Recipes for Systemic Change - Helsinki Design Lab

D2.3 Social And Service NetworksAn elderly person also faces an array of options concerning the socialfabric and service networks they will be connected to—who provides thecare and services for their well-being? The primary support sources areprovided by institutional systems, from independent social networks, or ahybrid situation such as a home care system. These systems will determinean elderly person’s social context and service environment. These optionsare combined with the different physical environments above for a range ofpossible permutations.Home CareAn elderly person who lives independently is still able to receive a rangeof different services and nursing care through the home care system. Careavailable at home ranges from yearly preventive visits to daily proceduralvisits. As of 2004, 10.6% of people over sixty-five living outside of institutionsreceived some form of daily assistance within the home (with 3.6%receiving 24-hour care), while 74.8% received little to no help at all (Healthin Finland 55, figures reported on the male population, but those for womenare similar, though slightly lower). Assistance fall into a number of differentcategories, which are based on the type and scope of services provided.The government has typically made a distinction between home servicesand home nursing (which are now merging under the umbrella conceptof home care) primarily based on the level of the qualifications of theservice providers. “Nursing” may include technical medical assistance andmental or physical rehabilitation, while “Services” might include mealson-wheels,transportation, or laundry and cleaning services. In addition tothese services, there are other “day services” that include programmemedactivities aimed at encouraging social interaction or exercise.Social Networks and Informal CareIn addition to governmental home care services, an elderly person livingalone or with family might receive more informal types of assistancefrom their surrounding community and social network. Assistance at varyinglevels of formality might be provided by family members, the community,volunteers, or even private organizations. If an elderly person liveswith others or has caretakers, care services may be financed by the governmentthrough informal care allowances. For those elderly living at home,the government offers different types of assistance in order to encourageindependence and self-sufficiency.In addition to different types of direct assistance, the government triesprovide access to indirect assistance in the form of renovation grants, whichmay be applied to home modifications that are better adapted to accommodatephysical needs, or informal care support allowances for family mem-290