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3This paper describes the approach used to identify elderly people’s needs and attitudes towards applying ambient sensor systems for monitoring daily activities in the home. As elderly are typically unfamiliar with such ambient technology, interactive tools for explicating sensor monitoring –an interactive dollhouse and iPad applications for displaying live monitored sensor activity data– were developed and used for this study. Furthermore, four studies conducted by occupational therapists with more than 60 elderly participants –including questionnaires (n=41), interviews (n=6), user sessions (n=14) and field studies (n=2)– were conducted. The experiences from these studies suggest that this approach helped to democratically engage the elderly as end-user and identify acceptance issues.
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Inaugural lecture, delivered upon public acceptance of the endowed professorship in Professionalisation of Nursing and Care in Elderly Care by Prof. Dr. Robbert J.J. Gobbens at Tilburg University on 29 September 2023.
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In the Netherlands, there has been much debate on the question whether elderly people over 70 who are tired of life and who consider their life to be completed, should have legal options to ask for assisted dying. So far there has been little research into the experiences of these elderly people. In order to develop deliberate policy and care that targets this group of elderly people, it is necessary to understand their lifeworld. The aim of this paper is to describe the phenomenon ‘life is completed and no longer worth living’ from a lifeworld perspective, as it is lived and experienced by elderly people. Between April to December 2013, we conducted 25 in-depth interviews. A reflective lifeworld research design, drawing on the phenomenological tradition, was used during the data gathering and data analysis. The essential meaning of the phenomenon is understood as ‘a tangle of inability and unwillingness to connect to one's actual life’, characterized by a permanently lived tension: daily experiences seem incompatible with people's expectations of life and their idea of whom they are. While feeling more and more disconnected to life, a yearning desire to end life is strengthened. The experience is further explicated in its five constituents: 1) a sense of aching loneliness; 2) the pain of not mattering; 3) the inability to express oneself; 4) multidimensional tiredness; and 5) a sense of aversion towards feared dependence. This article provides evocative and empathic lifeworld descriptions contributing to a deeper understanding of these elderly people and raises questions about a close association between death wishes and depression in this sample.
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This paper describes a participatory design-oriented study of an ambient assisted living system for monitoring the daily activities of elderly residents. The work presented addresses these questions 1) What daily activities the elderly participants like to be monitored, 2) With whom they would want to share this monitored data and 3) How a monitoring system for the elderly should be designed. For this purpose, this paper discusses the study results and participatory design techniques used to exemplify and understand desired ambient-assisted living scenarios and information sharing needs. Particularly, an interactive dollhouse is presented as a method for including the elderly in the design and requirements gathering process for residential monitoring. The study results indicate the importance of exemplifying ambient-assisted living scenarios to involve the elderly and so to increase acceptance and utility of such systems. The preliminary studies presented show that the participants were willing to have most of their daily activities monitored. However, they mostly wanted to keep control over their own data and share this information with medical specialists and particularly not with their fellow elderly neighbours.
MULTIFILE
A Dutch healthcare organisation modernizes its real estate portfolio to meet today’s requirements and acquired an office building for conversion into a nursing home for elderly with dementia. The purpose of the research has been to study the design principles for elderly with dementia, for innovative and smart application in work processes and the acquired building.
Methods – Using multiple-method qualitative research design, bachelor thesis students of a university of applied sciences explored the reconstruction of the acquired building and related healthcare processes.
Results – Application of design principles for the elderly with dementia were studied, among which were interior design, catering process, and connection with the neighbourhood. Feasible interior ideas were elaborated, intentions for change in the catering process were confirmed by stakeholders, and an action plan for neighbourhood connections was delivered. Elements are being used for a final design. Implementation has to be checked with close scrutiny.
Originality – The application of design principles for elderly with dementia (design, favourable state, beautiful moments) together with changes in work processes of health care employees aiming at patient-centred care is a new combination.
Practical or social implications – When a healthcare organisation chooses a new care concept, not only the surroundings change. Also, the processes around people and the way we take care of them change. In many ways a new concept can only succeed when the employees and the way they work change as well.
MULTIFILE
In this paper we investigate the precise focus required of a telemonitoring system for the domain of independently living elderly. Particularly, we investigate (1) the needs of telemonitoring for this particular domain, and (2) the requirements for such a telemonitoring system. For our investigation, we performed an extensive study of the literature, as well as performed interviews with 36 individuals active in the field. As a result, we established numerous needs to be considered, being foremost information need on safety, with regard to care response on emergencies (e.g., falling incidents, wandering), as well information need on dependence on care, with regard to inactivity, self-neglect and loneliness. Subsequently, we established numerous requirements to be addressed, being foremost the use of non-wearable sensors, unobtrusiveness, durability, reliability, privacy, and ubiquitousness. In our discussion of the requirements, we detailed specifically the topics of focus, functionality, and form of a telemonitoring system for this domain.
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Home rehabilitation after a hip operation can be daunting for the elderly. Lack of motivation to exercise and being insecure in the recovery process are common barriers. Personalized eHealth can help to ensure that the patient exercise efficiently, filling the gap between treatment in the practice with the physical therapist and practice at home.
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The study aims to describe the implementation of Activity Scheduling (AS) as a nursing intervention in an inpatient population of older adults with a major depressive disorder. DESIGN AND METHODS: In a single case report, the implementation of the intervention was described. FINDINGS: This case report shows that AS, when adapted into a brief and prescriptive course, can be beneficial for depressed elderly in an inpatient care setting. PRACTICE IMPLICATIONS: Although previous research shows promising results, there is a need for additional research on the effectiveness of the intervention when AS is executed by nurses.
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INTRODUCTION: Sufficient high quality dietary protein intake is required to prevent or treat sarcopenia in elderly people. Therefore, the intake of specific protein sources as well as their timing of intake are important to improve dietary protein intake in elderly people.
OBJECTIVES: to assess the consumption of protein sources as well as the distribution of protein sources over the day in community-dwelling, frail and institutionalized elderly people.
METHODS: Habitual dietary intake was evaluated using 2- and 3-day food records collected from various studies involving 739 community-dwelling, 321 frail and 219 institutionalized elderly people.
RESULTS: Daily protein intake averaged 71 ± 18 g/day in community-dwelling, 71 ± 20 g/day in frail and 58 ± 16 g/day in institutionalized elderly people and accounted for 16% ± 3%, 16% ± 3% and 17% ± 3% of their energy intake, respectively. Dietary protein intake ranged from 10 to 12 g at breakfast, 15 to 23 g at lunch and 24 to 31 g at dinner contributing together over 80% of daily protein intake. The majority of dietary protein consumed originated from animal sources (≥60%) with meat and dairy as dominant sources. Thus, 40% of the protein intake in community-dwelling, 37% in frail and 29% in institutionalized elderly originated from plant based protein sources with bread as the principle source. Plant based proteins contributed for >50% of protein intake at breakfast and between 34% and 37% at lunch, with bread as the main source. During dinner, >70% of the protein intake originated from animal protein, with meat as the dominant source.
CONCLUSION: Daily protein intake in these older populations is mainly (>80%) provided by the three main meals, with most protein consumed during dinner. More than 60% of daily protein intake consumed is of animal origin, with plant based protein sources representing nearly 40% of total protein consumed. During dinner, >70% of the protein intake originated from animal protein, while during breakfast and lunch a large proportion of protein is derived from plant based protein sources.
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The hospitalized elderly are at risk of functional decline. We evaluated the effects and care costs of a specialized geriatric rehabilitation program aimed at preventing functional decline among at-risk hospitalized elderly.
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