T2022-01 An elderly couple in poor condition did not receive help in Pöytyä in August–September 2022

An elderly couple in poor condition did not receive help in Pöytyä in August–September 2022. The home care service had visited the couple on 28 August 2022, but they had not been able to reach the couple after that for ten days. The police found the couple in their home on 7 September 2022. The wife had died after being left without medication. The husband was in extremely poor condition.

The husband had acted as the family care giver of his wife. The informal care agreement of the couple had started in 2016. They had occasionally needed home care services, but neither of them had officially been a client of home care services yet. The couple had no close relatives.

The social services had not identified the challenging care responsibility of or the risks pertaining to a family carer operating without any close relatives or a support network. In Pöytyä, the situation of family caregivers had been monitored every 1–1½ years through inspection visits or by contacting the family caregiver by telephone. There have not been any uniform or mandatory national criteria, processes, or indicators for monitoring the strain on family caregivers or the state of health of the family caregiver and the person receiving informal care. No party has had an overall picture of the strain on family caregivers.

For elderly family caregivers operating without any close relatives, a comprehensive assessment should be conducted on whether they are able to cope with their duties. The situation of elderly family caregivers operating without any close relatives, the strain they are under and the potential changes in their functional capacity should be monitored and assessed systematically and sufficiently often, taking their individual situation into account. When there are no close relatives or other support network available, the system should also ensure that family caregivers would have an equal opportunity to participate in activities that support wellbeing.

The client information and patient records of the elderly are fragmented over different information systems. Identifying weak signals and establishing an overall picture of the state of health of elderly people who live at home has been difficult. Client information and patient record systems should serve the users so that it would be possible to generate the necessary overall picture of the state of health and wellbeing of elderly clients easily.

The healthcare and social welfare services in Pöytyä had specifically prohibited the viewing of client information and patient records of persons other than those with a client relationship under the threat of punishment. Therefore, the home care nurses had not dared to review the couple's health information, which had led to an inadequate assessment of the couple's situation. The healthcare and social welfare system should encourage workers to study client information and patient records when the task requires it.

It would have been possible to use remote technology to monitor the health of the wife. Remote technology must be used more on the national level in the care of elderly people living at home.

Pöytyä did not have instructions for home care nurses for exceptional situations where the family caregiver’s health status changed rapidly or the where the client could not be reached. The wellbeing services counties must have comprehensive instructions that are as uniform as possible in case of exceptional situations with clients.

• The National Institute for Health and Welfare ensures that the wellbeing services counties start using indicators intended for assessing and monitoring the functional capacity of family caregivers and their ability to cope, and that the information they generate is used to develop family care.
• The Ministry of Social Affairs and Health ensures that the wellbeing services counties promote the safety of elderly people living at home by taking advantage of remote technology and digitalisation.
• The National Supervisory Authority for Welfare and Health (Valvira) guides the wellbeing services counties in cooperation with Regional State Administrative Agencies to ensure that home care services have comprehensive operating models for exceptional situations.