Scientific Monitoring of the Pilot Project “Community-Based Support for Older Adults” in Rosenheim

Project background

Demographic change poses challenges for both local governments and the health and long-term care system: The number of very elderly people is rising, while family support structures are weakening. As a result, the demand for professional support services is growing, and the relevant care systems and funding agencies are coming under increasing personnel and financial pressure.

The pilot project “Community-Based Support for the Elderly” in Rosenheim aims to proactively address this trend and apply the lessons learned from 20 years of community-based child and youth services to elder care: Community support coordinators from the organizations Caritas, Diakonie, and Startklar are working together with older adults in Rosenheim’s three community areas (North, West, and East) to develop tailored support arrangements. These are designed to enable them to live as they wish—for example, to remain in their own homes for longer and lead self-determined lives. The concept of community-based care is based on five fundamental principles:

1. Focus on the individual’s wishes

2. Focus on the individual’s own activities

3. Focus on the existing resources of individuals and the social area

4. Cross-target-group and cross-sectoral work

5. Networking and cooperation among the various stakeholders

Project objective

The scientific monitoring has two objectives. First, it analyzes whether—and, if so, which—effects of the pilot project become apparent during the project period (including changes in care levels, the rate of placement in nursing homes, and survival time), and supplements this with cost-effectiveness analyses and potential financing models. Second, it develops quality criteria for social-space-oriented work in elder care: Based on the practical experiences of the social-space guides and qualitatively documented case histories, indicators are derived and compiled into a draft municipal index, which can be transitioned into a long-term municipal monitoring system. The results serve as a sound basis for policymakers and funding agencies to decide whether to continue funding the pilot project.

Project procedure

This research project examines three complementary levels:

Level A: Process evaluation: How can we identify the extent to which municipal elder care services operate within a socio-spatial framework?

Level B: Outcomes for individuals and their families: What effects are observed for older adults and their family members?

Level C: Health economic evaluation: For whom is it cost-effective, and what funding models are feasible?

Innovation

The project complements care needs planning by incorporating a preventive, socio-spatial perspective: It focuses on neighborhood structures that help older adults live independently in their familiar surroundings for as long as possible and provide relief to family caregivers. In doing so, it addresses key areas of action outlined in the strategy paper “Good Care. At Home in Bavaria” (2022): support in the lead-up to and surrounding care, the establishment of “support networks” in the immediate social environment—understood from a socio-spatial perspective as empowerment rather than care—as well as the principle of “prevention before care.” The scientific monitoring provides the evaluation framework outlined in the strategy paper to determine whether—and under what conditions—the approach tested in Rosenheim proves effective.

Beyond Rosenheim, the results are relevant for other Bavarian municipalities that wish to further develop preventive approaches in line with the principle of “outpatient care before inpatient care.” To this end, the project provides guidance on cost structures, proven quality criteria for a social space-oriented approach, and a transfer concept with materials that can be adapted to local conditions.