Policies to create more age-friendly environments, in which a growing number of cities and communities, local authorities and regional governments participate, have become a forceful movement in Europe and globally. These policies explore synergies between improving the physical environment of neighbourhoods, transport and housing; increasing respect, social inclusion and community participation; and investing in public services. This publication provides a toolbox to guide local policy-makers and planners in developing, implementing and evaluating age-friendly policies and interventions – policies that support people to age actively and healthily and thus both to do the things that are important to them and to contribute to their communities. Based on lessons learned from existing age-friendly initiatives in Europe, this publication summarizes key factors for establishing and sustaining successful initiatives within four phases of the policy process: engaging, planning, implementing and evaluating. A wealth of examples illustrates how local governments have put the principles of age-friendly action into practice.
The implementation of the IROHLA pilot programmes showed positive attitudes of senior citizens towards the use of e-health applications (transfer of health resources and healthcare by electronic means) and m-health applications (delivery of healthcare services via mobile communication devices) for improving and managing their health.
Modern information and communication technology (ICT) can help senior citizens overcome difficulties related to distance from health centres and support them to understand their health issues, improve their communication with care givers and service providers, and enhance informed decision making. Additionally, ICT facilitates more targeted public health and medical interventions, as well as remote diagnosis and monitoring. In general, technology offers tools necessary for families, communities, healthcare professionals and the healthcare system to assist older people to age healthily. ICT creates innovative solutions, such as interventions through the internet, mobile phones, tablets, and video games that can improve the health of older people.
IROHLA’s work on e-health and m-health
The IROHLA project examined several promising practices among different groups of participants, including older adults with low health literacy, using different kinds of technical equipment. Some of these were applications that aimed to increase physical activity and track weight loss, while others supported behavioural change and sleep quality, or were games designed to improve cognitive skills.
One of the pilot projects designed by Prolepsis Institute aimed to improve participants’ knowledge about physical activity and healthy nutrition as well as related behaviours, while exploring attitudes towards ICT-based health applications. The content was based on the Greek National Dietary Guidelines for older people developed by the Prolepsis Institute. This tool enabled participants to set their own dietary and physical activity goals and assess them at the end of a specific period (normally one week) regardless of whether they achieved them or not. The system generated personalised messages based on the assessment of goals.
Research conducted during the implementation of the IROHLA project brought to the surface important learning points and obstacles that need to be carefully examined when developing similar interventions. One of the main conclusions was the need for active and continuous collaboration between application developers, healthcare professionals and researchers. Other matters that should be taken into consideration when designing such applications include simplification of the content and use of the application, and the ability to set short-term, personalised goals.
The importance of considering socio-economic status
In an era of technological innovations, a false perception dominates that all people are familiar with computers, smart phones and tablets. But this is not always true, especially when referring to the older generation. In addition, socio-economic status plays an important role in determining understanding of new technologies and the messages it delivers. That is why these factors should not be ignored when designing e-health and m-health applications that aim to contribute to the reduction of both inequalities between different social groups.
If a loved one has dementia you might be worried about how they’ll cope during the festive season. Read our simple guide to help you make Christmas as enjoyable as possible – for everyone.
1. Have a plan
Taking a, ‘let’s see what happens’ approach to the festive season isn’t going to work when you’re caring for someone with dementia. Spontaneous visits can be stressful so make sure to contact anyone who usually drops by (and who your loved one will definitely want to see) and organise dates and times in advance.
2. Trust your instinct
It’s not too late to change a plan you may have agreed to initially but which you’re now worried about. For example, if you’re dreading an overnight stay with Aunty Alice because you know your loved one won’t sleep and could become very unsettled, trust your instinct, confront it now and either cancel the trip or agree to a shorter visit which can be done in a day.
…antipsychotic medication given to elderly people with dementia it should be at the lowest possible dose for the shortest possible time and always after all other avenues have been tried and have failed.
A poignant and important article on the use of antipsychotic medications in treating people with dementia – please read and share!
Overlæge og leder af hukommelsesklinikken på Roskilde Sygehus, Peter Høgh, holder tirsdag den 29. november foredrag i Slagelse.
If you are like the majority of people, you use the internet to search for health information. In fact, during my PhD studies, I found that care partners with someone with dementia look up health information more than the general public. While it is great that there is so much information out there and that people are sharing experiences and research, it can also be overwhelming. Especially if you don’t know how to tell if the information you are getting is accurate and reliable.
