Demand-based provision of housing, welfare and care services to elderly clients:From policy to daily practice through operations management

Practical implementation of notions such as patient-orientation, client-centredness, and demand-driven care is far from straightforward in care and service supply to elderly clients living independently. This paper aims to provide preliminary insights into how it is possible to bridge the gap between policy intent, which reflects an increasing client orientation, and actual practice of care and service provision. Differences in personal objectives and characteristics generate different sets of needs among elderly clients that must have an appropriate response in the daily routines of care and service providers. From a study of the available literature and by conceptual reasoning, we identify several important operational implications of client-oriented care and service provision. To deal with these implications the authors turn to the field of operations management. This field has deepened the understanding of translating an organisation’s policy into daily activities and working methods. More specifically, we elaborate on the concept of modularity, which stems from the field of operations management. With respect to elderly people who live independently, this concept, among others, seems to be particularly useful in providing options and variation in individual care and service packages. Based on our line of reasoning, we propose that modularity provides possibilities to enhance the provision of demand-based care and services. Furthermore, our findings offer direction on how organisations in housing, welfare and care can be guided in translating demand-based care to their operational processes

The COVID rehabilitation paradox: why we need to protect and develop geriatric rehabilitation services in the face of the pandemic. Comment

Older multi-morbid persons often fall seriously ill due to COVID-19. To be able to participate in a social life again, they often need special rehabilitation measures. Geriatric rehabilitation is a multi-professional service geared to these needs. Paradoxically, however, capacities in geriatric rehabilitation are currently being reduced despite increasing demand. The reasons are manifold and are not only due to the current situation. This article highlights the current situation leading to the COVID rehabilitation paradox and shows ways to learn from it for the future.</p

Fragiliteit bij jonge ouderen: meting met de Tilburg Frailty Indicator

wonende ouderen van 70 jaar en ouder. Doelen: Bepalen van de prevalentie van fragiliteit van zelfstandig wonende jonge ouderen, en nagaan welke factoren een voorspellende waarde hebben voor fragiliteit bij deze doelgroep. Methode: 308 jonge ouderen (58 tot en met 64 jaar) vulden de TFI in, voorafgaand aan een bezoek aan een Consultatiebureau voor Ouderen in Roosendaal. De TFI bevat vragen met betrekking tot fysieke, psychische en sociale fragiliteit en vragen over mogelijke determinanten van fragiliteit. Resultaten: 18,4% van de steekproef van jonge ouderen was fragiel. Vrouwen scoorden significant hoger op psychische en sociale fragiliteit. De determinanten verklaarden 37% van de fragiliteitscore. Een laag inkomen, een ongezonde leefstijl, multimorbiditeit, het doormaken van levensgebeurtenissen en ontevredenheid over de woonomgeving voorspelden zoals verwacht fragiliteit. De drie domeinen van fragiliteit (lichamelijk, psychisch, sociaal) werden door verschillende determinanten beïnvloed. Conclusie: Een aanzienlijk deel van de jonge ouderen in de steekproef was fragiel. De bevinding dat de drie domeinen van fragiliteit door verschillende determinanten worden voorspeld onderstreept het belang om breed te kijken naar het functioneren van de individuele oudere persoon