Fostering collective self-reliance in elderly care: A value-based approach to the intake conversation in homecare at Surplus
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Abstract
This project responds to the increasing challenges in Dutch elderly care amid an undeniable ageing demographic. Between now and 2040, the number of individuals aged 80 and over will nearly double, and one in four people will need to work in the healthcare sector to satisfy the increasing demands.
The current system of elderly care is very much solution-focused, where professional caregivers often provide the answers and lead the discussions. Organisations like Surplus, a care and welfare organisation in West Brabant, struggle to continue to meet the expectations of (new) clients and their relatives, placing an additional burden on professional caregivers.
The increasing pressure highlights a need for greater autonomy and shared responsibility in elderly care. The urgent and multifaceted nature of the current challenges calls for a ‘new way’ of caring, with a greater reliance on answers from society. This project envisions a shift towards a caring society that focuses on what is still possible rather than on limitations, aiming for a meaningful life. Where self-reliance is a collective effort, and each individual is truly recognised.
Through a systemic design approach, this project seeks to navigate these challenges by uncovering key personal values in receiving and providing care and mapping out the elderly care system to identify opportunities to intervene. An intervention that incorporates these values is designed to initiate a shift towards the desired direction.
To facilitate this change, I have developed a new approach for Surplus to have value-oriented conversations, to match what we find important in life. Inviting people to think beyond the care question and to look together at what is possible instead of what is no longer possible. Transitioning from a traditional “intake” in home care to “acquaintance”, it introduces the T-Doos (Tijd voor gesprek, Thee voor twee, Langer Thuis: Time for Conversation, Tea for Two, Staying Home Longer) personal preparation package with a conversation box and a conversation framework. This invites the elderly in need of support to think together with their informal carers about what is important to them in daily life, who they are in contact with, what makes them happy and how they look ahead. It sets the stage for meaningful discussions with district nurses to collaboratively explore possibilities. The professional caregiver adopts a coaching role, and a transition is started in mindset and practice within care organisations and among healthcare professionals.