Denmark has been able to cut hospital visits and reduce the need for residential aged care by its proactive approach to home care, which includes the use of aged care “event planners”.
Michelle Carden from the Royal Danish Embassy in Canberra discussed why the Danish model for ageing in place has become an international success story at the LASA conference on Tuesday.
Denmark faces similar challenges to Australia, including an ageing population, high levels of chronic illness and the dual operation of an aged care and universal health system, Ms Carden said.
Yet Denmark is ranked as one of the top countries in the world to grow old and one of the best for providing high quality long term care, according to a report recently released by the aged care royal commission
Ms Carden says the quality of residential care is a direct result of the nation’s focus on home care, which has reduced the burden on the residential sector and allowed it to concentrate on the people who need it the most.
Ms Carden told the conference that from the 1980s Denmark shifted towards a policy of keeping people at home longer, a strategy to both improve quality of life for older people and reduce the burden on hospitals.
Denmark now spends 50 per cent of its aged care budget on home care compared to 25 per cent when the policy was first implemented, she said.
The policy, Getting older: Continuation of the Good Life, is based on the provision of assistive technology and home modification; rehabilitation and reablement; ongoing quality checking; use of mobile devices by workers and integration with the wider health system.
It puts the older person at the centre of decision making and empowers them to make decisions, Ms Carden said.
“It’s about them living the life they want to live and them determining the life they live it,” she told the conference via video.
The policy has seen the number of hospitals in Denmark reduced from 45 to just 16, and hospital visits are decling. The need for nursing homes has also fallen.
Aged care services in Denmark is federally funded through taxes and delivered by the country’s 98 federally municipalities, or local government areas.
Assessment coordinators, home care nurses and social care assistants are central to the system.
Rikke Louise Buttery, Home Care Group Manager, Elderly & Health at Aalborg Municipality, likens the role of the assessment co-ordinators to an ‘event planner’.
The co-ordinators assess the individual needs of a person, and the appropriate services are delivered via the municipality.
“It’s more like an event co-ordinator … if you imagine the event is your life,” Ms Buttery told the conference. “They look into your home and try and find out your needs.”
Local care workers report back to the event co-ordinator and conduct yearly follow-ups.
Quality and dignity
Ms Carden says quality and dignity lie at the heart of the Danish home care system.
“The Danish system is about enabling everybody to have access,” she said.
“It’s about encouraging people to stay at home in their own homes for as long as possible as opposed to going to nursing homes. It’s about putting the citizen at the heart of decision-making, it’s about integrating with the health care system, and most importantly it’s about prevention programs and rehabilitation .
“It’s about checking and monitoring citizen so if there is a decline you can pick it up early and address it, and hopefully fix it.”