What does continuity mean?

Sick leaves, relocations, schedule changes, expiring replacements, and other changes affect the resident. Changing a contact person can be a negative event. Continuity means that the resident usually gets help from the same people with personal care. Likewise, there is a person, a contact person, who knows the resident particularly well and who ensures that the care of the resident is done in the right way.

Relational continuity

At many residences, the contact person spends their own time with the resident. This is time where the contact between the resident and the contact person deepens. "Own-time" can be used for visits to cafes, the library, theater, or why not a walk in the park with conversations about life.

For many of the residents, the meeting with the contact person becomes important. Relatives may live in another location. The contact with the society outside the residence can be limited. When we as healthcare staff work for a long time with a resident, we get to know the resident on a deeper level. Then we remember birthdays and other meaningful things for the individual. We build a relationship with relatives. It happens that healthcare staff choose to go to the funeral of a person they have known for a long time.

Economic consequences of lacking continuity

There are also reasons to believe that shortcomings in continuity negatively affect the economy of the elderly home. Short-term absence costs in the form of waiting days. Recruiting new employees costs in terms of administrative work, introduction days, and further education in moving techniques and delegation training. Those who do not know the resident so well may also find it harder to work function-preserving with the resident as well as to see skin changes and other changes in the resident's condition.

It means that there are likely other costs such as increased costs for wound dressings, need for extra staffing due to restless residents, emergency visits due to fall injuries, etc. which can be a consequence of the lacking continuity.

Continuity and well-being

In the National Board of Health and Welfare's survey of what the elderly think about elderly care in 2019, it appears that only 48% of those living in special housing receive information about temporary changes. Social interaction and activities are the two areas that the elderly are least satisfied with.

If you want to be able to follow up to what extent you carry out what you have planned, there should be a clear daily planning of the activities at the residence. If there is daily planning, there is also planning of "own time" documented and it becomes easier to inform the individual about changes, for example in case of illness.

Work environment and continuity

The working environment for those who work at the elderly home is also negatively affected. Constantly getting new colleagues means stress and increases the workload on the one who knows the residents and the routines of the unit.

Continuity and patient safety

Good relational continuity in care contributes to likely reducing the risk of hospital admissions and premature death in several disease states according to SBU (The Swedish Agency for Health Technology Assessment and Assessment of Social Services). There are also reasons to believe that the care of the residents works better when it is usually the same people who help the resident. Likewise, it is easier to make transfers correctly and to see skin changes in the resident. The risk of residents not getting an adapted diet according to prescription also increases.

Reflection - staff changes
Care staff:
• How do you inform the resident you are responsible for in case of, for example, vacation?
• How do you handle sick leaves in the workgroup, do you inform the residents if a colleague is sick for a longer time?
• Do you have any form of replacement system when it comes to the contact person role?

Manager, nurse, occupational therapist, and physiotherapist:
• How do you inform the residents about staff changes?
• Does the individual get to choose or affect the choice of replacement?

Resident and relatives:
• Do you get good information about upcoming changes?

Erland Olsson
Specialist nurse
Sofrosyne - Better care every day