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Technological and architectural solutions for Dutch nursing homes

There is an increasing call in society for the improvement of well-being for nursing home residents and the support of care professionals through a wide array of architectural and technological solutions that are available in modern nursing homes. This study investigated which of these solutions are considered essential by stakeholders from healthcare and technology. Data were gathered via 22 simultaneously held multidisciplinary mind map sessions with 97 stakeholders, resulting in 43 mind maps. These, in turn, were grouped into a single mind map of the nursing home in general, the private rooms for residents with somatic or psychogeriatric health problems, and the group living room. A prioritization of solutions was added. The contents of the mind maps reflect a Dutch consensus on the necessary architectural and technological features for the design of nursing homes.

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Technological and architectural solutions for Dutch nursing homes

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Designing a "think-along dwelling" for people with dementia: a co-creation project between health care and the building services sector

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.

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Designing a "think-along dwelling" for people with dementia: a co-creation project between health care and the building services sector

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Creating age-friendly communities: Housing and technology [book]

The “Creating Age-friendly Communities: Housing and Technology” publication presents contemporary, innovative, and insightful narratives, debates, and frameworks based on an international collection of papers from scholars spanning the fields of gerontology, social sciences, architecture, computer science, and gerontechnology. This extensive collection of papers aims to move the narrative and debates forward in this interdisciplinary field of age-friendly cities and communities. (This book is a reprint of the Special Issue Creating Age-friendly Communities: Housing and Technology that was published in Healthcare)

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Creating age-friendly communities: Housing and technology [book]

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A sense of home through the eyes of nursing home residents

The nursing home is often a final stage in the living career of older persons, but the question remains whether it is a true home or merely a place where care is provided for the residents. This study investigates the sense of home and its constituent factors among both permanent and temporary residents of nursing homes in The Netherlands. A qualitative research design was chosen for the study, which consisted of in-depth interviews using a topic list that was developed through literature review and a focus group session. Autonomy and safety and security are the basic aspects for a sense of home. These aspects refer to the relationships and actions of nursing home residents and the environment in which people live. The research findings show that developing a sense of home encompasses much more than just being surrounded by personal belongings and having a private room with certain facilities. Subjective components of relationships and (inter)actions are as important as the physical component of living and housing. Only when a right balance is achieved between all factors, a true sense of home, albeit away from the familiar home someone spent most of his/her life, can be developed. Understanding these perspectives and needs can contribute to a better design and retrofitting process of future nursing homes.

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A sense of home through the eyes of nursing home residents

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Do nursing staff encourage functional activity among nursing home residents?

BACKGROUND: Nursing home residents are mainly inactive. Nursing staff can encourage residents to perform functional activities during daily care activities. This study examines 1) the extent to which nursing staff perceive that they encourage functional activity in nursing home residents and 2) the associations between these nursing behaviors and professional characteristics, contextual factors, and information-seeking behaviors. METHODS: In this cross-sectional study, 368 registered nurses and certified nurse assistants, working in somatic and psychogeriatric wards of forty-one nursing homes throughout the Netherlands participated. Self-reported data were collected with a questionnaire, comprising the MAINtAIN-behaviors, which assesses the extent to which nursing staff encourage functional activities, including different activities of daily living (ADL), household activities, and miscellaneous encouraging activities (e.g., discouraging informal caregivers from taking over activities residents can do themselves). Additional data collected included professional characteristics (e.g., age), contextual factors (e.g., ward type), and information-seeking behaviors (e.g., reading professional journals). Descriptive statistics were used to determine the extent to which functional activities were encouraged. Hierarchical linear regression analyses were performed to determine the associations between the encouragement of functional activities and other factors. RESULTS: Nursing staff perceived that household activities (mean 4.1 (scale range 1-9), SD 1.9) were less often encouraged than ADL (mean 6.9, SD 1.2) or miscellaneous activities (mean 6.7, SD 1.5). The percentage of nursing staff stating that different household activities, ADL, or miscellaneous activities were almost always encouraged ranged from 11 to 45%, 41 to 86%, and 50 to 83% per activity, respectively. The extent to which these activities were encouraged differed for some of the professional characteristics, contextual factors, or information-seeking behaviors, but no consistent pattern in associations emerged. CONCLUSIONS: According to nursing staff, household activities are not as often encouraged as ADL or miscellaneous activities. Professional characteristics, contextual factors, and information-seeking behaviors are not consistently associated with the encouragement of functional activity. Nursing staff should also focus on improving the encouragement of household activities. Future research could examine the role of other factors in encouraging functional activity, such as experienced barriers, and assess to what extent the perception of nursing staff corresponds with their actual behavior.

