Inhoud Samenvatting Zorg, ethiek & inclusie
Les 1: Inleiding en kernconcepten .................................................................................................................................................................... 6
Cursusoverzicht............................................................................................................................................................................................... 6
Algemeen .................................................................................................................................................................................................... 6
Drie centrale concepten ................................................................................................................................................................................ 6
Zorg ............................................................................................................................................................................................................. 6
Ethiek .......................................................................................................................................................................................................... 9
Inclusie ......................................................................................................................................................................................................11
Les 2. Ecologisch denken ................................................................................................................................................................................12
Ecologisch model Bronfenbrenner .............................................................................................................................................................12
Zorg op micro/meso niveau...................................................................................................................................................................12
Zorg op Exo/Macro niveau ....................................................................................................................................................................12
Model van Vranken ......................................................................................................................................................................................13
Verklaringsmodel armoede en soc. Exc. ..............................................................................................................................................13
Gerontologische theorieën ..........................................................................................................................................................................15
Eerste generatie.......................................................................................................................................................................................15
Tweede generatie ....................................................................................................................................................................................16
Derde generatie .......................................................................................................................................................................................17
Les 3. See Me ...................................................................................................................................................................................................19
Achtergrond...................................................................................................................................................................................................19
Algemeen ..................................................................................................................................................................................................19
Onderzoek .....................................................................................................................................................................................................19
Transities in zorgsystemen in eu landen ..............................................................................................................................................19
Persoonsgerichte zorg ............................................................................................................................................................................20
Potenties van ouderen ............................................................................................................................................................................20
Sociale behoeftes ....................................................................................................................................................................................21
Ann Peuteman, rebels.............................................................................................................................................................................21
Zingevingsbehoeften ...............................................................................................................................................................................21
Competenties & vaardigheden van zorgverleners om ouderen te kunnen zien.............................................................................21
Educational model ........................................................................................................................................................................................22
3 conceptual pillars .................................................................................................................................................................................22
Survey among 154 carers .....................................................................................................................................................................22
Development SEE-ME training toolkit .......................................................................................................................................................22
3 operational pillars......................................................................................................................................................................................23
Enkele oefeningen uit de toolkit .................................................................................................................................................................23
Les 4. Zorgbeleid en toegang .........................................................................................................................................................................24
Zorgbeleid in België .....................................................................................................................................................................................24
Verschillende beleidsniveau’s.................................................................................................................................................................24
Macro-processen, een illustratie - Geneesmiddelen ................................................................................................................................24
Geneesmiddelengebruik .........................................................................................................................................................................24
Prijssetting ................................................................................................................................................................................................25
Toegankelijkheid van (zorg)diensten ........................................................................................................................................................25
1
, 8 B’s ..........................................................................................................................................................................................................25
Vier onderdelen van het zorgtraject......................................................................................................................................................27
Les 5. Wonen & ouderen .................................................................................................................................................................................28
SARLAB – Ageing Well in the Right Place.................................................................................................................................................28
Introductie......................................................................................................................................................................................................28
Enkele centrale vragen ...........................................................................................................................................................................28
De wereldbevolking vergrijst ..................................................................................................................................................................28
Ageing in place .............................................................................................................................................................................................29
Ageing in place omwille van beleid .......................................................................................................................................................29
Ageing in place omwille van financiële situatie ...................................................................................................................................29
Ageing in place omwille van persoonlijke voorkeur ............................................................................................................................30
Is het Vlaamse woonpatrimonium geschikt voor ‘Ageing in place’? .....................................................................................................33
Woningsituatie: klaar voor de toekomst? .............................................................................................................................................33
Woning onaangepast? ............................................................................................................................................................................33
Woning aanpassen? ................................................................................................................................................................................33
Verhuizen?................................................................................................................................................................................................33
Conclusie .......................................................................................................................................................................................................34
Ageing in place mag geen dogma zijn .................................................................................................................................................34
Alternatieve woonvormen niet als oplossing maar als aanvulling .....................................................................................................34
Samenwerking rond ‘ouderen – wonen – welzijn over de beleidsdomeinen heen .......................................................................34
Les 6. Zorgeconomie, vermarkting en financialisering van zorg ................................................................................................................35
Zorg als essentiële economie .....................................................................................................................................................................35
Essentiële economie ...............................................................................................................................................................................35
Zorg & COVID19.....................................................................................................................................................................................36
Zorg en tewerkstelling ............................................................................................................................................................................36
Commercialisering in de zorg ................................................................................................................................................................36
