More and more elderly and less self-sufficient so that 34% also need help to eat. They are the elderly who live in the RSA, the assisted health residences. According to the analysis conducted by the Rsa Observatory of the Cattaneo University of Castellanza (Varese), Italy has 19 beds per 1000 inhabitants: a figure far below the average of the OECD countries (47 per thousand). In these structures there are our grandparents and parents who we can no longer take care of and who often feel bad about having to leave their home. A sense of abandonment and enormous loneliness that also weighs on family members who make this choice, sometimes experienced with enormous feelings of guilt. And weekly visits or phone calls are not always enough to fill the void of loneliness. A social issue that has become sadly familiar during Covid-19 due to the high number of deaths right within the RSA. But it was precisely from the experience of the pandemic that an idea was born that could shorten the distance between the elderly and their families.
A choice that ‘burns’
The emotional impact that the elderly suffer when hospitalized in a residential health facility is very strong and often underestimated. “The impact is even more profound if the hospitalization is not the result of a participatory process that involves the elderly person in the choice of moving to this type of structure, but the result of decisions made by others”, he explains. Giovanni Lamura, Senior Gerontologist of IRCCS Inrca, National Institute of Rest and Care for the Elderly. “It is evident that the more the cognitive abilities of the elderly person are intact, the more this choice will ‘burn’ for those who suffer it, with an impact that could become, in addition to emotional, also cognitive and even physical”.
The damage of the pandemic
The quality of care provided within the inpatient facility can reduce this impact. “The services of psychologists, neurologists and physiotherapists can intervene to also take into account the path that the elderly follow starting from their insertion in the structure, but in Italy the presence of such supports is certainly insufficient for the needs, with some exceptions reserved for structures private companies that cater to a target of more affluent users ”, continues Lamura. And then there are the damages of the pandemic: “Covid has made everything much more complicated, due to the restrictions imposed in order to contain the expansion of the virus, which have generally also led to a reduction in contacts with the outside world, contributing to greater isolation of the elderly hospitalized from the outside world, ”Lamura points out.
The sense of guilt of family members
The family of the elderly who is hospitalized also pays a price. “For family members, the experience of an elderly person’s hospitalization in residence is often associated with the onset of a sense of guilt, albeit in part balanced by the relief that such hospitalization entails for family members who are more involved in carrying out daily care activities. This relationship is affected in particular by the methods of managing the terminal phase of the existence of the elderly hospitalized family member, which if not well managed can also lead to significant repercussions with respect to the management of bereavement when this is missing “.
Fragile elderly-families-RSA: a difficult triage
The frail elderly-families-RSA balance is a difficult triage: how does communication between them currently work? “The communication between these subjects has been profoundly modified by the Covid-19 pandemic and only very slowly we are witnessing a resumption of regular contact between the various components”, explains Lamura. But then there is the theme of loneliness: “It is a sore point especially for the cognitively lucid elderly and if not adequately supported by ad hoc animation and social interaction programs”, continues the geriatrician.
The role of digital technology
The digital technology that proved so precious during the pandemic can also be a useful tool to counteract the social isolation and loneliness of the elderly. “The new digital technologies could be an extremely useful factor in contrasting the social isolation and loneliness of the elderly hospitalized in a hospitalization facility,” says Lamura. “However, in order to be truly effective, they must be able to count on adequately trained personnel capable of using them, as well as clearly requiring a minimum investment from the structures themselves”.
Digital healthcare
In particular, some ‘digital healthcare’ projects have been conceived precisely with the aim of staying close even without physically going to the facility. A sort of social telemedicine which, instead of connecting doctor and patient, connects elderly people, relatives and even health professionals. One of the examples of projects of this type is mySOLI, the app (designed by hot) designed precisely to counteract loneliness by shortening the distances between elderly or non self-sufficient patients admitted to health facilities, their families and operators. Objective? Staying in contact with loved ones, involving them in the care process and in the life of the elderly, improving their quality of life and the efficiency of care.
Connecting caregivers and healthcare professionals
Among the objectives of this application, the intuition of which was born shortly before the Covid emergency, and from the personal experience of some team members who live far from their families and do not have the opportunity to frequently visit their grandparents who live in care facilities, to support caregivers and health workers in daily communication with the families of the guests. With mySOLI the process of providing care services offered by residential and healthcare facilities becomes, in fact, simpler, operators are better supported in their care, dispersion or redundancy in information is avoided and patients feel more cared for. The app offers a direct channel of protected dialogue and within reach of a smartphone or tablet, in which to exchange messages and images, share information on the guest’s activities, allow the patient to feel the proximity of their loved ones and to speed up assistance to the facility. .
A digital ‘diary’
MySOLI provides a ‘diary’ function in which the nursing home operator can record the activities, mood and behavior of the guest, updating family members without having to call the facility. In the same environment, relatives, guests and operators can create posts, comment, send text messages, audio and video, like a real community. The photos, videos and voice messages received by the guest are collected in an easy-to-use gallery by the elderly person accompanied by the operator.
Less lonely seniors, facilitated operators, more involved family members
In addition, the operators have a direct communication channel to send requests on the practical needs of the guest. The use of the app is intuitive from the first use, does not require the assistance of operators or specific software installations, and guarantees total privacy in full compliance with the GDPR provisions. “The MySoli App – declares Lamura – is a tool that can facilitate the relationship between patients, family members and staff of the hospitalization facilities for the elderly, and therefore reduce the degree of isolation of non self-sufficient elderly people residing in these structures. On the one hand, it facilitates the work of the operators, who are guided in the provision of online information that is usually requested by most of the family members; on the other hand, it makes this information always available to family members who want to know the situation of their loved one in hospital. In perspective, the added value of the app consists mainly in allowing family members to participate, albeit at a distance, in the care pathway provided to their elder in the structure, and therefore feel involved in it “.
The support of the Lazio Region
The initiative was partly financed by Lazio Innova-Regione Lazio with the use of European funds as part of a more articulated project that aims to develop innovative models of assistance for a greater humanization of medical care. The development and release of the app took about 3 years of work, starting with a needs analysis activity with a qualitative-quantitative research aimed at residential structures in a sample region representative of the national context (Lazio).
Needs analysis
The work took an updated photograph of the conditions of hospitalized users, the difficulties of their families, the practices in use and priorities, also collected through the voice of sector operators, associations, experts, in a logic of co-creation. A series of excellent partners were also involved in this process, including INRCA-the National Institute of Rest and Care for the Elderly, the social information agency Redattore Sociale and the Di Vittorio Foundation for economic and social research. mySOLI has just been awarded the prestigious SilverEco & Aging Well Award 2022 at the fourteenth edition of the international festival dedicated to the silver economy held in Cannes on 12 and 13 September and which has selected the best world best practices on the subject.
How to use the App
The app is available to all facilities that request it and that bear a one-off activation cost and then decide whether to allow users access for free or with a fee of a few euros. mySOLI is already in use at some facilities in the province of Rome, including the Villa Romani nursing home. In addition, work is underway for the accessibility of the app also for users with absolute visual and hearing impairments.