This is how Helsingør municipality strengthens the vulnerable talks with citizens in elderly care

This is how the problem was formulated in a large project in Helsingør Municipality, for which Christina Hjulmann Schneekloth has been the project manager. She is a health consultant in the municipality's Centre for Health and Care and has managed the process for two units, namely the nursing home Montebello and the Elsinore Rehabilitation Centre.

But how do you break such an overarching vision down to concrete action?

What does it look like on a Tuesday morning in a nursing home and a rehabilitation center when you 'reinforce the present sessions'?

Of course, it all depends on the context. The solution was different in the two units, so that it actually suited the employees' everyday lives — and so it benefited the citizens as much as possible. Together with Christina and a small group of employees from each unit, Feedworks Mikkel developed two conversation tools that their colleagues could implement in their everyday lives.

“The tools provide a framework for a systematic approach to citizen conversations and employee sparring with each other,” says Christina.

Here are the stories from the Montebello nursing home and Elsinore Rehabilitation Centre, which participated in the project:

The nursing home Montebello: “We are taking care of the relatives much more now.”

At the Montebello nursing home, we quickly agreed that the employees might need a tool for better sparring with each other in everyday life.

Employees have daily meetings where they coordinate tasks internally. But there was one item on the agenda that was missing:

“Although we are good at coordinating the day, we lacked a framework and language to be able to talk about the things we have challenges with relatives and residents about,” says Christina. “How do you tell a relative in a good way that you should not bring your dog inside? Things like that are important to be able to say, but some relatives may get cross about it. So how did we create this space to spar with each other about the challenges in a more professional way?”

The solution became an internal sparring tool that Mikkel developed in close cooperation with the employees. As Christina says:

“Mikkel made a good presentation, but if the employees felt that “I would never say that myself”, then it would not be used in everyday life. So it's been tweaked in a way so that it's actually being used by both experienced and new employees.”

The sparring tool is a very low-practical way to go to a conversation with a colleague with questions such as “How much does the situation affect you in your daily life?” and “How would you like it to be?”

Whether it works? Yep, says Christina:

“Employees have been given a tool to be able to talk in a new way about those things where there may be challenges with residents and relatives. The employees themselves say: “We get good feedback from the relatives. We anticipate the relatives much more now and meet them more attentively.” We are very proud of this and our vision is that the tool can also be used in other nursing homes in Elsinore.”

It was the one example of how we helped create better citizen conversations with a concrete sparring tool in a nursing home. Now we go to Elsinore Rehabilitation and Training Center, where the challenge was different:

This is how Elsinore Rehabilitation and Training Centre made the first meeting more present

Elsinore Rehabilitation and Training Center can be seen as a kind of mini-hospital where the citizen has a course before going home or possibly to a nursing home. In this regard, employees hold a first meeting with the citizen and relatives.

“That meeting was really mostly for the employees' sake, we found out. They told a lot of things, but often the citizen just wants to know where they can read the newspaper. We therefore decided that this first meeting was a concrete situation in which we could work to make the meeting with the citizen more present.”

The solution here was a conversation guide that divides the meeting into a beginning, middle and end. And with different angles of good questions to ask the citizen and relatives so that they get involved.

“The employees have understood this very well,” says Christina. “The conversation guide has been adapted by them, so that it is used in the first meeting to get to know the needs of the citizen better — rather than just the employees providing information. Of course, changing culture takes time, but with this conversation guide we have a very concrete tool to do it.”

How have the two units fared overall since the end of the project in the summer of 2022?

“The general feedback on the project has been that the employees have come a very long way in a short time and with great commitment,” says Christina and concludes:

“The collaboration with Feedwork has been characterized by tremendous flexibility and responsiveness. And although at first we were a little skeptical about whether these military-trained consultants could work in a municipal context and with sosu assistants, there is something that these guys can do.”