Dynamic knowledge synthesis in local networks for coherent elderly care

We are getting older and more diverse, and that brings challenges. We cannot solve these challenges through healthcare alone. We also need municipalities, schools, companies, housing associations and older people themselves to achieve an age-friendly society. This requires cross-domain collaboration. But how can we achieve that?

An investigative look
On April 25, researchers Tineke Abma and Barbara Groot from Leyden Academy on Vitality and Ageing, and Mariëlle Schuurman from Leiden University Medical Centre (all based in the Netherlands) presented the dynamic knowledge synthesis of local networks related elderly care. This synthesis was created in collaboration with stakeholders from 110 local networks and on behalf of ZonMw. The aim was to provide the professionals in the networks with tools to look at their own practice with an investigative view and to further develop the collaboration between care, support and welfare in the neighborhood.

Systematizing lessons learned
Moniek Willemstein, program manager of the ZonMw Local Networks program: “A lot of experience and practical knowledge was gained in the various networks. For example, we looked at how to better organize fall prevention through collaboration between healthcare and welfare or at everything that is needed to properly design a meeting place for older persons in their neighborhood. But little knowledge and experience was exchanged between the networks. We wanted to bundle the various insights, lessons and experiences, and make them available to local networks. We also wanted to gain insight into the approach to the synthesis itself. How do you approach learning across multiple projects? Those involved have exchanged knowledge and experiences about this.”

Process and results
Prof. Dr. Tineke Abma, professor of Elderly Participation and director of Leyden Academy, about the challenges and insights gained: “We were tasked with initiating a dynamic, non-statistic, learning process between the networks. But how do you do that? People learn from and with each other when ‘productive interactions’ arise. In other words, people want to meet others who struggle with the same issues. Different perspectives are crucial, as is safety to share not only success stories, but also doubts, questions and disappointments.”
One of the most important findings is that local collaboration requires investing in relationships, getting to know each other and establishing new connections. This is often accompanied by tensions. Especially when domains that ‘speak different languages’ come together, for example healthcare and welfare. And sometimes even broader with housing associations, social entrepreneurs and municipalities. Results are important, but the process is just as important!

Participation of older participants is crucial
Most networks started from healthcare, for example a general practice or home care institution. But more is needed to improve the quality of life of older people. The eight domains of the WHO’s age-friendly communities model were helpful in this regard. It turned out that elderly people were often not included in the local network. New insights emerged in the networks where older people did actively participate. Professionals realized that not all questions can be solved with care. For example, when experiencing loss and loneliness, older people indicated that attention and a listening ear were in many cases more important than solving (care) questions. A ‘good life’ is not only achieved through good care. Citizen participation, inclusion, good communication and environment are also important.

“The value of collaboration is sometimes difficult to pin down. It has value, that is what many people experience, but what does that mean? Getting to know each other and therefore finding each other more easily, especially when problems arise, is very valuable when working together.” – Barbara Groot, researcher

Positive energy
The enthusiasm to actively participate in the process was unprecedented. The dynamic nature of the knowledge synthesis has released positive energy and set a lot in motion. Working with creative methods in particular made a lot of difference. The ‘Working together as a forest’ card set was designed together with the participants, in which the ecosystem of a forest is used to look at and talk about different aspects of networks. This helps to reflect and to think about the common vision.

Connection with education
During the final meeting with the project leaders, many students and teachers from different levels of education were also present. The participants concluded that it is important that the professionals of the future learn to work with so-called wicked skills; listening, asking open questions, putting yourself in the other person’s shoes, dealing with conflict, etc. These – in addition to substantive professional knowledge – are desperately needed to make sustainable cross-domain collaboration future-proof.