Although in the economy of building or adapting a nursing home in urban areas in Romania, the outdoor space is often very small - the land is expensive and the ground percentage of occupation is high - spending time outside and doing outdoor activities for the elderly is essential. In particular, in the case of elderly people with dementia, outdoor spaces are recommended to be carrefully designed to help decrease agitation and wandering.
MATERIALS AND METHODS: The institutionalized elderly with neurocognitive disorders present four manifestations that may be related to the environment: spatial disorientation, locomotor disability, mood disorders and perception disorder. The present research investigates different types of outdoor spaces of different scales in contemporary nursing homes insisting on the relation indoor-outdoor, accessibility, shapes, different types of vegetation, colors, materials, safety, exterior furniture, lighting, the interaction ability of the space. Case studies are used.
RESULTS: Regardless of the exterior space scale, a garden or a courtyard of a nursing home can achieve therapeutic valences by using loop circulation, different types of vegetation, from trees to flowering plants. Some gardens are designed as contemplative spaces, other combine various experiences, including gardening as dementia therapy. Architectural tools - light, shape, color, texture, sound are used both independent and synergistic. It is found that the form is more recognizable than the color and the color more recognizable than the function of a space.
CONCLUSIONS: Both in the design of a new nursing home and in the modernization of an existing one, the outdoor space plays an important role in improving the well-being and increasing the quality of life of institutionalized elderly people. Treating outdoor space as a space with therapeutic valences has beneficial effects, improving behavioral and memory disorders of the elderly with dementia. An interdisciplinary approach is needed for the outdoor space to function as a therapeutic space.

Professor Daniela Soitu have training-research experiences, as coordinator and expert in many international and national research and development projects; she is author of publications in areas of wellbeing, health and education, gerontology, social services for vulnerable groups.

She has postdoctoral studies in Social and health care policies for vulnerable persons - ethics of health care policies, social determinants of health. The research of vulnerabilities and risks in accessing the social and health care services has been published in peer reviewed journals.

The doctoral research underlined the social perceptions of institutionalised and not institutionalised elderly on their needs and opportunities of fulfilments. Relations with aims, resources, social services market and social policies had been suggested and directly contributed to debates on social care in Romania.

As professor, besides preparing courses, teaching and evaluation of students, and coordinating their final papers and dissertations, she is member in the final evaluation commissions of doctoral thesis and perform research activities in domains like: social work system, social care for the elderly, counselling in social work, mediation and other alternative disputes resolutions, counselling for personal development, applied social work, NGO`s and civil society cooperation.
She is manager (representing UAIC, as a partner) and manager for certificate modification in the project: Modification of the educational module - EDE certificate for providers of long-term care for seniors. (Coordinator: ASSP, Czech Republic. Partners: UAIC – Alexandru Ioan Cuza University of Iaşi (Romania); Akademie für Sozialmanagement (Austria); Bundesverband der Alten- und Pflegeheime Österreichs "Lebenswelt Heim" (Austria); Rath Wolfgang Consulting e.U. (Austria); IBG - Institut für Bildung im Gesundheitsdienst GmbH (Austria); E.D.E. – European Association for Directors and Providers of Long-Term Care Services for the Elderly  (Curently: European Ageing Network) (Luxemburg)). Erasmus +; Key Action 2 - Cooperation for Innovation and the Exchange of Good Practices; KA202 - Strategic Partnerships for vocational education and training. Project number 2018-1-CZ01-KA202-048076.
Professor Soitu is member in the UAIC team of the project: Study on elaboration of conceptual and methodological framework for analysis and interpretation of long-term care: conceptual definitions, ways of analysis and interpretation. (Contract PSCD MMJS nr. 3677/28.09.2018)
She represented the university, in many European projects:  ERASMUS-ENW –EUHAP - 14PS0003 (2014-1-BE01-KA203-000910) European Humanitarian Action Partnership: ERASMUS-ENW –EUHAP (http://euhap.eu/); EUPRHA - European Universities on Professionalization on Humanitarian Action; proiect 518362-LLP-1-2011-1-ES-ERASMUS-ENW.
ProfesorDaniela Şoitudesigned and managed the CompEd project: Comparing collaboration in education and practice in the health and welfare fields. Romania and Norway, SEE Small size bilateral cooperation projects (EEA Financial Mechanism 2009-2014) (http://www.fssp.uaic.ro/comped/).
She is National coordinator of Research Network COST IS 1409: Gender and health impacts of policies extending working life in western countries – and Management Committee member of European Concerted Research Action (https://www.cost.eu/COST_Actions/isch/IS1409)
At the faculty level, she coordinates mobility studies and teaching in Erasmus + and EAA frameworks.

Latest publications:

Social worker from passion and by profession, Anca graduated from the Faculty of Philosophy and Social-Political Sciences of the Alexandru Ioan Cuza University of Iasi. With more than 10 years of experience in implementing and developing the socio-medical programs for the elderly she is currently coordinating the "Home Care Services" Program at the Caritas Diocese of Iaşi. The Program consists of a network of 9 Home Care Centers through which socio-medical services are provided to the seniors from more than 30 different locations in Moldova's counties.
Anca has transposed her constant committment and devotion for the development of socio-medical services, in the creation of numerous local, national and European funding projects, in order to ensure the sustainability of the Caritas Diocese of Iaşi’s social programs.
Since 2014, she has been the manager of three European Strategic Projects and she is currently succesfully implementing the "A.M.I.C. - Multiple and Integrated Actions for the Community " project (SMIS Code 115048). The A.M.I.C. project’s aim is to reduce the number of people at risk of poverty or social exclusion by developing and implementing integrated measures: providing social services (education, counseling, mediation, training), medical (dental services, ophthalmological services) and social-medical services (home care services) for 560 marginalized (non-Roma) persons from the Preuteşti commune, Suceava County.

Organizational features of the psychogeriatric services in NHS England

This talk will illustrate the relevance of the clinical networks underlying the psychogeriatric services in NHS England, outlining the central role of the multidisciplinary team in the case management. Additionally, making reference to the best interest meetings, the social worker will be presented as the main partner of the psychiatric team in improving the quality of life of the elderly with mental health problems by playing an active role in ensuring a safe environment for these ones. Moreover, the current talk will highlight the importance of the psychosocial interventions, including the support groups, and it will also clarify the contribution of the occupational therapist to the care of the elderly with psychiatric disorders.