Luckily, there is the NGO (non-governmental organization) Health On the Net. They strive to ensure that the public gets safe, quality health information and have trusted sources to go to.
Some 7’300 sites are now formal HONcode subscribers, that is, they have a unique ID number and are indexed by us. About 80 per cent of these are US sites, but the proportion of European and other non-US sites is growing. The HONcode now exists in 34 language versions, in addition to English (see, for example, http://www.hon.ch/HONcode/Chinese/).
They suggest searching on websites belonging to hospitals, universities and government agencies. There are also websites that have obtained HONcode certification, including:
Some other tips:
Add the term HONcode to a Google search.
Use Khresmoi, a search engine bringing together certified sites.
Search directly on HON.
Click on the link to check out their infographic for more tips and information:
Out of the UK: Part of the summary of the ten priorities for commissioners, we look at the role of active support for self management in commissioning care in the NHS.
Self-management support can be viewed in two ways: as a portfolio of techniques and tools to help patients choose healthy behaviours; and as a fundamental transformation of the patient-caregiver relationship into a collaborative partnership (de Silva 2011).
This seems like an apt article to share today, this 2016 election day in the US. It touches on an issues that isn’t discussed too often, even among people who dedicate their lives to understanding, preventing, and treating dementia.
Dementia and voting.
This article and video discuss Rob and Margaret and their process of navigating voting after Rob’s diagnosis of moderate Alzheimer’s disease 2 years ago. Read the full article and watch the video at: https://www.statnews.com/2016/11/07/alzheimers-voting-dementia/
In practice, whether they cast a vote often gets left to the discretion of a caregiver. Many geriatricians and ethicists who study the issue say there’s one key question to determine whether someone with Alzheimer’s should vote: Can they express their choice? It doesn’t matter if they’re confused about what day it is. Or whether they can physically fill out the ballot. What matters is that they’re able to state, write, point at, or otherwise cogently indicate who they want to vote for. And for many people with dementia, especially in the early and middle stages of the disease, that’s entirely doable.
I have mixed feelings on this. Of course, there is no cognitive testing for someone to be allowed to vote. There is no IQ testing. You have to be 18 and registered. This also includes people with developmental (and other) disabilities.
In general, I would agree with the above quote, that as long as they can express their preference, they should retain their right to vote. We may not always agree with people’s reasons, but if they can clearly express their decision, they should be encouraged to exercise it. What is especially touching in the story about Rob and Margaret, above, is that Rob had a lifelong, active interest in politics and seemed to understand the issues and his (perhaps formerly expressed) opinions on them when Margaret explained them. It really would be a disservice to take away his right to vote.
However, it gets trickier when the person has been declared legally incompetent, such as when someone else takes over managing the finances, and health and legal decisions. At this point, it is very reasonable to think that the person with dementia can no longer understand complex topics and use their reasoning skills to arrive at a decision which is based on cognitive thought. And I also think that by this point, the care partner will know that and not put the person with dementia in the stressful position of trying to navigate voting anyway.
Here’s what Alzheimer’s Society has to say:
Question: Can a person with dementia vote in the UK general and local elections.
Answer: Yes, a person with dementia can vote regardless of their capacity.
It is clearly stated in the Electoral Commission’s guidance for Electoral Registration Officers that mental health conditions do not constitute a legal incapacity to vote, so a person would not be stopped from voting at the polling station.
However, it is important to note that the guidelines also state that the decision as to whether and how to vote at an election must be made by the elector themselves, and not by a carer or a person making decisions on behalf of the elector.
I also found a 2011 research article which looked at the capacity to vote in older adults and people with dementia. They conducted their research with people diagnosed with dementia and people of the same age with no presence of dementia. Categories they rated were: understanding of the nature of the vote, understanding of the effect of the vote, vote choice, comparative reasoning, consequential reasoning, and appreciation. They found:
We observe that patients with dementia understand the nature and eﬀect of the vote (53% and 44%, respectively), and appreciate its consequences (66.2%) but do not do as well when it is time to make a voting choice (25%) and to consequential reasoning (35.3%)…The criteria of understanding and appreciation are easier for the patients, but not those of vote choice and reasoning. Cognitive deterioration, but not age, inﬂuences the capacity to vote.
What are your thoughts on this issue? Please share them in the comments!