Criteria for granting services for the elderly

The legislation regarding the organisation of social welfare and health care services is observed in the granting of the services in question.

The acts that are essential in the granting of the services are as follows:

• Social Welfare Act (1301/2014)
• Health Care Act (1326/2010)
• Act on the Status and Rights of Social Welfare Clients (812/2000)
• Act on the Status and Rights of Patients (785/1992)
• Act on Supporting the Functional Capacity of the Older Population and on Social and Health Services for Older Persons (980/2012)
• Act on Client Charges in Healthcare and Social Welfare (734/1992)
• Act on Wellbeing Services County (611/2021)
• Act on Support for Informal Care (937/2005)
• Family Care Act (263/2015)
• Act on Organising Healthcare and Social Welfare Services (612/2021)
• Municipality of Residence Act (201/1994)
• Disability Services Act (675/2023)

The granting of services is based on a service needs assessment and client plan. Services are granted on the basis of a service needs assessment for reasons such as illness, disability, impaired functional capacity and a particular family or life situation to persons who need assistance with housing, treatment and care, promoting and maintaining functional capacity, accessing services and handling other tasks and functions that are part of day-to-day life.

The application for services as a new client is made by contacting Senior Info. More detailed contact information and methods can be found at www.luvn.fi. If the client is already a client of services for the elderly, they should contact their appointed worker or the service provider.

Each client’s need for services is assessed comprehensively. The service needs assessment must be initiated without delay and completed without undue delay. For persons over 75 years of age, the assessment must be initiated no later than on the seventh working day from the client, their loved one or another person contacting the social welfare services in order to obtain social welfare services.

The service needs assessment is free of charge to the client. The overall assessment considers the person’s ability to handle day-to-day life, physical functional capacity, psychosocial well-being, the obstacles that the living environment places on the functional capacity, financial opportunities, and the opportunities of loved ones and volunteers to support the persons day-to-day life.

The service needs assessment utilises the RAI assessment tools as well as other reliable indicators that measure functional capacity and care needs. A single functional ability scale result is not a criterion for granting assistance, support or service. The service needs assessment always primarily examines the potential of technological solutions to meet the client’s needs, and only then does it assess the suitability of other service forms. The decision on granting the services is made based on assessing the client’s overall situation. The assessment is carried out in cooperation with the client and, if necessary, their family and other loved ones.

The services granted to a client can be increased or reduced, or the services can be discontinued entirely if the client’s functional capacity and/or service needs change. Services can be granted for a fixed term or continuously.

Support services for living at home, remote services and rehabilitative services are primarily services to support the client with handling day-to day life and maintaining personal functional capacity. In the context of home care services, the lowest priority option is regular home care.

Support services refer to services that support the client’s ability to carry out everyday activities as independently as possible, as well as services that help the person receive content that promotes well-being in their life.

Support services in accordance with Section 19 of the Social Welfare Act are organised according to the person’s individual needs: 1) meal service; 2) clothes care service; 3) cleaning service; 4) service access assistance; 5) service that promotes engagement and social interaction.

In addition to the support services referred to in Section 19 of the Social Welfare Act, safety aid services may also be granted as a support service. Support services are provided to persons who need them on the grounds that their functional capacity has been reduced due to old age, illness, disability or other similar reasons. In addition, support services are provided to persons who need them on the basis of their particular family or life situation.

The meal service consists of frozen meals delivered to the home. The meals offered adhere to the nutritional recommendations for the elderly. If necessary, the service covers special diets.

The meal service can be granted as the only service or alongside other services based on an assessment of the service needs and, if necessary, nutritional condition.

Home delivery meals are intended for clients whose functional capacity has deteriorated enough for one or more of the following conditions to be met:

• The client is unable to take care of meals either independently or with the help loved ones (purchasing and preparing food, related travel).
• The client is unable to leave their home to eat.
• The client is in the recovery phase of an illness and therefore requires good nutrition to support rehabilitation. 
• The client has been found to be in a poor nutritional state, which needs to be rectified.

The meal service can also be granted to ensure age-appropriate intensified nutrition, with due consideration to special diets. The nutritional state is assessed with a suitable indicator (RAI, MNA).

