CareNet+ care network for the elderly
An ageing society, an ever growing number of long-term chronic conditions, and an increasing incidence of multimorbidity are presenting the Swiss system of help for the elderly with some massive challenges. And more of the elderly, in particular, are developing especially complex needs.
In cases where those already suffering from one or more chronic conditions experience a further critical life event or acute condition on top of this, there may be some restrictions in their mobility too and these people in particular will tend to lack a sustainable social network local to them – because we are talking about an especially complex situation (as regards their living arrangements and health). This will often then mean that various medical, care, and social services are required. But service providers are often not very well coordinated, with individual services often being provided in isolation and a kind of “silo” mentality governing people's attitude in many cases. Support processes are not ideal, those concerned are often overburdened, and the limits to care in the home are reached too quickly.
This is where the integrated CareNet+ care network for the elderly comes in: a two-year pilot project in the Affoltern am Albis district sponsored by Pro Senectute canton of Zurich. It is intended as an “add-on” to the existing care system and encourages very highly coordinated collaboration between existing service providers on a case-by-case basis. Thanks to the extra effort by way of coordination, the measures taken jointly with all those involved should represent the best possible fit – thereby optimising the deployment of human and financial resources. The Koordinationszentrum für Gesundheit und Soziales (Coordination Centre for Health and Social Care) is an independent and neutral body with no specific interests of its own.
The evaluation phase is all about analysing various aspects of the results and impact of pilot cases. And not least, the impact in terms of economic aspects of healthcare: can help also be improved from a financial perspective, and does this kind of coordinated outpatient care allow people to stay at home for longer? The methodology incorporates analyses of documents, case data generated as part of the process, discussions among focus groups, and interviews with specialists from the various stakeholder groups concerned.
Careum Research brings its targeted expertise to bear in terms of research involving relatives, coordination, case management, and integrated care processes (as regards delivery of health care in private homes). The aim of the evaluation element is to place the views of those requiring care and their relatives at the heart of things. With this in mind, their views are canvassed at various intervals using structured questionnaires.
Project consortium and team