The purpose is to give an overview of the extent, range and nature of existing definitions of the concept ‘ageing in place’. Providing such an overview may be helpful, for policy makers, researchers, communities and service providers, to make sense of the versatility and uses of the concept, and allow the improvement and increase the success of efforts to contribute to the quality of life of older people. The overview was created using Arksey and O’Malley’s scoping review methodology. Out of 3,692 retrieved articles, 34 met the inclusion criteria. These studies concentrate on the following five key themes concerning ‘ageing in place’: ‘ageing in place’ in relation to place, to social networks, to support, to technology and to personal characteristics. Each of these key themes consists of other aspects, like physical place and attachment to place for the keyword place. This study concludes that the concept ‘ageing in place’ is broad and can be viewed from different (i.e. five) key themes. A more thorough understanding of ‘ageing in place’ provides knowledge about the existing key themes and aspects. These findings might provide practical support for professionals and governments when they develop their policies about ‘ageing in place’ integrally and to develop fit policies.
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Older people today are more likely to age in their own private living environment. However, many face declining health and/or other issues that affect their ability to live independently and necessitate additional support. Such support can be provided by formal networks, but a considerable part can also be offered by informal networks of older people themselves. Going beyond these networks, older people can additionally and perhaps even more substantially benefit from vital communities. Nevertheless, even though this term is increasingly common in the literature, its meaning remains indistinct. A more thorough understanding of this concept might provide valuable knowledge that health care professionals, researchers and community workers can use to offer meaningful and effective support. The purpose of this paper is to draw on existing empirical research on vital communities to build knowledge of the different descriptions and dimensions of the concept. Arksey and O’Malley’s scoping review methodology was adopted. Our search, conducted on 23 March 2020 and updated on 06 January 2021, yielded 4433 articles, of which six articles were included in the scoping review. We deduced that the conceptualisation of a vital community is based on three dimensions: the aim of a vital community, the processes behind a vital community and the typical characteristics of a vital community. None of the selected studies have mapped all three dimensions. Nevertheless, we assume that understanding all three matters when vital communities aim to contribute to the quality of life of people ageing in place.
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Background: Most studies on birth settings investigate the association between planned place of birth at the start of labor and birth outcomes and intervention rates. To optimize maternity care it also is important to pay attention to the entire process of pregnancy and childbirth. This study explores the association between the initial preferred place of birth and model of care, and the course of pregnancy and labor in low-risk nulliparous women in the Netherlands. Methods: As part of a Dutch prospective cohort study (2007–2011), we compared medical indications during pregnancy and birth outcomes of 576 women who initially preferred a home birth (n = 226), a midwife-led hospital birth (n = 168) or an obstetrician-led hospital birth (n = 182). Data were obtained by a questionnaire before 20 weeks of gestation and by medical records. Analyses were performed according to the initial preferred place of birth. Results: Low-risk nulliparous women who preferred a home birth with midwife-led care were less likely to be diagnosed with a medical indication during pregnancy compared to women who preferred a birth with obstetrician-led care (OR 0.41 95% CI 0.25-0.66). Preferring a birth with midwife-led care – both at home and in hospital - was associated with lower odds of induced labor (OR 0.51 95% CI 0.28-0.95 respectively OR 0.42 95% CI 0.21-0.85) and epidural analgesia (OR 0.32 95% CI 0.18-0.56 respectively OR 0.34 95% CI 0.19-0.62) compared to preferring a birth with obstetrician-led care. In addition, women who preferred a home birth were less likely to experience augmentation of labor (OR 0.54 95% CI 0.32-0.93) and narcotic analgesia (OR 0.41 95% CI 0.21-0.79) compared to women who preferred a birth with obstetrician-led care. We observed no significant association between preferred place of birth and mode of birth. Conclusions: Nulliparous women who initially preferred a home birth were less likely to be diagnosed with a medical indication during pregnancy. Women who initially preferred a birth with midwife-led care – both at home and in hospital – experienced lower rates of interventions during labor. Although some differences can be attributed to the model of care, we suggest that characteristics and attitudes of women themselves also play an important role.
