Abstract: Existing frailty models have enhanced research and practice; however, none of the models accounts for the perspective of older adults upon defining and operationalizing frailty. We aim to propose a mixed conceptual model that builds on the integral model while accounting for older adults’ perceptions and lived experiences of frailty. We conducted a traditional literature review to address frailty attributes, risk factors, consequences, perceptions, and lived experiences of older adults with frailty. Frailty attributes are vulnerability/susceptibility, aging, dynamic, complex, physical, psychological, and social. Frailty perceptions and lived experience themes/subthemes are refusing frailty labeling, being labeled “by others” as compared to “self-labeling”, from the perception of being frail towards acting as being frail, positive self-image, skepticism about frailty screening, communicating the term “frail”, and negative and positive impacts and experiences of frailty. Frailty risk factors are classified into socio-demographic, biological, physical, psychological/cognitive, behavioral, and situational/environmental factors. The consequences of frailty affect the individual, the caregiver/family, the healthcare sector, and society. The mixed conceptual model of frailty consists of interacting risk factors, interacting attributes surrounded by the older adult’s perception and lived experience, and interacting consequences at multiple levels. The mixed conceptual model provides a lens to qualify frailty in addition to quantifying it.
DOCUMENT
The subject of this textbook is a methodical approach on the complex problem-solving process of conceptual structural design, leading to a controlled build-up of insight into the behaviour of the structure and supporting the actual successive design decisions during the conceptual design phase on the basis of a coherent set of solution components.
DOCUMENT
This project aims to develop a measurement tool to assess the inclusivity of experiences for people with varying challenges and capabilities on the auditory spectrum. In doing so, we performed an in-depth exploration of scientific literature and findings from previous projects by Joint Projects. Based on this, we developed an initial conceptual model that focuses on sensory perception, emotion, cognition, and e[ort in relation to hearing and fatigue. Within, this model a visitor attraction is seen as an “experienscape” with four key elements: content, medium, context, and individual. In co-creative interviews with experts by experience with varying challenges on the auditory spectrum, they provided valuable insights that led to a significant expansion of this initial model. This was a relevant step, as in the scientific and professional literature, little is known about the leisure experiences of people with troubled hearing. For example, personal factors such as a person’s attitude toward their own hearing loss and the social dynamics within their group turned out to greatly influence the experience. The revised model was then applied in a case study at Apenheul, focusing on studying differences in experience of their gorilla presentation amongst people with varying challenges on the auditory spectrum.Societal issueThe Netherlands is one of the countries in Europe with the highest density of visitor attractions. Despite this abundance, many visitor attractions are not fully accessible to everyone, particularly to visitors with disabilities who sometimes are not eligible to ride due to safety concerns, yet when eligible generally still encounter numerous barriers. Accessibility of visitor attractions can be approached in various ways. However, because the focus often lies on operational and technical aspects (e.g., reducing stimuli at certain times of the day by turning o[ music, o[ering alternative wheelchair entrances), strategic and community-focused approaches are often overlooked. More importantly, there is also a lack of attention to the experience of visitors with disabilities. This becomes apparent from several studies from Joint Projects, where visitor attractions are being visited together with experts by experience with various disabilities. Nevertheless, experience is often being regarded as the 'core product' of the leisure sector. The right to meet, discover, develop, relax and thus enjoy this core product is hindered for many people with disabilities due to a lack of knowledge, inaccessibility (physical, digital, social, communicative as well as financial) and discrimination in society. Additionally, recreation entrepreneurs still face a significant gap in reaching the potential market of guests with disabilities and their networks. Thus, despite the numerous initiatives in the leisure sector aimed at improving accessibility on technical and operational fronts, often people with disabilities are still not being able to experience the same kind of enjoyment as those without. These observations form the pressing impetus for initiating the current research project, tapping into the numerous opportunities for learning, development and growth on making leisure offer more inclusive.Benefit to societyIn total, the current project approach comes with a number of enrichments in terms of both knowledge and methodology: a mixed-methods approach that allows for comparing data from different sources to obtain a more complete picture of the experience; a methodological co-design process that honours the 'nothing about us without us' principle; and benchmarking for a group (i.e., people with challenges on the auditory spectrum) that despite the size of its population has thus far mostly been overlooked.
The question we have chosen – and been invited – to answer is “What is Europe: Past, Present, and Future.” This sits within the resilient societies theme of the NWA call. The reason for our choice of the ‘resilience’ theme is based on the many disciplines working on the project, which stretch beyond the historic (living history theme) into the societal.It has a deeper conceptual basis, however. It springs from an assumption that a shared sense of belonging and inclusion is one foundation for and aspect of resilience – just as a rope braided together from many strands is stronger than one where the strands are fraying apart. Positive and inclusive expressions of belonging and affiliation are present in education, sports, and music – highly visible sites of representation that have profound reach and impact in society. Racialisation, othering, and selective or stereotypical representations, however, work against resilience. They are circulated widely and generate exclusion and hurt. In these linked work packages, then, we take up the question’s invitation to expand and disrupt, what the NWA’s call itself defines as a normative prior understanding of Europe. In the words of the question, this definition emphasizes Europe’s nature as white, Christian-secular, bounded by the geographic limits of Western Europe, shaped by Greco-Roman heritage and tradition, democratic, and home of the enlightenment. Our consortium seeks to analyze this representation, research and present more expansive and accurate ones in consultative reflective and co-creative processes. Through the process, the new knowledge, and our highly participatory research and dissemination models we will change societal understandings of the bounds of Dutch, and European identities. This will forge a greater sense of belonging across all of the communities, including academia, involved in our project.This project is vital for building resilience through tackling sources of fragmentation and alienation in past and present. It is much needed as we look forward to an increasingly diverse and mixed demographic future.
