Underpinning the Nordic welfare state model is a social contract that guarantees an equal shot at life, a safety net when the going gets tough and a dignified old age. The model has been subject to almost universal praise but has also faced some tough questions of late.
In Finland, a key dilemma concerns the ageing generations living longer while adding pressure on a system that is upheld by a slimmer base of taxpayers. Finland has the second-oldest population globally, just ahead of Italy but behind Japan.
The COVID-19 pandemic turned most of society upside down, limiting the day-to-day of all but hitting the elderly the hardest. Senior citizens make up the majority of at-risk demographics the world over and have been subject to added restrictions.
“But what is the price of limiting the activity of the elderly?” asks Sandra Lounamaa, co-founder and CEO of elderly services startup Gubbe.
Lounamaa has been asking the question for a while now, but also answering it by founding Gubbe in 2018 with Meri-Tuuli Laaksonen to make an impact. The startup has developed an online platform that offers home care services to the elderly, employing the young and activating the old.
“The Finnish elderly care system works, and people expect to be covered by it,” Lounamaa explains. “But the system only treats sickness and can’t always provide meaningful in-person interaction for senior citizens.”
As we age, our bare necessities become much more evident and regular social interaction is perhaps one of the most important things that keeps our minds active and our hearts filled with purpose.
“By encouraging active ageing with a trusted friend, or Gubbe, we offer the elderly a reliable human connection and help with daily routines, be it exercising or cleaning the house.”
After each visit, the Gubbe updates the startup’s app on the day’s events and condition of the elderly person, giving peace of mind to, and perhaps even encouraging more communication from, the relatives.
“The feedback from the elderly, families and students has been extraordinary,” Lounamaa continues.
“New friendships have been born and relatives feel better knowing that there is a trusted person their loved ones can count on in their daily lives.”
The purpose-driven value of the startup hasn’t gone unnoticed by investors. Gubbe raised 300 000 euros in funding amid the COVID-19 epidemic from investors that are counting on the startup’s vision to offer every Finnish senior over the age of 75 living on their own their personal Gubbe within five years.
Lounamaa’s team proved resilient as the crisis hit, quickly setting up an alternative to their declining core business by tapping into the grocery delivery market to offset some of the more immediate damage to their operations.
As the restrictions are loosening in Finland, the lessons of the pandemic are becoming clear.
“For us the crisis has actually highlighted the need for our service,” says Lounamaa. “We’ve seen significant deterioration in our clients’ wellbeing during the lockdown, and it seems we might have an even bigger problem on our hands now than before the pandemic.”
Gubbe has been able to bounce back and is continuing its operations while observing social distancing and other hygiene measures when visiting its clients.
COVID-19 has indeed magnified the imperative of treating the elderly according to their needs, but the current lull in its spread in Finland has also begun to underline Lounamaa’s insights about the delicate balance between restricting and activating seniors.
“I think the question is acute,” states Marianne Dannbom, CEO of Sanoste. “The most vulnerable people in care homes are most affected by the restrictions, because inactivity for a person with multiple diseases has drastic consequences in a very short time frame.”
Sanoste connects personal trainers specialised in exercise for the elderly with both seniors living on their own and groups in care homes through its digital platform. All that is needed is a laptop or tablet.
The exercises are tailored for seniors and can be bought by home care personnel, relatives or the seniors themselves at Sanoste’s online marketplace. The company takes a fee from the total price for the platform’s upkeep and coordination.
The instructor calls the seniors on their tablet at an agreed time and begins the session when the whole class is ready. The real-time exercises vary but are simple enough to do on one’s own and provide a daily dose of physical and social engagement.
“YouTube is filled with exercise videos but what we’ve realised is that seniors long for two-way engagement because it prevents slacking and skipping exercises, according to our customers.”
Dannbom points out that a recurring concern for relatives and even industry professionals is the digital skills of the elderly.
