HOME CARE FOR THE ELDERLY AND DISABLED
We
have 200 beneficiaries who are cared for at home during temporary, chronic or
terminal illness. The cost is just £3.75 per week for each old person cared
for in their own homes. This home care project was the very first to receive
part-funding from the Romanian government - a sign of how good a model for future
practice it is viewed as being. The need Background
to the Project Current Project Monitoring Funding State
Involvement
THE
NEED Transition to a free market economy has left Romania a staggering
8 times poorer than 10 years ago with 44% of Romanians living in poverty. But
the North East area where we work is much more deprived than the average and poverty
rises to 80% in the rural parts. Aid intervention in Romania over the past
ten years has largely focused on children and orphans. The elderly have been mostly
forgotten and excluded from NGO initiatives in social and health care. There
is no community based social care network in Romania. Hundreds of thousands
of old people suffer chronic illness alone at home in terrible conditions. As
one ill old lady said "I'll have to go to the hospital with the white crosses"
- seeing the graveyard as the only option open to her. Recent health reforms
that have produced fund-holding GP's have done nothing to address the needs of
the elderly sick, particularly in rural areas where the few scattered GP's cannot
reach patients in outlying villages. Added to all this, greater poverty
has significantly increased the suffering of the elderly sick and their capacity
to afford even the basic necessities. The "luxuries" of health
care or medicines are simply unaffordable. 40% of patient days in acute care hospitals
are taken up with elderly social cases.
OUR
BACKGROUND IN ELDERLY CARE Our team have set up a project, now in its
5th year, which has received widespread acclaim and provides medical, nursing,
shopping, cooking and cleaning services to the poor elderly sick and disabled
in their own homes. We have set up a home loan centre for nursing and rehabilitation
aids such as wheelchairs and walking frames. In April this year, we opened a Day
Centre for the elderly where they receive counselling, physiotherapy, occupational
therapy and social support. Teams of a doctor, nurses, physiotherapists,
occupational therapists, social workers and home carers provide full care and
rehabilitation for elderly people suffering chronic illnesses including: Stroke
victims
Parkinson's Disease
Multiple sclerosis
Terminal illness
Burns and trauma victims
Heart failure
Alzheimer's disease
OUR
CURRENT HOME CARE PROJECT We provide a unique home care service for
old people so that they can stay in their own homes during temporary, chronic
or terminal illness. Our teams care for 200 homebound people in 4 areas
of Bacau county, NE Romania. By having a referral centre and social worker in
the local district hospital, an equipment loan service, home care teams and a
Day Centre, we are able to provide continuity of care from hospital discharge
through to recovery. For the chronically or terminally ill, where recovery
is not possible, we offer the highest standards of care. The project beneficiaries
are targeted by needs assessment criteria and these are reviewed regularly. In
this way, the project is able to adapt the therapy and rehabilitation plan as
necessary and discharge clients from its service when they are able to live independently. The
project delivers: A meals on wheels service
Regular training
courses in home care for state and charitable sector employees
An informal
national network of organisations involved in providing elderly care
Regular regional and national stakeholder conferences
A manual and guidelines
for elderly home care
Volunteer assistance in the project from local
nursing, social work and physiotherapy schools
Liaison with and support
to the district geriatrician OUR AREA OF OPERATION Bacau
is in the north-east of Romania in an area known as Moldova - a particularly poor
area even by Romanian standards. In rural areas, inhabitants live in small
villages often isolated from each other and the outside world. Transport is mainly
by cow cart on dirt tracks or unmade roads. Some houses have electricity, few
have running water, a village well being common. "Agriculture is
largely subsistence and the population elderly as the younger people leave for
employment in the towns. It is certainly an area of great need, even within a
Romanian context" (EU Phare report on our work in the area in
2001)
WHY IS THIS PROJECT IMPORTANT?
The project
is important in its own right in that it provides home care for 200 dependent
elderly sick, disabled or terminally ill patients to a high standard. However,
the wider impact of the work is what makes it really significant in Romania. Our
model acts as a seed-corn pilot project for communities to develop their own projects
which can be paid for by the state. There has been no precedent
for this and communities need to be shown how it can be done. SPREADING
THE WORK TO NEW AREAS Our three year project from January 2003 proposes
to extend our Home Care of the Elderly project in NE Romania. We will use
three new rural projects to promote rural councils to set up further satellite
projects employing local women as carers whom we will train. We will oversee
all projects until they are fully established and funded by local authorities.
The funding of home carers will eventually be paid by local councils but
a transition period is necessary so that budgets can be applied for based on a
cost analysis of start-up projects (because mayors cannot request a "theoretical"
budget).
VALUE FOR MONEY
Our clients' needs vary
from very high to low dependency. We've got some
case histories to give you an idea of the services provided. The average cost
per week is a mere £3.75 per beneficiary. OUR PARTNERS Fundatia
de Sprijin Comunitar - FSC (Community Support Foundation ) is an independent,
registered Romanian Charity set up by former Relief Fund for Romania key personnel.
FSC is our largest operational partner in Romania. They also have projects delivering
services to street children, therapeutic arts in institutions and rural health
care. Testimonials on our partners:
"Bearing in mind the enormous changes demanded by the altered situation,
the project has been very well implemented … what has been delivered is a
programme of integrated rural development that has crossed sectors and responsibilities
and produced a model of service delivery that is … being adopted and funded
by the local authorities themselves" Phare-Tacis
LIEN monitoring report
"…an effective, professional
organisation leading NGO development in its region and with good operating models,
including its training programmes … I was very impressed by this organization
and its operating style"
Dr John Chandler,
PhD British Executive Services Overseas monitoring report 2000
MONITORING
OF PERFORMANCE The project undergoes continuous internal monitoring.
It is assessed monthly by the local city council and annually by us - the Relief
Fund for Romania. Monthly financial and quarterly narrative reports are supplied
to us. A recent external evaluation stated - "FSC is a key player
in the local community and a role model for other NGOs on how to develop services
in a poor community…the service provision is carried out in a professional
manner…with good training, planning and monitoring of services…" (
'Opportunity Associates' the lead Romanian NGO training and evaluation service,
May 2002)
FUNDING OF THE PROJECT
The
Relief Fund has provided continuous funding with the help of grants from: -
The Community Fund (previously National Lottery Charities Board UK )
- The Phare Lien Romania programme
- The Open Society Foundation (Soros)
- United States Agency for International Development (USAID)/ World Learning
- Romanian National Government funding (Ministry of Labour and Social Security)
- Bacau city council
- Racaciuni village local council
- The Phare
Access '99 programme We are also able to access central government
funding for our poorest clients for food and incontinence materials.
GETTING
THE STATE INVOLVED Over the past 5 years, we have continuously lobbied
for government funding for home care services to the elderly sick. We have presented
homecare/hospital care cost comparisons, case histories and data to local and
national government bodies. Our research studies showed that home care
is more than three times cheaper than institutional care - hospitals
or long stay institutions. These
activities resulted in our project being the very first in Romania to receive
local council funding for home carers.
We then demonstrated
to local rural mayors that government funding can be obtained for the payment
of home carers.
Over the next 3 years, we will be spreading this project
to 3 large rural communities. Local mayors will then spread the project themselves
to up to 19 satellite villages in each rural district.
We will provide the know-how, the training and supervision. The
funds for rural spread will come from local council budgets, from
local businesses and specific grant funding.
Read the personal stories
of some of our beneficiaries
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