LIBRARY SERVICES TO THE HOMEBOUND ELDERLY IN DENMARK by Gyda Skat Nielsen

LIBRARY SERVICES TO THE HOMEBOUND ELDERLY IN DENMARK

As in many other countries, the number of elderly people in Denmark continues to grow. This means that there is an increasing need for special library services to those elderly who are not able to come to the library because of physical or mental limitations.

Some of these persons live in their own homes while others live in residential care facilities. All these individuals need special attention and service from libraries. In this paper I am concentrating only on services to those who, with a certain level of assistance, are able to live in their own homes but are unable to visit the library. Also included are those who may be able to come to the library but cannot carry the materials home. The age of the patrons varies from about 40 to 100.

The present Danish social policy is to keep elderly citizens in their own home as long as possible instead of placing them in institutions for the elderly. We have a well functioning home care system including cleaning and washing, personal care, shopping etc. We also have a delivery of meals service ("Meals on Wheels") and very good day care centers where the elderly who are not able to go there by themselves are taken by cabs.

But as an elderly disabled or ill person you also need some spiritual activities. According to the Danish Library Act, public libraries are obligated to serve all citizens-including those who are disabled or ill. We have a long tradition of library services to elderly and disadvantaged persons. During the 1960s, the outreach services called "The Book Comes" or "The Library Comes" were established. The outreach library services in Sollerod community were started by me in 1966 and was one of the first in Denmark.

Until that time, volunteer organizations like the Red Cross and the Scouts, in a limited number of municipalities, provided the homebound elderly with certain reading materials. The start of library services to the elderly and disabled provided by libraries and professional librarians was a big step forward in the move to integrate this large group of citizens into the mainstream of library services..

Today 184 out of the 275 municipalities of Denmark offer outreach library services to their homebound citizens. The service delivery methods, however, vary from library to library. For instance, in my library, the Sollerod Public Libraries, books and other materials are brought out once a month by the library's delivery service. The delivery schedule is published every three months.

Criteria for participating outreach services
All citizens who are unable to come to the library, whether they are temporarily disabled or suffer from chronic conditions, are entitled to participate in this service. Some persons participate for a limited time, others are permanent "members". There are many reasons for patrons to take advantage of our outreach services: problems walking or carrying the library materials, visual problems, or various other physical or mental problems that limit mobility.

The Sollerod Public Libraries also offer a delivery service to elderly persons who are able to visit the library themselves, but who are not physically able to carry the materials home. People who use this service can still come to the library and select their materials and at the same time enjoy the personal contact with the library staff and other members of the community.

It is important to emphasize that in Denmark all services offered to the elderly, whether they live at home or in institutions, are free of charge.

Personal contact with patrons
A few days after the library has been contacted by a potential borrower, a relative, a friend, or caregiver, the outreach librarian makes a home visit. This initial visit is made in order to establish a personal relationship with the elderly patron. Being acquainted with the individual person and his/her interests makes it easier for the library to meet this person's needs. In my opinion, it is very important that the elderly person is always served by the same librarian (that is what we use to call "my own librarian"). This gives the patron a feeling of stability.

After the first visit, it is important to keep in close contact with the borrower either by telephone or by mail. Unfortunately, time usually does not permit more than one initial home visit. Even so, the relationship between the elderly patron and the librarian is often very warm and close, and we receive many calls and letters.
After the first visit by the librarian the materials are brought to the patron by the library's delivery service.

How to select the materials?
Some patrons prefer that the librarian selects the materials to be sent to them. The librarian then makes the selection based on notes made during the first visit. Others prefer to make their own selection from the library's collection. In this case, we have order forms for the borrower to fill out and return to the library. The materials are generally selected from different catalogs, which we send out regularly, or from reviews in newspapers or magazines. Many borrowers keep in contact by calling their librarian once a month. This personal contact is of great importance for both parties. Some patrons prefer to send their orders via e-mail-a practical and easy way to keep in contact with the library.

