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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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The proportion of elderly people in the society is constantly growing. The elderly who live alone form one of the most vulnerable groups in the society that is also at considerable risk for poverty and social isolation. According to the last population census in Estonia (2011), 39.3% of the elderly (65+) lived alone. The ageing of the population is accompanied by novel challenges, among them especially the coping of the elderly living alone. In 2015, the research team at the Tallinn University School of Governance, Law and Society conducted a study to map Estonian community-based practices that are available for the elderly (65+), especially for those who live alone at home, and the way these practices support interdependent coping and prevent the need for institutional care. This study, based on qualitative and quantitative data collected in Estonian communities, suggests that cooperation between Estonian local governments and communities should be more effective and involve regular interaction. Promising practices include developing network-based community support models and broadening communication possibilities.
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In my work as a nurse and, later, as a clinical nurse specialist, I often encountered older people whose treatment for depression – performed according to the relevant guidelines – was inadequate, causing the depression to become chronic in nature. When the course of a depression becomes this adverse, with no improvement in sight, with the patient, his loved ones, and the treatment providers feeling helpless, and with the burden on the patient and his or her family being unrelenting, the clinical problem is enormous for all concerned. The helplessness that I experienced as a practitioner led me to think that when depression becomes chronic in nature, there may be a “missing link” in the known chain of cause and effect. That link might consist of a particular aspect of treatment that largely escapes the notice of practitioners, causing the patient’s feelings of depression to persist – in other words, dealing with the patient's unmet needs. My assumption was that the consequences of depression can be expressed in “unmet needs” but that there is a reciprocal relationship in this regard whereby the depression creates needs on the one hand, while unmet needs have an unfavourable effect on the course of the depression on the other. There has been very little research on the unmet needs of older people with depression and the reciprocal relationship referred to above, an observation that inspired me to undertake this study. To place the research in a more specific context, I formulated the general research problem as follows: There has been insufficient research exploring the consequences of a depressive disorder for the daily lives of older people. It is thus unclear to what extent the course of depression in later life is associated with unmet needs, particularly with regard to the individual’s ability to play a role in society. Read more: https://research.vu.nl/en/publications/needs-of-elderly-people-with-late-life-depression-challenges-for-
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Abstract Background: Good dental hygiene is important to prevent or reduce frailty in the elderly. Research shows that 66% of elderly patients admitted to a nursing home have bad dental hygiene. During their stay, dental hygiene remains moderate to bad. To start addressing this issue, a group of students (nursing, occupational therapy, computer science and health care technology), part of an exchange collaboration facilitated through our Vitale Delta Research Program, have been researching 1) why caregivers struggle to give good dental hygiene, 2) which eHealth applications could support the (professional) caretakers and the elderly in performing appropriate dental hygiene, and 3) to develop an app to support dental hygiene.
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The continuing aging of the population sparked off a public discussion on the extent of state care of elderly people. A historical evaluation of the Dutch system of family care is an essential part in the above discussion, especially regarding options like self-aid and 'mantelzorg'. Using population registers, household stutters of elderly people in the periode 1920-1940 were reconstructed for two different regions in the Netherlands. The most important conclusion of this investigation is that the Dutch elderly were, in most cases, living independently, as head (or wife of the head) of the household in which they were residing.
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This 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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The present study attempts to explore the field of creative music workshops with the elderly. A growing amount of research has been carried out into running (creative) workshops, and besides we know a lot about the elderly and ageing. The aim of this research is to gather knowledge on the merging of both subjects, creative music workshops with the elderly in the so-called ‘fourth age’. In particular, this research project has been carried out as a study of a potential professional field for musicians and music educators. For this reason the research objective is focused on the position of the workshop leader and what is needed to run creative music workshops with elderly in residential homes for the elderly successfully. We therefore aim to explore aspects connected to this practice such as entrepreneurship, musicianship and leadership.
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BACKGROUND: Depression in later life is a common mental disorder with a prevalence rate of between 3% and 35% for minor depression and approximately 2% for Major Depressive Disorder (MDD). The most common treatment modalities for MDD are antidepressant medication and psychological interventions. Recently, Behavioral Activation (BA) has gained renewed attention as an effective treatment modality in MDD. Although BA is considered an easy accessible intervention for both patients and health care workers (such as nurses), there is no research on the effectiveness of the intervention in inpatient depressed elderly.The aim of study, described in the present proposal, is to examine the effects of BA when executed by nurses in an inpatient population of elderly persons with MDD. METHODS/DESIGN: The study is designed as a multi-center cluster randomized controlled trial. BA, described as The Systematic Activation Method (SAM) will be compared with Treatment as Usual (TAU). We aim to include ten mental health care units in the Netherlands that will each participate as a control unit or an experimental unit. The patients will meet the following criteria: (1) a primary diagnosis of Major Depressive Disorder (MDD) according to the DSM-IV criteria; (2) 60 years or older; (3) able to read and write in Dutch; (4) have consented to participate via the informed consent procedure. Based on an effect size d = 0.7, we intend to include 51 participants per condition (n = 102). The SAM will be implemented within the experimental units as an adjunctive therapy to Treatment As Usual (TAU). All patients will be assessed at baseline, after eight weeks, and after six months. The primary outcome will be the level of depression measured by means of the Beck Depression Inventory (Dutch version). Other assessments will be activity level, mastery, costs, anxiety and quality of life. DISCUSSION: To our knowledge this is the first study to test the effect of Behavioral Activation as a nursing intervention in an inpatient elderly population. This research has been approved by the medical research ethics committee for health-care settings in the Netherlands (No. NL26878.029.09) and is listed in the Dutch Trial Register (NTR No.1809).
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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
Introduction - Life long sport and PA pleasure in an inclusive environment (Nationaal Sportakkoord, 2020) - Aging population (Loket Gezond Leven, 2024) - Physical activity in elderly (65+) 38% (Loket Gezond Leven, 2024) - Loneliness is limiting factor (Volksgezondheid en Zorg, 2024) - Save and inviting outer space, also for elderly
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