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Do nursing staff encourage functional activity among nursing home residents?

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Exploring innovative solutions for quality of life and care of bed-ridden nursing home residents through Codesign sessions

Bed-ridden nursing home residents are in need of environments which are homelike and facilitate the provision of care. Design guidance for this group of older people is limited. This study concerned the exploration and generation of innovative environmental enrichment scenarios for bed-ridden residents. This exploration was conducted through a combination of participatory action research with user-centred design involving 56 professional stakeholders in interactive work sessions. This study identified numerous design solutions, both concepts and products that are available on the marketplace and that on a higher level relate to improvements in resident autonomy and the supply of technological items and architectural features. The methodology chosen can be used to explore the creative potential of stakeholders from the domain of healthcare in product innovation.

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Designing for dementia

Discussions about the importance of the built environment for healthcare delivery extend at least as far back as Hippocrates 1 (400 BC). The iconic Florence Nightingale (1859) also strongly believed in the influence the indoor environment has on the progress of disease and recovery. Today, the role of the built environment in the healing process is of growing interest to healthcare providers, environmental psychologists, consultants, and architects. Although there is a mounting evidence 1 linking healthcare environments to health outcomes, because of the varying quality of that evidence, there has also been a lack of clarity around what can and cannot be achieved through design. Given the ageing of society and the ever increasing numbers of persons with dementia in the Western World, the need for detailed knowledge about aged care environments has also become increasingly important. The mental and physical health state of these persons is extremely fragile and their needs demand careful consideration. Although environmental interventions constitute only a fraction of what is needed for people with dementia to remain as independent as possible, there is now sufficient evidence (2, 3) to argue they can be used as a first-line treatment, rather than beginning with farmalogical interventions.

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Environmental design for an ageing population