As maintenance cleaning, the cleaning service can include vacuum cleaning, dusting, and floor and toilet washing. The cleaning service does not cover thorough cleaning, window washing and carpet beating. The service is primarily provided through service vouchers. The service is available on weekdays (Mon–Fri) between 7:00 and 18:00.

Cleaning services are available to persons whose functional capacity has been impaired in the long term and who are unable to purchase the service directly or arrange the service for their home.

The cleaning service, clothes care service and service access assistance are discretionary and granted on the basis of a service needs assessment. The services are aimed at people who are in a disadvantaged financial situation, which means that the assessment considers the client’s financial situation. The guiding income limits are the income limits for granting national pension.

To determine their financial situation, the client must submit their latest tax decision. The decision is not taken solely on the basis of the client’s income, and exceeding the income limit is not in itself a reason for a negative service decision. The service can be granted as the only service. The income limit is reviewed annually in line with the national pension index. Front-line veterans with a front-line military badge, front-line service badge or front-line badge are granted support services based on their client plan, regardless of their income and assets.

The service is primarily intended for clients over the age of 65 and is primarily implemented through service vouchers. Service vouchers are normally granted for two (2) hours a month. The value of the cleaning voucher is determined in accordance with the value confirmed by the county government of the Western Uusimaa Wellbeing Services County. If the client does not have the opportunity to use a service voucher, the service will be arranged as an outsourced service. As regards support services that are arranged as outsourced services and voucher services (cleaning, clothes care and service access assistance), a total maximum of eight (8) hours per month can usually be granted

Clothes care means laundry and further processing of clothes outside the home. Clothes care includes the washing of clothes and linen and hanging them up to dry in the client’s home or the housing company’s laundry room. Clothes care can also include folding clothes and putting them where they belong. Clothes care does not include washing hand washable clothes or mangling linen.

The service is organised as an outsourced service. The service is available on weekdays (Mon–Fri) between 7:00 and 18:00.

The cleaning service, clothes care service and service access assistance are discretionary and granted on the basis of a service needs assessment. The services are aimed at people who are in a disadvantaged financial situation, which means that the assessment considers the client’s financial situation. The guiding income limits are the income limits for granting national pension.

To determine their financial situation, the client must submit their latest tax decision. The decision is not taken solely on the basis of the client’s income, and exceeding the income limit is not in itself a reason for a negative service decision. The service can be granted as the only service. The income limit is reviewed annually in line with the national pension index. Front-line veterans with a front-line military badge, front-line service badge or front-line badge are granted support services based on their client plan, regardless of their income and assets.

The service is intended for washing clothes and linen when the client is unable to wash them independently or with help. In exceptional cases, clothes care can also be arranged outside the home when the housing unit cannot fit a washing machine, the housing company does not have a laundry room and the client is unable to use laundry services with assistance.

The service is organised as an outsourced service for the client. As regards support services that are arranged as outsourced services (cleaning, clothes care and service access assistance), a total maximum of eight (8) hours per month can usually be granted.

The safety aid service provides assistance in acute situations. The service enables non-urgent assistance to the home around the clock. The safety aid service is not responsible for pre-planned assistance tasks. The purpose of the safety aid service is to improve safety and reduce concerns when the client suffers from deteriorated functional capacity or a memory disorder, or the client is at risk of falling or having a seizure.

The safety aid service means a service that includes the suitable safety equipment, round-the-clock receipt of alerts through the equipment, assistance need assessments resulting from an alert and making sure that the client receives the necessary assistance regardless of the time of day. The safety equipment includes an emergency telephone, which consists of two parts: a fixed central unit and an alarm button that the user carries with them (on their wrist or around their neck).

Service access assistance mainly means running errands and handling various affairs with the client at home and outside the home. This can include buying foodstuffs, daily consumer goods and medication as well as assisting service access at government agencies or service points.

The tasks can include preparing an electronic shop order with the client, going shopping for groceries on behalf of the client, picking up medication from the pharmacy, placing purchased goods in the cupboards, assisting with contacting government agencies or escorting the client when accessing health care services. Service access assistance can include escorting the client to various events or hobbies, such as a service centre or indoor swimming pool.

