With ageing of the population, the development and implementation of novel strategies for care of people aged 60 or more have become crucial issues. Since 2019, WHO, within the framework of Decade of Healthy Ageing, has set up the integrated care for older people (ICOPE) approach. ICOPE aims to promote healthy ageing by maximising every person's intrinsic capacity and functional ability. The preventive model is focused on reorienting care and social services and promoting continuity of care with a life course perspective.
Integration of care services for older people to promote heathy aging strongly relies on primary and community care. In this context, foster families for older people might represent an interesting but still poorly developed and explored strategy to address the unmet clinican and social needs and prevent nursing home admissions for people aged 60 yers or above. In the West Indies (Caribbean islands), foster families have been in place for 20 years, and are currently taking care of more than 200 people.
This model of care is due to local health policies and the social, cultural, and anthropological specificities of the territory. Each foster family is responsible for one to three people aged 60 years or above; the family provides a room in the house for each person and provides them with meals and activities. The links between the foster careers and the care recipient are strong; participation of the residents in the family's life and the close contact with a single referent person could have a strong effect on their wellbeing and feelings of loneliness. A medical follow-up is frequently in place, with a nurse visiting once or twice per day, and physical therapy sessions if necessary.
Unfortunately, foster families for people aged 60 years or more have not yet been sufficiently studied over the past 30 years and are not particularly developed in high-income and middle-income countries. In fact, it is important to better define the clinical profile of the type of person who can be candidate to a foster family. The effectiveness of this model should also be explored, especially by comparing it to existing alternatives (eg, nursing homes, residential care facilities, community-based care, and home-based care). Analysis of the direct and indirect costs of the model should also be conducted. Another possible point of concern to be addressed resides in the training of the carers in foster families.
Despite the many aspects that need to be clarified to eventually optimise the functioning of existing foster families, this alternative care model should evoke special interest. It gathers the need for care of many people aged 60 or above, whose isolation and clinical conditions might hamper their independent life with the objective of preventing nursing home admissions and hospitalisations. Foster families might have a place in the evolving organisation of care present in many countries, to address the unmet needs of older people. Furthermore, foster families might also promote intergenerational solidarity and potential job creation, particularly in areas of rural or medical desertification.