How to live better! The approach to the change of care model in gerontology centres from a methodological point of view.

The transformation from medical and care models to people-centred ones will only be possible if the change is perceived by the recipients as useful and necessary and if all of them are given the opportunity to participate.

Therefore, the methodology developed in the transformation should be sensitive to the characteristics and resources of the people and the environments in which the changes are intended to be implemented. In addition, it should systematize the interventions and obtain information about their effects.

The experience developed in the Etxean Ondo Project helps to illustrate the main phases developed in the change process:

Awareness raising.  Firstly, it is necessary to provide information about the process of change in the places where it is intended to take place. This information, as well as indicating the components and objectives of the change, must aim to raise the awareness of those involved in the process.
Implementation. In this phase, the obtaining of previous information in relation to professional and organisational practices, characteristics of the physical environment, of the participants, etc. is combined with the implementation of the initial interventions associated with the new model of care.
The interventions must affect aspects of the physical environment, the resources of the professionals, especially those who provide direct care, and the organisational environment.

Within the framework of the Etxean Ondo Project, a study was designed with a quasi-experimental design with a control group, in order to identify the effects of the interventions on residents, family members and direct care professionals. In addition, this study has been complemented with other research that looks at some specific aspects of the interventions developed

Consolidation. In this phase, attention must be paid to ensuring that the changes established are incorporated into the organisational routines and professional practices of those involved.
Actions such as follow-up and continuous training will help to establish new objectives to increase the degree of personalisation of care, and to successfully face the challenges derived from the evolution of the model.

In short, the implementation of new models of care in gerontology centres involves the development of planned actions, in the different dimensions which define the model, which have to consider the starting point of the contexts in which the change takes place.

On the other hand, and in order to prove the impact of the interventions, it is convenient to evaluate the effects on the different people involved: elderly people, workers and families.

References:

Díaz-Veiga; P. Sancho, M. Residences, crisis and preferences of the elderly. Spanish Journal of Geriatrics and Gerontology. 2013 (48) 3 101-102

DIAZ VEIGA, P; SANCHO, M (2012). "Units of Coexistence. Accommodation for elderly people to 'live like at home'" Madrid, Informes Portal Mayores, nº 132. Publication date: 15/06/2012

 http://www.imsersomayores.csic.es/documentos/documentos/diaz-unidades-01.pdf

Martinez, T.; Díaz-Veiga, P.; Sancho, M.; Rodriguez, P. (in press) Cuadernos Didácticos para la implantación del modelo de Atención Centrado en la Persona. Basque Government