Clients' own goals for care in HC and LTC. Kim Josefsson, psychologist, PhD. Finnish Institute for Health and Welfare THL. World interRAI Conference 2020.

1. Finnish Institute for Health and Welfare
Clients‘ Own Goals for Care in HC and LTC
Kim Josefsson, psychologist, PhD, Aleksandr Gerasin, Anja Noro, Satu Havulinna, Matti
Mäkelä
Finnish Institute for Health and Welfare

2. Finland facts
• Area about the same
size as Germany
• Population: 5.5 million
• Length: 1157 km
• Width: 542 km
• Most people live in
Southern Finland
Source: EU Open Data21.1.2020

3. We have a long experience of
RAI in Finland
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4. Why Do Clients’ Own Goals Matter?
Older people
usually wish for
flexible care that
fully recognizes
their individuality
 high quality
care
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5. Background
• The Finnish home care (HC) and long-term care (LTC)
instruments were augmented with an open-ended
question, “what are your own goals or expectations for
your care”
• We describe the first responses to these questions in a
convenience sample of older Finnish people (1101 using
HC, 509 using LTC, mean age 84 in LTC and 81 in HC ),
assessed in 2018.
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6. Methods & results
• The goals were grouped to 13 categories in an entirely
data driven process. One answer could belong to several
categories.
• Ten categories were thematic (e.g. pain related), and
three were “no goals / couldn’t say”, “other”, and “strange
/ peculiar answer”.
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7. Results: The Goal Categories
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8. Results
• Although the goals were supposed to be expressed by
the clients, some goals (about 1/3) were classified as
goals formulated by the nurses.
• Nurses need more experience and training to follow the
procedure of what is and is not “a client’s own goal” as it
is defined in the RAI-manual.
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9. Discussion
• An older person is, in the constraints of possible
performance deficits, an active participant and actor.
Clients set their own goals, choose topics of interest and
reflect on their own actions.
• Most older people in HC and LTC can express goals for
their care always ask about these goals.
• Knowing and acting on the goals is respecting the client.
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10. THANK YOU
ANY QUESTIONS?
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