Offering physical activities matching with the preferences of residents in long-term care facilities could increase compliance and contribute to client-centered care. A measure to investigate meaningful activities by using a photo-interview has been developed (“MIBBO”). In two pilot studies including 133 residents living on different wards in long-term care facilities, feasibility, most chosen activities, and consistency of preferences were investigated. It was possible to conduct the MIBBO on average in 30 min with the majority (86.4%) of residents. The most frequently chosen activities were: gymnastics and orchestra (each 28%), preparing a meal (31%), walking (outside, 33%), watering plants (38%), and feeding pets (40%). In a retest one week after the initial interview 69.4% agreement of chosen activities was seen. The MIBBO seems a promising measure to help health care professionals in identifying residents’ preferred activities. Future research should focus on the implementation of the tailored activity plan, incorporating it into the daily routine.
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Background The experiences of residents who have communication difficulties such as dysphasia are largely absent from the literature. Aim To illuminate the everyday experiences of four residents with severe communication difficulties living in a residential care setting in the Netherlands. Methodology & Methods A collective case study methodology was used. Seventy-five hours of observation, interview and documentary data was gathered over six weeks. Alternative strategies of communication were developed to enable the co-creation of dialogue between participants and researcher. For example, a participant who could not talk used intentionally created artwork to share her ideas with the researcher. Findings Participants' daily experiences were characterised by struggling against the constraints of the residential setting: having to wait, having unmet needs, experiencing vulnerability and uncertainty. Participants' communication difficulties exacerbated these constraints. Their experiences of struggling were sometimes ameliorated by significant social contact with family or particular staff members, and engaging in enjoyable activities. Occasionally the experiences of enjoying the here-and-now, and being 'seen' as a person by the other, would create beautiful moments in which truly person centred engagement would occur. These moments were neither articulated nor recorded, and were thus invisible after they had occurred. Similarly, the experiences of struggling against the constraints were neither acknowledged nor recorded. Significant experiences in the lives of these four residents were therefore invisible to others. The unifying theme representing the participants' daily experiences was: That which goes unsaid. Discussion It was necessary to develop communication strategies which would by-pass the researcher's assumptions and enable participants to introduce their own ideas and opinions. This ongoing process of co-creation of dialogue required work from, and trust between, participants and researcher. What is new? Expressly seeking the views of residents with communication difficulties Successfully using process consent with participants in this situation Using intentionally created artwork during data gathering in this context What has regional, national or international relevance? The findings indicate that people with communication difficulties may not receive optimal care in residential settings in the Netherlands. Methods are described which could be used by practitioners in their everyday work, and which show facilitators or practice developers how they can help carers to engage in more effective communication with this kind of resident. Additionally, this research contributes to the international discussion about ethical participation of vulnerable people in research.
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The economic recession has hit especially hard the residential building sector in the EU region, e.g., the number of the housing completions has decreased -49% and the total residential output has been squeezed down by -24% between 2007 and 2014 (Euroconstruct, 2015). In turn, the aim of our paper is to suggest a set of radical, novel programmes for developing the national residential building sectors within EU member countries up to 2025. We have applied the framework of strategic niche management (SNM) to the diagnoses of the current portfolios of the innovation, R&D programs in our two member country contexts. In the case of the Northern Finland, the prime example is Hiukkavaara, the largest district to be built in the City of Oulu. Homes will be constructed for 20,000 new residents. Hiukkavaara is a model for climate- conscious design in the northern hemisphere. Energy and materials are conserved, nature is valued and human beings adapt to their environment. One sub-programme involves Future Buildings and Renewable Energy Project. In the case of the Netherlands, the prime example is Energiesprong (Energy Leap), i.e., the innovation programme commissioned by the Dutch Ministry of the Interior. The aim is to make buildings energy-neutral and boost large-scale initiatives. The sub-programmes are targeting homes owned by housing associations, privately owned homes, office buildings, shops and care institutions. This programme is about ensuring new supply by encouraging companies to package a variety of technical sub-solutions, full services and financing options as well as about asking clients to put out tenders and ask for quotes in novel ways, with the government making changes to the rules and the regulations. Experiences on which the Dutch case in this paper focuses are sub-programmes for residential buildings, which include de Stroomversnelling, LALOG and Ons Huis Verdient Het. Based on the emerging Finnish and Dutch evidence, we are suggesting key elements to be incorporated into future national residential programmes within EU member countries on: (1) radical direction with balanced stakeholder groups, trustworthy advocates, contextual goal-setting and barriers management, (2) radical networking with entrepreneurial roles and causal links, novel expertise, transparent choices and digital platforms and (3) radical learning processes to arrive at better informed markets on user preferences, co-innovating, new rules and regulations, higher performance/price ratios, higher quality, new roles and responsibilities assignments.
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