The service does not entail the assistant taking care of the client’s finances, handling any cash or using the client’s debit card. The handling of banking and financial affairs is arranged through family members and other persons close to the client. However, the service provider can escort the client when accessing banking services or going shopping. The service is organised as an outsourced service. The service is available on weekdays (Mon–Fri) between 7:00 and 18:00.

Clients are referred to home care through a service needs assessment. Home care services can be granted to persons who cannot handle day to-day activities at home independently or with the help of family members without treatment and care. The general rule is that the client’s treatment and care requires the professional expertise of social welfare and health care personnel, and the client is unable to seek outpatient health care services independently or with an escort.

The functional capacity and service needs of home care clients are assessed on a regular basis. The assessment of the functional capacity is conducted with the RAI assessment tools when a client is found to be in need of regular home care or there are substantial changes in a home care client’s functional capacity or conditions. Services granted to the client based on the assessment can be increased or reduced, or the services can be discontinued.

Home care services are implemented pursuant to the Act on Organising Healthcare and Social Welfare Services (612/2021) either as part of the wellbeing services county’s own activities, as outsourced services or through service vouchers. Home care can be either temporary or regular. Home care is carried out with a rehabilitative approach, supporting the client’s functional capacity.

The home care service is primarily provided by means of remote home care and an automatic medicine dispenser, if they have been assessed as being appropriate and suitable means for organising the services. The remote home care and medicine dispenser are used to support the client’s independence and ability to cope at home. For home care clients who require assistance with medication, the medicine is distributed through dispensers at pharmacies and the treatment itself is primarily carried out using an automatic medicine dispenser. 

In addition to the planned service, home care visits always include monitoring and assessing the client’s overall situation and recording it.

Safe and high-quality home care requires commitment to a jointly prepared care and service plan as well as the following principles of implementing the service:

The client undertakes to use the aids needed for the treatment, if their use is essential in terms of the client’s care and a prerequisite for ensuring the safety of the client and worker in the treatment situations. This equipment includes an electrically adjustable treatment bed, a lifting and moving devices, keyless door opening, and various safety and remote connection devices.

If the client is provided with technological equipment, such as an automatic medication dispenser or remote device, the client undertakes to ensure the appropriate use of this equipment.

Workers are entitled to a smoke-free working environment. The client and their relatives undertake to not smoke in the presence of the worker.

The substance abuse of the client or their relatives must not compromise the safety of the personnel. The general condition of a client who is under the influence of intoxicants is checked, and the planned treatment measures are only carried out once the client is no longer inebriated. If necessary, the treating doctor is consulted.

Pets that that behave in a manner that is unpredictable or disruptive to the care work are to be kept on a leash or in another room during the visits. In some cases, even a familiar pet can react unpredictably to treatment measures. The tasks of the home care workers do not include pet care. The home care workers are obliged to file an animal welfare notification where necessary. 

In order to ensure the occupational safety of the workers, their integrity and non-discrimination must be ensured. The workers must be treated appropriately regardless of their gender, religion, ethnic background or similar characteristic.

Clients cannot choose the care workers who treat them. The home care staff are qualified and professional, and the employer has ensured their suitability for the work.

If there are guests in the client’s home during a visit, the guests undertake to let the staff carry out their work in peace during the home visit. The presence of guests must not jeopardise the safety of the staff. The duties of the home care workers do not include taking care of the guests’ dishes, rubbish or laundry, for example.

The home visit will be stopped in the event of any threatening or dangerous behaviour. The client’s care implementation plan will then be reassessed, and the visits will be conducted with other actors, such as security guards.

Clients, relatives or carers may only video or otherwise record care situations with the valid consent of the client in question.

It is prohibited to publish any video material or other recordings without the consent of all parties involved.

It is the responsibility of the client and family members to ensure the accessibility of the housing unit and yard area (for example, clearing snow, gritting, access inside the home).

The clients and their family members must ensure the fire safety of the home and the working order of the electrical equipment. Home care workers are obliged to report any situations in which safety risks are observed.

The duties of home care workers do not include heating the home or sauna.

Home care workers will not take care of the client’s finances, handle any cash or use the client’s debit card. The handling of banking and financial affairs is arranged through family members and other persons close to the client.

