When Maarit Junnola visited her ex-mother-in-law in Hanko recently, she was shocked to find the elderly woman hungry and thirsty, laying in her own urine-soaked bed sheets.
In the caregiver diary was a note to say the old lady hadn’t eaten, except for some candy. She hadn’t taken any medication. And some bottles on the shelf were even labeled for a different patient.
A week later, she died in hospital from malnutrition.
The case is being highlighted as another example of how Finland is failing its senior population – a population that is only set to increase in numbers over the next few decades. Statistics predicts the percentage of people over 65 in Finland will rise from 20% now, to 30% by 2050.
“The whole system for elderly care is in big crisis, especially home care” says Leena Kaasinen of the Union of Finnish Practical Nurses SuPer
“The trend in all European countries, and also in Finland, is that they want people taken care of at home. And at the same time, institutions are closing the doors, and there are less and less places where you could be taken for care, even if you are very sick, diagnosed with dementia, and in need of constant care” she says.
SuPer represents about 90,000 workers across Finland, the majority of whom, explains Kaasinen, work with elderly patients.
The growing number of elderly people in society who need some form of professional care, especially those with dementia who require extra attention, is not being matched with an equal increase in resources or funding.
But none of this is news to the government.
A damning report first published in 2005 compared care for the elderly across the Nordic region. It showed that Finland was lagging behind Norway, Sweden and Denmark in terms of staffing levels caring for elderly patients.
Ten years later, the study was done again, and the results in 2015 were worse in terms of resources and staffing.
During the day shifts, Finnish nurses can be handling 12 patients, while their counterparts in Denmark would have an average of 7.6 patients each.
To try and ease this burden in care homes, more patients are being encouraged to stay at home instead, and receive visits from care givers.
“It is very sad, but that’s the situation in Finland at the moment” says Leena Kaasinen.
“People are left at home alone, because people think all the elderly want to stay at home, but that’s not the case. There is a line when you need care, and it would be better to be in an institution or residential care home. It will become even worse in the future” she predicts.
Research from the Ministry of Social Affairs & Health confirm this. The numbers of elderly people in group homes and chronic care hospitals in Finland declined steadily from 2007 to 2013, as structural changes took place in the way municipalities organised their health care services for senior citizens, and promoted home care as the best option for the majority of people who need some form of care.
One answer to a shortage of trained nurses and care givers, and a lack of residential care places, could be technology.
More devices in patient homes will in future connect the elderly, with medical professionals or family members, and play a part in promoting regular tasks.
In Espoo, Rauno Saarnio set up his company Senior Some after seeing first hand with his own family how dementia can affect elderly people, and their reliance on help. He also saw that traditional methods of care giving were not sustainable.
“We would need in the next 25 years two thousand more nursing homes in Finland to keep up with the demographic demand” says Saarnio.
“Of course we can build care homes. But the question is where is the money coming from and where is the nursing staff coming from. Technology offers much cheaper solutions”.
Senior Some’s tech answers aim to keep elderly people living in their own homes, connected, for longer.
Their tablets and software remind people when to take medicine, when to eat, or do exercises; or help them play brain training games. They can be contacted by doctors and nursing staff, or family members. The services can be pre-booked by relatives or local health authorities. And they never have to touch the tablets themselves, it can all be done remotely.
Finnish legislation guarantees equal care for elderly patients, including those suffering from dementia, no matter where they live in the country. So there is some concern that not every local health department will be able to afford technology solutions – although they’re certainly cheaper than building new care homes, or training and hiring the number of nurses needed in future.
Leena Kaasinen from the Union of Finnish Practical Nurses worries that technology will also be out of reach of people without the cash to pay for it.
But she also knows that something needs to be done to change the current situation, where elderly patients, especially those without families or support networks around them are not receiving the care the need, and are guaranteed by law.
“It means people are left at home alone” she says. “And they die”.