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Detecting practical problems of persons with dementia (PwD) experience at home, and advising them on solutions to facilitate aging in place are complex and challenging tasks for nurses and case managers. In this two group randomized, controlled laboratory experiment, the efficacy of a decision support application aiming to increase nurses' and case managers' confidence in clinical judgment and decision-making was tested. The participants (N = 67) assessed a case of a PwD within the problem domains: self-reliance, safety and informal care, and provided suggestions for possible solutions. Participants used either their regular procedure with (intervention group) or without the App (control group) to conduct these tasks. No statistically significant difference was found on the primary outcome measure, the overall level of confidence. However, nurses and case managers highly recommended use of the App in practice. To explain these results, more research on the potential added value of the App is needed.
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Ambient intelligence technologies are a means to support ageing-in-place by monitoring clients in the home. In this study, monitoring is applied for the purpose of raising an alarm in an emergency situation, and thereby, providing an increased sense of safety and security. Apart from these technological solutions, there are numerous environmental interventions in the home environment that can support people to age-in-place. The aim of this study was to investigate the needs and motives, related to ageing-in-place, of the respondents receiving ambient intelligence technologies, and to investigate whether, and how, these technologies contributed to aspects of ageing-in-place. This paper presents the results of a qualitative study comprised of interviews and observations of technology and environmental interventions in the home environment among 18 community-dwelling older adults with a complex demand for care.
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BACKGROUND: There is a growing interest in empowering older adults to age in place by deploying various types of technology (ie, eHealth, ambient assisted living technology, smart home technology, and gerontechnology). However, initiatives aimed at implementing these technologies are complicated by the fact that multiple stakeholder groups are involved. Goals and motives of stakeholders may not always be transparent or aligned, yet research on convergent and divergent positions of stakeholders is scarce. OBJECTIVE: To provide insight into the positions of stakeholder groups involved in the implementation of technology for aging in place by answering the following questions: What kind of technology do stakeholders see as relevant? What do stakeholders aim to achieve by implementing technology? What is needed to achieve successful implementations? METHODS: Mono-disciplinary focus groups were conducted with participants (n=29) representing five groups of stakeholders: older adults (6/29, 21%), care professionals (7/29, 24%), managers within home care or social work organizations (5/29, 17%), technology designers and suppliers (6/29, 21%), and policy makers (5/29, 17%). Transcripts were analyzed using thematic analysis. RESULTS: Stakeholders considered 26 different types of technologies to be relevant for enabling independent living. Only 6 out of 26 (23%) types of technology were mentioned by all stakeholder groups. Care professionals mentioned fewer different types of technology than other groups. All stakeholder groups felt that the implementation of technology for aging in place can be considered a success when (1) older adults' needs and wishes are prioritized during development and deployment of the technology, (2) the technology is accepted by older adults, (3) the technology provides benefits to older adults, and (4) favorable prerequisites for the use of technology by older adults exist. While stakeholders seemed to have identical aims, several underlying differences emerged, for example, with regard to who should pay for the technology. Additionally, each stakeholder group mentioned specific steps that need to be taken to achieve successful implementation. Collectively, stakeholders felt that they need to take the leap (ie, change attitudes, change policies, and collaborate with other organizations); bridge the gap (ie, match technology with individuals and stimulate interdisciplinary education); facilitate technology for the masses (ie, work on products and research that support large-scale rollouts and train target groups on how to use technology); and take time to reflect (ie, evaluate use and outcomes). CONCLUSIONS: Stakeholders largely agree on the direction in which they should be heading; however, they have different perspectives with regard to the technologies that can be employed and the work that is needed to implement them. Central to these issues seems to be the tailoring of technology or technologies to the specific needs of each community-dwelling older adult and the work that is needed by stakeholders to support this type of service delivery on a large scale. KEYWORDS: aged; eHealth; focus groups; health services for the elderly; implementation management; independent living; project and people management; qualitative research; technology
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High-tech horticulture production methods (such as vertical farming, hydroponics and other related technology possibilities), combined with evolving market side possibilities (consumer’s willingness to pay for variety, food safety and security), are opening new ways to create and deliver value. In this paper we present four emerging business models and attempt to understand the conditions under which each business model is able to create positive market value and sustained business advantage. The first of these four models is the case of a vertically integrated production to retail operation. The second model is the case of a production model with assured retail/distribution side commitment. The third model deals with a marketing/branding driven production model with differentiated market positioning. Finally, the forth is a production model with direct delivery to the end-consumer based upon the leveraging of wide spread digital technology in the consumer market. To demonstrate these four business models, we analyze practical case studies and analyze their market approach and impact. Using this analysis, we create a framework that enables entrepreneurs and businesses to adopt a business model that matches their capabilities with market opportunities.
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