Toekomst van de zorg?..........................................................................................................................................................................37
Verdienmodellen in de commerciële zorg .................................................................................................................................................37
Binnenlopen met bejaarden - Artikel uit Groene Amsterdammer (NL) ...........................................................................................37
Artikel: Peuters zijn een markt ...............................................................................................................................................................38
Varia ...............................................................................................................................................................................................................38
Zorgen is de kern van samenleving ......................................................................................................................................................38
Booming business ...................................................................................................................................................................................39
“Valorisatie” informele zorgers ...............................................................................................................................................................39
Les 7. Feedback moment ................................................................................................................................................................................39
Les 8. Compassionate communities ...............................................................................................................................................................40
Compassionate university............................................................................................................................................................................40
Ageing in place (SARLab)...........................................................................................................................................................................40
Voorspellingen vergrijzing ......................................................................................................................................................................41
Ageing in place ........................................................................................................................................................................................41
Ageing in place -> Dying in place .........................................................................................................................................................41
End-of-life care (EOLC)....................................................................................................................................................................................42
Plotse en/of natuurlijke dood.................................................................................................................................................................42
2
, Opkomst palliatieve zorg ........................................................................................................................................................................42
Palliatieve zorg op verschillende locaties .............................................................................................................................................43
Public health benadering van palliatieve zorg .....................................................................................................................................43
Work-Life Balance (WOPS – ID) ................................................................................................................................................................43
Work-care conflict ....................................................................................................................................................................................44
Death/grief at work .................................................................................................................................................................................44
Compassionate Communities .....................................................................................................................................................................44
Onumenten...............................................................................................................................................................................................45
FERM troostplekken................................................................................................................................................................................45
Reveil .........................................................................................................................................................................................................45
Compassionate Brugge en Herzele ......................................................................................................................................................45
Les 9. Zorgzame buurten ................................................................................................................................................................................46
Achtergrond...................................................................................................................................................................................................46
Definities zorgzame buurten..................................................................................................................................................................46
Vermaatschappelijking van de zorg ......................................................................................................................................................46
Dynamieken van onderuit.......................................................................................................................................................................47
Internationaal ...........................................................................................................................................................................................47
Vlaanderen en Brussel ............................................................................................................................................................................47
Modellen als lens ..........................................................................................................................................................................................48
VVSG bollenschema ................................................................................................................................................................................48
Sombreromodel Kenniscentrum WWZ ..................................................................................................................................................49
Buurtlens VICINIA ....................................................................................................................................................................................49
Integrated Community Care (TRANSFORM).......................................................................................................................................50
Conclusie ..................................................................................................................................................................................................50
Reflecties & conclusies ................................................................................................................................................................................51
Extra kritische reflecties ..........................................................................................................................................................................51
Varia ...............................................................................................................................................................................................................51
Wachthuis .................................................................................................................................................................................................51
Les 10. Zorg voor ouderen met een migratieachtergrond ..........................................................................................................................52
Inleiding en situering, belangrijke actoren.................................................................................................................................................52
Historiek thema........................................................................................................................................................................................52
Situering: Project Diverse Elderly Care .................................................................................................................................................52
Cirkelmodel van zorg: vermaatschappelijking van de zorg ................................................................................................................52
Context......................................................................................................................................................................................................53
Onzichtbaarheid van informele zorgtaken en betrokken mantelzorgers .........................................................................................53
Theoretische denkkaders ............................................................................................................................................................................54
PCC & CSC ...............................................................................................................................................................................................54
Macro-invloeden die een invloed hebben op de zorg .............................................................................................................................56
Vanuit macroperspectief: duidelijk zichtbare tendensen ....................................................................................................................56
Factoren die (dementie) zorg bij ouderen met migratieachtergrond beïnvloeden ........................................................................56
Neo-liberalen invloeden op zorg ...........................................................................................................................................................56
Vermaatschappelijking van de zorg ......................................................................................................................................................57
Invloeden van het koloniaal denken in de zorg...................................................................................................................................57
3
, Structurele machts- en uitsluitingsmechanismen................................................................................................................................57
Globalisatie ...............................................................................................................................................................................................58
Ouderenrechten als bril ..........................................................................................................................................................................58
Aandachtspunten in beleid en praktijk ......................................................................................................................................................58
Diversiteit in zorg voor ouderen met een migratieachtergrond ........................................................................................................58
Diversiteit in zorgvoorkeuren van ouderen ..........................................................................................................................................59
Invulling van mantelzorg voor ouderen met een migratieachtergrond ............................................................................................59
Complexiteit en uitdagingen van het zorgnetwerk .............................................................................................................................59
Tekortkomingen in huidige (dementie)zorg........................................................................................................................................60
