Tubbemodellen

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Tubbemodellen

Skärhamn, Sweden
Project Stage:
Established
Project Summary
Elevator Pitch

Concise Summary: Help us pitch this solution! Provide an explanation within 3-4 short sentences.

The Tubbe model is a housing model that was developed to give elderly people power to control their daily living at home.

About Project

Problem: What problem is this project trying to address?

Elderly care is facing a big callenge in several ways. Economy is one part; the elderly live longer, their number is increasing and above all, each individual is different with different needs. Finding staff with the right qualification is antoher dilemma. If we don´t change focus to give coworkers more responsibility and increase their participation at work they will choose other careers. Senior citizens of today have preferences and demands concerning the life they want to live. Many of them have had qualified jobs and carry a rich experience from their previous lives. They know what is meant by a good life and what contributes to good health. They can formulate their needs and the public sector is challenged to respond to these needs according to social service legislation and to financial resources. We know that health promoting elderly care has to provide a sense of coherence, comprehensibility, make things seem manageable and meaningful. The pace in elderly care is often so accelerated that action comes before reflection and we don´t have the time to consider what is really in the best interest of the elederly person. If we don´t organize ourselves well enough to meet these challenges we will inevitable lag behind within our own organization and only have time to deal with problems and complaints. The model - or form of organization - we use, is critical for our capacity to provide an elderly care with dignity where we contribute to give health and happiness a central role. Finances also need to be handled efficiently. With better insight and more knowledge, employees in elderly care can increase their understanding of what is important for an elderly person. Thereby a service that can offer an extra flavour to life for the clients can more easily be provided.

Solution: What is the proposed solution? Please be specific!

Tubberödshus (a housing association in the village of Tubberöd) visited a housing complex in Denmark founded on the ”Lotte model”. We then adapted this model to Swedish norms and regulations. Some of the unique characteristics of this model are how the elderly are included at all levels in planning and decision making to ensure control and quality in their own living conditions. Employees are given a high degree of responsibility and participation in their work. The leadership is participative and process-oriented. We also work to minimize the difference in roles between employees and seniors. Work groups have been formed within the organization for all different work areas that are needed for modern elderly care. All activities rest on these groups and have confidence that all of them contribute with their part in each care work area that have been assigned to each of the groups. The pedagogical group works with coworker supervision to ensure an adequate approach in care and with care implementation plans to guarantee that each elderly person gets the support they need. This group also works with quality development in management to ensure routines and security and they regularly evaluate (through questionnaires) how the seniors peceive the quality of living in Tubberödshus. The activity group works in dialogue with the seniors to plan and arrange activities to cover all kinds of needs, both when our seniors wish to travel or when somone is so fragile they can only be commincated with through touch and food. A brochure describes all available monthly activities. In general two activities are offered each day. We offer gymnastics, parties, reading aloud, bingo, ice cream walks and much more. We also invite seniors that do not live in Tuuberödshus as they add a lot for ”our” seniors. We also have group responsible for all purchases and a personell group responsible for hiring and managing our staff. During the recruitment process, our seniors often participate in the selection of new staff, which is much appreciated. We also have our own restaurant and the seniors participate in the "food council" that decides the menu. One representative from each of these workgroups form the board for Tubberödshus together with two representatives from the municipality and, starting the coming autumn, including senior representatives.
Impact: How does it Work

Example: Walk us through a specific example(s) of how this solution makes a difference; include its primary activities.

Before this summer we needed to recruit new staff. At the recruitment interview, a senior representative participated together with the leader of Tubberödshus and co-workers. Questions were made from different perspectives and it could be noticed that the seniors used slightly different criteria that added to the quality of the recruitment process. After the interview we had a dialogue to select the most suitable candidate and a consenus decision was reached that included the senior as well as the coworkers. This is an example how we value knowledge and experience that the elderly can add. Our experience is that the more opportunity we give for the seniors to participate in this way, the more interested they are to do so. Everyone wants to feel needed independently of where we are in terms of other needs. To decide to use all knowledge that is available in an organization, or, as we usually do, only part of it, and in addition only that part which is represented by the employees, really makes a difference. Our seniors grow with this kind of participation, exemplified here through participation in a job interview.
Sustainability

Marketplace: Who else is addressing the problem outlined here? How does the proposed project differ from these approaches?

