Prove that frail elderly people can continue living at home safely and independently despite the deterioration in their health, thanks to service innovation
The elderly-friendly housing model was elaborated, tested and implemented by the Hungarian Charity Service of the Order of Malta (HCSOM) and financed by the government. It tackled the problem that many of the elderly had one or more falls at home because of different obstacles were not removed and their immediate environment was not adapted to their loss of functions.
Modifications to turn their flats more user-friendly were made in three different ways: 1) with technically modern solutions if they were accepted by the elderly; 2) with a solution adapted to the knowledge and needs or demand; 3) with mental help, explaining the technical solution through a time-consuming procedure. In the course of the modifications it was often necessary to apply solutions falling in category 2, despite it was not up to date. Quality of life of elderly can be improved by creating an obstacle-free environment. Such a simple measure with a cost-effective impact can help to prevent hospitalisation or placement in a residential home. HCSOM implemented a pilot in 2003-2004. The pilot was followed by a large scale call in 2009 at national level and has been replicated almost every year at local level since 2013.
The Ministry of Social Affairs and Labour and the HCSOM concluded an agreement to open call for applications submitted by people receiving social elderly primary care services. The call offered support to improve living conditions of elderly and physical accessibility to their homes.
The Ministry provided app. EUR 1 M for funding the programme, enabling allocating EUR 1600/applicant. The programme was executed by a staff of 2-3 people working in part-time. HCSOM provided this capacity under its charity services.
Evidence of success
The expenses of implementation amounted only half of the cost of a one-week-hospital-treatment for a hip fracture, or less than half of the cost of stay in a residential home for one year operated by normative state funding. As a consequence of the successful innovative model programme, in 2009 the opportunity was created to apply for state funding to create obstacle-free housing for recipients of home care. In one month 2700 applications were submitted (of which a quarter were accepted).
The need for making homes of elderly obstacle-free became generally accepted, but selecting the proper solution and the implementation were unknown area. Home improvements for the elderly were understood as painting, renovations and improving conveniences. The necessary approach was lacking.
Potential for learning or transfer
It is a Good Practice (GP) for a public driven innovation to answer unmet needs of end-users delivering obstacle free housing re-construction to enable appropriate environment for home care with or without support of technological innovations.
One quarter of the falls at home happen due to physical obstacles inside the home. The follow-up after one year of making a flat obstacle-free at relatively low cost clearly showed a great reduction in the number of falls.
It is also proven that success could be achieved if the endusers’ opinion on changes and needs for modifications were taken into consideration. The GP suggests new solutions in the respective societal, cultural and economic context, and creates new patterns of social practices to overcome shortcomings of traditional arrangements. It managed to overcome the traditional dichotomy between technological and social innovations, and promotes the integration and/or collaboration/partnership of heterogeneous stakeholders.
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