Care: What we can learn from Denmark

Denmark is often cited as a positive example how a care reform could look like. The country has initiated fundamental changes. What makes it different in terms of care – and what can we learn? Anja Herberth was on site.

The showroom is set up like an apartment: The table is set, the bathroom and toilet are spotlessly clean. I’m at the “DokkX” innovation center in Aarhus, the second largest city in Denmark, and I’m taking a look at the municipality’s showroom on the subject of “Assisted Living”. Together with a group from the Austrian care sector, I went on a trip to see the future and gain my own impression of care solutions in Denmark.

In recent days, Denmark has often been cited as a positive example of what a care reform could look like. Healthcare policy in Austria and Germany was the subject of heated debate: German Federal Health Minister Karl Lauterbach warned at a press conference that the number of people in need of care would explode by 2024. An increase of 50,000 people in need of care had been expected – but there are now 360,000 new people in need of care. How can a federal minister and his entire ministry be so wrong in the EU’s largest economy? In any case, experts were not surprised, as more than 300,000 new people in need of care have already more than 300,000 new people in need of care in recent years. There is a fine line in politics between refreshing honesty and complete incompetence.

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In Austria, instead of a fundamental reform of financial equalization, more money will be available for health and care. A care development commission is to achieve better coordination in the fragmented system with its many supporting organizations and federal states. Many topics are still open. Example: Although more and more people are being cared for at home due to the shortage of skilled workers, mobile care is not available everywhere. Especially away from the cities, the supply is not sufficient.

Conclusion: The hot potato of an overall reform is not taken up. The coalitions in both countries cannot agree on a reform, the approaches are too far apart.

Austria votes in 2024, Germany in 2025. There will probably be no developments in the next one to two years. So let’s take a closer look at the Danish system, which has been initiating fundamental changes for years. What is the country doing better in terms of care?

Seeing and understanding new technologies

The “X” in “DokkX” stands for the unknown, the experiment. Citizens have been able to obtain advice on the technological solutions of the future since 2016. The assisted living showroom is set up on one of the floors. It shows around 10,000 visitors a year which assistance technologies and aids for care are available on the market. Half of the 74,000 visitors to this location came from the local community. In order to be able to try out solutions even for a short time, longer journeys are sometimes accepted.

Around 200 products can currently be seen and tested in the exhibition. After a few months, the exhibition is reassembled to make way for new developments. Aids often make people look needy and old. Nice and chic design is very important, we are told. From smart toilet seats and cutlery for Alzheimer’s patients to meowing cats: there are now many solutions on the market for a wide variety of needs. Sensors monitor activity: if the fridge is opened for milk in the morning, the system knows that everything is in order. If it is not opened within a certain time window, a warning is sent to the next of kin. What is not (yet) available on the market is simply produced using a 3D printer and the instructions are made available.

A smart toilet seat that makes it easier to sit down, stand up and clean up. Credit: Anja Herberth

The aims of the showrooms: to view and try out solutions and make informed decisions. Credit: Anja Herberth

Cutlery for people with special needs. Credit: Anja Herberth

What is not available on the market is sometimes produced using a 3D printer. Credit: Anja Herberth

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In Denmark, these solutions are called “Welfare Technology”. Its aim is to improve the independence of older people and people with disabilities and maintain their autonomy. This requires visibility of the solutions and advice. Instead of making bad investments, you can choose the right products competently.

The challenges: Skills shortage and demographic trends

It is not only the wish of many people to be able to remain independent and active for as long as possible. The administration has also had a goal for years: To enable people to live in their own four walls for as long as possible. The Nordic countries, including Denmark, recognized the challenges early on: The shortage of skilled workers, exacerbated by the pandemic, ensures that we will spend the last third of our lives at home. Care is increasingly becoming the responsibility of the family again.

Peter Julius, co-founder and partner of the “Public Intelligence” agency, sometimes gets emotional about this topic. The consulting firm advises municipalities and companies in the public sector internationally. Demographic developments are not only challenging in Europe. He talks about his contacts in Asia, where there is also a lot of pressure due to the ageing population. In his opinion, there is no point in spending more money – i.e. increasing pay and starting salaries. Because the labor market is empty.

So Denmark started to restructure the system years ago. Up to a certain level of care, older people remain at home; only then is there a place in a care home. On average, Danes only enter a care facility at the age of 85/86. Staying at home is supported by a wide range of services that start even before the need for care arises.

This means that we start at a young age to keep people healthy and independent for as long as possible. Coaches come home and explain: How do we stay healthy into old age? Mental stability is also an important factor: helping people to stay socially connected so that they don’t slip into loneliness. Doctors are not necessarily needed to make decisions – nurses and geriatric nurses are also given the power to make decisions quickly. Diseases are detected and intercepted at the earliest possible stage.

Not everything is rosy

Even though Denmark has already taken important steps towards reform: The challenges are still overwhelming here too. The country is divided into 98 municipalities. They are responsible for maintenance. The services are low-threshold and great attention is paid to people’s equality. Every Dane should have access to a certain basic quality of care. Not an easy task in a rugged system with 98 regions. Work is carried out with coordinators and ambassadors: In 10 training and further education centers, Welfare Technology Consultants such as Mikkel Gram Hansen explain new technologies and how they are used in practice to nursing and healthcare staff. They play a key role in the introduction of future technologies.

The decentralized decision-making landscape is also a challenge for companies. The Danish Technological Institute is a world leader in the field of assistance solutions. In such a fragmented market, selling solutions is a major challenge. Practical tests have also become difficult because the care and healthcare system is already under massive pressure. Tests cost time and resources, which places even greater demands on staff.

One solution is for the regions to work together: For a large tender for new lighting solutions, several municipalities worked together to achieve a lower price through higher quantities.

The need for reform is overwhelming

The need for reform in the care sector in many countries is overwhelming. In the meantime, politicians in Germany and Austria are busy with election campaigns. Nothing will change in the next 1-2 years.

The main victims are those affected and their relatives, and for them the following applies: those who can afford it organize help – if available on the market. The shortage of skilled workers will become even more acute, as the baby boomer generation will soon be retiring and qualified young people are becoming scarce. The pressure in the system will therefore continue to increase.

I myself have accompanied loved ones in their final months and had to fight my way through the care system. Without large reserves, I and my family would not have been able to accompany these people to their deaths with dignity. And that makes me sad – because they do exist: The innovative countries and regions that are already testing solutions and innovations and have introduced reforms. And we should be guided by them.

Read more about this in the market survey on “Assisted Living”

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Anja Herberth
Author: Anja Herberth

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