Lifelong Learning Programme

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Best Practice

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Document Typology: Training on the field
Target groups: Health Workers,Caregivers,Patients,Policy Maker and Administrators
country Where It Took Place: Romania
Name of compiler: Constantin Musteata
name of institution: CECMA
role: Trainer /Researcher
language Of The Description: English
title: Care for the elders
description Of The Best Practice:
The Public Service of Social Care and Palliative Care at Home is an initiative of the Association St. Damian from Iasi embodied in a local project implemented in partnership with the Community Assistance Division of the City Hall of Iasi. .

The mission of the St. Damian association is to serve in the spirit of philanthropy, to alleviate the sufferings of others affected by disease and poverty and to contribute to the development of the individual and human communities by combating social exclusion and by defending the human rights and protecting the environment.

The values of the association are:
• Philanthropy – by loving people we understand to treat them without discrimination, with the desire to contribute to their development in accordance with their ideals and personal values;
• Life – we understand that life is unique and therefore will defend and work to improve the quality of life for all people;
• Durability - everything we do we do with responsibility, love and transparency to ensure sustainable development and lasting effects of our activities.

Services offered
HOME HEALTH CARE
I. I. Socio-medical home care
1. personal care;
2. Domestic and household services;
3. social services;
4. healthcare;
5. rehabilitation services .
II. Palliative care at home
1. personal care;
2. healthcare;
3. spiritual support and counseling services;
4. Bereavement services (bereavement support for spouse / family).

The project proposed the provision of social care and palliative care at home to the elderly, contributing to:
- the development of palliative care services and socio-medical home tailored to elderly patients and based on the principle of equality;
- to facilitate access of vulnerable groups of elderly to the social care services;
- developing partnership between institutions that can offer support, innovation and flexibility of specialized services and palliative care social care.
More information on http://www.ingrijirevarstnici.ro
Results:
The private-public partnership aims to develop the local social assistance system by creating social services adapted to the needs of beneficiaries and contribute effectively to solving the problems they face. The beneficiaries of the project are: 1. elderly immobilized at home or at bed, lacked of care; 2. elderly lacked of care in the phase of a terminal illness; 3. elderly patients, who are in areas without access to social services and medical care for which deprivation leads to worsening health. Given the social character of the services, they are for the elderly who are in the above situations and are affected by poverty. Quality standards for home care services: Socio-medical home care Palliative care at home Project beneficiaries are given medical care (medical consultations, prevent and treat, treatments, injections, infusions, enema, probe mounting bladder, collection of biological samples, electrocardiograms, blood glucose testing, blood pressure measurement, monitoring health status, etc..), physical therapy services, personal care (hygiene, diaper change, feeding, communication, movement inside etc.) Domestic services and household (household activities, change clothes and bed linen, washing clothes, making purchases, paying bills, etc..) and social services (social-medical assessment, counseling, information on risk situations and social rights, liaising with other social and medical service providers as appropriate). Care is given after the socio-medical assessment at the home of elderly and fulfillment of criteria of inclusion in the project. Quality Standards: services comply with quality standards for home care services for the elderly, approved by OMMSSF no. 246/2006. Sponsors: Between 1 December 2008 - 30 November 2009, provided care were funded by Phare 2006 Economic and Social Cohesion of the European Union (in proportion of 88.62%) and financed by the City Council Iasi (at a rate of 11.38 %).
Quality indicators:
Use of strategies to collect narrative descriptions
Comment:

This program envisages helping patients in final stages that also need other kind of support such as belongingness. All services are tailored on the needs of the patients taking into consideration the feedback received from the patients and their families. Support groups are organized on a regular basis based on the idea that bringing family, relatives, friends and acquaintances for talking with the patient this will make him feel more cared. These support groups are also a good mean of receiving feedback on the health care services from all these above mentioned groups.
Also the health carer becomes closer and closer to the patient as he helps the patient in different house chores, thus enabling a more opened communication.
Evaluation:
The project was undergone during a period of 2 years in which both health carers and health workers assisted patients at their homes offering their support not only in health issues, but also to do daily activities such as shopping, cooking etc. This made the health workers be closer to the patients and collect feedback on the healthcare services and improve them according to each patient’s needs.
Thus the impact was easier to be noticed as the staff could obtain feedback as regards the health services and could thus improve them according to the needs of each pacient.
Offering support to patients in different stages is a relatively new service in Romania that unfortunately not too many pacients benefit of and the support groups organized regularly had the aim to support and become closer to the family, friends, relates of the patient in order to make him/her fill beloved.
The closeness and permenant support of the cares, even with house work, has made the patients to increase their trust and to become more open to communication, being thus possible to assess better the individual needs of patients.

Testimonials:
C.C., 87 years old - Iaşi
“I'm alone since 30 years ago, have no children and loneliness is the worst "disease" that I have, but now that I've got you I do not feel alone and I thank God for that. Your help is very welcome and it means a lot for us, I appreciate your idea.
Thank you! "
M.V., 81 de ani - Iasi
" ”(...) I am very happy with the help I received from you and the St. Damian Association in Iasi. The doctor came to my home and gave me proper treatment. I also received the necessary pills. The medical staff who took care of me treated me very nicely.”

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