Home care has significant safety problems compared to other forms of care. This is evident from a study conducted by the Finnish National Rescue Association (SPEK), which is based on a survey for members of the Finnish Union of Practical Nurses SuPer about housing safety for special groups. Experts from SPEK and SuPer discussed the results of the study, see discussion below.

Toinen ihminen koskettaa hoidettavan kättä.

According to the study, nearly three out of four home caregivers had noticed several safety problems in their clients ’everyday lives. They related not only to movement and general housing safety but also to fire and exit safety. In home care, a person is almost always responsible for their safety alone.

– In round-the-clock care, society takes care of safety, but in home care, safety is left to the individual, SuPer chairman Silja Paavola says in a discussion between SPEK and SuPer.

– Once a decision has been made that home care is the number one priority in which to live, society must also invest in it. The investment must not be such that an unpaid pensioner must pay for their self and dies if they cannot afford to take care of their own safety.

– It is clear from the data that home care customers pay for the safety technology themselves to a very large extent. In other forms of care, it can be part of the service provider’s service, says Tarja Ojala, SPEK’s specialist researcher, who states that support for safety technology can also be obtained, and this is best achieved in disability services.

But if the public sector finances only a part of the expenses, and the rest remains on the customer’s own responsibility, the safety technology is easily not acquired if the person’s funds are not sufficient for the deductible.

– The hob guard is a good example of cost. It costs 300-500 euros with its installations. If I think about the cost from the perspective of a person living on a guaranteed pension, it is more than half of their monthly earnings and that is quite a lot, Ojala says.

Two-thirds of nurses are concerned about home care clients frequently or continuously

66 percent of practical nurses and primary caregivers are concerned about the safety of their home care clients on a weekly, daily, or even continuous basis. Employees were particularly concerned about the safety of elderly and memory-impaired customers.

Employees are required to report grievances but are sometimes prohibited from making reports in accordance with the law. SuPer’s specialist Sari Ilonummi says that this is a well-known problem at SuPer. Although the legislation states that notification must not lead to retaliation, it is targeted at employees.

Reports of grievances by employees must be taken seriously. In the opinion of Paavola, the biggest problem is whether something is being done about the problems and how quickly.

– We [in the social and health care sector] traditionally start looking for someone to blame when we should look for the cause, Paavola points out.

Chairman Paavola reminds that the priority of nursing staff is to keep a person alive and well, and if this concern is not considered in society, nursing staff will be exhausted under their workload when they try to make home care a reasonably good and safe type of housing.

Ojala also draws attention to the fact that the nursing staff has not received sufficient guidance, training, and counseling to conduct a notification of the need for social welfare services.

– If less than a third of those who have made a notification of need have received guidance, and about a quarter of these respondents are required to report under the Rescue Act, that is a really low number, Ojala says.

A home cannot become a safe place to live without investment

Legislation has long required the assessment of the exit safety of the institution and service housing and the implementation of the necessary technical solutions. Instead, the current housing stock is built to meet the functional capacity of a healthy adult and does not provide the kind of security solutions that people in special groups need.

While a home is an economically attractive alternative to care, without any investment, homes cannot provide them with safe residences. For example, when a fire breaks out, a person has very little time to escape safely.

– Life-threatening conditions can develop in as little as two or three minutes, and in ten minutes 80% of people have died in a room where the fire occurs if they have not been able to escape and no one has saved them, emphasizes Kari Telaranta, SPEK’s chief advisor. Telaranta presents solutions for those who are in home care and for whom it is genuinely the right care environment:

– For example, future wellness areas could have portable apartment-specific fire extinguishers to be installed in the homes of people at greatest risk. And when a certain risk threshold is exceeded, investment should be made in lighter safety technology, such as hob guards. In the overall health care budget, these are not large sums, but amounts that should be considered when making decisions, says Telaranta.

An adequate number of nursing staff is a prerequisite for safe care

Paavola and Ilonummi emphasize the importance of adequate staffing in ensuring safety. A sufficient number of trained nursing staff is a prerequisite for safe and high-quality care and occupational safety.

Experts from SPEK and SuPer want safety to be considered in addition to sovereignty. Deciding for yourself requires that the individual has knowledge. Therefore, the home care client should be provided with information about the different safety options so that they can choose safety for their self. Home is also not the best place of care for everyone.

The survey was conducted in the spring and winter of 2019 and was answered by 3,430 practical nurses and primary caregivers by SuPer. The study was conducted by SPEK’s specialist researcher Tarja Ojala. A debate on the results of the study was held on 3 March 2021. From SPEK, debaters include Director Mika Gröndahl, Specialist Researcher Tarja Ojala and Chief Advisor Kari Telaranta. Debaters from SuPer include Chairman Silja Paavola and Specialist Sari Ilonummi. The debate was hosted by SPEK’s Communications Manager Helena Grönstrand and Specialist Soili Nevala from SuPer.