Stakeholder collaboration in long‐term care of older people in Lithuania

Abstract

Demographic situation, changes in the role of women in society and growing demand for long‐term care (LTC) of older people have challenged the ability to meet the growing LTC needs in most developed countries. In countries where responsibility for LTC is still largely laid on families, it is, however, even more critical and calls for improvements in formal LTC systems. More intensive stakeholder collaboration in LTC policy development, organising and delivery are of primary importance in improving LTC systems. Such collaboration, however, is not always successful; thus, it is critical to understand what makes it effective and efficient. In this paper, we specifically look into multistakeholder collaboration in LTC in Lithuania, one of the fastest ageing countries in the EU, with the demand for LTC services growing fast and exceeding the supply despite rising business and NGO engagement. To determine facilitators of such collaboration, we build on the data obtained through eight focus group discussions with all key stakeholder representatives (LTC policymakers, organisers and service providers [public, private and NGOs], 54 participants in total). Our findings indicate that in addition to national and organisational level facilitators studied in prior research, there are important individual level factors, such as meaningfulness at work, concern and care for others, possibility for personal growth and development, satisfaction with supervision, a sense of belonging and role clarity. On the other hand, our results show that collaboration is constrained by a shortage of human resources, increased workload caused by growing LTC demand, bureaucratic requirements, legal restrictions, lack of awareness of LTC service availability among elder persons, and prevailing social norms and attitudes to institutionalised care. Interestingly, a lack of financial resources is not perceived as a major constraint.

Care for the Caregiver : Internet intervention for informal caregivers in Lithuania

“…It should also be mentioned that in recent years there has been a growth of various non-state institutions (NGOs), or business institutions aimed at long-term care provision. However, findings indicate that despite the growth, a shortage of such services remains (especially in rural municipalities) and that the public, as well as the policymakers, do not view them as entirely serious (Poškutė et al, 2021).…”

“…Some services, such as nursing, provided by the two institutions are similar and even overlap. However, the financial reimbursement differs, with services in the healthcare sector being priced higher than those in the social domain (Poškutė et al, 2021). This does not only make it more difficult for the informal caregivers to receive the best possible support needed but also causes tensions between the institutions.…”

“…Overall, the nursing home and the day-care services were previously described as underdeveloped, offering limited support, and covering a small portion of highly dependent individuals (Žalimienė et al, 2020). The lack of services might be partly explained by the general lack of nursing hospitals and nursing personnel across the country (Poškutė et al, 2021). The social care system in the country has institutionalized care for patients as an alternative to nursing healthcare hospitals.…”