Population ageing has been a focus of research since the 1960s (Michael et al. 2006), and it has become a domain of international discussions, debates and research throughout a myriad of disciplines including housing, urban planning and real estate (Buffel and Phillipson 2016, van Bronswijk 2015, Kort 2017). Kazak et al. (2017) described how the ageing population has a profound impact on the real estate market, which is transforming in terms of availability of retirement accommodation for older people including accessibility, adaptability, and the availability of single-floor dwellings. Older people usually have a strong connection with the environment they understand and know well (van Hoof et al. 2016), enabling them to spend the latter years of their life in a familiar setting, which, in turn, influences their self-confidence, independence and the potential to successfully age in place. Older people are encouraged to continue living in their homes a familiar environment to them, instead of moving to an institutional care facility, and this is referred to as “ageing-in-place” (van Hoof 2010). This can be supported by creating a functional and spatial structure of cities that are friendly to older people (van Hoof et al. 2018, van Hoof and Kazak 2018). In the domain of environmental design, a series of home modifications can be identified. The most frequently encountered measures in and around the home are adaptations to improve the accessibility of the home (i.e., removal of barriers such as thresholds, installation of stair lifts in multi-storey homes, and the replacement of bath tubs by walk-in showers,). Separately from these expensive measures and adaptations, simple handgrips can improve the accessibility, safety and mobility of older people (van Hoof et al. 2010, van Hoof et al. 2013). A further concern that should be considered within the living environment is the lack of storage space for wheeled walkers and mobility scooters (including a place to charge batteries) whilst living in an apartment block with limited space to manoeuvre on corridors (Kazak et al. 2017). However, with increasing demands for care, it is not always possible to remain living in one’s own home and moving into a residential or nursing facility is the only remaining option; whereby, specialist and/or nursing care can be accessed and provided in these living environments (van Hoof et al. 2009). Policy principles within long-term care aim to provide a home from home environment for their residents (Moise et al. 2004). Several specialised housing models have been developed in order to facilitate this person-centred care approach, as more traditional institutional settings often do not match with the new holistic and therapeutic goals (Verbeek 2017). Radical alterations have been made in comparison with traditional nursing homes, implementing changes in the organisational, physical and social environment of settings (Verbeek et al. 2009, van Hoof et al. 2009). For example, smaller groups of older people (six to seven persons) form a household, with nursing staff having integrated tasks, including assistance with activities of daily living, preparing meals, organising activities and doing household chores together with residents. Daily life is mainly determined by residents and nursing staff, and the physical environment resembles an archetypal house. With this distinct increase and popular notion of the role real estate plays in ageing-in-place and living well in old age, there is also a shifting focus regarding participation, activation, and helping each other. Home modifications and the home environment itself have a profound influence on the care provided and received at home. In short, the fewer barriers there are at home, the easier and less onerous responsibilities placed on the family carer(s) (Duijnstee 1992). Family carers themselves need such environmental interventions that support care, and a sense of community and belonging. Enabling one to age-in-place and to successfully age requires more than a simple occupational therapeutic approach of environmental interventions. It requires innovative new housing encompassing suitable technology arrangements that can facilitate and enable older adults to live comfortably into old age, preferably with others and offer family members (i.e., children, grandchildren and spouse). Furthermore, interconnecting technology into such environments can offer family members the option and opportunity to monitor their loved one remotely whilst all actors know there are additional safety barriers in place. This chapter discusses and provides innovative examples from a Dutch social housing association and their practices, which illustrates a new approach to environmental design that focuses more on building new communities in conjunction with the building itself, as opposed to the occupational therapeutic approaches and environmental support. First, we take a closer look at why we care for each other, which is the basis of the participation society, in which we must look after people who are near to us. This should ideally be at the basis of new housing arrangements -in which people are stimulated to meet, engage, survey and care- that social housing associations are developing, retrofitting and developing.

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Environmental design for an ageing population

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The factors influencing the sense of home in nursing homes: a systematic review from the perspective of residents

Purpose. To provide an overview of factors influencing the sense of home of older adults residing in the nursing home. Methods. A systematic review was conducted. Inclusion criteria were (1) original and peer-reviewed research, (2) qualitative, quantitative, or mixed methods research, (3) research about nursing home residents (or similar type of housing), and (4) research on the sense of home, meaning of home, at-homeness, or homelikeness. Results. Seventeen mainly qualitative articles were included. The sense of home of nursing home residents is influenced by 15 factors, divided into three themes: (1) psychological factors (sense of acknowledgement, preservation of one's habits and values, autonomy and control, and coping); (2) social factors (interaction and relationship with staff, residents, family and friends, and pets) and activities; and (3) the built environment (private space and (quasi-)public space, personal belongings, technology, look and feel, and the outdoors and location). Conclusions. The sense of home is influenced by numerous factors related to the psychology of the residents and the social and built environmental contexts. Further research is needed to determine if and how the identified factors are interrelated, if perspectives of various stakeholders involved differ, and how the factors can be improved in practice.

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Technological and architectural solutions for Dutch nursing homes

Designing a "think-along dwelling" for people with dementia: a co-creation project between health care and the building services sector

Creating age-friendly communities: Housing and technology [book]

A sense of home through the eyes of nursing home residents

Do nursing staff encourage functional activity among nursing home residents?

Exploring innovative solutions for quality of life and care of bed-ridden nursing home residents through Codesign sessions

Designing for dementia

Environmental design for an ageing population

The factors influencing the sense of home in nursing homes: a systematic review from the perspective of residents

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Producten 14

Technological and architectural solutions for Dutch nursing homes

Designing a "think-along dwelling" for people with dementia: a co-creation project between health care and the building services sector

Creating age-friendly communities: Housing and technology [book]

A sense of home through the eyes of nursing home residents

Do nursing staff encourage functional activity among nursing home residents?

Exploring innovative solutions for quality of life and care of bed-ridden nursing home residents through Codesign sessions

Designing for dementia

Environmental design for an ageing population

The factors influencing the sense of home in nursing homes: a systematic review from the perspective of residents

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