Streven naar inclusieve ouderenzorg en samenleving .......................................................................................................................60
Inspirerende voorbeelden ............................................................................................................................................................................60
Cultuursensitieve dagbesteding bij IMEAN in Almelo, Nederland .....................................................................................................60
Toekomstplannen van IMEAN in Almelo, Nederland ..........................................................................................................................61
Intercultureel wzc Saphir in Brussel ......................................................................................................................................................61
Om te besluiten: ......................................................................................................................................................................................61
Conclusie .......................................................................................................................................................................................................61
Les 11. Zorg voor personen in detentie ........................................................................................................................................................62
Gevangenissen in België..............................................................................................................................................................................62
Soorten gevangenissen ..........................................................................................................................................................................62
Vele oude gebouwen volgens Ducpétiaux-model ...............................................................................................................................62
Ook nieuwere gebouwen .......................................................................................................................................................................62
Klassieke gevangenissen ........................................................................................................................................................................63
Kleinschalige detentie – steeds meer opkomend ...............................................................................................................................63
Re-integratie .............................................................................................................................................................................................64
Verlies van vrijheid, maar niet van het recht op hulp- en dienstverlening ............................................................................................64
Hulp & dienstverlening ...........................................................................................................................................................................64
Les 12. Onderwijs in detentie .........................................................................................................................................................................66
Vocvo..............................................................................................................................................................................................................66
Onderwijs aan gedetineerden: Situering en kader ..............................................................................................................................66
Functie onderwijscoördinator......................................................................................................................................................................66
Organisatie onderwijs in detentie ..........................................................................................................................................................66
Wat is de taak van de onderwijscoördinator? .....................................................................................................................................67
Knelpunten in beleid & praktijk...................................................................................................................................................................67
Uitdagingen eigen aan de context ........................................................................................................................................................67
Inclusieve praktijken & projecten................................................................................................................................................................68
Learning Inside Out (LIO)......................................................................................................................................................................68
Triangle .....................................................................................................................................................................................................68
Peer-to-peer projecten: enkele voorbeelden .......................................................................................................................................68
Vragen ............................................................................................................................................................................................................69
Hoe kunnen we kwalitatieve zorg organiseren? .................................................................................................................................69
Les 13. Words matter .......................................................................................................................................................................................70
Inclusie ...........................................................................................................................................................................................................70
Spreken over doelgroepen .....................................................................................................................................................................70
4
Les 1: Inleiding en kernconcepten .................................................................................................................................................................... 6
Cursusoverzicht............................................................................................................................................................................................... 6
Algemeen .................................................................................................................................................................................................... 6
Drie centrale concepten ................................................................................................................................................................................ 6
Zorg ............................................................................................................................................................................................................. 6
Ethiek .......................................................................................................................................................................................................... 9
Inclusie ......................................................................................................................................................................................................11
Les 2. Ecologisch denken ................................................................................................................................................................................12
Ecologisch model Bronfenbrenner .............................................................................................................................................................12
Zorg op micro/meso niveau...................................................................................................................................................................12
Zorg op Exo/Macro niveau ....................................................................................................................................................................12
Model van Vranken ......................................................................................................................................................................................13
Verklaringsmodel armoede en soc. Exc. ..............................................................................................................................................13
Gerontologische theorieën ..........................................................................................................................................................................15
Eerste generatie.......................................................................................................................................................................................15
Tweede generatie ....................................................................................................................................................................................16
Derde generatie .......................................................................................................................................................................................17
Les 3. See Me ...................................................................................................................................................................................................19
Achtergrond...................................................................................................................................................................................................19
Algemeen ..................................................................................................................................................................................................19
Onderzoek .....................................................................................................................................................................................................19
Transities in zorgsystemen in eu landen ..............................................................................................................................................19
Persoonsgerichte zorg ............................................................................................................................................................................20
Potenties van ouderen ............................................................................................................................................................................20
Sociale behoeftes ....................................................................................................................................................................................21
Ann Peuteman, rebels.............................................................................................................................................................................21
Zingevingsbehoeften ...............................................................................................................................................................................21
Competenties & vaardigheden van zorgverleners om ouderen te kunnen zien.............................................................................21
Educational model ........................................................................................................................................................................................22
3 conceptual pillars .................................................................................................................................................................................22
Survey among 154 carers .....................................................................................................................................................................22
Development SEE-ME training toolkit .......................................................................................................................................................22
3 operational pillars......................................................................................................................................................................................23
