MUNICIPALITIES: 134 PRACTICES
The Region of Crete is a Local Self-Administration Organization of second level and consists of 4 Regional Units : Heraklion , Lasithi , Rethymno and Chania. ROC designs and implements policies on economic, social, tourist and cultural development of the island .
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The general objective of the program is to promote healthy and active ageing through a) the psychological empowerment, promotion of psychological resilience and the improvement of the quality of life of the elderly, b) combatting loneliness and social exclusion/isolation and c) mental empowerment and enhancement of their functional abilities.
Specific aims are (A) the psychosocial and mental empowerment of the elderly living in elderly care units/nursing homes in the Region of Crete, combatting loneliness, enhancement of self-care skills, improvement of their well-being and quality of life and (B) the updating of the knowledge and professional skills of the health professionals/formal caregivers working in the elderly care units/nursing homes in the best practices of care, early diagnosis and empowerment of self-care of the elderly, in order to provide services of optimal care to the elderly living in elderly care units/nursing homes in the Region of Crete.
The program addresses two groups (DIRECTLY): (a) elderly people living at 20 elderly care units/nursing homes in the Region of Crete and (b) health professionals/formal caregivers working in elderly care units/nursing homes and (INDIRECTY): (a) the general population (sensitization of the general population against negative stereotypes and discrimination of the elderly that will be achieved through the publicity actions of the program) and (b) the Region, organizations and any other interested body, public or private (use of results for the design of an integrated program of social cohesion and social inclusion of the elderly as an active and important part of society)
Start: February 2021. End/Completion: 31.12.2022.
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According to recent Eurostat data (2017), Greece has one of the most aging populations in the EU-28 (21.5% are over 65 years old). From the perspective of healthy and active ageing, promoting mental health and improving the quality of life of older people is as important as improving their physical health. However, according to the AgeWatch World Index (https://www.helpage.org), Greece holds the 79th place (last place in Western Europe) in relation to the quality of life of older people in 96 countries. We know that while older people are healthier and more active than before, they are increasingly facing "new type" of problems, such as loneliness and social isolation (Active Ageing Index - UNECE/European Commission, 2019), with dramatic consequences (e.g., decrease in cognitive ability, decreased psychological resilience, increased risk of depression, premature mortality). The economic crisis, as well as the recent pandemic (COVID-19), have increased the risks for the elderly and have created conditions of poverty and further social isolation. Therefore, it is necessary to improve the quality of life of the elderly and especially those who live in elderly care units/nursing homes.
Employees who have to face the challenges of the elderly daily are not specialized and in addition they are employed for more than 10 years without training and updating of their knowledge. Therefore, a specialized training of the staff of the nursing homes is necessary for the management of the vulnerable group of the elderly. The training will help them to better address the multiple problems faced by the elderly, to improve services and therefore to improve the quality of life of the elderly.
Local and Regional Government can make a decisive contribution to maintaining social cohesion and improving the quality of life of the elderly. In particular, the Region of Crete with the elaboration of the Regional Strategy for Combating Poverty and Social Inclusion, aims at developing an integrated policy of prevention and combating the social exclusion of the vulnerable population groups. It is also the only Region in the country with a special Measure for active aging in the Social Inclusion Strategy, recognizing the need to promote initiatives at the local level to improve the quality of life of the elderly.
Therefore, this intervention is considered necessary, as it implements actions to achieve the objectives of the Regional Action Plan for active aging and is aligns with the overall strategy of the Region of Crete for social cohesion and development and aims at empowering elderly for self-care and independency and improve their "well-being".
Method of design and implementation
This program is implemented by the Laboratory of Interdisciplinary Approaches for the Enhancement of Quality of Life, of the Hellenic Mediterranean University, the head of which Argyroula Kalaitzaki, Associate Professor of Clinical Psychology and Head of the Department of Social Work. The project is funded by the Region of Crete and Argyroula Kalaitzaki is the scientifically responsible / coordinator of the project. The program is implemented online (due to COVID-19) in the elderly care units/nursing homes. For this purpose, the Region of Crete provided 91 tablets at the 20 nursing homes in Crete and ELMEPA developed an educational digital platform ("Body & Mind Academy") and all the other digital material needed. The program includes actions in two (2) sub-projects:
Subproject I: Psychosocial and mental empowerment of the elderly. Subproject II: Training of professionals-employees
Details for Subproject I: Psychosocial and mental empowerment for groups of approximately 10-15 elders (total 20 hours per group: 5 hours for 4 weeks) with actions for: (1) Psychological empowerment and improvement of well-being (2 hours/week): (a) Recognition of emotions and (b) Improving well-being and increasing happiness with practical exercises based on Positive Psychology (focus on strengthening skills, virtues, talents, increasing subjective happiness, reducing stress and depression and achieving a fulfilling life). (2) Combatting loneliness / social isolation (2 hours / week): (a) Addressing social problems of the elderly and (b) Training in communication (3) Mental empowerment (1 hour / week): (a) time orientation and (b) Recall of Experiences.
The means used are interactive - experiential exercises, storytelling, therapeutic fairy tale, music, painting, discussion - storytelling, etc.