Today it is also possible to search the library's catalog via the Internet and to make reservations online. This new option allows the elderly to keep up-to-date with the stock of the library. Many elderly persons, however, still prefer to keep the contact in the good old fashioned way by sending a handwritten letter.

Is there a difference between the reading habits of the younger (mobile) generation and the elderly?
It is incorrect to think that, because a person is disabled or old and homebound, he/she only reads popular literature. Indeed, from my daily work I know that the range of reading interest among "my" borrowers is just as broad as among those visiting the library in person. Many of "my" borrowers for the first time in their lives have time to concentrate on reading. And they have many diverse interests, like natural science, ancient history, etc., and they read both Goethe, Kierkegaard and Kant. Many of the materials are in foreign languages, and many titles have to be ordered from special libraries.

Looking back at my library work all these years, there is a clear evidence that the more recent generation of elderly is better educated and therefore has higher expectations of services provided by the library. Today more elderly read foreign languages primarily English, French and German. This development is indeed also a challenge to the skills of the librarians serving the elderly.

Here are some examples of the types of materials that are very much in demand:

Talking books: Used by those who have problems reading printed books because they are visually impaired, are unable to hold a books in their hands (rheumatism, etc.) or have other reading difficulties, e.g., dyslexia. The Sollerod Public Libraries can offer about 6.000 talking books for children and adults both fiction and non-fiction. Talking books in English, French and German are also available. A note of interest: About 50% of our homebound patrons use talking books instead of printed books or as supplement to the print version.

Magazines on cassette: A good selection of magazines on cassette on history, culture, medicine, art, and various other subjects supplements to our talking books.

Large print books: Very popular with our visually impaired borrowers; unfortunately too few titles are produced to meet demands.

Music on CD or cassette: Also very appreciated by our borrowers who request all types of music: classical, opera and operetta, pop, old songs, jazz ,etc. Another note of interest: More than 50% of the materials lent to the homes for the elderly in my community are music CDs or cassettes.

Videos: Feature films, operas, and other entertainment, are also becoming very popular with our elderly patrons.



The Talking Newspaper: Advanced age is frequently associated with vision problems. As mentioned, talking books and large print books are invaluable to the elderly who have problems reading print. To these individuals, the Talking Newspaper is a wonderful substitute. In 132 out of the 275 Danish municipalities, local talking newspapers are produced for persons with vision and reading problems and physical disabilities. Some smaller municipalities jointly produce a single regional newspaper on tape. All 132 talking newspapers with the exception of a few published by private organizations - are produced by the public libraries and distributed free of charge.

Reading Service: A few libraries among them the Sollerod Public Libraries offer a Reading Service for persons with reading problems. This service involves the recording on tape of articles, personal letters, instructions, etc. This is also a free service.

Weak and unaccustomed readers: It is worth remembering that among our homebound patrons as in other groups in society there will be persons who for different reasons have reading problems caused by dyslexia or other reading disabilities. Others are just unaccustomed with reading, for instance because during their working life they have not had time and energy for reading. All these patrons have a need for special service. Useful materials are not only the talking books, magazines etc. but also the Easy-to-Read Materials, some of which are combined with the taped text.

How do we market our service to potential borrowers?
It is essential to continuously publicize the outreach services to the elderly. Some examples of effective marketing methods are:

• announcements in local papers;

• articles in local newspapers and various magazines aimed at elderly and disadvantaged population groups;
• personal contact with the news media;
  Library press releases are very useful in promoting library services. For libraries in communities with local TV and radio these media are very useful, too.
• information brochures from the library written in a clear and easy-to-read language. The brochures are distributed through all libraries in the area and other frequently visited places,
  like social service agencies, city hall, doctors' and dentists' offices, local shops, and community centers for the elderly;
• close contact with institutions and organizations for the elderly and disabled;
• close contact with home-help providers; and last, but not least
• daily contact with other citizens of the community, i.e., the "word of mouth" method, where relatives, neighbors, and friends inform the elderly about the library's services .