Enkele oefeningen uit de toolkit .................................................................................................................................................................23
Les 4. Zorgbeleid en toegang .........................................................................................................................................................................24
Zorgbeleid in België .....................................................................................................................................................................................24
Verschillende beleidsniveau’s.................................................................................................................................................................24
Macro-processen, een illustratie - Geneesmiddelen ................................................................................................................................24
Geneesmiddelengebruik .........................................................................................................................................................................24
Prijssetting ................................................................................................................................................................................................25
Toegankelijkheid van (zorg)diensten ........................................................................................................................................................25
1
, 8 B’s ..........................................................................................................................................................................................................25
Vier onderdelen van het zorgtraject......................................................................................................................................................27
Les 5. Wonen & ouderen .................................................................................................................................................................................28
SARLAB – Ageing Well in the Right Place.................................................................................................................................................28
Introductie......................................................................................................................................................................................................28
Enkele centrale vragen ...........................................................................................................................................................................28
De wereldbevolking vergrijst ..................................................................................................................................................................28
Ageing in place .............................................................................................................................................................................................29
Ageing in place omwille van beleid .......................................................................................................................................................29
Ageing in place omwille van financiële situatie ...................................................................................................................................29
Ageing in place omwille van persoonlijke voorkeur ............................................................................................................................30
Is het Vlaamse woonpatrimonium geschikt voor ‘Ageing in place’? .....................................................................................................33
Woningsituatie: klaar voor de toekomst? .............................................................................................................................................33
Woning onaangepast? ............................................................................................................................................................................33
Woning aanpassen? ................................................................................................................................................................................33
Verhuizen?................................................................................................................................................................................................33
Conclusie .......................................................................................................................................................................................................34
Ageing in place mag geen dogma zijn .................................................................................................................................................34
Alternatieve woonvormen niet als oplossing maar als aanvulling .....................................................................................................34
Samenwerking rond ‘ouderen – wonen – welzijn over de beleidsdomeinen heen .......................................................................34
Les 6. Zorgeconomie, vermarkting en financialisering van zorg ................................................................................................................35
Zorg als essentiële economie .....................................................................................................................................................................35
Essentiële economie ...............................................................................................................................................................................35
Zorg & COVID19.....................................................................................................................................................................................36
Zorg en tewerkstelling ............................................................................................................................................................................36
Commercialisering in de zorg ................................................................................................................................................................36
Toekomst van de zorg?..........................................................................................................................................................................37
Verdienmodellen in de commerciële zorg .................................................................................................................................................37
Binnenlopen met bejaarden - Artikel uit Groene Amsterdammer (NL) ...........................................................................................37
Artikel: Peuters zijn een markt ...............................................................................................................................................................38
Varia ...............................................................................................................................................................................................................38
Zorgen is de kern van samenleving ......................................................................................................................................................38
Booming business ...................................................................................................................................................................................39
“Valorisatie” informele zorgers ...............................................................................................................................................................39
Les 7. Feedback moment ................................................................................................................................................................................39
Les 8. Compassionate communities ...............................................................................................................................................................40
Compassionate university............................................................................................................................................................................40
Ageing in place (SARLab)...........................................................................................................................................................................40
Voorspellingen vergrijzing ......................................................................................................................................................................41
Ageing in place ........................................................................................................................................................................................41
Ageing in place -> Dying in place .........................................................................................................................................................41
End-of-life care (EOLC)....................................................................................................................................................................................42
Plotse en/of natuurlijke dood.................................................................................................................................................................42
2
, Opkomst palliatieve zorg ........................................................................................................................................................................42
Palliatieve zorg op verschillende locaties .............................................................................................................................................43
Public health benadering van palliatieve zorg .....................................................................................................................................43
Work-Life Balance (WOPS – ID) ................................................................................................................................................................43
Work-care conflict ....................................................................................................................................................................................44
Death/grief at work .................................................................................................................................................................................44
Compassionate Communities .....................................................................................................................................................................44
Onumenten...............................................................................................................................................................................................45
FERM troostplekken................................................................................................................................................................................45
Reveil .........................................................................................................................................................................................................45
Compassionate Brugge en Herzele ......................................................................................................................................................45
Les 9. Zorgzame buurten ................................................................................................................................................................................46
Achtergrond...................................................................................................................................................................................................46
Definities zorgzame buurten..................................................................................................................................................................46
Vermaatschappelijking van de zorg ......................................................................................................................................................46
Dynamieken van onderuit.......................................................................................................................................................................47
Internationaal ...........................................................................................................................................................................................47
