Dialogue between substance abuse services and elderly care

1
Dialogue between substance abuse services and
elderly care

• Maria Viljanen(M.A), project manager, Finnish
  Blue Ribbon, Finland
• Too Much Is Always Too Much - Ageing and Alcohol
  Project 2005-2008
• The project is funded by Finland's Slot Machine
  Association (RAY)

2
The presentation

• The goals and the structure of the project
• What has been done in the project
• Some findings of the project
• How the dialog between substance abuse services
  and elderly care has been developed

3
Finnish Blue Ribbon

• Central organisation (NGO) for Christian welfare
  work with alcohol and drug abusers.
• Deaconic values every individual is valuable and
  worth helping
• Member organisations (100) are very different and
  of varying sizes
• Finnish Blue Ribbon has a lot of development
  projects in the field of addiction work
• The present project involved associations for
  pensioners and the elderly as well as
  municipalities

4
Too Much Is Always Too Much - Ageing and Alcohol
Project 2005-2008

• The goals of the project has been as follows
• to develop, through client work, processes of
  addiction work suitable for attending to and
  treating the elderly
• to inform people of the adverse effects alcohol
  can have on the health of the elderly
• to increase the know-how of substance abuse and
  elderly care professionals
• to conduct a survey on the drinking habits of the
  elderly
• to arouse discussion about the topic

5
How the development work has been done?

• The client work undertaken during the project has
  involved 129 persons/clients over the age of 60
  who have a recognised drinking problem.
• Abstinence is not our main goal but help the
  client, to find her/his own forgotten resources.
• Support peer groups has been founded.
• Lot of training mainly to elderly care
• First shorter training sessions, which are events
  to raise discussion and awareness about these
  topics rather than to actually begin a dialogue.
• Now mainly longer process trainings

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The project comprises

• Finnish Blue Ribbon
• Coordination (3-4 workers)
• Project manager, addiction work developer,
  preventive addiction work project planner, and
  communications officer In 2006-2007 a
  researcher
• Contact with partner organisations as well as
  addiction work and elderly care organisations in
  the metropolitan area
• Production of materials, contacts with the media
• Contact with the A-Clinic Foundation medical
  part
• One subproject conducted by Finnish Blue Ribbon
  Foundation and Helsinki Deaconess Institute -
  seeking and mobile addiction work and peer
  support low threshold groups (2 workers)
• Tyynelä Development Centre
• Senior project - mobile addiction work in
  Pieksämäki and Savonlinna. Also peer support
  groups (2 workers)
• Age Institute
• Subproject increasing addiction know-how in
  sheltered homes
• (1 worker)

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What has been done

• Website set up immediately
• Client work in subprojects
• Process descriptions, quality assurance and
  development reports
• The topic has sparked plenty of discussion - a
  fair number of articles
• Training, special topic information sessions,
  production of training material a dvd/video
  produced on the topic
• Events organised for the elderly, articles
  published in newspapers

• Key partners interviewed - development seminars
• Collection of research data, initial categorising
  - 31 interviewees
• Survey of international research
• The medical part of the project started in spring
  2007
• Intermediate evaluation Feb/07 - outside
  evaluation organised (Social Development Ltd)
• Bikva evaluation carried out in the Seniori
  project

8
Timetable 2005-2008

• 2007
• Description of client processes
• Development seminars
• Training
• Second part of the research
• Survey of international research
• Societal embedding
• Medical part
• Intermediate evaluation
• 2008
• Societal embedding continues
• Concluding client work
• Products of development work
• Medical part
• Training
• Reporting
• Final evaluation
• New project application

• 2005
• Project launched
• Recruiting
• Project plan defined
• Cooperation agreements made
• Website launched
• 2006
• Client work goals defined
• Preventive work launched
• Development work goals defined
• The first part of the research, interviews
• Interest group interviews

9
Products

• Listening to the voice of the elderly -
  background material May 2008
• Aging, alcohol and wellbeing - material autumn
  2008
• A study on the drinking habits of the elderly
  (Haarni Hautamäki) autumn 2008
• Recognising and treating large-scale alcohol
  consumption of the elderly -article (Aalto
  Holopainen) Duodecim publication summer 2008 (in
  Finnish)
• Report on development work, early 2009
• Reports on subprojects end of 2008 and early 2009
• Seminar in Espoo January 12-13
• Book about client work cases spring 2009

10
Some findings of the project

• In the field of elderly care, there is great need
  for more addiction know-how.
• Difficulties to distinguish problem use from
  occasional use of alcohol
• On the other hand, addiction services should pay
  attention to the special needs of their elderly
  clients.
• Older people are not always able to reach the
  addiction services
• The basis of elderly care is comprehensive help
  and care, whereas addiction work is based on the
  autonomy of the individual
• The role of addiction work is to help and support
  the individual as she/he makes life changes
• Elderly care and addiction services could have
  strong dialog
• in the field of elderly care, there is a strong
  focus on rehabilitation and on finding and
  supporting the client's own resources.
• Using these approaches when working with clients
  with alcohol problems has worked very well in our
  own project, and these approaches are also very
  close to the ethos of addiction work.

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Developing the dialogue 1

• The subproject of Tyynelä Development Centre
• has worked closely with clients and home care
  workers
• Work has been started in the clients home
• Social services, the A-Clinic, the regional
  hospital, the welfare workers of the local
  church, and volunteers from the Red Cross have
  also been involved.
• These partners have formed a multiprofessional
  team who have for example analysed difficult
  client cases and aimed at creating new working
  methods and practices.
• Based on the clients' wishes, a peer support
  group was set up in the municipality. The peer
  group activities have been the responsibility of
  the project worker, but a worker from the local
  A-Clinic has also taken part as a partner.
• All clients are also clients of the municipality.

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Developing the dialogue 2

• Age Institute
• Subproject increasing addiction know-how in
  sheltered homes
• initial survey was carried out, process training
  was arranged, a working method for each home was
  started to plan.
• Sheltered home staff who work with the elderly
  have also discussed ethical questions, gotten to
  know their regional addiction services, and
  started to routinely bring up questions regarding
  alcohol use, for example in connection with
  physical examinations.

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To sum up

• Training, work methods and the basic principles
  behind practices are rather different from the
  start
• The ethoses of these two fields are based on
  different views of humanity elderly care is
  based on nurture and care - nursing. Addiction
  work is based on the idea of the autonomous
  individual and her own responsibility and
  motivation.
• Dialogue requires finding a common language.
• It is important to find the smallest common
  denominator and start building a partnership from
  there.

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To sum up

• Dialogue does not develop out of in-service
  training or seminars.
• We must get in deeper and understand what the
  everyday work, bases of work practices, and the
  underlying values and principles of our partners
  are like.
• What are realistic goals to provide a good life
  for elderly who has substance use problems? Could
  we first try to better their functional capacity?
  
• Should we only help the person/the client and
  not talk about abstinence?

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• Thank you for your attention!