The home care worker can switch on a washing machine or dishwasher if the client can then monitor the operation of the device. If the device cannot be left on after the home visit, the home care worker will not take care of the operation of the washing machine or dishwasher.

The need for home care services is assessed on a regular basis. If the home care services are to be discontinued, the client and, if necessary, their family member or legal representative will be heard. The client’s service need and the method of arranging the services are assessed together. If necessary, clients will be referred to other services that meet their needs. Furthermore, the continuity of the care is ensured in situations where the responsibility for the care is transferred to another party.

Home care services can be discontinued for the following reasons:

• The client no longer has the need for home care (the grounds for granting it are not met) or the service can be arranged in some other way.
• The client is legally competent and understands the need for the treatment but does not want or repeatedly refuses to accept the services.
• The client is legally competent but will not commit to cooperation even though they understand its significance in terms of their care and well-being (the client is repeatedly unreachable, for example).
• The safe working conditions and personal integrity of the home care workers cannot be ensured in the client’s living environment (Occupational Safety and Health Act 738/2002).

In the event that a client’s service need increases permanently by more than 55 hours a month and/or if the client’s care can no longer be sufficiently or safely conducted in the home, the client’s overall situation will be assessed in a multiprofessional manner. Based on the multiprofessional assessment, a decision is made on the services needed by the client, which will then be observed. Should the multiprofessional assessment indicate that home care is no longer a sufficient or safe option for the client but the client would like to continue living at home with the help of home care services despite the ample need for assistance (more than 55 hours), the client must purchase the additional services at their own cost.

Temporary home nursing is medical treatment provided at home.  It covers stitch removal, wound care, treatment of stomas or drains at home, the administration of injections and the administration of eye drops after an operation. The treatment is provided until the client can access a treatment facility, such as a health centre, independently or with an escort.

The treatment requires the expertise of health care and social welfare professionals, and the client is unable to seek outpatient health care services even with assistance. The need for medical treatment mainly involves a single visit, a few visits or visits that take place less frequently than once a week.

If the client’s need for assistance only pertains to applying supporting bandages or support stockings, the service will be initiated as temporary home nursing. The home care workers actively practice the use of aids that help donning and removing support stocking with the client. The aim is that the client can use the stockings independently or at least remove them. The service need is assessed regularly.

The service is intended for clients with impaired functional capacity due to illness, injury or other similar reason. The client’s functional capacity has been temporarily impaired following surgery, for example. The service need can also be due to an informal carer being temporarily prevented from caring for the customer.

Temporary home care is available on a visit basis around the clock according to the service need. Nighttime visits are planned home visits that are agreed upon in advance. Nighttime visits are carried out to support living at home as part of regular and temporary home care.

The service need must be temporary and last no more than two months. The home care services will assess the client’s service need during the care period.

The treatment requires the expertise of health care and social welfare professionals, and the client is unable to seek outpatient health care services even with assistance. A single indicator result cannot be regarded as a criterion for being granted or denied assistance, support or service.

Medication services are intended for clients who need assistance with their medication. Medication services include dose distribution and medication dispensers. As a general rule, medication administration is carried out through dose distribution and medication with an automatic medication dispenser, based on a service needs assessment, in a manner that suits the client’s situation.

The home care services are responsible for the safe medication, according to the medication plan. The responsibility entails cooperating with the pharmacy and doctor, maintaining the client’s list of medication, reacting to any changes in medication, and monitoring and assessing the implementation and effectiveness of the medication.   The implementation of safe medication means that the home care services deliver the client’s medication to the dispenser or the medication in question are, as applicable, covered by the dose distribution.

• The client needs help with the full or partial implementation of the medication. 
• A partial need can arise from the client dividing and taking the medication independently but needing help with injections, for example. 
• To be fully realised, drug treatment requires control, monitoring and assessment.

When granting the medication service, the capabilities of the home care services to carry out the treatment safely are assessed. If the home care services are responsible for the client’s medication and it is found that, for reasons related to the client’s illness, it is not safe to store the medication at home without a lockable storage solution, the client’s medication can be stored at home in a locked drug cabinet or box. If a lockable drug box is used, an entry is added in the client’s treatment and service plan.

