Guest blog: Future-proof elderly care: it can be done, but it must be done differently

With staff shortages, an increasingly aging population and the task of doing more with the same resources, we face enormous challenges in elderly care. Innovation can make an important contribution to future-proof elderly care. This is a challenge for all parties, including us as insurers.

By Mijke Buijs, Program Manager Sustainable Coalitions at health insurer CZ. This blog was written within the theme 'Growing old healthy' of the innovation program ZorgTech. Read an earlier guest blog within this theme by lecturer dr. Ton Bakker here. 

Old age comes with shortcomings. In general, the older you get, the higher the use of care. Things taken for granted from the past no longer exist, while many older people still assume that care is always available. At the same time, wishes are changing: what the current generation of older people wants is different from what it used to be. There is more need for self-direction, and to continue living an independent and meaningful life.

Future-proof elderly care therefore means a different way of thinking, a different way of working together and a different way of doing things.

Another way of thinking

The traditional way of providing care contributes to loneliness and loss of personal control. Instead of care in a hospital or nursing home, elderly people want to live a fulfilling life with their own direction, freedom and support preferably at home. So a different perspective, from 'this is the care you need', to: 'what would help you stay independent longer'?

This new perspective takes the quality of life as its starting point. To map this out, we examined the 'life journey' of older people: what do they themselves consider to be the moments of truth in growing older? And how should care fit in with that? On thuiswaarts.nl we have set it out in a whitepaper.

Most elderly people want to live independently at home for as long as possible and maintain control over their lives and health. This requires a different design of care.

A few conclusions: most older people want to live independently at home for as long as possible and maintain control over their lives and health. This requires a different arrangement of care. For example, after hospitalization for hip surgery, a quick return to independent living becomes the starting point, with the help of home care, supported by smart monitoring. And so not automatically admission to a rehabilitation center, but sometimes at home.

Independent living can be smarter. CZ is now doing pilots with assisted independent living, using the expertise of the nursing home, supported with social and technological innovations. We are looking at what the elderly can still learn in order to work on their own health. With an eye for joint activities in a day-and-do center to combat loneliness, with activities to maintain mental and physical health and with more control and independence to increase the well-being of the elderly.  

A different way of working together

Not only elder care as a whole is changing. As a health insurer, we also have a different role. Our buyer's chair is set next to, instead of, facing the care provider. And we are talking to new parties, such as municipalities or housing corporations, because together we need to start making a move. Health insurer, care office and care organizations are increasingly defining joint goals in terms of costs, quality, staffing and accessibility of elderly care. In long-term partnerships, we engage in constructive discussions about what is really needed: providing smart and optimal care with increasingly scarce resources.

Collaboration also means daring to be honest. In the healthcare sector, we are too often nice to each other. Not everyone is always right and not every opinion carries equal weight. Above all, it is important to trust each other's expertise and professionalism. Why do we accept a treatment proposal from a surgeon, but enter into a discussion with a healthcare professional in elderly care about what is right? The same applies to innovations: if an innovation has proven itself, let's embrace it instead of setting up time-consuming and money-consuming pilot projects for every situation and every care organization. We should dare to scale up more quickly.

A different way of doing things

If we want to offer older people their own direction, this also means that we must take them seriously as end users of innovations. This is becoming increasingly important in the innovation process. In the ZorgTech innovation program, it is even an obligation for a company to form a consortium with a care organization. But actually, it should be an intrinsic motivation in every healthcare innovator to develop innovations in co-creation with end users. 

Innovation must not lead to more work - it must provide improvements in health and it must lead to savings rather than more costs.

So a different approach to elder care requires new care processes and innovations to match. One that the elderly and their caregivers can use themselves. The framework for this is that an innovation must not lead to more work - it must improve health and it must lead to savings instead of more costs. This requires coordination with healthcare organizations, end users and health insurers.

These frameworks must therefore be included in the business case right from the start. That can be in small things. Smart incontinence materials, for example, that give a notification. It not only means less consumption and more comfort for the elderly who are changed more quickly, it also prevents unnecessary and routine changing rounds and thus saves a lot of time for care workers.

Effect and impact

Fortunately, there is no shortage of good care innovations and ideas, but there is a shortage of sustainable implementation. Only then do we realize that innovations have sufficient impact. Therefore, during the innovation process, constantly think about the goal. What problem does it solve? For whom? What is the effect of an intervention, and how do we measure that effect? As an insurer, we want to think along with the impact cases of innovations, to make them a sustainable part of the care of the elderly, to get them reimbursed and scaled up, and to put them on the agenda at the national tables.

A different perspective on healthy aging, smart cooperation, an eye for the business case and co-creation with end users: these are the determining elements for successful care innovations for the elderly. Here we need to look much more at implementation and scaling up. As an insurer, we have an important role in this and are happy to think along.

Ultimately, with these adjustments, together we can perpetuate elderly care - despite all the challenges - for the future.