Yours, Mine or Ours: Who is Responsible for Social Care of Older Persons?
On November 26, 2015, the University of Leeds’ School of Law in England will be host to a program on “Yours, Mine or Ours: Who is Responsible for Social Care of Older Persons?” I’m very pleased to be part of the panel, under the leadership of Professor Subhajit Basu, PhD. We will use a research report we completed with colleagues in 2015 for the Commissioner of Older People in Northern Ireland (COPNI), to offer comparative international examples of legislation and public policy initiatives that support the wide array of potential care needs for older persons. We’ll be looking beyond the needs for health care.
One likely focus of the discussion is a proposal for a state-supported home visits by trained professionals, including social work professionals, for individuals age 75 or older, with a goal of providing advance assistance to the individual or family in meeting needs. The proposal now under consideration in Northern Ireland has roots in other jurisdictions we studied, including Denmark.
In Denmark, one of the inspirational leaders for “preventative home visits” is Mikkel Vass, M.D. at the University of Copenhagen. Beginning in 1998, Danish laws established an obligation for municipalities to offer “all citizens 75 years and older two annual preventative home visits.” A great deal of freedom to design the content of the home visits was given to the municipalities, but the goals are:
- to support personal resources and networking; and
- to offer social support, thereby preserving functional ability
In his study of 15+ years of home visit operations, Dr. Vass concludes that with a nationally-supported home visitation program:
- Functional decline can be prevented;
- Education of professionals makes a difference to the interview success;
- Interdisciplinary education makes a greater difference to the program success;
- To maintain effectiveness, education must be ongoing and based on simple messages and professional routines that respect local healthcare cultures; and
- Operation can be cost-neutral.
Cost neutrality — that will be important to every element of modern social care programs — including home visits.