Problem: What problem is this project trying to address?
Although Scandinavia is known for its highly efficient and universal health care system, many elderly people experience poor life quality and insufficient fulfillment of their rights as individuals in nursing homes. To ensure ease of care, nursing staff often prescribe more medicine than necessary, leading to many elderly spending upwards of twelve hours per day sleeping or sitting passively between medicine dosages and meals. Meals are regularly referred to as “feedings” by nursing staff, language that only reinforces the larger societal view of older people as passive. Even though there has been an increase in psychotropic drugs prescribed to the elderly in Scandinavia, there is little evidence to support these drugs’ effectiveness on this target group. In fact, use of psychotropics prescribed to the elderly has increased by more than 60 percent in nursing homes in Norway since benzodiazepine-sleeping medicines went on the market. Given that elderly in Norway take on average five to ten drugs per day, many are at increased risk for drug interactions, which further compromises one’s health, leading to feelings of disorientation and fatigue at a minimum. A possible side effect of several types of psychotropic drugs, for example, is increasing dementia symptoms such as cognitive impairment.
In addition to the excessive use of medicines in nursing homes, activities are not prioritized in nursing homes, degrading life quality of the elderly. Although bingo or card game evenings are events that take place universally in many nursing homes, these activities are considered a way to fill time, rather than to assure that the personal preferences of the individuals are fulfilled. As a result, the elderly feel disempowered to participate in activities that lack any connection to their personal background or interests. Without better use of available human resources – family, volunteers, young people, and nursing staff – this poor life quality of the elderly (and of the nursing staff) will persist. More than 50 percent of Norwegian nurses feel that the elderly need more meaningful activities, connections, and opportunities to socialize, yet they are unable to fulfill those needs because of lack of know-how and other demands on their time. Family members, friends, young people or volunteers are under-utilized resources that can relieve some of the responsibilities of the nursing staff and improve the happiness of patients. Currently these groups lack easy entry points for visiting and sharing experiences with the elderly.
Within the next ten years, the number of elderly people in Norway will double due to the aging of the baby boomer generation. There is an urgent need to improve the experience for the nursing staff as well as the elderly patients. The Norwegian government has recently released several new active care bills and white papers highlighting the need for new solutions. Unfortunately, however, although policymakers’ thinking is responsive to the need for new, more effective measures to assure that the needs of elderly residents of nursing homes are met, practice lags far behind.
Solution: What is the proposed solution? Please be specific!
In an age of continuing development of improved medical treatments for the elderly, Lone’s organization, Aktivitetdosetten, is addressing the absence of parallel gains in opportunities for revitalizing activity and social interaction in most eldercare institutions. Lone and her colleagues are repositioning the individual as the focal point of care in eldercare institutions. They are changing care practices to ensure that nursing staff consider each person’s individual life experience and needs for social interaction, rather than focusing solely on their physical ailments, in designing and providing the needed care. As a result, nursing homes are transformed into more “caring” and more “humane” institutions and the physical vitality, emotional satisfaction, and mental health of their newly empowered residents are markedly improved.
Lone is mobilizing care staff, family members, volunteers and residents of eldercare institutions in Norway to incorporate a diverse and creative array of new activities and unprecedented social interaction into the previously rigid routines and cultures of eldercare institutions. By training a growing cadre of nurses in such institutions across Norway, as “activity doctors,” Lone is building a new, more empathetic workforce who are motivated by the power of the new activities and social interactions to reduce the reliance on pharmaceuticals in addressing the elderly residents’ needs. In the new regime that she is putting in place, the elderly residents of the growing number of institutions in which she working, the elderly have also assumed more active roles in working with the “activity doctors” and other staff in designing individualized plans for activities and social interaction that are more closely aligned with their own interests and life experiences.
Since the formal launching of Aktivitedosetten some eighteen months ago, Lone has trained more than 200 “activity doctors” from various parts of Norway, and she has implemented the program in nine Norwegian nursing homes, and she has attracted the attention of several key policy makers in the health field. Because of the universality of the issues that Lone is effectively addressing, the Aktivitetdosetten approach is also increasingly recognized as an important step forward in addressing a major global challenge.