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Presentation AIPNI Makassar 11.11.2011
- 1. Home Care for elderly Indonesia; a new challenge in community managed healthcare In the community For the community By the community
- 5. The rapidly ageing society: ARE YOU READY?
- 9. CARE LADDER The Netherlands Nursing home Home care volunteer Day care Short stay Home for elderly Home care professional Connected senior apartments Residence care compound In-house Small-scale living Continuum of care Costs Level of dependence Community care Institutional care Difficulties Homebound Assisted living Bedridden
- 19. HomeCare4Indonesia Needs elderly + family Self-managing home care team Other actors in healthcare and social system: PUSAKA, Social worker, Hospital, Posyandu (Lansia), Puskesmas, Fysiotherapist, Dietist, Psychologist, Pharmacy …. Coordination Education: AIPNI, STIKES, FON-UI Quality of Life Quality of care Trust-based relationship Intermediary (feedback ) Social welfare Health care
- 21. HOME CARE NURSE ELDERLY ?
- 22. Critical ethical reflection Analitical and solution focused Careful Consultation and Advice Openminded and creative Compassionate Dedicated Respect & partnership Coaching and training Coordination and organisation Pro-active Knowledge and insight Co-operative Build up a trust-based relationship Human-centred Communication & negotiation Sense of humor 6. Competencies home care nurse decisionmaking
- 23. To be ahead of new developments and to be pro-active in developing home care 7. Commitment educators
Editor's Notes
- Attention: I speak about managed, most of the time people say community based, but I prefer managed, used by government and meaning you are active. In, for, by the community Buying a house: location location location Services: people, people, people
- Earlier experience in Indonesie with UI, project specialised nurses and Univ Diponegoro, I don’t know if there are nurses from Dr. Kariady Hospital Semarang here, a nice stay, people were very much research minded.
- This is the line of my presentation, I will discuss different aspects of home care.
- If we do not take care for the elderly in the last phase of their life, it means we have no respect for life. If you just wait and see, it is too late, if you are pro-active, you are prepared for the ageing society, and there will be not such a gap between needs of elderly and service provided
- We are on the edge of the rapidly ageing society and the question we have to answer: are we ready
- Density 114 people per square km 8,5 % = 20 million 25%= 75 million 80+ from more than 1 million to around 15 million, which is almost the entire population of The Netherlands
- Just in a nutshell
- Home care consists of a social and a health component. In practice these two components are linked with each other. The older the elderly population gets, the more chance of one or more chronic diseases. In case of more chronic diseases the care becomes complex.
- First an overview of the continuum of care, illustrated as a ladder. You will see, as the level of dependence rises, also the costs rise. Small scale living people with dementia, sickness of Alzheimer, small living units attached to a central hall, as close as possible to a homely situation Homely interior design has positive influence on people
- Why do I use the word client centred instead of patient centred? Because the use of the word implies that the elderly is treated with respect, as a client who can expect the best care possible, adapted to his or her situation and wishes. A patient is more dependent, has to be ‘patient’…
- The training can be in cooperation with a hospital about how to handle new equipment or provided in the skills lab of the nursing schools, or even provided by another home care team
- One of the few initiatives of home care. This is a good initiative for the first phase as shown in the care ladder. But what if health is no longer good, then elderly move to the second phase and need professional health care.
- Home care nurse as a spider in the web
- A home care system with trust-based relationships, a good quality of care, will improve the quality of life. Based upon the needs of the elderly and their family, social welfare and health care. Health-care is provided by independent home care teams, that cooperate closely with other organisations in health care and social care Initiators from education in this system are AIPNI, STIKES and FON-UI
- East and west, different nurses, different levels, specialised nurses and now also home care nurse
- This is a palette of competencies, linked to each other, important in all education & training of home care nurses. You can consider this as some kind of compass to improve your service during your whole professional life. Developing competencies of home-care nurses needed for client-centred care, Communication skills and negotiation skills : dialoguing is important: Nurses demonstrating ‘dialoguing’ are aware of competing responsibilities and take responsibility together with the client. Client-centred care means commitment with the Client demand, knowing what they want, concerns a process of actively signalling, discussing and negotiating with the client, and actively searching for compromises, or creative solutions, sometimes at organizational level (avocate for patients). Nurses reported having to be very patient sometimes. Dialoguing includes giving and grounding a professional opinion, even if the client did not agree, and respecting the client’s point of view. Professional and personal boundaries are made clear. Respect and partnership, careful consultation and advice: support client participation (negotiate, coach, trust based, humor). It helps when they trust you, clients will not be ashamed to tell you their anxieties, and you will be able to help them better Handle situations of tensions and dilemmas,( solution focused, openness, creativity). Critical ethical reflection means that sometimes wondering if what you do or did is the most effective, or are there better or new ways? Can you improve yourself? Ethical issues in health care particularly affect the elderly for several reasons: older people are sick more often than younger people, suffer more from being in the end stage of various chronic progressive degenerative diseases and are most likely to lack the capacity to make critical decisions when such decisions have to be made. Clients with the capacity to make health care decisions should have the right to make decisions about their own bodies, based upon good access to information. Analytical: sometimes there are underlying causes for a problem. Not problem solving, but solution focused which is a different approach (knowledge & insight, human centred, creative) Human-centred, not task centred. Sometimes some understanding and compassion is valued more than washing and grooming. You can do both at the same time. Be pro-active, if you see that a patient is sitting all day, and barely walks, may be pressure wounds will be the result. Do something about it before that happens.
- Anticipate new developments, don’t wait till a gap arises
- Anticipate new developments, don’t wait till a gap arises
- Yayasan Kanker Indonesia PKK welfare organisation
- Education and training suited to needs elderly clients
- Home alone movy: you should not leave your children alone at home, because terrible things happen, the same goes for the elderly, if we leave them alone, the most terrible things will happen.