Abstract
Background: Sustainability of high-quality health care is a major challenge, due to financial and personal shortages and social support. This account also for elderly care, which faces problems that are aggravated by double ageing of this population. Therefore, urge exists for the development of innovative ways of thinking about and organizing care. This includes changes to domain-cross, community and network care, in which professional care, social welfare and citizens join forces. To realize future-proof arrangements and living which contribute to meaningful ageing for the elderly, elderly care organizations in the Netherlands initiated several testing grounds in the beginning of 2023. This study intended to explore initial network movements towards community building and to define general factors that influence the developments in these testing grounds.
Approach: Participative action research (PAR) was conducted in five testing grounds (districts/neighborhoods) concerning a housing and care concept on elderly people, with a high range in contextual factors and located in a variety of environment. PAR is suitable to realize a change in practice, due to its participatory nature of the actors, ie. the care providers, (future) elderly, citizens, welfare, housing cooperations and policy makers. In co-creation with all stakeholders, the first two steps of the Practice Development cycle were performed: determination of situation and focus. Each testing ground had one project leader related to an elderly care organizations and one researcher, who supported the action combined research. In the testing grounds, awareness on the upcoming problems on elderly housing and care was created and developments on community building were facilitated. Cross-analyses on generic factors was performed including all testing grounds and experts on community building, physical environment, cross-domain care and social business case. Factors were categorized on the five elements of the existing model on collaboration between organizations (Kaats & Opheij, 2012): ambition, interests, relationship, organization and process.
Results: There was a large variety in involved/engaged partners, developments and actions over time within the five testing grounds. Cross-analyses revealed several generic factors in each of the five elements of the model on collaboration between organizations. Several factors concerned two or more elements. Among other things, findings were on a ownership of the ambition, transparency of the elderly care organization (the true story please), equal partnership, unframing of the organization, and early inclusion of all important stakeholders. Furthermore, one transcending factor was defined, concerning the attitude and opinion of professional care organizations towards community building. Lessons learned were formulated and evaluated in the testing grounds, which continue their work in practice.
Implications: This study revealed insight in several main issues on a network collaboration to create a solution-oriented movement for a complex problem such as sustainable elderly care. Although the elderly care organizations initiated the surroundings and facilitated the first steps, citizens and the community are an indispensable partner in the actual movement on community building and care solutions. Health workers should embrace this knowledge and actively implement the lessons learned, in order to better support collaboration networks including professional care, social welfare and citizens.