Ageing-in-place is the preferred way of living for older individuals in an ageing society. It can be facilitated through architectural and technological solutions in the home environment. Dementia poses additional challenges when designing, constructing, or retrofitting housing facilities that support ageing-in-place. Older adults with dementia and their partners ask for living environments that support independence, compensate for declining and vitality, and lower the burden of family care. This study reports the design process of a demonstration home for people with dementia through performing a literature review and focus group sessions. This design incorporates modifications in terms of architecture, interior design, the indoor environment, and technological solutions. Current design guidelines are frequently based on small-scale studies, and, therefore, more systematic field research should be performed to provide further evidence for the efficacy of solutions. The dwellings of people with dementia are used to investigate the many aspects of supportive living environments for older adults with dementia and as educational and training settings for professionals from the fields of nursing, construction, and building services engineering.
The transition from home to a nursing home can be stressful and traumatic for both older persons and informal caregivers and is often associated with negative outcomes. Additionally, transitional care interventions often lack a comprehensive approach, possibly leading to fragmented care. To avoid this fragmentation and to optimize transitional care, a comprehensive and theory-based model is fundamental. It should include the needs of both older persons and informal caregivers. Therefore, this study, conducted within the European TRANS-SENIOR research consortium, proposes a model to optimize the transition from home to a nursing home, based on the experiences of older persons and informal caregivers. These experiences were captured by conducting a literature review with relevant literature retrieved from the databases CINAHL and PubMed. Studies were included if older persons and/or informal caregivers identified the experiences, needs, barriers, or facilitators during the transition from home to a nursing home. Subsequently, the data extracted from the included studies were mapped to the different stages of transition (pre-transition, mid-transition, and post-transition), creating the TRANSCITmodel. Finally, results were discussed with an expert panel, leading to a final proposed TRANSCIT model. The TRANSCIT model identified that older people and informal caregivers expressed an overall need for partnership during the transition from home to a nursing home. Moreover, it identified 4 key components throughout the transition trajectory (ie, pre-, mid-, and post-transition): (1) support, (2) communication, (3) information, and (4) time. The TRANSCIT model could advise policy makers, practitioners, and researchers on the development and evaluation of (future) transitional care interventions. It can be a guideline reckoning the needs of older people and their informal caregivers, emphasizing the need for a partnership, consequently reducing fragmentation in transitional care and optimizing the transition from home to a nursing home.
Studies on care networks of home-dwelling older adults often focus on network composition. However, looking at network mechanisms (negotiation, navigation and contagion) can be helpful to improve the support generated by the care network. A European study on diabetes patients identifed network types based on interaction, which can be benefcial (generative, proxy) or detrimental (struggling, avoidant) to support. This study explored whether these network types are present in care networks of home-dwelling older adults in the Netherlands, and how these types manifest in composition or mechanisms.
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