Ana María Porcel Gálvez is a Doctor from the University of Granada and a Post-doctorate in Nursing from the University of Florianópolis. Statutory of the Andalusian Health Service, she exercised her care activity for more than ten years at the Alto Guadalquivir Hospital emergency and critical care profile. In addition, he has obtained pre and postdoctoral scholarships, carrying out research stays in Catamarca (Argentina), (Colombia), Florianópolis (Brazil), Beja (Portugal), London (United Kingdom) and Maastricht (Holland). Since 2009, she is Principal Investigator in the line of Complex Care and Health Results: INICIARE (I + D), where she also works as an Evaluator of research projects in the area of Nursing. Currently, she is coordinator of the European project “Development of a transcultural social-ethical care model for dependent populaton in Mediterranean basin (TEC MED)”.
For those who still do not know this project … Could you explain what TEC-MED consists of and what are its objectives?
The European TEC-MED Project focuses on the creation of a cross-cultural social-ethical-care model for dependent older people and / or at risk of social exclusion in the Mediterranean basin. Led by the University of Seville, being the coordinating entity, we work together in six countries of the Mediterranean basin; Spain, Greece, Tunisia, Italy, Lebanon and Egypt.
We have developed an integrated care model from a holistic perspective, centered on the person, that includes them in the social care process, linking them with health care. Therefore, in our study, we also included caregivers, family and / or social support group, if any. For the creation of the TEC-MED model, work has been done jointly between the countries, where more than 350 people have contributed, expert professionals in the field of care and healthcare in the Mediterranean Basin.
And those objectives… How are they achieved? What is the process?
It is achieved with a lot of effort and more now with social distancing in an eminently participatory research project. The project lasts 36 months and has a total budget of 3,331,225.33 million euros (of which 2,998,102.80 million euros are a contribution from the EU) corresponding to the European financing program ENI CBC MED.
There is a rigorous organizing process among all countries. With virtual meetings practically weekly and daily contact. We are currently in the piloting phase, for which 6 local agents in Spain will be trained to train on the model. A cascade result is intended to be operationalized through the action plan and developed through an online platform to help the elderly population and all the key agents involved.
Let’s go back to the beginning, how did the idea for this project come about?
For more than a decade, as Principal Investigator in the line of dependency and complexity in care of the Research group Andalusian Plan for Research, Development and Innovation CTS 1050 “Complex Care, Chronicity and Health Results”, we have been investigating for more than a decade on the complexity in this area, with the validation and creation of a tool, INICIARE, which allows the assessment of care dependency.
Tool that assesses dependency not only from a functional point of view, but also from a physiological and cognitive perceptual. In addition, demographic changes foresee that, in the following decades, there will be an increase in the situation of dependency, since, by 2050, the world population over 60 years of age will increase by around 20%, reaching 2,000 million population.
Therefore, it seemed to us an opportunity to carry out this project to respond to the real needs that society has in relation to the care of the elderly.
There is no doubt that the pandemic has aggravated the situation of older people in our society. Do you think that the pandemic has made it more necessary to have a model like the one you present?
Totally sure. We have all witnessed this need for care in general and care for the elderly in particular. As age increases, we become more vulnerable and we need more care and more focused on frailty and / or dependency.
We must achieve a change in the paradigm and achieve dignity in the lives of the elderly. Given this, the TEC-MED project puts the person at the center and studies and evaluates their social and health situation as a whole, thus we carry out a comprehensive intervention tailored to the specific social and health situation of each person.
One of the main objectives is to improve the well-being of the elderly through the design of policies, what do these policies focus on?
Ideally, public or private Institutions and Entities, as well as non-profit organizations work with this care model.
The impact on society of a care model focused on social and health needs, promoted by the institutions is of vital importance. We bring study, perseverance and confidence that it works, but they have the tools to make it possible. Making it possible for it to be a governance model.
A country without its people is simply a piece of land in the world. Hopefully the Covid-19 pandemic has made visible the need for dignified care for the elderly and making policies focused on the good of citizenship becomes a fact.
The TEC-MED project began in September 2019, before the pandemic caused by Covid-19 arrived, how did the new coronavirus affect the project?
Like most, it greatly affected the development of the project. We work with people over 65, the same ones who suffer the most from Covid-19. For our part, we have had to reorganize the work, since the face-to-face meetings between the different countries have become very complex, until now, impossible in person.
Therefore, we have had to approach it from an online dynamic, maintaining a correct organization and expanding communication with all the digital channels that we have at our disposal. This has allowed us to continue with the development of the same and that, currently, the six countries are in the phase prior to the implementation of the pilot of the model.
Despite this effort to move forward and the adversities, now we see much more necessary a care model like the one we are building, since we have seen how loneliness can affect, for example, cognitive impairment and the medical history of patients. old people.
Focusing on the project itself, it is not a national project, but encompasses several Mediterranean countries, why?
Mediterranean countries are showing common trends in terms of population aging, declining social support and the need for innovative and sustainable socio-ethical models of care. These problems have an impact on many categories of vulnerable people, such as dependent older people and / or those at risk of exclusion who suffer from chronic diseases and lack the support of a family network, with the consequence of being even more marginalized.
Mediterranean culture does not unite us only in terms of gastronomy, but our development as a region is also linked to the growth and development of people’s lives and we have in common the figure of a caring person that is not present in other countries. Therefore, from the TEC-MED project, we believe that it is necessary to create a network of support and cooperation between the countries of the Mediterranean basin and work together for the health of our elders.
How are you working with the rest of the countries to develop the project?
Spain, as a leading country, has taken the first steps in terms of creating the socio-care model and has worked together with the other countries, allowing for the active participation of all of them.
From there, they have adapted the model to the national situation of each one, since the health systems are not the same in Spain or Italy as in Lebanon or Egypt. We contribute more than 350 people, expert professionals in the field of care and healthcare in the Mediterranean Basin.
What stage are you currently in?
We are currently beginning the piloting phase, that is, beginning to work with the training agents to collect the evaluations of the users and caregivers. For this, we have the Order of San Juan de Dios and the Seville City Council as partners to the project, which will allow us access to these people in their homes or residential centers. However, given the magnitude of it, in which it is intended to incorporate more than 4,000 people into the assessments, we are also in contact with the participation of the Ministries of Health and Families and the Department of Equality, Social Policies and Conciliation, for be two key entities in this area.
What role do socio-health professionals have in this model?
The role of healthcare professionals is key, both in the creation of the model and in its implementation and evaluation. From the first moment that we began to work on this project, we have had the participation of a multidisciplinary team, since I firmly believe that care for the elderly must be holistic and comprehensive and that it covers all the needs of the person.