Several other models of elderly care show good results, including models with individual plans for care implementation and for activity programs. The Tubbe model is unique in relation to such models through the degree of senior participation and influence. With more participation opportunities, the interest to participate has increased even more. The seniors realize that our work is based on their values and interests. In this way a gradual power transition from employees to seniors is created. We think such an approach is appropriate and necessary to meet future demands in elderly care. Those who need assistance should have the right to influence what kind of assistance they will receive. Another unique feature of the Tubbe model is the kind of new knowledge the staff can acquire through this approach. Step by step employees learn to master new areas of work and develop a more holistic understanding of the different aspects in elderly housing management, ranging from implementation of the elderly care dignity guarantee, scheduling activities to financial management. All employees should feel they have freedom to take initiatives and that they have the mandate to realize them.
About You
About You
First Name

Lilian

Last Name

Bohlin

Implementer(s) and cooperation partners
Name

Tjörns kommun

Type

Public body

Country where main implementer is located

, VG, Skärhamn

How long has the main implementer been operating?

More than 5 years

Please provide a short description of the main implementer.

Tjörns kommun is a municipality with almost 15000 inhabitants and comprises 1546 islands on the west coast of Sweden. Tjörn is the biggest of these islands and the sixth largest island in Sweden.

The information you provide here will be used to fill in any parts of your profile that have been left blank, such as interests, organization information, and website. No contact information will be made public. Please uncheck here if you do not want this to happen..

Cooperation partner
Name

Tubberödshus (appr Tubberöd Housing)

Type

Public body

How does this cooperation partner support the initiative? What competencies and resources does this partner bring to the initiative?

Tubberödshus is the result of a political decision by the municipality of Tjörn to offer housing for elderly bases on the Lotte pedagogy. Tubberödshus is responsible for the operation, development and management of this housing model and works under an intraprenad agreement within the municipality.

Cooperation partner
Name

Culture Department (Kulturförvaltningen)

Type

Public body

How does this cooperation partner support the initiative? Which competencies and resources does this partner bring to the initiative?

They help us to arrange entertainment events for our seniors at Tubberödshus.

Cooperation partner
Name

Information Office

Type

Public body

Website
How does this cooperation partner support the initiative? Which competencies and resources does this partner bring to the initiative?

They help us to make information about Tubbehus available for the inhabitants in Tjörn through the municipality's web site and also through other channels.

Cooperation partner
Name
Type

Please select

Website
How does this cooperation partner support the initiative? Which competencies and resources does this partner bring to the initiative?

Approximately 50 words left (300 characters).

Problem and solution
Which of these fields of Active and Healthy Ageing are addressed by your initiative?

Health literacy and patient empowerment, Prevention and early diagnosis of functional and cognitive decline, Social inclusion (intergenerational practice, work and volunteering), Age friendly buildings, environments, and communities.

If none of the above, answer here:
Please describe if and how your stakeholders (cooperation partners, funders, users, etc.) have been participating in defining the problem and developing the solution.

One of the stakeholders is the municipality. The chairman of the Social Board and the top executive in the municiaplity always participate in the board meetings where we continuously discuss how the implementation of the Tubbe model can be further developed. These meetings take place several times each year.

The most important stakeholders are the users, i.e. the seniors. From the coming the autmumn they will also have a seat in the board of Tubberödshus, next to the representatives of the municipality and the employees and with and equal say.

A concrete example is the workgroup meetings in the pedagogical group. We learned that one of our seniors had expertise in how to organize meetings by using agendas and protocols in a more professional way. By utilizing this expertise we could improve structure and the efficiency of our meetings. This was also an opportunity for seniors and co-workers to get to know each other better and to be able to exchange ideas and suggestions in a natural and efficient way around a common theme.

We regularly use external experts and consultants to train our staff and for continuing education.

Has your solution been tested in trials, experimentations, or pilot projects? If yes, please describe the process and outcome.

The quality of the activity is evaluated twice a year through a survey where the seniors anonymously can rate different aspects of how the Tubbe model works for them.

The most recent evaluation is from February 2013. On a 1-10 scale, 86 % of seniors said they were very satisfied (scores 8-10) with the degree of perceived security, 95% with the way they were approached by staff, 90% with how well their opinions and suggestions were received and 90% said they were very satisfied with the quality of food. When asked to make a summary judgement of how satisfied they were with living in Tubberödshus, 95% said they were very satisfied.

How long has your solution been in operation?

for 1‐5 years

Please select the relationship between your solution and related solutions currently established in our society. Is your solution…

independent (your solution is approaching a problem that has not been approached before)

What barriers might hinder the success of your initiative? How do you plan to overcome them?

