Finland: Educational Profiles in the Care of the Elderly

Educational profiles in the care of the elderly presented in this paper have been compiled from the national curricula for social and health care as well as from the national strategy papers published by the ministry of social affairs and health and the ministry of education.

The present situation in Finland

The fields of competencies in this paper are divided into two educational branches: higher education (registred nurse and social counsellor) and secondary vocational training (practical nurse). The competencies have been listed also on the basis of feasible working settings.

At the present (see figure 1) registered nurses are mostly working on the clinical settings while social counsellors and practical nurses are allocated more to the open care settings. This division of working settings will be remained also in the future, if not practical nurses' role in the clinical settings will be even smaller than at the present.

hospitals

nursing homes registred nurse

homes for the aged practical nurse social counsellor sheltered care

community care

Figure 1. Working settings for registered nurses, practical nurses, and social counsellors (socionom) at the present in the field of elderly care in Finland.

The present professional competencies could be divided into two main groups: generic competences required in caring, and professionally distinguished specialized skills in the field of elderly care. Human relationship and communication skills are more or less the same on RN, PN, or social counselling sides. When going into details on specialized skills the differences are more obvious (see table 1).

As to the registered nurses the specialized skills are related to the nursing procedures, medication, medical knowledge. Social counsellors main mission is on advocacy of clients' rights, social secur- 2

ity and empowerment. Practical nurses' responsibilities are more focused on the elementary care, and supporting a person on the daily activities. Differences on caring become more obvious on the basis of decision- making (RN's and social counsellors more independent decisions, coordinating and evaluating the care while PN's are more dependent on the team in which they are members). Also as to the guidance and patient education, assessing and evaluating the care, or prevention, the RN's and social counsellors are more holistically responsible on coordination of services, sharing the specialized knowledge (illnesses) while the PN's focus is more on group activities and implementing the knowledge within the daily situations.

Table 1. Fields of competence in the care of the elderly in Finland

Field of Registred Nurse Social counsellor (socionom) Practical Nurse competence Duration of 5600 hours 5600 hours 4800 hours education human relation- -understanding senior ages as part -supporting developmental tasks -understanding senior ages as part of ship skills of normal human development characteristic to the age groups normal human development -networking, collaborativeness -focus set on the mental health by -networking, collaborativeness -social skills means of maintaining the sense of -social skills -respect of human values being needed and obtained skills -respect of human values -developing and managing psychoso- cial client work interaction -active listening -passing the information concerning --active listening skills -argumenting, counselling the client's rights and obligations -argumenting, counselling -communication skills -empowerment -communication skills -being available for clients and their families substance -maintainance and assessment of -maintainance and assessment of -assistance in daily activities know-how functional capacity functional capacity -promotion of meaningful life  assistance -nursing care/ general care, spe- -promotion of meaningful life -general care cialized care -assistance in daily activities -keeping connections with the relatives -developing service systems in the society

 decision -professional independence in de- -professional independence in de- -acting as member of caring group making cision making cision making - ethical decision making -coordination of services -coordination of services - principles of nursing -ethical decision making -ethical decision making -principles of nursing -acting as member of caring group -observing the relatives' resources  supporting -creation and maintanance of sup- -supporting the relatives' resources -support of the client and the family porting webs -critical and reflective approach in situations of imminence -strengthening of the client's expert- -functioning as a member in the cli- ise in his/her own life ent's support web -advocating the client's rights in multiprofessional services  caring -planning, implementing and eval- -supervising the health condition, -general care uating nursing care provided mental wellbeing, meals, hygiene, -implimenting social services in basic -geriatric diseases/ geriatric treat- medications level ments -coordinating day care activities -assistance in daily activities -medication -cooking meals -domestic services -rehabilitative approach in nursing -being in charge of controlling and -elementary environmental hygiene care coordinating caring processes in -provision of healthy nutrition -care of terminally ill patients home settings -promotion of meaningfulness in -specified dietary questions -controlling and helping in daily situ- daily life (activities, rehabilitation, in- -enabling successful aging despite ations dividualization of care) illnesses -general care of terminally ill patients - rehabilitation in basic level 3

