The Necessary Pivot in Society

In business slang, it is increasingly common to study, implement and be inspired by two
Japanese organizational models. The Kaizen model, which comes from the Japanese
words "Kai" and "Zen", referring to the action of changing and continuous
improvement. And the Lean model that focuses on minimizing system losses while
maximizing value creation for the customer.

Focusing on Japan, on production or/and organizational models, should be especially
relevant when it comes to Ageing, as Japan also has a high rate of elderly people.
The convergence of the concepts described above, should immediately lead us to the
need of urgently raising “pivots” in our models of care for the elderly, especially living
on a daily basis the effect that the COVID-19 pandemic is having on the social sector.
And this change must occur immediately, accompanied by substantial changes in
organizational models and putting technology at the service of the eldest person, in a
real and effective way.

The central model to look should be "The Person-Centered Care Model", a model
supported by health professionals who believe that the situation we are experiencing in
geriatric institutions must force a fundamental “pivot” mindset, which should be
groundbreaking and innovative, since the current model, was already questioned long
before COVID, in the face of a significant increasing in the ageing population.
The lacks identified at the moment we live should make us wonder: how could we better
serve our society, specially the seniors?

It is common to find studies and surveys of older people that reflect where and how
they want to grow old. However, this contact with reality, which some organizations
make periodically such as the Spanish Society of Geriatrics and Gerontology (SEGG)
seem not to have a real application in the field. For example, interviewing elderlies that
live in residences, only 4% actually want to live there.

If in the world of Startups, the business plan is continually suffering “pivots” (rapid
changes and adaptations) lead by the periodic contact with its users, why, knowing what
is the desire of the elderly, we do not provide and generate the solutions that they wish?
Meaning, if their biggest hope is to grow old in their homes, then why are we not looking
in ways to facilitating their staying at home for as long as possible?

This approach, alternative to the institutionalization of the person, must be
accompanied by a paradigm shift to two main points: one is to repopulate
the territory whose population has migrated to the large demographic centers;
second is to use technology to make the life of the eldest person easier, towards an
active and healthy ageing, providing adequate attention when it comes to dependence
situations. In this way we can create more and better professional profiles as a
complement to the auxiliary work; as physiotherapists, occupational therapists and
psychologists, especially in the rural area, so devoid of opportunities. This would allow others
to design life projects aimed at preventing loss of physical activity, improving basic
functions and overcoming the psychological pain caused by loneliness, fear, anxiety or

Finally, we must embrace the multiple solutions offered by technology, such as
advanced tele-assistance, video-conferencing systems, tele-monitoring of pathologies or
telematic control of vital signs. These tools, effectively implemented throughout the
social-health care area, especially in the field of home care services, must be extended
decisively, immediately and without complications to all the ranges of the older

Therefore, a pivot consists of a change of course and this social pivot is more of an
urgent matter than an important debate to have in the future.

Ángel Barrera Nieto 

Ambassado Seville & Mérida (Spain)