Functional support immediately after the hospital period reduces the need for home care later
3. March
Vivago in the discharge unit in the city of Rauma
The Rauma discharge team specializes in demanding home discharge and care assessment cases after a ward period for the elderly. The team started five years ago with four nurses and two community nurses, and the operation has continued to evolve and expand continually. In 2019 the team has 11 permanent employees and a Service Manager who will work two-hour shifts at clients' homes.
The duration of the team evaluation period varies from customer to customer, from approximately one day to five weeks. During this period each customer is offered practical, comprehensive assistance. The goal is that after the evaluation period a customer wouldn’t need care services or would be able to get by with only light service selection at home. In addition to medical care, nursing and rehabilitation it may include help in shopping or banking, as well as advice on filling out forms. During the evaluation period nurses will have an individual and comprehensive overview of the need for support for a customer, and this information will be used to plan the necessary support actions. After the evaluation period the customer may be able to cope independently with no services or switch to a city home care or private service provider.
Experience in Rauma has shown that supporting functionality immediately after a hospital period reduces the need for home care later. The aim is to develop the discharge team's activities in an even more rehabilitative direction. There is more time available in the enhanced assessment and rehabilitation period than in home care. This time would be used to support the customer’s daily coping, and the goal is to enable the customer to live independently at home for as long as possible.
The Vivago system was deployed by the Rauma discharge team in August 2018. We asked the Vivago administrator, nurse Essi Mattila, about the team's experience with the new system. Ms Mattila says that during the Vivago deployment phase staff learned how to interpret wellbeing information by first using Vivago watches themselves. Each nurse in the team got a Vivago watch and instructions to test it in their daily lives, both at home and at work. During the test, the nurses saw on their own curves how the night's sleep had gone and what the daily balance of activity and recovery was. The team learned that technology doesn’t seem difficult when you first learn how to use it on themselves. The unit's continuous development and inspiring culture of working together also ensured that the introduction of new technology was smooth.
Since the introduction of Vivago, two new nurses have been hired to the discharge team, and they have easily adopted Vivago along with other unit practices. All in all, Essi Mattila describes Vivago as a well-established tool that is in constant use. Rauma has achieved good results in rehabilitating the elderly and ensuring that customers remain in good condition after the hospital period is a key goal. The discharge team understands that the wellbeing of the elderly is mainly determined by how regular and active life they have.
Vivago is mainly used to monitor sleep and circadian rhythm, and the measured data guides daily decision making. At the beginning of the morning shift nurses take a look at how customers have slept, and Vivago reports are reviewed with the customers too, often daily. According to Ms Mattila, this has an activating effect as it motivates customers to move and act on their own initiative. Encouraging feedback from a nurse can be a boost in the right direction and inspire customers to take care of their own wellbeing even better than before.
For one customer Vivago monitoring has led to re-evaluating the need for pain medication. It was found that the customer did not sleep well at night, which resulted in passiveness and daytime sleepiness. Tweaking pain medication resulted in more regular circadian rhythm, better sleep, and increased activity and ability to function.
The Rauma discharge team has succeeded in its work when a customer gains the ability to manage daily living independently again. Essi Mattila sees that Vivago has the potential to monitor the progress of rehabilitation customers also in the future. The most important criterion for attending a longer evaluation and rehabilitation period is the customer's own motivation. One’s own activity is very important and participating in everyday activities and following the rehabilitation guidelines are reflected in the customer's Vivago activity curves. For customers with mental health problems Vivago can be of significant benefit, as problems often appear as poor sleep or low activity levels. The evaluation and rehabilitation period aims to find solutions to these issues. Ms Mattila sees that going through sleep and activity data with a customer can improve their motivation, so sharing information with the customers and their families will definitely continue to be favoured.