ocial support and long term care for older people – Ghenta

The MOPACT Coordination Team The University of Sheffield

Department of Sociological Studies Northumberland Road

Sheffield, S10 2TU, UK T: +44 (0)114 222 6458 F: +44 (0)114 276 8125

E: [email protected]

www.mopact.group.shef.ac.uk

This project has received funding from the European Union’s Seventh Framework Programme for research, technological development and demonstration under grant agreement no 320333

Social Support and Long-term Care for Older People –Potentials for Social Innovation and Active Ageing

The CARER+ Final Conference Paris27 March 2015


• Objectives of research• Background and definitions• The status of social support and long-term

care for older people in different ‘care regimes’• Potential and innovative practice• Future research

Contents


• To analyse the status quo of active ageing strategies in long-term care

• To identify potentials for, drivers of and barriers to social innovation in long-term care– quantitative: financial incentives– qualitative: case studies of innovative practices

• To provide indicators for active ageing scenarios

Objectives


Active Ageing as the process of optimising opportunities for health, participation and security in order to enhance quality of life as people age. It allows people to realise their potential for wellbeing throughout their lives and to participate in society according to their needs, desires and capabilities, while providing them with adequate protection, security and care when they need assistance” (WHO, 2002: 12).

Long-term care (LTC) as a system at the interface between health and social care, and between formal and informal care, is only just emerging as a specific area of social protection and support (Leichsenring et al., 2013).

Active Ageing and LTC – the often omitted part of ‘Active Ageing’


Informal carers:family, friends …

Social caresystemServicesResidential careProvidersProfessionsMethodsLegal FrameworkPolicies

The health-social care divide

Long-term carelinked-in, co-ordinated,

integrated?

Users

Identity - Policies - Structures - Functions - Processes -

Resources/FundingVolunteers

The formal – informal divide

Health caresystem

Hospitals - ServicesProviders - Professions

GPs - MethodsLegal Framework

Policies

Social support and long-term care

Source: http://interlinks.euro.centre.org; Leichsenring et al. (2013)


Linking active ageing & long-term care

• A large number of older people are already very active in caring for a partner with LTC needs.

• Access to prevention, rehabilitation and other formal care services is unevenly distributed among European countries.

• Active ageing in the context of LTC is highly dependent on social investment strategies across a range of policy fields.


‘Social Innovation’ in the context of long-term care• They are oriented towards exceptional societal challenges/social issues.• They suggest new solutions in the respective societal, cultural and economic context.• They create new patterns of social practices to overcome shortcomings of traditional

arrangements.• They tend to overcome the traditional dichotomy between technological and social

innovations.• They promote the integration and/or collaboration of heterogeneous stakeholders that

have hitherto not co-operated.• They include reflective and multidisciplinary approaches towards the key goal of societal

usefulness.• They create structures and processes that are sustainable and realise new growth

potentials in terms of regular employment.• It involves end-users as co-producers of services or products. (cf. Heinze and Naegele,

2012)


Long-term carepolicies and practice in

national contexts

Social Innovation

new ideas,social ties and

collaborations

Active ageingrealising potential for well-being

Testing potential of active ageing strategies in social innovation


A typology of European long-term care regimes • Governance• Needs and coverage• Agency

Preliminary clusters of care regimes:

• Care mix (Western): AT, DE, FR, UK• Universal (Nordic): DK, FI, SE, NL• Family-based (Mediterranean): EL, ES, IT, PT• Transition (Central and East Europe, New Member

States): BG, CZ, EE, HU, LT, LV, SK, RO


Huge differences in establishing long-term care regimes

Source: Eurostat, [hlth_sha_ltc]


Potential and innovative practiceThe methodological process has three different steps:

1. Literature review and social innovation initiatives overview:

• A literature review was carried out in order to provide an overview of country-specific, regional and international sources contributing to the discourse on the key factors, drivers and barriers in social innovation in long-term care.

• 18 innovative initiatives representing 12 EU countries were analyzed individually to determine the drivers of and barriers to its development. In a later stage, in the course of a collaborative workshop in which the work package partners participated, these barriers and drivers were grouped into key themes/factors.

Key-factors in Social Innovation


Key factors Drivers Barriers Coordination/integration

Uses integrated care model Structural fragmentation of LTC system; Lack of coordination between partners

Design Evaluation is incorporated into design; Efficient use of ICT; Universal access; Expert input and feedback; Successful dissemination; Quality management system is incorporated; Rigorous evidence base

Lack of underlying incentive structure; Difficulties recruiting participants; Difficulties evaluating the initiative; Design is ill-suited to meet needs

Framework/structural conditions

Legislative foundation/recognition of services provided; Draws on existing resources (e.g. human resources, existing built infrastructure); Autonomy of affiliate organizations;

Unfavorable framework/structural conditions; Lack of harmonised data; Ill-defined identity of the initiative (e.g. legal status); Disinterest on the part of policymakers

Funding Affordability for the end user; Raising private funds; Public sector co-financing; EU-level funding;

User payment required; Insufficient funding (public or private); No public funding; High implementation costs; Difficulties securing transition from EU- to public funding

Leadership Institutional leadership (often by an organisation in the third sector)

Local/community focus

Adapted to meet local needs and contexts; Strong sense of community ownership; Broad community involvement

LTC specificity Incorporates a community care model; Case management component; Incorporates individualized, user-centered care plan

Network Well-established/active stakeholder network; Public-private partnership; Contributions of volunteers; Formalized institutional partnerships; Multi-actor/multi-sector cooperation

Sustainability Successful transition from pilot program; Integration of services into publicly-provided services

Short duration leading to lack of continuity and sustainability; Lack of dissemination/awareness-raising

Target group Restricted coverage; Resistance to participation; Lack of computer literacy

User involvement User-led components; User input and feedback during development and implementation

Workforce Multi-disciplinary project team; Built-in element to ensure workforce sustainability

Unskilled/ill-supported informal care workforce; Insufficient (human) resources

Curent research


2. Analysis of implementation at national level

• To verify whether and how the key factors typologies identified in the previous step are applied in each different care regime area.

• Consultation of experts and relevant stakeholders at national level (only in partner countries).

• This consultation is carried out by focus groups/expert interviews or via the contribution of the mushrooming ‘innovation hubs’, to check out whether LTC is on their radar and how they address it in terms of drivers and barriers.

3. Analysis of the implementation at a European level

• Same methodology as that applied for the national level.• Consultation with case experts and stakeholder representatives selected among

organisations and professionals operating at European level. • This consultation is carried out during the recurrent stakeholders forum (April

2015).

Building future scenarios


Integration of qualitative and quantitative analyses into a limited number of highly innovative and realistically implementable scenarios of social support and long-term care in EU Member states.

Targets:

• The reduction of poverty risks and social exclusion caused by long-term care needs in older family members

• The quantitative increase of employed and unpaid carers of older people• The improvement of health and quality of life of older people in need of care

and their caregivers• The quality and integration of social, health and long-term care services,

including a more user-centred implementation of new technologies.

Thank you for your attention!



Healthcare

ocial support and long term care for older people – Ghenta