 guidance, -coordination of services available -informing the clients about various -leading small group activities  education -guidance on obtaining relevant services available -guidance for clients, family mem- services -giving advice of the issues related to bers, and students -patient education and guidance for social security -dietary advice the family members regarding -crosscultural collaboration between treatments and care different generations - guidance for clients, family mem- -assessing, planning, implementing, bers, and students advicing in the needs for various appliances  evaluation, -continuous assessment of the cli- -preventive and community oriented -continuous assessment of the client's  assessment ent's condition and care provided work condition and general care provided -evaluation and developing of the -sustainable development in domestic -assessing one' own professional de- care services provided by a single care velopment and up-dating the skills re- carer as well as the whole profes- -future development of the care of the quired sion elderly -assessment of the service requests of -assessing one' own professional -management and development of senior citizens development and up-dating the working societies, and expert net- -awareness of services available skills required works -basic knowledge of getting right ser- -assessment of the service requests -local expertise in elderly care vices for right persons of senior citizens policies -knowledge and utilization of services available -coordinating right services for right persons  prevention -preventing domestic accidents -coordinating the advocating persons -keeping safe environment -environmental safety and health for the client's interests -preventing domestic accidents -prevention of marginalization of the elderly people -activation of the elderly people

The future visions

The future vision within the field of the elderly care concerning the educational profiles in Finland have been based on the competencies embedded on the changes in the population's changing health needs (see table 2). The age level of the elderly population requiring senior services will be higher and higher. Also among the ageing population the educational level, the awareness of their rights of obtaining various services, as well as the awareness of the services available is better than before. Technological development makes it possible to use more developed appliances and technical equipments in supporting the daily activities of the elderly people in home care settings. Ageing people are also more skilled to use computerized services, which challenges the professional staff to provide that kind of services, too. 4

Table 2. Future vision on the educational profiles between registered and practical nurses on the care of the elderly

Future visions Focus points Registered Nurse Social counsellers (socionom) Practical Nurse Preventive work: -gerontechnology -assessment of appropriate techno- -assessing the needs for taking appli- -guidance in using technical appli- logy due to the personal require- ances to periodical services and keep- ances ments and indications ing them working -coordinating relevancy in technical appliances

-maintainance of -measurements -rehabilitative approach in daily -assistance in daily activities in re- functional capacities -evidence- based practice and con- activities habilitative approach tinuous evaluation -organizing programs for gymnastics -home visiting and physical exercises

-prevention of alien- -deepened knowledge of loneliness -activation -activation ation problems -recreation -recreation -prevention of discrimination in -human contacts -human contacts health services due to ageism -member in support webs -member in support webs -helping to find out the personal development task in each phase of ageing

-maintaining support -home hospital services -involvement in construction plan- -general knowledge and skills in webs -district nursing ning of the accommodations for the working as a member in multiprofes- -community nursing elderly sional care team -support groups The usage of ser- -general and special nursing care -attempts to postpone the time of be- -general nursing care vices among senior due to increased number of ill- coming cared by means of active par- -member of caring team citizen in higher age nesses ticipation of the elderly people due to the extension -multiprofessional team work + -activation of cross-generation family in expected life time family participation to caring pro- members to take part in caring processes cesses -bringing nursing expertise into the team -contact person among the family

Efficient services, -increased need for information -advocacy in client's rights, social se- -skills to obtain and share new in- renewed patterns services require increased skills to curity and other benefits in the soci- formation and their steering obtain and share new information ety -skills to obtain and share new in- models in social and -coordination and supervision of formation health care services: the care provided to quarantee con- -computer skills tinuity of care -case/ care management -computer skills required in e- health services

Strengthening of rel- -early diagnosing of depression -mental health problems seen as de- -therapeutic attitude/ approach evant mental and suicidal behaviour grees of disability in an individual's health services: -care of the depressed people life and self-care capacity -cp. Prevention -quality of nursing care -strengthening social coping

