Elderly Care in Finland

This day we had a short lecture about the organization of the care for elder people in Finland. Also, in the morning, we visited a public elderly care center - Koukkuniemi, the oldest in the Nordic countries - and in the afternoon we went to a private one, "Viola-home". (The idea was to get a general overview about how society deals with the problem of aging, focusing on nursing home places for old people who are dependent in their daily living activities (ADL). In both cases, the quality of the "core" services seemed very similar to me: facilities and assistance in basic activities of daily living was of good quality, meeting required standards. Also, almost every person who needed to be institutionalized could get a place, being the responsibility of the social and health insurance system to provide the services either in the private or in the public sector (Again the implementation of this was managed at the municipal level, with (mostly) municipal founding). Taking this into account, differences existed mainly in relation to the number of employees per patient and also in the kind and quality of hosteling services, like the size of the rooms, furniture, beauty of common spaces, etc. Not surprisingly, the later aspects were better in the private one.

However, as statistics show, informal care by relatives or friends of the patient is, in practice, the main way for giving support to the elder population dependent on ADL, and the trend for this is to increase even more in the future, both because population is aging and because providing services at this level is cheaper for the health system than providing institutionalized care (and also has a more positive social impact on health). I think this has been understood well in Finland, since today the political and technical focus is giving economical, psychological and

technical support to informal caregivers (they receive instruction regarding to how to take care for dependent people and also receive an stipend).

In Chile, (different from the situation of our primary care, that is comparable to the Finnish one), we do not have any organized way to provide services for the elderly. IN my opinion this is a burning problem, since most of the care is provided by relatives: this makes difficult to see and assess the real impact of this condition. Taking care of other person is very demanding in the physical and social aspects (many of the caregivers report fact like having to left their jobs because of the need of providing care and also a detriment in their social and health-related quality of life) and also very expensive. Because of that, I think this constitutes a inequity-perpetuating mechanism because the cost of this condition is not being shared by the society as a whole, and usually women (and specially the poorer ones) are more affected (becaus

e, in my country they are most of the caregivers), not being difficult to imagine the social consequences of that (There are recently published studies in Chile that show some this facts, but we lack of comprehensive research on this topic).

Finally, I would like to talk about other thing that impressed me: In both institutions there were saunas for the elderly. In my country, that would be interpreted as something luxurious and unnecessary, and someone could easily think of the Finnish as lavish and extravagant people.

However, I could appreciate by myself that this places are very important in the social life (In fact I went there many times with friends). That let me remember the importance of grasping the whole context to understand the function of every component or particular aspect of a system. Given this explanation, is easy to understand the "why"... but I wonder how many time one makes judgments or proposes interventions without taking time to see the global picture. I'm sure this was one of the most important things I learned in this course.