Innovation: Integrated Help-at-Home

Lithuania

AAI Domains:

• Independent, healthy and secure living (improving access to health care services, care giving to older adults, independent living)

• Participation in society (voluntary activity)

Lithuania, in common with all European states, faces an ageing population with an increasing level of need for social care provision to enable older people and their families to live independently but with an appropriate level of social support. Long-term care provision is continuing to develop in Lithuania but there are notable deficiencies in the existing system that particularly affect older people in rural areas and there are ongoing issues about how services should be delivered and financed. Informal care is the main source of support for older people, people with disabilities and families with children in need of support and institutional care is also available. However, there is clearly a need for improved provision of long-term care in the community for the benefit of older people, people with disabilities and their carers.

The Integrated Help-at-Home Development Programme ran across 21 of Lithuania’s 60 municipalities and attracted approximately €6 million of funding from the European Social Fund. It consisted of 67 mobile multi-disciplinary teams of nurses, social workers with support from counsellors and physiotherapists that provided nursing and social care support to people in their own homes.

The integration of nursing and social work is genuinely innovative in Lithuania where nursing care falls under the ambit of the Ministry of Health while social work is the responsibility of the Ministry of Social Security and Labour although both ministries rely on municipalities for local implementation. The 67 teams consisted of approximately 300 nursing, social work and associated professionals and they provided long term care to over 750 people during the programme.

A key aim of the project was to train and support carers so that they would be better able to cope with the demands being placed upon them and to mobilise neighbourhood volunteers to provide additional support to older people and other groups in need. The programme provided training to over 800 carers and mobilised scores of volunteers across Lithuania although the issue of sustainability after the initial European Social Funding financing is exhausted has yet to be determined.

In terms of active ageing, the Integrated Help-at-Home Development Programme provided improved access to health and care services in a fashion that had not been seen on a significant scale across Lithuania. This social support provision enabled independent living for older people and provided opportunities for voluntary activity for people in numerous neighbourhoods. There is certainly a case for a thorough evaluation of the impact of the programme and for considering further funding for the innovation if it provided improved outcomes for older people and their families.