“There’s a misinformed contention that ‘my dad can’t use a tablet, he’s over 70’ that needs correcting,” says Dannbom. “Firstly, our whole purpose is to design our service for the utmost user-friendliness and, secondly, seniors do pick up digital stuff pretty quickly if you just give them a chance.”
Remote exercise could be a way to hedge against the consequences of inactivity, which can be tragic for the lives and families affected and include double-digit percentage increases in healthcare costs. The global pandemic has proved and magnified the severe broader costs of the situation throughout the globe.
As Gubbe and Sanoste have demonstrated, the solutions already exist but a recognition of the opportunity cost of restricting the lives of the elderly may yet be lacking. Over time, digital solutions can provide cost-efficiency and meaningful social interaction across the board and especially for countries facing geographical challenges in healthcare, like Finland.
“There’s a chronic hurry and a clear lack of resources in elderly care, which create huge pressures on professionals in the industry,” says Juhana Ojala, CEO of VideoVisit, a software company focused on remote care. “There’s also still some scepticism about digital solutions for many reasons in management and staff.”
By implementing digital visits into care plans, nurses are able to monitor home care residents to remind them of their medicine and other daily tasks, all the while engaging with the elderly more and with a lower price tag. While scepticism of technology is often based on a belief that it will replace the essential human element in care services, VideoVisit takes a holistic approach.
“Digital isn’t an alternative to traditional treatment, but a supplement to it,” continues Ojala. “It is only when technology is integrated into the care model that things will change.”
In Finland, VideoVisit provides virtual home care services for all Finnish public sector organisations and is scaling its solution internationally, currently present in Japan, Australia, Iberia and the Baltic countries. A total of 75 per cent of the company’s revenue stems from elderly care.
Accelerated market entry
At the beginning of the Finnish epidemic, digital foresight proved its worth. The VideoVisit system had been operational in various cities for a number of years before the crisis forced society to lock its doors.
“When COVID-19 hit Finland, our virtual care service orders rose by 650 per cent and, within one month, the usage of the service had doubled in Finland to over 90 000 remote care contacts per month,” says Ojala.
VideoVisit also doubled its sales domestically and shifted its internationalisation efforts into high gear.
In the United Kingdom, where the virus hit the populace hard, VideoVisit’s ready-to-go virtual care service was selected for Techforce19, an NHS initiative to find solutions that can be quickly implemented into the healthcare system’s operations.
“We’ve had the UK in our sights for a while now,” says Ojala. “The pandemic offered an accelerated market entry for us. We’re sitting at the right tables now and discussing how to bring virtual care to the elderly in the UK.”
A crucial companion was fellow Finnish company Nursebuddy, a partner for VideoVisit in the UK with an existing clientele of over 150 home care providers in the country.
The family company also found its way into international negotiations with multiple significant global technology providers, which are due to be concluded by the end of summer and early autumn 2020.
“Our mission stems from societal thinking,” says Ojala. “We want to offer our end-users the chance to live at home as long as they want. At the same time, we’re giving decision makers the tools to fulfil their promise of a dignified longevity at a time when customer volumes are increasing but the resources simply aren’t there.”
Fiksari offers a helping hand
The number of home electronics that are hooked up to the digital realm can be overwhelming even for a so-called digital native or millennial. For the elderly, the picture is even more complex since the bulk of user interfaces are not designed with a long digital learning curve in mind.
Luckily there are devices and software designed specifically for the elderly, offering a way to get into the digital language and develop as a tech user. However, finding the right devices, broadband deals and campaign offers can be a daunting proposition especially for the non-savvy.
This is where Fiksari comes in, remotely due to the pandemic.
Fiksari offers tech assistance services to the elderly, which include communicating with relatives, taking care of routine banking or medical services online and taking a good hard look at the deals an elderly person has bought from service providers. Fiksari also offers package deals that are tailored for the budget and daily needs of the end-user.
The startup’s stated purpose is to make elderly life technology-fluent.