Vlaanderen en Brussel ............................................................................................................................................................................47
Modellen als lens ..........................................................................................................................................................................................48
VVSG bollenschema ................................................................................................................................................................................48
Sombreromodel Kenniscentrum WWZ ..................................................................................................................................................49
Buurtlens VICINIA ....................................................................................................................................................................................49
Integrated Community Care (TRANSFORM).......................................................................................................................................50
Conclusie ..................................................................................................................................................................................................50
Reflecties & conclusies ................................................................................................................................................................................51
Extra kritische reflecties ..........................................................................................................................................................................51
Varia ...............................................................................................................................................................................................................51
Wachthuis .................................................................................................................................................................................................51
Les 10. Zorg voor ouderen met een migratieachtergrond ..........................................................................................................................52
Inleiding en situering, belangrijke actoren.................................................................................................................................................52
Historiek thema........................................................................................................................................................................................52
Situering: Project Diverse Elderly Care .................................................................................................................................................52
Cirkelmodel van zorg: vermaatschappelijking van de zorg ................................................................................................................52
Context......................................................................................................................................................................................................53
Onzichtbaarheid van informele zorgtaken en betrokken mantelzorgers .........................................................................................53
Theoretische denkkaders ............................................................................................................................................................................54
PCC & CSC ...............................................................................................................................................................................................54
Macro-invloeden die een invloed hebben op de zorg .............................................................................................................................56
Vanuit macroperspectief: duidelijk zichtbare tendensen ....................................................................................................................56
Factoren die (dementie) zorg bij ouderen met migratieachtergrond beïnvloeden ........................................................................56
Neo-liberalen invloeden op zorg ...........................................................................................................................................................56
Vermaatschappelijking van de zorg ......................................................................................................................................................57
Invloeden van het koloniaal denken in de zorg...................................................................................................................................57
3
, Structurele machts- en uitsluitingsmechanismen................................................................................................................................57
Globalisatie ...............................................................................................................................................................................................58
Ouderenrechten als bril ..........................................................................................................................................................................58
Aandachtspunten in beleid en praktijk ......................................................................................................................................................58
Diversiteit in zorg voor ouderen met een migratieachtergrond ........................................................................................................58
Diversiteit in zorgvoorkeuren van ouderen ..........................................................................................................................................59
Invulling van mantelzorg voor ouderen met een migratieachtergrond ............................................................................................59
Complexiteit en uitdagingen van het zorgnetwerk .............................................................................................................................59
Tekortkomingen in huidige (dementie)zorg........................................................................................................................................60
Streven naar inclusieve ouderenzorg en samenleving .......................................................................................................................60
Inspirerende voorbeelden ............................................................................................................................................................................60
Cultuursensitieve dagbesteding bij IMEAN in Almelo, Nederland .....................................................................................................60
Toekomstplannen van IMEAN in Almelo, Nederland ..........................................................................................................................61
Intercultureel wzc Saphir in Brussel ......................................................................................................................................................61
Om te besluiten: ......................................................................................................................................................................................61
Conclusie .......................................................................................................................................................................................................61
Les 11. Zorg voor personen in detentie ........................................................................................................................................................62
Gevangenissen in België..............................................................................................................................................................................62
Soorten gevangenissen ..........................................................................................................................................................................62
Vele oude gebouwen volgens Ducpétiaux-model ...............................................................................................................................62
Ook nieuwere gebouwen .......................................................................................................................................................................62
Klassieke gevangenissen ........................................................................................................................................................................63
Kleinschalige detentie – steeds meer opkomend ...............................................................................................................................63
Re-integratie .............................................................................................................................................................................................64
Verlies van vrijheid, maar niet van het recht op hulp- en dienstverlening ............................................................................................64
Hulp & dienstverlening ...........................................................................................................................................................................64
Les 12. Onderwijs in detentie .........................................................................................................................................................................66
Vocvo..............................................................................................................................................................................................................66
Onderwijs aan gedetineerden: Situering en kader ..............................................................................................................................66
Functie onderwijscoördinator......................................................................................................................................................................66
Organisatie onderwijs in detentie ..........................................................................................................................................................66
Wat is de taak van de onderwijscoördinator? .....................................................................................................................................67
Knelpunten in beleid & praktijk...................................................................................................................................................................67
Uitdagingen eigen aan de context ........................................................................................................................................................67
Inclusieve praktijken & projecten................................................................................................................................................................68
Learning Inside Out (LIO)......................................................................................................................................................................68
Triangle .....................................................................................................................................................................................................68
Peer-to-peer projecten: enkele voorbeelden .......................................................................................................................................68
Vragen ............................................................................................................................................................................................................69
Hoe kunnen we kwalitatieve zorg organiseren? .................................................................................................................................69
Les 13. Words matter .......................................................................................................................................................................................70
Inclusie ...........................................................................................................................................................................................................70
Spreken over doelgroepen .....................................................................................................................................................................70
4