Increased demands -computer skills -open university, critical university, -computer skills along with the raised -evidence-based practice adult education activities educational level of -activation of participation into soci- 5

the aging popula- etal and educational activities tion, and due to tech- -future sciences nological development: -e-health services Environmental de- -maintaining safe and healthy en- -involvement in city planning (esp. -maintaining safe and healthy envir- velopment vironment in caring settings parks, services) and infrastructure onment in caring settings

Care of demented -specialized care demands in- -informative task regarding dementia - implementation of memorizing patients creased as an illness, and how to adopt to it groups or other activities available -validation therapy or other ther- -production of new services for de- apies mented patients and their family -knowledge of dementia

Intermediate form -development of relevant services -development of relevant services services

The future trends on health care seem to put emphasis more on the open care. Institutionalized care will be decreasing in number while the care in home and community settings will be increased (see figure 2). RNs will be allocated on the institutionalised and specialized care but their responsibilities are also increasing on the developmental work and coordination of various home care services. The amount of services embedded on the cross-generations family-centered, inter- and multi-professional team work, and voluntary sector will be increasing all the time.

Cross- registred generation hospitals nurse Home hospitals Family e r

a nursing homes C

c Inter- and i t

s multiprofes e homes for the aged District m sional practical o Nursing D teams nurse social counsellor Community sheltered care Nursing Voluntary services community care

Figure 2. Future visions regarding health services 6

Finland: Education of teachers and managing officers in the field of Elderly Care

Teachers in Nursing Education

Nursing education is a higher education programme in Finland. The teacher in nursing has to have the following qualifications: qualified registered nurse (5600 hrs), bachelor degree in nursing (6400 hrs), studies of pedagogy (1400 hrs), and three (3) years work experience in the field of nursing.

Teachers in Social Counsellor Education

Social counsellors are qualified from a higher education programme like nurses in Finland. The teacher in Social counsellor education has to have the following qualifications: bachelor degree in social sciences (6400 hrs), studies of pedagogy (1400 hrs), and three (3) years work experience in the field of social services.

Teachers in Practical Nurse Education

Practical nurse education in Finland is a secondary level vocational training. Teachers are to have the following qualifications: qualified registered nurse (5600 hrs), bachelor degree in one of appropriate sciences (health or societal sciences,or science of education; 6400 hrs), studies of pedagogy (1400 hrs), and three (3) years work experience in the field of nursing.

Managing officers in the field of Elderly Care

In order to work as a managing officer in the field of elderly care are as follows: bachelor degree (6400 hrs) in health or social sciences, or in administration. Qualified social counsellors (bachelor level education on polytechnics; 5600 hrs) are also qualified enough to work as superiors in the field of elderly care. 7

Bibliography:

Helakorpi S (2002) Osaaminen. [www-document]. http://www.htk.fi/public/helakorpi/osaaminen.htm. Read 1.3.2002 Ministry of Labour (2002) Occupation descriptions. [www-document]. http://www.mol.fi/tietoa/ammatti/00/1/0/6/10610.html . Read 1.3.2002 http://www.mol.fi/tietoa/ammatti/00/1/0/10315.html . Read 1.3.2002 OPM (Ministry of Education) (2001). Kansallinen ikäohjelma. Opetusministeriön toimenpiteet 2000-2001. Opetusministeriön ikäohjelmatyöryhmän raportti 22.1.2001.l STM (Ministry of social affairs and health) (2001) Social and health policy strategies 2010. STM 2001 (Ministry of social affairs and health). Ikäihmisten hoitoa ja palveluja koskeva laatusuositus. Sosiaali- ja terveysministeriön oppaita 2001:4, Helsinki. STM 1999. Sosiaali- ja terveydenhuollon tavoite- ja toimintaohjelma 2000-2003. Sosiaali- ja terveysministeriö, Helsinki.