Community-Led Ecosystem: A Promising Strategy to Strengthen Person-Centered Geriatric Care in Preventing Age-Related Dependency

Community-Led Ecosystem: A Promising Strategy to Strengthen Person-Centered Geriatric Care in Preventing Age-Related Dependency

Elzbieta Bobrowicz-Campos (Nursing School of Coimbra, Portugal), Filipa Costa Couto (Nursing School of Coimbra, Portugal), Luísa Teixeira-Santos (Nursing School of Coimbra, Portugal) and João Apóstolo (Nursing School of Coimbra, Portugal)
DOI: 10.4018/978-1-5225-9818-3.ch003

Abstract

In this chapter, the triangulation analysis of connections between older adults, relevant stakeholders, and community will be made in order to acknowledge the challenges resulting from demographic changes, identify the gaps in current health and social policy in the field of geriatric care, and outline the pathways for joint actions to achieve successful aging. This analysis will also consider health and health equity drivers, highlighting the relevance of the community-led ecosystem in the spreading and scaling up of the person-centered and integrated healthcare model. By focusing on frailty and frailty-related consequences, this chapter will reflect on the need for implementing joint actions that promote health throughout the lifecycle and that empower citizens for informed decision making. It will also discuss the role of modern societies in creating innovative solutions for successful aging.
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Introduction

The global development that societies have accomplished in the past years across Europe leads individuals to live more (European Commission, 2012, 2014, 2016). The gains and achievements associated with this evolution are mostly recognized in the health systems. However, this increase in lifespan does not necessarily mean that individuals experience more years of healthy life or perceive their quality of life as high (World Health Organization, 2015). The consequences of demographic aging go beyond the individual sphere and gradually widen into supportive networks such as families, groups and communities, affecting the resilience of society in general (United Nations Population Fund & HelpAge International, 2012). In this context, considerable efforts must be made to align visions of actors from different community sectors (scientific and academic experts, public authorities, industrial partners and civil society organizations) and assure a shared approach to the challenges imposed to health and social care systems by the rapid ageing of the world population (World Health Organization, 2017a). This unanimous and shared vision of various community stakeholders allows the clear identification of urgent points of action with the older people and their support network. Following this identification, it is crucial to understand and integrate measures of practical managerial significance that provide health education researchers and practitioners with tools to address issues related to the practical significance of person-centred interventions.

This chapter will reflect on the impact of demographic changes on the health and well-being of citizens, focusing on age-related frailty, disability and multimorbidity, and analysing the evidence that supports the need for change in the health paradigm from acute intervention to prevention. Then, the authors will identify gaps in current health and social policy with respect to geriatric care, demonstrating the weaknesses of the “one size fits all” paradigm, and establishing the pathways for engagement of community in activities that promote successful (it means, healthy, active, participatory and inclusive) ageing. Finally, the authors will explore the possibilities of building a consensus vision to address priorities within the framework of action in health. The overview of the key topics associated with demographic aging will allow outlining strategies to strengthen the person-centred approach in geriatric healthcare, thereby contributing to the activation of mechanisms for awareness raising and mobilization for action. To ensure that these strategies are suitable for use in the community-led ecosystem, their conceptualization will consider the guiding principles of inclusive, innovative and reflective societies (World Health Organization, 2017b; European Commission, 2012). It will also contemplate the expected capacity of the community to make health and ageing a shared value, to prioritize health needs that enable maximization of functional ability and well-being in older age, to establish standards for implementing new approaches, and to enable translation of the evidence-based knowledge into health practices and policies (World Health Organization, 2012a). By exploring the current and future perspectives on health systems in the aging society, with the simultaneous analysis of associated threats, opportunities, weaknesses, and strengths, the authors of this chapter will contribute to the spreading of the new sustainable and efficient model of healthcare. This new model will promote an integrated and personalized approach to geriatric care, and where citizens take responsibility for their own autonomy and well-being, thus boosting a shift in health paradigm from acute intervention to prevention.

Key Terms in this Chapter

Aging in Place: The possibility of older people to continue to live at home and in the community over time, in a safe and independent manner.

Sustainability, Responsiveness, and Effectiveness of Health and Social Care Systems: The capacity of health and social care systems to provide cost-effective responses that are tailored to the individual needs.

Person-Centered Geriatric Care: A type of care where interventions, products or services are implemented, delivered or offered by healthcare professionals, informal/formal caregivers or stakeholders, in accordance with older adults’ preferences, needs, wishes and values (holistic approach).

Health-Oriented Global Citizenship: This term reflects the idea of social responsibility for the effective changes in the field of health through sensitization actions focusing on understanding, attitudes, and behaviors.

Inclusive Society: Is a society where all people, independently of their individual circumstances, feel included. In the perspective of demographic changes, inclusive society provides opportunities for older people to achieve their individual goals, despite the loss of cognitive or physical capacities.

Active and Healthy Aging: Process for developing and maintaining functional capacity that enables wellbeing in older age.

Frailty: A geriatric clinical condition that is associated with physical, psychological and social impairments that influence the way older adults deal, react or manage with internal or external stressors. This condition is closely associated with loss of independence and quality of life.

Drivers of Health and Health Equity: Interconnected key-aspects that influence global health and could determine or not the existence of equity among individuals, independently their age. Drivers of health are essential to ensure social cohesion and sustainability and contribute to the establishment of a culture of health.

Community-Led Ecosystem: Dynamic strategy where several endogenous and exogenous scientific, academic, clinical, political and economic resources are considered by different ecosystem actors aiming at developing, reinforce or protect the community where they belong and are inserted.

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