Learning about elder care in Finland

When I first got here I envisioned frequent posts about my experiences here. And then suddenly it is June!

This week Masters of Social Work students from Michigan State University were in Tampere with my colleague Karen Newman as part of our MSU – Tampere of University of Applied Sciences exchange. They visited a variety of agencies, had class with Finnish MSW students, and had fun learning about social services here, the Finnish culture, and the ways we are the same and different.

I’ve learned a lot in my time here as well. Thanks to my collaborator Ulla-Maija Koivula for putting together a great program for the students and making my time here so pleasant and productive.  (Here are are some blog posts by Ulla-Maija and her students who visited the United States in Fall 2013. Sorry – it’s in Finnish, but there are some pictures and headlines that will give you a sense of where they went).

Here are a few tidbits from what I’ve learned so far related to elder care:

• As in the United States and elsewhere, elder care is in flux. Finland is struggling with a lagging economy and a growing population of older adults. They are making changes to the structure of all health and social services and anticipate more changes on the horizon
• The focus for elder care and the issues Finland is facing are also similar to those in the United States. In particular, there are more resources being put into caring for older adults at home for as long as possible so that residential care is a final resort. Consequently, older adults are in need of more care by the time they enter residential care, although staffing has not always changed to accommodate this greater need.
• The City of Tampere has been quite thoughtful about how to manage this shift. For example, they closed geriatric residential units in a local hospital and used that money to fund a start up project for an in-home rehabilitation program. After a year of getting the program off the ground, it has become integrated into overall home health services as a means of improving customers’ quality of life and helping them stay at home longer.  This service isn’t free, but older adults pay on a sliding scale based on their income.  The balance is covered by the municipality and for those who can’t pay anything the full cost is covered.
• As in the United States, the people who do this work do it because they love it and they love the people. It’s hard work that can be both physically and emotionally draining, but the people I have spoken to have a passion for it.
• Unlike the United States, there is very little turnover in residential care staff in Finland. I need to delve into the details and reasons behind this a bit more. Two initial thoughts that come to mind include better financial supports (including salaries as well as the overall health and social services available to workers and customers) and the country’s investment in education (which is free at all levels) which means that workers in all roles tend to be better educated.
• The decision to enter residential care is not entirely up to the older adult and his/her family. More on this later, but in a nutshell, an interdisciplinary municipal board made up of health care professionals evaluate the situation of the older adult and if he/she meets the criteria they will be placed on the waiting list. When they reach the top of the list, the next available place will be offered to them which may or may not be in the facility of their choice.

More thoughts about differences and similarities in future posts. And if anyone has suggestions for slowing down time, please let me know.