The medication dispenser ensures that the drugs are dispensed to the client in a safe and timely manner. The dispenser is filled with dose dispensing bags, or the client’s medication doses are placed in the device in cups. With a medication dispenser, the client can obtain the necessary medication independently without home care services having to conduct a home visit. Alternatively, the medication dispenser can help to shift the timing of a home care services visit or enable a remote visit.

The home care services are responsible for filling the dispenser, monitoring the implementation of medication for home care clients, and, if necessary, making a visit if the client’s medication is not collected from the dispenser. If necessary, the method of implementing the medication will be reassessed.

The dose distribution of medication is a service in which the pharmacy provides the client’s regular drugs in dose-specific bags.  Home care provides the medication to the client according to the plan.  

Regular home care is intended for clients with impaired functional capacity due to ageing, illness or injury who are unable to cope independently, with the help of relatives or other services in everyday life. The need for regular home care is continuous (weekly or daily) and lasts for more than two months. The service is available on a visit basis around the clock according to service need.

The home care service needs assessment always primarily examines the potential of technological solutions to meet the client’s needs, and only then does it assess the suitability of other service forms.

Nighttime visits are planned home visits that are agreed upon in advance. Nighttime visits are carried out to support living at home as part of regular or temporary home care.

The granting of the services is based on a comprehensive assessment of service needs. The client’s situation in life and functional capacity is examined as a whole. The planning of the service package considers the client’s living environment, the network involved in the treatment and other services that have already been granted.  The treatment requires the expertise of health care and social welfare professionals, and the client is unable to seek outpatient health care services even with assistance. The RAI functional capacity indicator is used in determining whether or not the service is to be granted. A single indicator result cannot be regarded as a basis for being granted or denied assistance, support or service.

Daily activities: ADL-H ≥2. The client needs a limited amount of assistance from another person in the context of daily activities. The need for assistance occurs when eating, moving from bed to chair, moving around, using the toilet or taking care of personal hygiene.   ADL0=1 need for guidance or assistance with eating, personal hygiene or movement at home or when using the toilet and/or

Cognitive functional capacity: CPS ≥ 2 or MMSE≥24/30.   Slight cognitive deterioration. The client’s short-term memory and daily decision-making has been impaired in the areas of medication, nutrition or other day-to-day activities and/or 

Service need: MAPLe5 ≥3. The client needs treatment and care on a daily basis and/or

Mood: The GDS-15 result is ≥ 5/15 despite optimal treatment (mild depression). The client has a mental illness that requires continuous treatment and care.

In terms of nighttime visits, there is also a need for specialised treatment, medication, basic treatment and positioning treatment and/or the visits are covered by the assessment of the ability to cope at home.

Remote home care refers to a service in which home visits are conducted remotely via a video link. Remote home care is granted on the basis of a service needs assessment, which always primarily examines the potential of technological solutions to meet the client’s needs, and only then does it assess the suitability of other service forms. Remote home care is granted as part of other home care when the client’s care needs also require physical home care visits at least every other week.

A condition for the implementation of the remote home care is that the client is able to move to the terminal device and follow the instructions provided. The suitability of the remote home care service is also assessed during the client relationship. The same criteria apply as for temporary and regular home care.

Remote contact as a support service refers to a support services in which home visits are conducted remotely via a video link. Remote contact as a support service can be granted as the only service based on a service needs assessment. The service is granted as a fixed-term service for two months at a time. The suitability of the service is assessed during the client relationship.

The service is primarily intended for persons who live alone and feel lonely or insecure due to reduced functional capacity, illness, advanced age, disability or other similar reasons. 

The agreed support calls can be used, for example, to provide psychosocial support and increase the feeling of security related to living at home.

The price of a support call includes the use of the necessary equipment. In connection with initiating the service, a tablet is installed in the client’s home and the client is instructed in the use of the device.

Clients are referred to home rehabilitation and rehabilitative daytime activities through professional assessment. The client is assessed as having the potential for rehabilitation. The service aims for restoring or promoting functional capacity or slowing down its deterioration. The service need can be indicated by a variety of parties, such as a hospital, discharge team, home care, Senior Info or joint social welfare and health care services.

