On greening senior care and cultural differences
This week I started as an academic supervisor for a truly exciting student project: greening residential and other senior care.
I have a special relationship with elderly care, for deeply personal but also professional reasons. Some years ago my family spent a lot of time managing the care of my grandparents, and as a result of that experience ended up founding a start-up on care communications. The concept didn’t fly in the end, but a desire to help remained. News on the heartbreaking failings of the elderly care systems of different countries are much too frequent, unacceptable in their disregard for human dignity and care for the vulnerable.
Now, it is reasonable to ask whether a student project on greening care will actually move the needle on anything I just mentioned. Perhaps not. But the students and I will learn about the industry, get to be a part of some kind of positive movement, and there is surely some value in that, immediate or delayed.
I read today a draft paper that contrasted “future-directed imaginaries” with “past-oriented imaginaries”. The hunch I have that connects this to the topic at hand is that in supporting one future-directed imaginary, greener care, a community will be more ready to accept and adopt others — a virtuous cycle. This hunch comes partially from observing European politics in recent years and how political parties and identities tend to adopt imaginaries with similar orientations, perhaps most obviously the far right holding onto a bouquet of past-oriented imaginaries on a variety of topics.
But I digress, as I do.
For there are more interesting aspects to this project than the topic alone. In the year that I have now been in the Netherlands I have been continuously impressed by the effects of the “Green Deal Duurzame Zorg 3.0”, the last part translating to “sustainable care”. This initially bottom-up initiative has now become the new standard for politicians, municipal authorities, private healthcare providers and everyone else in the health care ecosystem in a way I could not have imagined while working with the sector in Finland.
I have yet to understand the cultural difference here, the difference that makes Finns say health care can’t be greened, at least not this part, at least not now, we have enough worries as it is, and the Dutch say ok, how do we do that? Resources are certainly one reason, and a big one at that; the Finnish health care system is largely public, very expensive, and has in recent years undergone massive organizational changes and budget cuts. The Dutch system seems to have much more robust financing, partially as a result of the way insurance is set as a financial mediary between state governance and market provision of services. Staying away from any national character type explanations while noticing a distinct difference in mindsets, I can’t help but wonder how both of these perspectives developed. What is the cultural baggage Finnish health care carries that the Dutch don’t? For now I have no answers beyond the €€€, past and present.
I find it remarkable that this care provider proactively approached my university with a request for research into greening their operations. There is curiosity, there is openness to change. As many times before in the Netherlands, I even find it a little difficult to position myself with regards to them when there’s no need to argue for the fundamental need of greening. But the grass on this side is certainly green; the students and I can focus on solutions, on considering possible levels of change, points of intervention, barriers and enablers, theories on how impact and influence travel in social and practice networks, how to include the other key priorities of care quality and costs into the mix. The cognitive experience so far has been wonderful, experiencing this mental space to juggle possibilities. I wonder if the students feel the same?
I hope for two things.
That I have fundamentally missed something in the Finnish discourse, and that the Finns are just doing their characteristic understatement thing of actually developing something impressive while forgetting to market it.
And that as the results of the Dutch experiments and research start to bear fruit, the world will look this way and implement what we have developed. Health care systems are remarkably similar around the world, the hospital as an institution being a particularly standardized example. Much can be directly exported, and much more simply localised rather than re-invented. We could be smart about this.