Partnerships with other service providers
In my daily work, I am in close contact with social service agencies, and I often talk to groups of district nurses, home helpers, and other social workers about the services offered by my library. It is important to maintain these relationships, either by telephone or in person. Every two years, I meet with the district nurses and home helpers to inform them about what the library has to offer to their clients. The social and health care staff are not always familiar with the library, but they are very open to this information, and after my visits there is a clear increase in the number of new borrowers. Contact with local family doctors and clergy is also important in spreading the word to the elderly.

Job Shadowing: I would like to mention a very interesting and useful experience which I had some years ago: Wanting to know more about the work going on in the social field of our community I contacted the social authorities and proposed that I spent a period of three weeks in the social services department. The idea of a job shadowing project was something new to them at least with a librarian as the shadow! The reactions were very positive and I had the opportunity to spend first one week in the administrative offices and after that two weeks in the two activity centers for elderly. During these weeks I learned a lot about the work being done for the elderly in other fields. What was very important to me: the last two weeks gave me the opportunity to meet with the elderly on a daily basis. I was able on several occasions to inform them about the services being offered by the library to the elderly citizens. Surprisingly enough many elderly did not know about it. The result was a flow of new patrons to the library when I returned after 3 weeks.

But let me return to the partners of the library. Local organizations for the elderly are important partners. Those who volunteer in such organizations can be great advocates. Disability organizations, likewise, are obvious partners. Our library keeps in contact with an advisor to the local association for the blind, who informs us of potential customers. We also cooperate with other disability organizations in arranging joint exhibits and events in the library.

The local community centers which I already mentioned often invite me to talk to their clients about our library services. Most of these persons coming to the centers are quite mobile, but many of them have homebound friends, neighbors, or relatives who might want to use our services.

Common projects: A couple of years ago, a formal agreement was made between the Sollerod Public Libraries' Department for Outreach Services and the two local community centers for elderly. Once a year the administrators from each agency meet to exchange ideas and plan joint events. Together we have organized several successful month-long campaigns and programs with concerts, exhibits and other events.

The first program was a project called "Age no Hindrance" and was aimed at healthy and resourceful older adults. Later came a program called "Baltic Neighbors," arranged in cooperation with the embassies of the three Baltic states and Poland. This October we are planning a joint "Greenland Festival".

Orientation for new pensioners: I recently had the opportunity to participate for the first time in the yearly orientation for new pensioners arranged by the social service authorities. It was the perfect opportunity to inform the audience about our library services to the elderly. Although they may not need to take advantage of these services immediately, it is important for them to know they exist.

Information: It is important that the library takes the first step to "reach out." Information is the key word, since many people do not immediately associate services to the elderly with library services. Many elderly who are not able to leave their homes live a withdrawn life at home. The services of the library can make a very big difference to their quality of life. That is what I use to mention "Culture instead of medicine".

Special arrangements for the homebound elderly
We sometimes invite our homebound patrons to special events in the library. These arrangements have been very successful, with artists entertaining and refreshments being served.
Subscribers to the local talking newspaper are invited every other year to discuss this service also in connection some type of entertainment. At these arrangements we get a lot of useful feedback from our subscribers.

Promotion: Promoting the library takes a lot of time and effort. But once the library has gained a place of high visibility in the public consciousness, it becomes much easier to persuade both the library administration and especially the government to invest in and support library services to the elderly. They may even realize that these services help reducing health care expenditures!

A job filled with challenges and rewards
Working as an outreach librarian and serving, among others, the elderly in their homes is a challenging but exciting and rewarding job. Not two patrons are alike and not two days are the same. It has been interesting throughout the years to see a change in the group of elderly and disadvantaged. While in earlier times many were very humble and non-demanding the new generation of elderly is better educated and are much more aware of what the library has to offer and which rights they have!

Also to have the possibility to change the attitude of your colleagues to the elderly and disabled is very challenging. When you experience how a very limited interest in this group of elderly and disabled citizens changes into understanding and you suddenly realize that a former "low status job" has achieved a higher status you really feel that you accomplished something.
In conclusion I can only say: If you do not yet have library services to the elderly in your community, start a program now! It is well worth the effort.