ANTENNEBEROEPEN IN DE LOKALE GEMEENSCHAP ALS SLEUTEL VOOR DOORVERWIJZING VAN KWETSBARE OUDEREN NAAR HULPORGANISATIES

Abstract

SAMENVATTINGZowel in Vlaanderen als in Nederland werd de voorbije jaren sterk geïnvesteerd in preventie en interventieprogramma’s om kwetsbaarheid bij ouderen tegen te gaan. Kwetsbaarheid wordt doorgaans gedetecteerd door gezondheidsprofessionals. Deze studie exploreerde hoe andere professionals buiten de zorgsector zoals postbodes, winkelbediendes of apothekers een antennefunctie kunnen hebben in de detectie van kwetsbare ouderen door hen door te verwijzen naar zorg wanneer dit nodig is. Daarnaast werd nagegaan in welke situaties zij acties ondernemen en welke ondersteuning nodig is om de rol van antenneberoep op te nemen. 18 professionals werden individueel (n=12) of in focusgroep (n=6) geïnterviewd. Resultaten van dekwalitatieve analyse tonen aan dat zij veelvuldig in contact komen met kwetsbare ouderen tijdens het uitoefenen van hun beroepsactiviteit. Door in gesprek te gaan met de ouderen detecteren zij verschillende vormen van kwetsbaarheid. Zij kunnen en willen een sleutelrol opnemen om deze ouderen door te verwijzen naar zorgondersteuning maar stellen zich vragen omtrent de privacy. Een centraal meldpunt per gemeente zien zij als een oplossing. ABSTRACTBackground: When older adults have early symptoms of frailty, research indicates that an early intervention can delay or avoid adverse frailty outcomes such as hospitalization or institutionalization. Frailty is to date mostly detected in a medical setting. General practitioners or home care nurses are care professionals who are the key persons in this detection. The informal network of frail older people as well has a crucial role in avoiding the worsening of frailty and the prevention of adverse frailty outcomes. Unfortunately, not all older adults in need of care have adequate care networks. In the past years, many policies have seriously invested in prevention and intervention programs for frail older adults. Within the D-SCOPE study, the potential role of ‘non-care professionals’ is explored for detecting frail older adults without an informal network and potentially leading them to formal care. Professionals such as pharmacists, mailmen or cashiers have frequent contact with frail older adults and can be seen as “antenna professionals” given they receive considerable information from their clients or costumers. This explorative study researched (a) whether antenna professionals can detect frail communitydwellingolder adults, (b) which action they undertake when they detect a frail person andwhich barriers may occur to initiate an action and (c) which support is needed to be an antenna professional.Methods: 18 persons with different professions were interviewed: pharmacists, police inspector, bank clerk, mailmen, local business owners such as florist and grocer, manager from a hair salon or supermarket and more. Professionals who didn’t had contact with frail community-dwelling older adults during their work were excluded for an interview. Participants were asked to what extend they had contact with frail older adults who were according to them in need for help, if they everreferred them towards appropriate care, what an antenna profession meant to them, what support they need to act as one and which barriers one can expect for this kind of function. All interviews were thematically analyzed.Results: The professionals could detect frailty in numerous ways. Physical frailty was visually noticeable and by starting conversations, other psychological and social frailty became visible while practicing the profession. Not seldom older adults themselves shared tragic stories of their lives. Cognitive frailty was recognized with alert signs, for example when older adults came to buy the same item twice. These professionals regularly initiate actions that were sometimes linked to their profession such as giving advice or delivering groceries. Just listening to thestory could also be seen as an action for helping frail persons. In specific cases, situations were passed towards healthcare professionals or relatives. Barriers for referring frail older adults towards care organizations were concerns about privacy, fear of losing the continuity of the daily activities, correct estimating if one in fact needed help and finding the right balance between professional and personal life. Most participants in the study thought they could act as an antenna function for referring towards professional care although they are most concerned about the privacy regulation on this matter. One central contact point in the community for referring frail older adults was believed to be a solution to prevent frailty worsening and the question to mention this anonymously was more than once raised. More concerns of the possible antenna professionals were found in three evolutions that were analyzed across the interviews. A first was the disappearance of local business owners in the community. A second was the decline of neighborhood social capital, which makes older adults increasingly turn to neighborhood stores for social contact. A third evolution is the transformation of the social character of antenna profession in a digitized world or higher work pressure.Discussion and conclusion: The findings illustrate that professionals can have an antenna function in the detection of different types of frailty. To use the information of these professionals, their concerns should sincerely be acknowledged. Not only was correctly estimating if one effectively needs help a concern, also privacy issues were discussed. Referring a frail person with care needs anonymously is straightforward not possible according to the European Union regulation on the protection of natural persons with regard to the processing of personal data. Therefore, all professionals must have the permission of the older adult before referring him or her to a care or welfare organization. It should be noted that this study was explorative and possible other persons with an antenna function such as members from clubs or societies for older adults, neighborhood volunteers, priests or Imams were not included in this study and could have an important antenna function as well. The findings of this study however provide a basis for care or welfare organizations in the development of a policy towards the implementation of professionals with an antenna function for detecting frail community-dwelling older adults. These professionals already have valuable information that can be used to prevent frailty worsening.

Keywords

• ouderen, oudere volwassenen, kwetsbaarheid, detective, preventie