June 18 2010International Conference

of Integrated Care

Finland

Hetti Willemse - Publicarea

Hetti WillemseSocial geographer/plannerFounder and owner consultancy firm Publicarea (2004)Experienced in:

Policy making Government Care

Management supervision AdviserPublicistMediator

Former city councillor of AmsterdamStrategy management Foundation ILC Zorg voor Later

Global ageing: Europe en USRising life expentancy -> increase of chronic

illnesses and multi-morbidity

Universal consequences:Higher need for careShortage of personnelHigher expenses

Seniors wishes: changing level of wealth and education

Statistics NetherlandsCentral Bureau of Statistics; age 65 and over

2007 2.4 million

2038 4.3 million

More vital seniors: emancipation and social activity- Seniors improved purchasing power

Rise of costs- A wealthier society demands more care

Technological developments-New methods of care: e-health & telediagnoses

Seniors wishesFamiliar environment substituted by nursing

homeSeniors wish to continue their life in a safe

and familiar way they choose (= demand)Existing gap demand-supplyNext generation of seniors:

babybomers/flower power

Nursing homes in the NetherlandsAll-inclusive packageSmall-scale homes versus homes at large

extentFocussed on the insidePersonnel:

Mainly focussed on care and organisationMinimal time for daily contact with residents

Loved ones of resident on side path

Nursing homes future-proof?

Examples of Nursing homes

On the outlook for respectful careExtend your life with days or add life to your days?

Feeling at home is one of the most important aspects of a

health care institution: quality of life

Daily activities: next to the hours filled with caring and sleeping, there are plenty of hours left….

What makes people feel at home in an institution?

Resident and his social networkRole of loved ones? - past, present and future of resident - emotional connectionCurrent position loved ones - Powerlessness - DependencyConcept of Mantelzorger

Starting point: Partnership between loved ones and health care institution

Cooperation based on reciprocityin favor of resident

Loved ones Personnel

Emotional dimension Functional dimension

Book Being at Home

14 small portraits of loved ones and personnel Display of commitment and communication of

involved

Loved ones struggle with their possibilities to participate in providing care

‘Hold on to your Loved Ones’Staged pilot- projectFase 11.Conversation with initiator2.Conversation with loved one3.Orientation of organization and specifics of location4.Agreement on realization Fase 2 and invitations Fase 2

Fase 25.Meeting with staff of different levels of organization6.Meeting with loved ones7.Combined meeting organization and loved ones, goal is to come to an agreement on steps of action8.Final report: an Agenda of Respectful Care

“Throughout organization. Meeting with loved ones, carers and direction.”

‘Feeling at Home’ (2009)Practical guide written for loved ones and

institution as partners to accomplish respectful care

Based on: ‘Hold on to your loved ones’ pilot projectField research

Provides insight and tips describing various stages: Stage prior to admission Admission and the first few weeks The residence Connect with family members after residence period Role of supporting functions

Examples of Tips (1)Tip: Businesscard

Tip: List of usefull websites

Examples of Tips (2)

Tip: Get to know your residents:

Profile of Ms. Pieterse

Examples of Tips (3)Tip: Create a family tree or social network poster of every resident

Examples of Tips (4)Tip: Personal placemat and logbook

Examples of Tips (5)

Tip: Cd

Tip:What to wear?

Tip: Traincompartment with moving landscapes

Role of supporting functions

ArchitectureNeighbourhood surrounding nursing home

Interior design and the public areaPersonnel en organizationICTGeneral and technical serviceCommunication

Observations architecture and neighbourhoodProfessionalize construction of nursing homesOffices personnel: Ground floor nursing home versus

non-residential Parkinglots determine frontal view of homeUnattractive instead of attractive entranceLow level ceilingsUnefficient routes inside the nursing homeUnclear or absent informational and directional signsLack of connection to surrounding neighbourhood

Quickscan building and neighbourhood:

Checklist provided in ‘Feeling at Home’

Potention: -> 3 options for architecture and environment

For caring Efficient interior logistics facilitate efficient time

management -> more time for personal careOn degree of recreation, enticement and activities

Opening the nursing home for facilities and activities for the neighbourhood facilitates visiting the nursing home and creates recreation and enticement for residents.

In finance Small merchants and clubs may be willing to hire a

section or room of the building which creates income out of rent. Sharing a location even offers possibilities for shared financing.

CommunicationTop PriorityWebsiteNews letterIntranetIntroduction DVD (new house)WifiHyvesInformative roomfolder (like in hotels)

Important highlightsEvery half an hour a resident is satisfied relieves caring

personnel.Financial ‘significance’ of Feeling at Home -> financial

result of implementation of tipsGrand design versus relative small but effective

improvements at work. Try to think small-scale and personal!

Research Project offered to ZonMW in cooperation with union Elderly

Care Amsterdam Partners: Academic hospital, Nursing home organisations

and Publicarea

Looking forwardEngage in partnerships with residents and

neighbourhood.Communication!Facilitate social cohesionQuality and effectiveness

Most importantKeep life respectful: residents should ‘feel at home’

in an institutionBenefit organization and personnel: an improving

atmosphere at work

Innovation and transfer

Questions?

Situation in other countriesRecognizable?Relevant and applicable? Similar experiences?

More informationFlyerWebsite: www.publicarea.nl Contact:

PublicareaAmsterdam, NetherlandsTel. 0031-206386425Email: hettiwillemse@publicarea.nl