Bridging gaps and building connections: the Social Care initiative in Cremona, Italy, supporting caregivers in elderly health

Context: As the global healthcare system faces risks due to population ageing and declining autonomy, Cremona, Italy, with over 22% of the population aged 65+, deals with challenges exacerbated by limited healthcare access and intricate needs. The Social Care project, supported by Fondazione Cariplo, addresses caregivers’ challenges in navigating fragmented health and social care services. Fostering collaboration among diverse stakeholders, the initiative strives for a sustainable solution. It ensures integrated care management, responding effectively to the intricate and evolving needs of the elderly while providing essential support for caregivers in this critical network. Moreover, it encourages methodological reflections on the project's stakeholders’ engagement approach. Methods: The Social Care project in Cremona adopts a participatory co-design approach, engaging public entities, private organisations, non-profit associations, cooperatives, foundations, and caregivers in a co-design process. To facilitate collaboration for shaping the "Social Care" platform, the project employed various engagement modalities, among which nine focus groups, 10 workshops, four surveys, and 20 individual interviews, tailored to stakeholders' social and political roles. Communication methods varied, encompassing formal presentations, informal discussions, and electronic correspondence. The iterative development process, inspired by the plan-do-check-act cycle, consisted of two main phases, during which the team worked autonomously in some stages and actively engaged stakeholders in others. This approach aimed at refining the platform through continuous improvement, utilising feedback from stakeholders to ensure a comprehensive and inclusive mapping of 75+ services in the region, which were then recorded in the Social Care database. Results: The employed methodology yielded significant outcomes, reflected in the following key points throughout the project: • Initial design workshops prompted numerous modifications. Stakeholders’ feedback revealed the necessity to categorise services based on two primary criteria: the nature of the needs they address and their distinctive characteristics • After initial workshops, a first validation check highlighted the effectiveness of these modifications. • Subsequent design workshops led to further adjustments, refining the Social Care platform. • The final iteration of the Social Care platform incorporates all modifications, resulting in a comprehensive and user-friendly solution. Throughout these iterative processes, insights from meetings underscored the abundance of services for frail individuals, with 20+ registered service providers and 17 educated on platform usage. The Social Care platform emerged as a crucial resource, with a potential impact on community well-being, particularly emphasising the platform's pivotal role in bridging awareness gaps in the community. Discussion: The Social Care project stands at the forefront of digital transformation in elderly care, embodying stakeholder collaboration to drive innovation. The participatory method, marked by substantial meeting turnouts, not only revealed previously unknown realities but also strengthened awareness and created connections among diverse stakeholders, while also allowing for the anticipation of potential platform usage challenges by stakeholders. Moving forward, the results guide the next steps, involving comprehensive engagement across the entire province with additional service providers, enhancing territorial service knowledge, and ensuring an optimal response to needs. The Social Care platform’s capacity to record elderly community needs allows for a comprehensive understanding of their challenges and demands and also facilitates the evaluation of service responsiveness. It enables the identification of strengths, weaknesses, and potential gaps in the current service landscape. These detailed insights act as a guiding compass for future service development, contributing significantly to sustainable health ecosystems.