A Pilot for the Elderly

1
A Pilot for the Elderly

• - Listening to elderly help-line users in
• collaboration
• (Integrated Care)

Rebecka Arman, R.N. and phd student
2
The promise

• If You live in the central or western parts of
  Gothenburg City and are 75 years or older, you
  now have another number to call about questions
  concerning home-help services, healthcare and
  rehabilitation,
• but also other things that You are wondering
  about.
• You are welcome to call, around the clock
•  

3
Who chose to listen?

• The initiative came from the head of the
  Geriatrics department at the hospital. Inspired
  by a similar project in Stockholm and EPICS
• A collaborative group of managers from the
  municipalities met together with primary and
  specialized healthcare managers
• The idea was planted there and grew roots a
  project-organization was constructed
• the Home-help services, Home-healthcare services,
  quality developers from the municipality, the AE
  department, the Geriatrics department, the
  Primary healthcare (the GPs and Health Advice
  help-line) and rehabilitation took part in the
  planning and implementation (18 persons)
• A network of fifteen organizations with different
  services. Written contracts of collaboration
• The staff answering the phones also answer the
  home-help security-alarms. Mostly social workers

4
Goals

• To improve older peoples feelings of
  security/safety
• To improve availability, reliability and
  trust/faith
• To help people to stay living at home
• To decrease unnecessary visits to the AE the
  right kind of healthcare at the right level
  (primary/secondary, home)
• To guide the person to where the help can be
  found in spite of the complexity of different
  services
• A second stage with preventive services was
  planned

5
Who did they choose to listen to?

• Decisions based on the representatives own
  experiences and one survey done at the AE
• No initial investigation of the populations
  needs
• What age limit is appropriate?
• Only people who do not already receive help in
  their homes?
• Only the frequent users?
• Choice everyone 75 years or older

6
What kind of listening occurred?

• Healthcare needs (40 )
• I can not reach my GP.
• Who can help me with my hearing-problems?
• What should I do about my symptoms?
• My medicine runs out on Wednesday, is the new
  batch arriving soon?
• I have already been to the hospital but I am
  still not well.
• I was treated badly (demeaned) and I do not want
  to have to call back to that person.

7
What kind of listening occurred? continued

• Social care needs (29 )
• I need a security alarm in my home, how do I get
  one?
• My mother is getting too frail to take care of
  her-self all alone, what kind of help can she
  get?
• My home-help assistant is late, is she on her
  way?
• The Pilot is a higher level within the social
  care organization, to complain to

8
What kind of listening occurred? continued

• Information needs (25 )
• May I have the number to the convenience store on
  NN street?
• How can I reach the social insurance office, it
  is always busy. Do you have any alternative
  numbers?
• Where can I get free computer classes?
• I need to call a taxi, can you give me the
  number?
• What time does the local bus leave?
• What food are they serving at the nursing home?

9
What kind of listening occurred? continued

• Other needs (15 )
• Freedom from the telephone-tyranny
• When it is hard to hear what the answering
  machine says or hard to read the phonebook
• Loneliness I feel so anxious sometimes, since my
  husband died
• What kind of help can the Pilot offer?

10
How is the listening carried out?

• An assessment of what the need is about. If it
  has anything to do with healthcare is should be
  directed to the Healthcare Advice help-line
• An assessment of how frail or independent the
  person is, if the person can make the phone call
  on her own
• Listening and keeping company
• Offering advice, based on ones knowledge and
  experience
• Perhaps not listening too much, when the call is
  piloted to another service

11
What do the pilots say about the users?

• It is satisfying to be able to give help by
  simple means such as searching on the Internet.
• I can call to many different places and say our
  name and then they help us
• Some people use us as a simple and free version
  of the yellow pages information service
• The questions are mostly the same as the ones we
  got before too. More variety now

12
What do the users say about the Pilot?

• How does it effect your feelings of
  security/safety? (percent)

13
What do the users say about the Pilot?

• How does it effect your trust that there is help
  to get, when you need it? (percent)

14
Examples of the uses

• (- What feelings does it awake in you, knowing
  that this number exists?) Security. It is an
  incredible security. For me this is pure
  medicine.
• (-How did you perceive the contact you had with
  the Elderly Pilot?) It was completely
  fantastic to be able to call them. //The best
  part was that I felt so secure with the Pilot.
• Actually, what I fell for was that it was so
  nicely put together with the lighthouse and
  everything. //She was so friendly, it turned my
  whole situation around.
• Now I dont need the Healthcare Advice Line and
  all those things. I just need to call there (the
  Pilot) when I have fallen. Either the send
  someone here or when they consider it serious
  enough then they send an ambulance.
• I couldnt look in the phonebook so I think I
  would have called SOS. It is a little stupid, but
  what should I have done? So this was of course
  much better, one feels secure. Even now when I
  feel better something might still happen. Then I
  know about the Pilot and there I get all the
  information I need (- about your health, or other
  things?) No, it is about my health, if I fall or
  become sick. Otherwise I have the number
  everywhere else.

15
Less enthusiastic examples

• (-Had you solved it otherwise?) Yes, I most
  certainly would have. With a some rounds or
  referrals. Yes, I would have but it might have
  taken a little bit longer.
• It was as usual. I do not think that it was
  anything special. But that might be because I am
  jaded on telephone calls.
• But I dont think that I got any particular help.
  // I called but nothing happened. I dont know
  if they can help me.