Services can be granted to clients who cannot handle daily activities at home independently or with the support of family members/loved ones.

The services of home rehabilitation and, generally speaking, rehabilitative daytime activities are produced by the wellbeing services county itself. Remote services are primarily used in the production of home rehabilitation services and rehabilitative daytime activities services. The suitability of remote services is assessed on a client specific basis.

Home rehabilitation is primarily periodic in nature, but it can also consist of individual assessment and guidance visits.

The purpose of the service is to ensure the client’s safe discharge and the ability to cope at home.

The service includes an active multiprofessional rehabilitation period, which enables the client to live at home independently or with support from services. The service seeks to fulfil both treatment-related and rehabilitative needs. The service can be produced remotely either in part or in full.

The aim of the service is to ensure the client’s ability to cope independently or with as few services as possible. The service responds to the client’s needs for physiotherapy and/or occupational therapy. The service can be produced remotely either in part or in full.

The service includes personal rehabilitation for the client in the home environment to bolster functional capacity and, if necessary, instructing a family member/loved one on supporting the client’s functional capacity.

Rehabilitative daytime activities are always periodic. The rehabilitation period involves personal goals, the achievement of which is assessed at the start and end of the period. At the end of the period, the need for further rehabilitation is assessed and the client is referred to a service as needed.

Remote daytime activities is the primary way to produce rehabilitative daytime activities. The service is intended especially for clients whose psychosocial functional capacity has deteriorated or they need support with maintaining their functional capacity.

Rehabilitative remote daytime activities involve wide-ranging group based activities/rehabilitation services that promote functional capacity and are arranged remotely. A period of remote and in-person rehabilitative daytime activities can also be arranged as a combination of the two.

This involves providing the client with wide-ranging group activities that promote functional capacity. This particularly applies to clients whose functional capacity has changed or who need support with maintaining their functional capacity. A period of in-person and remote rehabilitative daytime activities can also be arranged as a combination of the two. The length of the period and the weekly visits are assessed on a case-by-case basis.

Support for informal care consists of the informal carer’s care fee and services aimed at supporting the care and treatment provided by a relative or loved one at home. Support for informal care consists of the informal carer’s care fee and services aimed at supporting the care and treatment provided by a relative or loved one at home.

According to the Act on Support for Informal Care (937/2005, §3), a Wellbeing Services County can grant support for informal care in the following cases:

• a person needs treatment or care at home due to reduced functional ability, illness, disability or other similar reason;
• the relative of the person being cared for or other person close to them is prepared to take responsibility for the person’s treatment and care by means of the necessary services;
• the carer’s health and functional ability meet the requirements of informal care;
• informal care, along with other necessary health care and social welfare services, is adequate in terms of the well-being, health and safety of the person being cared for;
• the home of the person being cared for is suitable for the treatment provided there in terms of health and other conditions; and granting the support is deemed to be in the best interests of the person being cared for.

Support for informal care is a discretionary benefit that is granted within the limits of the appropriation reserved for the purpose in the wellbeing services county’s budget. The applicant’s need for assistance and care is assessed and compared as a whole to those of other applicants. In the Western Uusimaa Wellbeing Services County, support for informal care is targeted at demanding care and treatment in accordance with the criteria and conditions listed below.

Support for informal care can only be granted for situations that require care and treatment related guidance, support and/or assistance (e.g. help with transitions, getting around, going to the toilet, washing, getting dressed, eating, taking medication, treatment measures, communication) beyond that included in normal close relationships.

Informal care can be even more demanding if it involves difficult mental symptoms that do not respond to treatment, challenging behavioural traits, social or safety-related symptoms, or severe sensorial disabilities.

• Managing the care recipient’s affairs and taking care of their household alone are not considered sufficient grounds for granting support for informal care. Normal family responsibilities, such as spouses helping each other in a customary manner and normal parenting (age-appropriate care and upbringing of a child), are also not considered informal care.
• The extent to which informal care is considered binding is affected by the care recipient’s independence and functional ability as well as their need for assistance and supervision.
• When assessing how binding and demanding the informal care is, the other social and health care services received by the care recipient are considered and the informal carer’s share in the care entity is examined. If the care responsibility mainly rests elsewhere, the care category may be lowered or the support denied entirely.
• If there are any changes as to how binding or demanding the care is, the need for support and care category will be reassessed as necessary.

