End-of-project assessment : home care project for the elderly -- Budapest, Hungary

With assistance from USAID, JDC-IDP, and the Hungarian Ministries of Health and Social Affairs, Hungarian physicians, nurses, home health workers, supervisors, and physiotherapists were trained to deliver services to the home-bound elderly. Over the two years of the project, the JDC-IDP team of experts trained a total of 38 physicians, 46 nurses, 57 home health workers, and 8 supervisors in home care service provision. Services for the home-bound were provided by multidisciplinary teams, each comprised of a physician, nurse, home health worker, and physiotherapist. Bringing services to the homes of the elderly improved their quality of life while reducing the need for costly hospitalization. It is estimated that the cost of hospitalization is three times that of providing services in the home. As a direct result of the project, physiotherapy was introduced as a legitimate profession. Hungarian physiotherapists became integral members of the health care team, and dramatic improvement was evident in several of the physiotherapy patients. The curriculum developed for this project has been incorporated into that of the Budapest School of Physiotherapy, testimony to the effectiveness of this project component. Budapest's five "social clubs" were turned into day centers, where higher functioning, well elderly were provided with physical, educational, recreational, and social stimulation in order to maintain and improve their health. Before this project began, these clubs provided little else besides meals and a warm place to stay. In the fourth quarter of 1992, project activities came to a halt because of local political problems. However, due to the commitment of the mayor and the Hungarian professionals trained through the project, home care services continued. There are now 18 home care teams serving approximately 300 elderly, and requests are being received from other districts for these services. A Professional Committee, consisting of accomplished professionals from each medical specialty, oversees and guides home care activities. The critical goal for the immediate future is to obtain new funding to allow additional training, the continuation of home care services, and expansion into additional areas of Budapest. The mayor and the professionals of the Eighth District are taking steps to ensure that the important gains realized through this project continue. (Author abstract)