Strain on elderly family caregivers and their functional capacity must be better monitored

An el­derly cou­ple in poor con­di­tion did not re­ceive help in Pöy­tyä in Au­gust–Sep­tem­ber 2022. The home care ser­vice had vis­ited the cou­ple in late Au­gust, but had been un­able to reach the cou­ple for ten days fol­low­ing the visit. The po­lice found the cou­ple in their home in early Sep­tem­ber. The wife had died af­ter be­ing left with­out med­ica­tion. The hus­band was found in ex­tremely poor con­di­tion.

The husband was the family caregiver of his wife. There were no close relatives. The couple were clients of social services through an informal agreement, but were not official clients of the home care service.

“This investigation clearly highlighted that social services have not identified the challenging care responsibility of a family caregiver who doesn’t have any close relatives or a support network. There are no national criteria, processes or indicators for family caregivers which makes getting the bigger picture complicated. A starting point for a way forward would be to regularly conduct a comprehensive assessment on elderly family caregivers who do not have a support network of a family. The questions to ask is whether they even have the capacity to carry out their duties. Special attention should quite frankly also be paid to promoting their wellbeing,” emphasises Dr. Hanna Tiirinki, Investigator-in-Charge.

The current information systems are fragmented, and they do not support generating an overall picture of client information and patient records on the health and wellbeing of elderly persons living at home. The healthcare and social welfare system should encourage workers to study client information and patient records when the task requires it – not the opposite.

“With the given recommendations, we are now calling specifically for the creation of national indicators for measuring the family caregivers’ capacity to cope and the assessment and monitoring of their functional capacity. Today, remote technology and digitalisation enable better monitoring – the opportunities they offer should be used. Home care should also have comprehensive operating models for exceptional situations – here, the patient and family caregiver were left without help or contact for ten days,” says the Investigator-in-Charge Tiirinki.

Ministerial Adviser Ms. Satu Karppanen from Ministry of Social Affairs and Health, states that family care is one social service among others, and the wellbeing services county is responsible for arranging it. The statutory requirement for granting a family care allowance is that the health and functional capacity of the caregiver are sufficient for providing the care, and that family care together with the other necessary healthcare and social welfare services is sufficient with regard to the wellbeing, health and safety of the person receiving care. For that purpose, the wellbeing services counties must assess the service needs of both the caregiver and the person receiving care regularly.

“Healthcare and social welfare services develop and adopt different kinds of technologies to meet the needs of clients. In that sense, we at the Ministry of Social Affairs and Health endorse the use of remote technology, among other things, for establishing situational awareness of the health and wellbeing of the clients. Remote connections can make it possible to receive information quickly on matters such as the condition of a client within the scope of family care (i.e. a person receiving family care) and the family caregiver”, states Ms. Karppinen.

Further information

Investigator-in-Charge, Dr. Hanna Tiirinki, Safety Investigation Authority, Finland, tel. +358 2951 50747
Ministerial Adviser Ms. Satu Karppanen, Ministry of Social Affairs and Health, tel.+358 2951 63549