• The informal carer’s health and functional ability meet the requirements of informal care and the carer is suitable for the task in terms of their age, resources and life situation. A person under the age of 18 or a hired employee cannot act as an informal carer. All guardians must give their consent for the care and treatment of a minor child to be organised as informal care.
• By signing a care contract, the informal carer commits to the care responsibility.
• The carer acts in accordance with the best interests of the care recipient, taking into account their views and requests.
• The informal carer must be able to cooperate with the wellbeing services county employee responsible for informal care as well as with other parties involved in the care recipient’s treatment.
• Informal care does not jeopardise the carer’s health or safety.
• The informal carer is obliged to notify the wellbeing services county if there are any changes in the care or other circumstances.

The care category and care fee paid to the informal carer are graded based on how binding and demanding the care provided by the informal carer is considered to be. As a rule, all items in the care category description must be met.

Clients in this care category are in a short-term transition phase that is difficult in terms of care, or they have a highly demanding need for round-the-clock care (e.g., palliative care).

• The informal care is highly binding and requires special skills or learning demanding treatment measures, or is in other respects particularly demanding.
• The care recipient’s functional capacity or state of health requires from the carer extensive physical assistance, supervision and care in almost all daily activities around the clock, including several times a night.
• The care work mostly requires round-the-clock attendance from the informal carer. The care recipient cannot be safely left home alone at all, and the carer’s presence cannot be replaced by technical aids.
• The care recipient does not regularly spend a part of their day or week outside the home.
• Without the informal care, the care recipient would require extensive round-the-clock care outside the home, such as service housing or care at a ward

In accordance with current legislation, the category 3 care fee will not be paid if the carer has considerable work income from the same period of time or if the carer would be entitled to receive special care allowance in accordance with chapter 10 of the Health Insurance Act (for a child under the age of 16) or job alternation compensation in accordance with section 13 of the Act on Job Alternation Leave for the same period of time (Section 5. Act on Support for Informal Care).

Family care refers to organising treatment or care in the private home of a family carer (family home) or in the customer’s home with the help of a family carer. Family care can be part-time or round-the-clock, short term or long-term. Long-term family care can only be provided in a family home. Family carers are not employees of the wellbeing services county. Instead, the cooperation is based on a commission agreement.

The aim of family care is to provide the client with the opportunity to enjoy home-like care and close relationships as well as to promote their basic safety and social relationships. Family carers are required to complete preliminary training and be suitable for the role.

The suitability and appropriateness of family care is assessed in relation to the client’s overall situation and the family carer’s capabilities. The assessment considers the client’s need for assistance, functional capacity and wishes, as well as the capacity of the family carer to respond to them. 

The aim of a short-term assessment and rehabilitation period is to support the return home and living at home. The service is primarily intended for seniors.

The aim of the short-term assessment and rehabilitation period is to support the client’s living at home. The service can be granted on the basis of a person’s reduced functional ability, illness, injury or other similar reason, or in acute crisis situations.   The decision will be made on the basis of a service needs assessment. Granting the short-term assessment and rehabilitation period is always based the client’s need.

Communal housing is rental housing that includes the housing unit, common areas and activities for the residents, and care according to needs. The service is primarily intended for seniors.

Communal housing is the primary form of housing when home-based services and services supporting living at home are not sufficient to meet the client’s service needs. The need for support services is assessed as part of the assessment of the suitability of communal housing. Communal housing can be granted as a short-term or long-term service.

• The client’s functional capacity is sufficient to cope with daily activities with assistance and to call for help, if necessary.
• The client is able to move about safely without getting lost repeatedly, even if their memory is somewhat impaired. 
• The client does not exhibit disruptive behaviour related to their own safety or living or the safety of other clients.

The meal service involves the client receiving meals at the communal housing unit. The service may include all meals of the day or some of the meals. The meals offered adhere to the nutritional recommendations for the elderly. The meal service takes into account any special dietary requirements of the client. If the wellbeing services county has granted the client meal services as a support service, the service provider is responsible for the provision of the client’s meal service in accordance with the service granted.

