Rights of older people in long-term care situations are sometimes violated, which might lead to elder abuse. WeDO 2 , a European project concerned with the Wellbeing and Dignity of Older People developed a training to keep on improving quality in care.
About the authors
Sofie Van Regenmortel & Prof. dr. Liesbeth De Donder work at the Free University, Brussels and are both members of the research group Belgian Ageing Studies. Dennis van den Brink, Henk Smets, Lena Hillenga & José Broers are affiliated to LOC Zeggenschap in zorg.
LOC Zeggenschap in zorg is committed to the improvement of quality in care in the Netherlands, based on their vision on valuable care. Valuable care is about the values of (care dependent) people. For more information you can contact the WeDO2 project leader (email@example.com).
Website Dutch partner: http://loc.nl
Website Flemish partner: http://www.belgianageingstudies.be
This project has been funded with support from the European Commission. This publication reflects the views only of the author, and the Commission cannot be held responsible for any use which may be made of the information contained therein.
Working on quality care
In Europe there are different projects that take the ageing population as a starting point. An EUropan Strategy to Combat Elder Abuse (EUSTaCEA), WeDO and WeDO2 are three examples of such projects. Furthermore these projects build on each other. All three projects aim to (1) guarantee the rights of older people in need of long-term care, (2) enhance the quality of long-term care and (3) fight elder abuse in care situations.
The European Charter of the rights and responsibilities of older people in need of long term care and assistance (EUSTaCEA project, 2008-2010) states that: “Human dignity is inviolable. Age and dependency cannot be the grounds for restrictions on any inalienable human right and civil liberty, acknowledged by international standards and embedded in democratic constitutions. Everybody, regardless of gender, age or dependency is entitled to enjoy these rights and freedoms, and everybody is entitled to defend their human and civil rights.” Advancing in age does not involve any reduction of a person’s rights, duties and responsibilities but it is possible that a person could end up in either a permanent or temporary state of incapacity and is therefore unable to protect his/ her own rights. As we grow older and may come to depend on others for support and care we continue to have the right of getting respect for our human dignity, physical and mental wellbeing, freedom and security. It is our shared responsibility to promote and protect these rights as stated in the EUSTaCEA document.
The European Quality framework for long-term care services (WeDO project, 2011-2012) introduces 11 quality principles and 7 areas of action that define what quality care is and where effort is needed to guarantee the wellbeing and dignity of older people in need of long term care and assistance.
Belgium launched this quality framework on the 18th of February 2014 and it was signed by five ministers.
Working on quality care, a never ending story
To further quality care and meanwhile building on the EUSTaCEA charter and the European quality framework, the European partnership WeDO2 was created. This partnership, funded by the Grundtvig programme, comprises 8 organisations from 7 different countries (Austria, Belgium, Germany, Greece, Poland, Netherlands and UK), and one European organisation (Age Platform Europe). Each partner is engaged to strengthen stakeholder’s (e.g. older people, formal and informal care providers, volunteers and professionals) ability to participate in the process of long term-care and consequently in combating elder abuse. Besides, the partnership aims to foster learning experiences between organisations in the field of formal, non-formal and informal adult education.
Quality principles – A quality service should be:
Areas of action – A quality service should contribute to
1. Respectful of human rights and dignity
1. Preventing and fighting elder abuse and neglect
2. Empowering older people in need of care and creating opportunities for participation
3. Preventive an rehabilitative
3. Ensuring good working environment and investing in human capital
4. Developing adequate physical infrastructure
5. Developing a partnership approach
6. Developing a system of good governance
7. Developing adequate communications and awareness-raising
9. Outcome-oriented and evidence based
11. Gender and culture sensitive
To contribute to quality care in long term care, the partnership developed and tested an innovative train the trainer toolkit about quality care. The training is flexible, can be adapted and used for various groups (older people, formal and informal caregivers, volunteers) and in different fields. The training is based on the two former projects that are described above.
The WeDO2 train the trainer toolkit was created using a co-creative methodology in the complete process from concept to implementation: from the development of the content of the trainings to testing and evaluating the training, etc. The WeDO2 train-thetrainer toolkit is freely available in 7 languages and downloadable from: http://wedo.tttp.eu/quality-care-training-package . The quality care training package includes: an introduction guide, a manual for trainers, and the training material itself (e.g. movies, pictures, quiz questions,).
The WeDO2 toolkit is aimed at everyone. It will be of particular interest to those who are linked to or engaged with providing services to older people and are committed to improving the quality of life for older people in need of care and assistance. This includes family and friends as well as small locally run groups and clubs, regional organisations, national bodies and Europe wide establishments. These target groups can be both learners and become trainers themselves.
To stimulate learning experiences between partners, the partnership first collected and presented good practices of training material on quality care on the first transnational meeting in Brussels (November 2013). Besides, six study visits were done between November 2013 and June 2015. For these study visits, the partnership focused on good practices concerning quality care. Various initiatives were visited, both residential care services and supporting services regarding health, wellbeing and social services at home. The partnership visited for instance domaine des Rièzes et Sarts à Couvin, a living home in Belgium where human beings are central and not the care they receive, and Hogeweyk in the Netherlands, a living arrangement for people with dementia who live according to different life styles. In Greece the partners gained insight in how Nestor Psychogeriatric Association supports older people and their informal caregiver to enable them to continue living at home by using a holistic approach.
A WeDO2 movement?
In total, the partnership tested the toolkit in more than 30 trainings. To date, the training and project influenced the participant’s ability to think and talk about their expectation of and vision on quality care. Furthermore participant’s vision on quality care was enlarged and made them realize “that it can be different”. The next quote illustrates how the training changed the view of a geriatric nurse in a Belgian care home:
“WeDO brought a new, innovative perspective to quality care. In my professional life I am responsible for quality control, but I mainly have to focus on medication safety and the physical aspects of care. When talking about ‘quality care’ it was about feeling at home, happy, having freedom of choice, etc. Things that at this point don’t have our full attention. We say we often lack time for this or ‘it is not possible in a nursing home’, but in the workshop I heard several examples that did work.”
Besides, the project and the training also raised the awareness of older people that they have rights and the importance of intergenerationality. A Greek older participant suggested: “Our children/young people should be the ones to be aware of these rights, they should get the same training.” Because this opinion was shared in other countries, the partnership decided to involve society and youngsters as target groups of the training as well. Finally, efforts of the Polish partners resulted in political support to finance the project in Poland and to include the training in the curriculum of schools in the province Lublin.
Although the project has ended, working on quality care still continues. The partners will distribute the training material in their own country. What is more, new countries will be involved in the future.