An advocate for old people is an influential social commentator

Submitted on Fri, 04/29/2016 - 09:58
Jaakko Valvanne
“People have been silent about the defects of elderly care for a long time. If I think what is best for old people, I cannot remain silent,” says Jaakko Valvanne, Professor of Geriatrics. Photo: Jonne Renvall

In recent years Jaakko Valvanne, Professor of Geriatrics, has become one of the most prominent experts of the University of Tampere. He has shed light on the dark side of elderly care, demanded a change to care culture and proposed simple and efficient solutions to existing problems. His recently published book offers an empowering standpoint about bringing joy to the lives of people who are 60 years old or older.

In addition to his professorship, Valvanne has a fixed-term contract at the City of Tampere as the head of planning in a unit that works to maintain the functional ability of the elderly, and as a part-time medical expert at the Pirkanmaa Hospital District.

At the moment, the most topical aspect of Valvanne’s work is the establishment of the Geriatric Care Unit, which will open at the Tampere University Hospital in May. The unit is the first of its kind in Finland.

A geriatric specialist, a nurse and a clinical instructor in geriatrics will work at the unit with the aim of developing the diagnostics and treatment of the fragile elderly who are patients in the hospital and have multiple health problems.

“Our aim is to diagnose the hidden syndromes of the elderly, such as confusion and undernourishment. It is very important to identify these conditions because they have a direct bearing on both the prognosis and functional ability of the elderly and the time within which they can be discharged,” Valvanne explains.

“If one is not looking, it’s very hard to spot such symptoms. The traditional medical training does pay enough attention to the fact that doctors should always look for these symptoms.”

The aim is also to increase the geriatric know-how of doctors and nurses and to offer consultations.

“Setting up this unit is probably one of my greatest achievements as a professor – in cooperation with the clinical instructors and hospital personnel, of course,” Valvanne adds.

Valvanne’s research group studies and develops geriatric services

The most important goal of Valvanne and his research group is to study and develop the chain of geriatric services. His working in three different roles facilitates the cooperation between the organisations that provide the services.

“I am now focusing on the chain of acute elderly care of patients in Tampere and the Pirkanmaa region. We are also cooperating with the Pirkanmaa Hospital District.”

The City of Tampere is about to change the structure of its service provision in elderly care.  Valvanne, who participated in the design of the new services, thinks that the most important thing is to develop the care in the homes and hospitals.

“The care at home should support rehabilitation and maintaining the elderly people’s physical capacity. The care should not just be about helping the elderly and making them passive recipients; instead, we should activate them. We have our work cut out for us in that regard.”

The City of Tampere is developing an operations model in which home carers can reach a doctor immediately and get instructions if the condition of their clients suddenly becomes worse. The aim is to reduce the number of unnecessary visits to the emergency room and hospital care. For bedridden patients, hospital care is often detrimental.

Simple methods for more humane care

Already for a decade, as a professor as well as in his previous job as the director of elderly services at the City of Espoo, Valvanne has spoken about the necessity to change the management and culture of elderly care.

“I don’t understand why we should look at things from the organisation’s perspective. We are ready to tie fragile old people to their beds and label them as “resisting treatment” – in other words we are punishing people for normal behaviour. Instead of helping their digestion so that they can vacate their bowels or help them urinate, we tie them up and feed them neuroleptic drugs,” Valvanne sighs.

As a professor, he participated in a reality television show produced by the Finnish Broadcasting Company, which dealt with improving residential care facilities. The methods he used were simple but effective.

“When I started in my professorship I wondered if I could continue such extracurricular activities. But then I heard the rector of our university give a speech and say that the most important task of a university was social impact. I knew I was at the right place doing the right things – I try to make things better.

At the start of 2016, the Bachelors of Medicine in Tampere elected Valvanne an honorary senior member of their association.

“I am very proud and happy about this nomination. It is a recognition of the things I have been able to achieve – I started in the new professorship from a rather modest starting point; that the students received me like this was fabulous!”

During Valvanne’s professorship, the number of doctors training as medical specialists in geriatrics has grown from 30 to 60 – a small specialism has grown into a medium-sized one.

Why not use our chance of changing things?

The book Joy to life at 60+, which Valvanne authored together with Lotta Tuohino, who is a nurse and a journalist, was published in Finnish in early April.

“Getting old and dying is the grim reality facing us all, and nobody wants to do it. Tuohino and I turned growing old upside down into a positive thing.”

Valvanne noticed that he is following in the footsteps of his mother Leena Valvanne, a midwife and Master of Health Sciences, who was able to change the Finnish birthing practices so that giving birth became a thing that also concerns the mothers instead of just being a process managed by midwives and doctors.

“I am bringing the same revolutionary spirit to care practices and growing old. Growing old is a thing shared by us all, and we can have an impact on the process!”

The book encourages people to exercise, eat well, enjoy the company of others and life itself.

“We get sick or are unlucky, or we might have faulty genes, but there are still many things we can change. So what’s stopping us?”

Rector Liisa Laakso awarded Professor Jaakko Valvanne the annual prize for achievement for his active work on behalf of the elderly in Finland. The prize was awarded at the University of Tampere’s anniversary celebration on 29 April.

Text: Pirjo Achté