National criteria, monitoring and reporting are needed for the quality of services for older people

As the population ages, an increasing number of older people need services to support their daily life and health. However, resources for services are not increased in proportion to the growing need for assistance.

According to THL Development Manager Katri Kakko, attention should now be focused on the quality of services for older people and on improving it.

"If quality is not prioritised, for example hazardous situations may increase. When resources do not grow in proportion to the number of people needing assistance, it is particularly important to do the right and effective things in relation to clients' needs."

This means, for example, services provided at the right time and adjusted according to the older person’s situation and needs.

Good services are consistent in quality

If the quality of services deteriorates, the need for them increases. For example, a decline in an older person’s functional capacity must be addressed quickly, and rehabilitation must be provided for a sufficient duration. Otherwise, functional capacity will continue to decline and more intensive services will soon be needed.

"Quality does not always mean higher costs or that more staff are needed. It can also be achieved by focusing on the client’s needs. By investing, for example, in early services, more months and years of functional capacity can be gained," Kakko says.

Research shows that when older people receive services that meet their needs, unplanned hospital visits decrease. Loneliness increases the use of health and social services among home care clients, as does the situation where a client does not wish to live at home.

At present, there are significant differences in services between wellbeing services counties and units. For example, planned service hours in home care are implemented very differently across wellbeing services counties. There are also major differences in areas such as pain management and access to rehabilitation staff. This means that older people are not in an equal position.

"If nothing is done, disparities will increase," Kakko estimates.

The needs of the person receiving care as the basis for the service promise

To achieve consistent quality, there should be a shared understanding of what good quality is. At present, there are no quality criteria for services for older people. Kakko therefore calls for a nationally defined service promise that would create uniform frameworks for the core content of services and define target or minimum levels of quality. In addition, it should be defined how service quality is monitored and reported, and how the knowledge base and supervision of services need to be developed at the national level.

"The quality recommendation for services for older people is not sufficiently binding and does not adequately guide the improvement and monitoring of quality. Services for older people need a common service promise as a basis for implementation that takes individual needs into account. Quality and concrete targets should be defined in cooperation between experts, wellbeing services counties, service providers and older people," she says.

A good everyday life is not created solely through services for older people and their professionals.

"In addition, multi-actor models are needed in which the public sector, private actors, organisations, volunteers and relatives work together to ensure a meaningful everyday life," Kakko adds.

Developing service quality based on clients' needs may require a shift in thinking.

"We should move from using quantitative indicators to measuring outcomes – do the services improve older people’s well-being, functional capacity and ability to manage everyday life," Kakko says.