Network careCompany (Netzwerk pflegeBegleitung)

Why was this example implemented?

Faced with increasing numbers of dependent older people, scarce public financial resources and an expected decline in the number of family carers, the German government has come to recognise in the last few years the importance of developing and enhancing voluntary work in care as a way of tackling these problems (BMFSFJ, 2005: 339). Civic engagement has been identified in the scientific discourse on welfare pluralism as one of its ‘mega-trends’, complementing the manifold political efforts at national, regional and local levels (Klie, 2010: 574).

The ‘care companions’ concept is concerned with the mobilisation of a range of mixed resources to make long-term care personally, financially and humanly feasible through involving relatives, professionals and volunteers. The ‘care companions’ project is one of many exploring the potential of new forms of active citizenship in relation to care, but is unusual in being explicitly aimed at accompanying and supporting family carers through voluntary work (Bubolz-Lutz /Steinfort).

In addition to activities directly targeting family carers and interested volunteers, other indirect target groups of the project include dependent older people, professional care providers, and local authorities.

Description

‘Care companions’ focus on the empowerment of family carers, offering information about direct and indirect supportive measures, building bridges towards professional service providers and functioning as confidantes who understand the specific problems and burdens that the care situation entails. The concept is structured as follows:

• Interested volunteers receive 120 hours of training informed by the ‘participative curriculum development’ principle. This means that they select contents and training methods within a framework of predefined learning aims and subject matter.
• After completing the training and receiving a certificate, the volunteers are organised in local groups and commit themselves to taking part in follow-up training sessions and assessment meetings.
• So-called ‘project initiators’ (PIs) are responsible for establishing and running the local initiatives in tandems of two people. They receive 160 hours of special training (including putting theory into practice).
• The local initiatives are independent and responsible for their own funding but with back up from care, education, and welfare associations as well as local and regional authorities.

Within this framework, ‘care companions’ connect with family carers, listen to needs and inform them about opportunities for respite, acknowledge efforts and point out strengths, create networks for mutual exchange and support, and they guarantee discreetness of what has been shared.

The ‘care companion’ concept was initiated by the research institute Geragogik in Witten. It was tested as a pilot project between 2004 and 2008 with financial support from Statutory Care Insurance funds (§ 8 SGB XI). Since then the hierarchical project structure has been replaced by a vertical network. Activities have spread from the first 4 pilot regions to all German federal states. The local initiatives are organised at state level with elected spokespeople and the national network is coordinated by the Geragogik institute.

The volunteers are unpaid and only reimbursed for actual expenditures, e.g. telephone and travel. However, approximately €5,000 per annum are needed at a local level to pay for monitoring, further qualification of PIs and ‘care companions’, working materials, that efforts are acknowledged and a membership fee for the national network. Since 2008, local initiatives have been eligible for financial support from the Statutory Care Insurance (if self-help or voluntary work structures apply) in addition to funding through local and regional governments and other forms of sponsoring (§ 45d SGB XI).

No regular funding is available from federal state and national offices. Their staff operate within a framework of short-term projects or mandates.

What are/were the effects?

The scientific monitoring and evaluation of the pilot project reached the following conclusions: “The need for voluntary engagement on behalf of family carers was (…) confirmed: psychosocial support alleviates the personal stress family carers feel, and they notice an improvement in their own health. They find that the care at home situation stabilises. Those who experience this kind of support would not like to do without it“ (Bubolz-Lutz/Kricheldorff, 2009: 148). Accordingly, the situation of dependent older people could also be improved.

With regard to systemic impact, the following results were confirmed in several cases (Bubolz-Lutz/Kricheldorff, 2009: 149ff):

• empowerment of family carers through offers that are easy to access;
• development of the overall capacity, not only of family carers but also of volunteers, professionals and organisations; and
• linking up existing services to facilitate their use by family carers.

An indicator of sustainability is the fact that the concept not only survived the end of the first funding period but actually spread throughout Germany from the 4 pilot regions to all federal states. To date (April 2011) ‘care companions’ operate in 114 locations in Germany. However, no systematic evaluation at national or local level has been performed for the project activities since 2008.

The ‘care companion’ approach has also been implemented successfully in the Austrian state of Salzburg. In addition, it was transferred between the twin towns of Guben, Germany, and Gubin, Poland. At present, Schaffhausen, Switzerland has signalled an interest in learning more about the project with a view to implementation.

What are the strengths and limitations?

A specific strength of the concept of ‘care companions’ is that it offers a win-win-situation for all parties concerned. Consistent networking and cooperation on an equal footing enable a balance to be achieved between volunteering and professionalism, between individual and organisatonial interests and between local independent and central association structures. One of the secrets of this success may lie in a sufficient degree of independence to negotiate the conflicts between institutional embedding on one hand and autonomy on the other. This protects the local initiatives’ own profile and promotes the highest possible degree of independence in relation to professional monitoring and qualification structures.

The profile of ‘care companions’ meets the specific needs of familiy carers and has proved sustainable. The more the project continues to be rolled out, the more it will create further opportunities to back-up family care or render this possible in the first place.

Despite these strengths and opportunities, the project does not run of its own accord. The volunteers need to be trained and monitored to rise to the challenges. Continuous communication is indispensible, especially at the interfaces between organisations, municipalities and volunteers. Due to the speed of developments in the long-term care field, the profile of the care companion needs careful thought and adjustments in agreement with all parties concerned. So the lack of financial resources at federal state and national levels constitutes the greatest threat to the operational scope of the network and its future existence.

Credits

External Links and References

• Netzwerk pflegeBegleitung (project website) 
• Bundesministerium für Familie, Senioren, Frauen und Jugend (BMFSFJ) (ed.) (2005) Fünfter Bericht zur Lage der älteren Generation in der Bundesrepublik Deutschland. Potenziale des Alterns in Wirtschaft und Gesellschaft. Der Beitrag älterer Menschen zum Zusammenhalte der Generationen. Bericht der Sachverständigenkommission. Berlin
• Bubolz-Lutz, Elisabeth/Kricheldorff, Cornelia (2009) “Pflegebegleiter” – ein Modellprojekt des Forschungsinstituts Geragogik mit institutionellen Kooperationspartnern, Endbericht. Retrieved 4 April 2011 from the World Wide Web: http://www.gkv-spitzenverband.de/upload/Endbericht_Pflegebegleiter_8512.pdf
• Bubolz-Lutz, Elisabeth/Steinfort, Julia (no year) Bürgerschaftliches Engagement im Pflegemix – freiwillige ‚Pflegebegleiter’ begleiten pflegende Angehörige. Retrieved 4 April 2011 from the World Wide Web: http://www.b-b-e.de/uploads/media/nl0712_bubolz-lutz.pdf
• Klie, Thomas (2010) Bürgerschaftliches Engagement in der Pflege pp. 571-591 in Olk, Thomas/Klein, Ansgar/Hartnuß, Birger (ed.) Engagementpolitik. Die Entwicklung der Zivilgesellschaft als politische Aufgabe. Wiesbaden: VS Verlag für Sozialwissenschaften