Thinking about a meaningful life: the new vision of care?

In recent months, we have witnessed a wide range of pronouncements, documents and conferences on the future of long-term care in our country.

This has been a pending issue for years, but the dramatic effects of the pandemic have brought to light, in all its harshness, the weakness of the resources that, as a society, we dispense to the elderly who need support in general, and in particular to those who receive it in residential centres.

Terms such as cohabitation units, increased ratios, personalisation, home environments, new professional skills are some of the axes that are proposed for the future in the framework brought to us by the European funds of the Next Generation Programme.

This is a unique opportunity for a profound transformation in the way we understand care.

A few weeks ago I read in a headline in The New York Times that people do not want to leave their homes to go into a nursing home. Nothing new, on the other hand.

I believe that behind this statement, or others like it, there is not only a judgement about quality, resources, or other issues related to these centres. Surely, it also contains the meaning for people and their families of such a move, which in most cases is due to a situation in which care needs far outweigh the possibilities of receiving care in the place where they have lived all their lives. 

In a way, moving to a nursing home is not something chosen, but is a result of personal circumstances, and the need for support is the main argument for moving from home to another place. We must not forget this, if, as we repeatedly state, we want care to be person-centred.

Person-centred approaches to care are based first and foremost on human rights and also on the transfer to professional practice of the knowledge accumulated over decades about the environments that generate choices for autonomy, independence and well-being on the part of those who live in them.

Therefore, the commitment of scientists, policy makers, professionals and others involved in the planning of care environments must be to contribute to providing people, in addition to the support they need, with opportunities to make life, each their own, meaningful. To do this, we must not only have the knowledge and skills, but also the space and time to get to know and listen to those we care for, because "Caring is first and foremost knowing oneself".

Some recent work (Nygaard, et al. 2020) that incorporates the voice of the people helps us in this task. Issues such as enough space for oneself, having the opportunity to do meaningful activities, and exchanging affection with people who matter are some of the central issues that participants point out. All of this, of course, at the pace and time that everyone needs.

We could think that caring for a meaningful life is then configured as the elaboration of a complex, harmonious and very personal chain of attentions, linked to each other so that daily actions such as getting up, eating, talking, looking, doing something... are developed taking into account the desires, needs and resources of each person.To do this, we need to transform the current model of care for another approach, the one that people want and need. We need spaces, times, professionals and organisations that make this possible. It is a complex, laborious and also essential change.

This is the challenge and the opportunity we have before us at the moment.

We owe it to the generations that preceded us and we owe it to ourselves as a society committed to the rights of people, regardless of their age, gender or need for support.

In line with the above, I would like to invite you to an appointment that will take place on 18 November, in which professionals and public representatives will talk about the small achievements and the many difficulties that have arisen in a decade of transition in the implementation of person-centred care in Matia. During the event you will have the opportunity to get to know new materials that we have developed together with Teresa Martínez, and a documentary that includes the testimony of a fundamental part of this change, that of the elderly people who live in these homes. You have more information about this event here.