We see no major obstacles to continue with the Tubbe model, but we think it is important that we stick to the basic concept of the model while developing and refining it further. All activities need refinement and development. At the same time it is important that progress is gradual to give room for everybody to participate and feel included in the process.

Our next step to give official power positions to seniors will probably give rise to thoughts and reflections. This should not be a problem, but rather imply a healthy transition of perspectives and also a more mature perception of what elderly care should be about.

The co-worker perspective is also gradually changing to imply more responsibility. Also in this case a gradual change will be needed due to individual differences and to the different kinds of support that will be needed for different persons. Problems that could arise are not related to the change itself, but could arise if we see a dilemma in the fact that people are different.

Organization and funding
Regularly paid employees

26 employees

Volunteers

1 Volunteers

Trainees

0

External advisers and experts

0

Others (please specify)

No

What are the specific professional backgrounds and competencies your team brings to the initiative?

Nurses and assistant nurses, competency in care
Social pedagog, competency in personal development through social activities
Competency in physical exercise and health

Please describe your management or coordination structure in the initiative.

To implement the Lotte pedagogy in our municipality was originally a decision by the local parliament. It is run as an intraprenad, i.e. a relative independent activity within the community, but still according to the same regulations that apply to all elderly care. All important decision are taken by a board with representatives from both staff and the elderly. The elderly are also involved in the daily work and each employee has a great amount of freedom and responsibility to carry out their work in accordance with the Lotte Pedagogy. The management model can be described as participatory.

Please provide the total yearly budget in Euro that your initiative spends on implementing the solution.

We receive the same amount from the municipality as for any elderly care (=no extra cost).

National public funding

100 %

European Union public funding

0 %

Economic return from own products/services

1 %

Foundations and philanthropy capital

0 %

Single donations from private individuals

0 %

Donations from private companies

0 %

Crowdfunding platforms

0 %

Participation fees

0 %

Other (please specify)

0 %

Target group, scale and impact
Which target group(s) do you want to reach with your solution?

We would want this to be an option to choose for all elderly care in the country, i.e. for all persons +65.

Please estimate the number of persons within your target group (users, clients, etc.) that you currently reach directly with your solution.

The 30 seniors that live in Tubberödshus come from the city of Skärhamn on Tjörn, the main island in the municipality.

In which local/regional/national area(s) is the solution currently implemented?

The city of Skärhamn on the island of Tjörn on the west coast of Sweden north of Göteborg.

What is the impact on your target group (users, clients) you want to generate?

We want the care recipients to actively participate in the development of their own care model. Power and influence should be transferred to our senior clients as much as possible. We should be able to offer a care system where this inherent, not an option only. All staff that work with care should be given authority with more responsibility and power to participate and influence the nature of care activities, as they are closest to the persons who receive the care. This needs to be recognized by society at large.

What is the wider impact on society you want to generate?

If the contributions from seniors are valued in our context, we think it will encourage higher participation in society outside.
This model can support other municipal activities in the social field by offering a systematic and tested approach for senior empowerment. Activities and social events are integrated to provide a more relational approach in elderly care.

What are the impacts on your target group you already achieved?

Participation and involvement has increased and the relation between staff and seniors has become warmer. The type of care has become more relational. Staff and senior perspectives have become more integrated and there is more of a family atmosphere. Security, belonging and the sense of always being welcome have been built into a public organization.

How has the impact of your initiative been assessed?

Experience-based self-assessment (you assessed the impacts based on your experiences with the target group), Feedback-based self-assessment (you assessed the impacts based on feedback from the target group without using specific methods), Self-evaluation (you used qualitative and/or quantitative methods to assess impacts).

Public information and strategy
What information on your initiative is publicly available?

Mission and strategy, Organisational structure, Information on team members, Evaluation report, Financial report, Activity report, Working method and 'theory of change'.

Please indicate webpage or contact for obtaining the respective information.
What are your milestones for further developing, implementing, and establishing your initiative in the next three years? Please describe 1-3 milestones.

We have participated in elderly care webinars in Sweden (http://www.svid.se/sv/Design-o-Halsa/Webbinarier-Design-for-battre-halsa... ) and appeared in media (http://www.akademssr.se/text/-har-bestammer-de-boende) to promote implementation in other places. These activities will continue.
A second milestone will be inclusion of senior board members at Tubberödshus, starting in September 2013.
A third milestone is to summarize our model and experiences in a strategy document on how to increase participation for seniors in the future.