Ensuring Wellbeing of Chronically Ill People in Lithuania: Pilot Integrated Home Care Projects

Background: Increasing number of elderly and people with chronically illnesses requires complex services. Home care services were undeveloped in Lithuania, and family members mainly took care of long-term patients at home. In 2011 the Ministry of Social Security and Labour began a process to develop integrated home care (IHC) using new collaborative processes. 21 municipalities in Lithuania (out of 60) showed inciative to start pilot IHC projects. Aim: The aim of this presentation is to describe pilot (IHC) projects in Lithuania as the new service for improving wellbeing of chronically ill people. Methods: The qualitative research case study design was applied to reveal the experiences and perceptions of the individuals involved in IHC processes. 12 focus groups were conducted with IHC providers from 19 municipalities of Lithuania. In-depth interviews with IHC receivers - patients (n=20) and family caregivers (n=14) focused on the stories about informants‘ situation before and with IHC. Results: The existing social care services were supplemented with newly created teams of nurses, their assisstants, and physiotherapists. In reality teamwork was a challenge and a new experience for municipalities and practicionaries. Municipalities differed according their perceptions of teamwork and the ways they organized teams. Interview results revealed variety of patterns of team interaction and collaboration. Despite the differences team members expressed togetherness in doing „one important job“. Counselling services improved self-management skills of the patients and their family caregivers. The family caregivers got a possibity to combine work and family commitments. Conclusions: Integrated team-based home care ensured the provision of complex everyday care for patients with long-term care needs and support for family caregivers. Togetherness in doing „one important job“ was emphasized by health and social. [...]