Awarded the Gold Medal of the European Society For Person Centered Healthcare

This election to the Gold Medal Award of the European Society for Person Centered Healthcare recognizes the importance of person centred community focused models of care to individuals in need of care, their families and wider communities, and the very many relationships that connect all.

Lecovich E (2014¹) discussed the many dimensions that impact the “ability to age in place”: the physical dimension, the social dimension, the emotional and psychological dimension and the cultural dimension.

Yet, the home care services industry is essentially a low cost volume based intermediation model: the service provider focuses on caregiver selection and coordination and the personal support or nursing professional delivers the homecare and medical support. In this respect, the homecare model is not naturally at one with the many dimensions of personal need.

The two key arguments supporting provision of home care in the community are (a) the lower “costs” of delivering care and (b) that individuals are much happier “aging in place”, leading to better physical and cognitive outcomes. But (a) conflicts with the ability to influence (b):

• Delivering care in the community via this lower cost model has separated out core competencies from care delivery creating gaps in care.
• Low barriers to entry and relatively small exit costs create, for the purchaser of services, a highly price competitive industry with an impact on the quality of care (Forder and Allan (2014²), Jung and Polsky (2014³)).
• Even though private home care is a lower cost option, it is for many a not insignificant expense.
• The cost constraints and limited service provision of state funded home care, unwittingly, validates the highly competitive low cost model of care delivered by the for profit private sector.

Mosaic Home Care Services and Community Resource Centres achievements must be viewed in the context of the structural and competitive market dynamics.

Mosaic’s achievements

Development of a model for integrating for profit and not for profit community services and supports for home health care and for encouraging wider community involvement along a number of dimensions (2010 to date):

Mosaic has set up and funded community resource centres that combine both educational and fun events for individuals in need of care and their families with information on the many supports and services available in the community. It operates two resource centres across the GTA.

It has developed a number of close partnerships and joint ventures in the community: note its hosting of Alzheimer Cafes and its most recent partnership with Evergreen Hospice.

Centres provide socialisation opportunities for individuals, help for families and family caregivers, social integration of seniors within the wider community and the building of relationships with many service providers and businesses in the community.

Development of person centred care home care services

Some key aspects of service that differentiate it from its competitors include:

• Rigorous initial assessments of client needs (face to face) – these also address wider social and socialisation issues, provide advice on community supports and community events and assess the need for more detailed case management or onward referral to other subject matter expertise.
• Centralised service processes that focus on oversight of client/caregiver relationships and communication with the client, family and wider care relationships that also provide the basis upon which other health care professionals can interface with the home care service model.
• Caregiver introductions (face to face) – these introduce caregivers to clients and brief caregivers on the individuals in care. Note the provision of our unique “All About Me™” caregiver profile sheet.

Person Centred Services: The Meaning of Me® and Client liaison

Drawing inspiration from the Joseph Rowntree Report “A Better Life – What older people with high support needs value”, “The Meaning of Me®” addresses the needs of the individual outside of the home care model and develops a framework in which caregiver and client, family and client and ultimately the wider community and client can establish a richer set of conversations, relationships and connections. The Meaning of Me® is a journey of potential for the individual to reconnect with themselves, their interests and where possible their communities.

The Client Liaison team implement non care based services and introduce The Meaning of Me® to the client, discuss interests and hobbies and help link the client, with the help of the caregiver, to activities and interests that can be conducted both at home and in and around the community.

A blueprint for addressing the person at the centre of a community based homecare services model

“The Meaning of Me ®” closed the loop that Mosaic started with its community resource centres. It reached out to the community and drew it in and then reached out to the people in need of care and drew them in.

It has set standards and promoted the importance of community, person centred care and the importance of addressing the individual at the centre of care to individuals and families and the wider service and professional community. In so doing it is introducing new models and benchmarks of care. While we see the future of care embraced within a person centred community based model, we consider it impractical that the market place as a whole can deliver this under the current market dynamics.

Recognised as a best practise leader at home and abroad

Mosaic is recognized as a best practice leader in homecare services, and especially so in the way it addresses human values and social and community interaction. On October 20th, 2016 Mosaic was asked to present to the Ontario Society of Senior Citizen’s Organizations Symposium on “Overcoming Loneliness and Social Isolation: Celebrating Best Community Practices” its person centred community focused home care services model.

1. Iecovich E, Aging in place: From theory to practice, ANTHROPOLOGICAL NOTEBOOKS 20 (1): 21–33. ISSN 1408-032X ,2014
2. Forder J and Allan S, The Impact of competition on quality and prices in the English care homes market, Health Economics, March 2014
3. Jung K and Polsky D, Competition and Quality In Home Health Care Markets, Journal of Health Economics, May 2013