Recipes for Systemic Change - Helsinki Design Lab

D3—Beyond Functional CapacityContemporary research suggests that an elderly person’s well-being canbe judged by two major indicators, one related to medical issues and oneto social issues:1. The condition of their musculoskeletal system.2. The robustness of their social networks.Current government policy in Finland echoes these assumptions: theprimary objectives of the government in providing care for the elderly areto increase the functional capacity of the elderly, maintain their independence,and promote their involvement in society. (National Framework forHigh-Quality Services for Older People)In order to maintain functional capacity, independence, and involvement,care must address both medical and social issues. Care for the elderlytherefore straddles the line between two traditionally distinct disciplines.Health and social services are often separated in Finland, in terms of philosophicalunderpinnings, to training regimes, to the service structures ofadministrative policies.The difficulty of the situation is generally recognized at most levelsof the welfare service structure. For example, Helsinki is currently in theprocess of trying to combine their Health and Social Services departmentsinto one coherent unit. Yet, if Finland is to achieve its goals with regard toelder care, it will have to do more than simply close this divide. The stateswill have to provide more sophisticated services without further isolatingthe elderly within an institutionalized regime, and do so under a tighterbudget.Finland’s current strategy has been to promote extended home care asthe major mode of caring for the elderly. From the ministries to local healthcentres, there is an increasing acceptance of home care as a panacea thatcan potentially integrate medical and social care, decrease isolation andpromote independence, and still remain the more cost-effective alternativeto other forms of care:“…support for independent living in the community is supposed to bethe cornerstone of future old age policy…outpatient and housing servicesmust be developed in such a way that older people can continue to liveindependently in their own homes as long as possible…effective housingand planning policy can help to reduce the need for services…it isimperative to have better coordination and integration of social welfareand healthcare services. Private services are needed alongside the existingrange of public services, and better coordination is needed betweenservice providers.” (Health in Finland 145)294