The cleaning service includes weekly cleaning. As maintenance cleaning, the cleaning service can include vacuum cleaning, dusting, and floor and toilet washing. The cleaning service does not cover thorough cleaning, window washing and carpet beating.

The cleaning service is subject to discretion and is granted on the basis of a service needs assessment

The service is arranged by the unit’s service provider or with a home cleaning service voucher. With a service voucher, the service can be granted primarily for two (2) hours per month to people over the age of 65. The value of the cleaning voucher is determined in accordance with the value confirmed by the county government of the Western Uusimaa Wellbeing Services County. Support services (cleaning, clothes care and service access assistance) can be granted for a total of up to eight (8) hours per month.

Clothes care includes washing and hanging up clothes and bed linen. Clothes care can also include folding clothes and putting them where they belong. Clothes care does not include washing hand-washable clothes or mangling linen.

The cleaning service, clothes care service and service access assistance are discretionary and granted on the basis of a service needs assessment. The service is intended for washing clothes and linen when the client is unable to wash them independently or with help.

The service is provided to the client by the communal housing service provider. Support services (cleaning, clothes care and service access assistance) can be granted for a total of up to eight (8) hours per month.

The safety aid service provides assistance in acute situations. The service enables non-urgent assistance to the home around the clock. The purpose of the safety aid service is to improve safety and reduce concerns when the client suffers from deteriorated functional capacity or a memory disorder, or the client is at risk of falling or having a seizure.

The safety aid service means a service that includes the suitable safety equipment, round-the-clock receipt of alerts through the equipment, assistance need assessments resulting from an alert and making sure that the client receives the necessary assistance regardless of the time of day.

The safety equipment includes an emergency telephone, which consists of two parts: a fixed central unit and an alarm button that the user carries with them (on their wrist or around their neck).

The service is arranged for communal housing clients who need it due to illness, disability or a similar reason that reduces functional capacity.

A locating emergency bracelet can be issued to clients who are at risk of getting lost. A person with a locating emergency bracelet must have two appointed loved ones who are notified of any alerts. A stove alarm device can be issued as part of the safety aid service on the following grounds, even if other reasons for granting one are not fulfilled:

• a person with a memory disorder actively uses the stove or another person in the household uses it and
• there is a risk of the person with a memory disorder using the stove alone and the stove cannot be disabled by removing a fuse, for example.

Service access assistance mainly means running errands and handling various affairs with the client at home and outside the home. This can include buying foodstuffs, daily consumer goods and medication as well as assisting service access at government agencies or service points. The service is planned and recorded in the client’s care plan.

The tasks can include preparing an electronic shop order with the client, going shopping for groceries on behalf of the client, placing purchased goods in the cupboards, assisting with contacting government agencies or escorting the client when accessing health care services. Service access assistance can include escorting the client to various events or hobbies, such as a service centre or indoor swimming pool.

The service does not entail the assistant taking care of the client’s finances, handling any cash or using the client’s debit card. The handling of banking and financial affairs is arranged through family members and other persons close to the client. However, the service provider can escort the client when accessing banking services or going shopping. The service is available on weekdays (Mon–Fri) between 7:00 and 18:00.

The service is intended for clients with impaired functional capacity such that they need the assistance of another person to complete tasks. The service is subject to discretion and is granted on the basis of a service needs assessment. The grounds for granting the service are that the client is unable to use self-financed services or volunteer operators, and the client does not have relatives or loved ones who could help.

The service is provided to the client by the service provider. Support services (cleaning, clothes care and service access assistance) can be granted for a total of up to eight (8) hours per month. Clients must arrange any transport at their own cost. Clients cannot be transported by the assistant’s car.

Short-term round-the-clock service housing is a planned care period at a care home. The aim is to support living at home. The service is primarily intended to support informal care for the elderly and situations involving loved ones providing care. The service includes treatment and care as well as meals.

Round-the-clock service housing is arranged for persons who need continuous care and attention or demanding professional care on a daily basis, regardless of the time of day, when it is not possible or in the client’s best interests to arrange this care as home care, informal care, family care or in some other way. The service consists of a rented flat, care and attention, and meals. The service is primarily intended for seniors.