Origins and Development of the ICOPE Model
The World Health Organization (WHO) developed the Integrated Care for Older People (ICOPE) framework as part of its Global Strategy and Action Plan on Ageing and Health. The initiative promotes 'healthy ageing' by focusing on functional ability, which includes an individual’s intrinsic capacity and the environment. The ICOPE model offers guidance for health and social care professionals to identify, manage, and prevent declines in older people's capacities.
A key aspect of ICOPE is its shift from a disease-focused approach to a person-centered one. The WHO collaborated with global experts, including the Gérontopôle of the Toulouse University Hospital, a WHO Collaborating Center, to develop and implement the framework. Since its 2017 launch, ICOPE guidelines have been adapted internationally to enhance healthcare systems.
The Five Steps of the ICOPE Framework
The ICOPE model is a five-step pathway for healthy ageing and managing intrinsic capacity declines.
- Screening: This involves a brief assessment of six intrinsic capacity domains: locomotion, vitality, cognition, psychological well-being, vision, and hearing. Tools, including mobile apps, can be used by various healthcare workers or volunteers.
- Comprehensive Assessment: Individuals screened with potential declines undergo a detailed, person-centered assessment covering needs, preferences, conditions, and social support.
- Care Plan Development: An individualized plan with goals set with the older person is created, outlining interventions and provider roles.
- Follow-up and Monitoring: The plan's progress is regularly monitored and adjusted, potentially using digital tools.
- Community and Caregiver Engagement: This step focuses on involving community resources, caregivers, and families to support the older person.
Benefits of the ICOPE Model
Implementing ICOPE improves patient outcomes and care quality by focusing on functional abilities.
- Improved Health Outcomes: Early detection helps prevent or slow declines in physical and mental capacities. Studies, like one in Hong Kong, show ICOPE screening effectively identifies intrinsic capacity impairments.
- Person-Centered Care: The model involves older adults in their health decisions, tailoring care to individual circumstances.
- Efficiency and Coordination: ICOPE enhances communication among providers and social services, reducing duplication and improving care delivery.
- Reduced Burden: The integrated approach can lessen caregiver burden and improve end-of-life care quality for those with complex conditions.
ICOPE vs. Traditional Care Models: A Comparison
| Feature | ICOPE Model | Traditional Care Model |
|---|---|---|
| Focus | Person-centered; maintaining intrinsic capacity and functional ability. | Disease-centered; managing and treating specific medical conditions. |
| Approach | Proactive and preventative; early screening to detect and address declines. | Reactive; treatment often begins after significant impairment or a health event occurs. |
| Coordination | Integrated care plans shared across multidisciplinary teams (medical, social, community). | Fragmented; care is often siloed, with limited communication between different providers. |
| Assessment | Holistic assessment covering intrinsic capacity domains like mobility, cognition, and senses. | Medical assessment focused on specific illnesses and symptoms. |
| Empowerment | Actively involves older people and their families in setting goals and planning care. | Often a passive recipient of care; decisions made by healthcare professionals. |
Challenges to Implementation
Implementing ICOPE faces challenges, including the need for a shift in healthcare system practices. Barriers can include:
- Need for Training: Professionals require training for assessments and person-centered care. The WHO offers a specific training program.
- Systemic Adaptation: Adapting ICOPE to local contexts requires changes in policies, funding, and service coordination.
- Resource Constraints: Low- and middle-income countries may face limitations in personnel, digital infrastructure, and funding.
- Data and Technology Integration: Effective monitoring relies on robust digital infrastructure and interoperable health records.
Conclusion
The WHO's ICOPE model is a strategy to meet the needs of an ageing global population. It promotes a proactive, person-centered approach by focusing on intrinsic capacity and functional ability, involving multidisciplinary teams and the community. Despite challenges in adaptation and resources, ICOPE provides a framework to improve the health and well-being of older individuals and is a cornerstone of the UN Decade of Healthy Ageing.