For Subproject II (Training of professionals): The training (54 hours in total) was implemented synchronously (22 hours) and asynchronously (32 hours) in the following topics: Use of tools for early diagnosis of bedsores, dehydration, diabetic foot, Management of pressure ulcers and diabetes, Elderly feeding techniques (oral, nasogastric catheter, gastrostomy, gastrostomy), Measures to prevent the spread of infections and Prevention of thromboembolism. The following tools were used for synchronous training: PowerPoint presentations, videos, case studies. For asynchronous training were used: study material, exercises through electronic platform, multiple choice questions, filling the blanks, etc.
After the completion of the Subprojects I & II, the following will be carried out: (I) evaluation (a) of the effectiveness of the program (whether the objectives for both groups were achieved) and (b) of their satisfaction with the program. (II) actions to raise awareness and disseminate / publicize the results of the program.
Originality and Innovation.
Reproducibility of the practice
The material used is available for anyone interested to use it. The Region of Crete is already in the process of signing a new contract with the Laboratory of Quality of Life for the extension of the actions of the program called “NOT ANYMORE ALONE” to the Day Care Centers for the Elderly (KIFI) of the Region. Specifically, it will implement training activities for KIFI employees (title: "Integrated Intervention Program for Updating KIFI Employees' Knowledge").
Preliminary results of the Subproject I (elderly) are available for some of the participants, as the project has not yet been completed.
ASSESSMENT OF THE MENTAL HEALTH OF THE ELDERLY BEFORE AND AFTER THE PROGRAM: The elderly after the intervention showed a significant reduction in depressive symptoms and loneliness and an increase in psychological resilience (see Figure 1).
ELDERS’ SATISFACTION FROM THE PROGRAM: The elderly generally reported that they were quite satisfied (see Figure 2). EVALUATION BY THE SOCIAL WORKERS IN THE NURSING HOUSES: In focus groups and in a respective questionnaire, the employees in the nursing homes (mostly Social Workers) reported that they believe that the elderly the elderly has gained many benefits from the program.
The results of Subproject II (for professionals) are in the final stage of the analysis. A questionnaire of 26 questions was given to be completed for reporting their satisfaction from (a) the training program/courses (Figure 1), (b) the professors (Figure 2) and (c) the contribution of the training program to their daily practice (Figure 3). The results were very encouraging, with the trainee professionals reporting that they are very satisfied with the program. For example, answering the question “Do you think that the program has made a significant contribution in updating your knowledge?” 58.1% reported “Extremely”, 38.7% “Very much”, and 3.2% “moderately”.
Four Prefectures of the Region of Crete.
The program is implemented in collaboration with the Laboratory of Interdisciplinary Approaches for the Enhancement of the Quality of Life (hereinafter referred to as the Quality of Life Laboratory) is an institutionalized laboratory of the School of Health Sciences of the Hellenic Mediterranean University, which offers educational, academic, and research work related to the improvement of the quality of life. The head of the Laboratory is the Associate Professor of Clinical Psychology and head of the Department of Social Work, Argyroula Kalaitzaki. The laboratory has specialized scientific staff in areas that cover a wide interdisciplinary range in the health and social sciences and is active in the following areas: (a) Vulnerable Groups (b) Chronic Diseases, (c) Technology and Health, (d) Intercultural and Quality of Life, (e) Quality Assurance of Care, (f) Health / Social Care Systems and Improvement of Quality of Life, (g) Design and implementation of training and social intervention programs, and (h) Crisis situations. Among the interests of the members of the laboratory are aging, dementia and Alzheimer's disease, areas in which they have carried out activities and numerous studies, publications in scientific journals, presentations in national and international conferences, workshops, etc. The Laboratory has developed tools / methods for the provision of services to the elderly and the education/training of the carers (formal and informal), as well as for the awareness of the general public. The research staff of the Laboratory has the know-how to provide psychosocial support services to the elderly and lifelong education/training to the healthcare and social services professionals in topics of clinical practice, administration, evidenced-based care on best practices, etc.
Region of Crete collaborates with another research laboratory of the Hellenic Mediterranean University (ELMEPA), called NILE. NILE has specialized staff and know-how in ICT and in Virtual Educational Environments. NILE provides the platform "Body & Mind Academy", which is an educational digital environment that supports through interactive and non-interactive tools, the mental, physical, and social activity of the elderly.
The program “NOT ANYMORE ALONE” employs / employed 16 people: In Subproject I (for the elderly groups): 1 faculty member of ELMEPA, 3 external collaborators (2 Social Workers and 1 Psychologist) and 2 Social Workers voluntarily (1 professional and 1 PhD student). In Subproject II (training): 2 faculty members of ELMEPA, 1 faculty member of another University (PADA) and 2 professional Nurses (1 of them a PhD student). Also employed (for the platform): 1 faculty member of ELMEPA (voluntarily), 1 Administrative employee of ELMEPA (voluntarily), 1 undergraduate and 1 postgraduate student of ELMEPA. Additionally, 1 Sociologist (voluntarily).
Measurable results
Other results
