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Expectations and user experience of a multimodal medicine management system for older users
- Authors:
- HARJUMAA Marja, et al
- Journal article citation:
- Journal of Assistive Technologies, 8(2), 2014, pp.51-63.
- Publisher:
- Emerald
Purpose: The purpose of this paper is to analyse the adoption of a multimodal medication management system (MMS) targeted on older people and home care professionals. The paper aims to describe the expectations of the system and the user experience findings from an empirical qualitative field trial. The field trial results are used to discuss how MMSs should be designed in order to improve adherence to medications. Design/methodology/approach: The paper suggests that building a multimodal medicine management system targeted on both older users and home care professionals brings many benefits over electronic medicine dispenser systems or general reminder systems. The research process uses an iterative prototyping approach including phases of requirements analysis and concept design, prototype building and evaluation in a field trial. Findings: The study demonstrates how a system that merely satisfied users during the prototype building phase does not necessarily succeed as well as expected in the field trials. It would be important to consider reasons for medication non-adherence and non-technology factors influencing willingness to adopt new assistive devices in order to promote diffusion of new MMSs at home. The paper also discusses how the different persuasive functionalities of the system addressed patient-centred factors influencing non-adherence and how they could be addressed. Research limitations/implications: This study has some limitations. The actual adherence to medications was not measured. However, in the future, it will be important to study how the MMSs influence medication adherence. Also, the user experiences of the home care professionals were not studied in the field trials. Home care professionals who were involved in the user studies and trials merely estimated the value for their patients and not for themselves. Originality/value: This paper analyses design issues relevant when designing systems to help older people manage their medications. (Publisher abstract)
Analysing equity in the use of long-term care in Europe
- Authors:
- RODRIGUES Ricardo, ILINCA Stefania, SCHMIDT Andrea
- Publisher:
- European Commission
- Publication year:
- 2014
- Pagination:
- 39
- Place of publication:
- Brussels
There are significant differences across social protection systems in Europe in the scope, breadth and depth of coverage of the risk to need long-term care in old-age. Together with other factors, such as education, household structure or societal values regarding care for frail older people, these differences can have a significant impact on the use of long-term care. Using SHARE data, this Research Note compares differences between European countries in the use of long-term care across income groups, for older people living at home. It analyses not only inequalities in the use of long-term care, but also differences in use that persist after differences in need have been taken into consideration, i.e. horizontal inequity. For this purpose, concentration indices, concentration curves and horizontal inequity indices are estimated for home care services and informal care. The countries analysed here are Austria, Germany, Sweden, the Netherlands, Spain, Italy, France, Denmark, Greece, Belgium and Czech Republic. The findings suggest that differences in use of home care services across income groups mostly reflect differences in need between those same groups. For informal care, the differences in use persist even after accounting for needs, and less affluent individuals are much more likely to use informal care. Some possible causes for these differences and policy implications are considered.
Regulating long-term care quality: an international comparison
- Editors:
- MOR Vincent, LEONE Tiziana, MARESSO Anna
- Publisher:
- Cambridge University Press
- Publication year:
- 2014
- Pagination:
- 519
- Place of publication:
- Cambridge
This edited book provides a comprehensive international survey of long-term care provision and regulation, built around a series of case studies from Europe, North America and Asia. The analytical framework allows the different approaches that countries have adopted to be compared side by side and readers are encouraged to consider which quality assurance approaches might best meet their own country's needs. Wider issues underpinning the need to regulate the quality of long-term care are also discussed. The book is aimed at policymakers working in the health care sector, researchers and students taking graduate courses on health policy and management. (Edited publisher abstract)
The experience of family care-givers and migrant paid care-givers' relief of burden: a contrasted qualitative analysis
- Authors:
- DE LA CUESTA-BENJUMEA Carmen, ROE Brenda
- Journal article citation:
- Ageing and Society, 34(7), 2014, pp.1219-1242.
- Publisher:
- Cambridge University Press
Older people are increasingly being cared for in the community across Europe. Dependent care in Spain largely remains a private issue involving family carers and migrant women from developing countries. Qualitative research on respite care has contributed to our understanding of respite as a subjective experience. Nonetheless, how care-givers relieve the burden of care is still not fully understood. Migrant care-givers are present in family life but their need for rest remains unseen. The aim of the study presented in this paper was to contrast family care-givers and migrant care-givers' strategies for relief from their caring role. Care-givers rest by thinking, doing and being but in a different manner from that of care-giving, that is: when they are a different person. To leave the life of care-giving is the general strategy that family care-givers use to rest from their care-giving selves while turning to one's own world describes the way migrant care-givers seek to relieve the burden of care. The comparative analysis shows that both strategies have in common the necessity to disconnect from the care-giving identity and that both migrant and family care-givers employ strategies that are false exits to a care-giving identity: they apparently relieve the burden of care. Respite goes beyond places, times and activities; as family care itself, it requires identity. (Publisher abstract)
Multidimensional psychosocial profiles in the elderly and happiness: a cluster-based identification
- Authors:
- MORENO Raquel Lara, et al
- Journal article citation:
- Aging and Mental Health, 18,(4) 2014, pp.489-503.
- Publisher:
- Taylor and Francis
Objectives: Evidence supports that subjective well-being (SWB) diminishes in the old age and that this decline is strongly determined by elders’ psychosocial resources. This study explored person-centred, multidimensional, empirically-derived profiles of psychosocial functioning in the elderly and related each trajectory to differing configurations of SWB.Method: A community-based, convenience sample of Spanish institutionalised and non-institutionalised elders voluntarily participated in this cross-sectional study.Results: A cluster analysis produced three within-person psychosocial profiles characterised by distinct patterns of functioning: highly successful elders demonstrated to be healthy, highly confident in their own resources and very active in daily life; moderately successful elders demonstrated average functioning across domains, although they expected decreases in the future; and highly impaired elders were ill and stressed, at a high risk for future health problems and depression, and tried to compensate for their status mainly through social support. Each of these profiles was related differently to SWB configurations: highly successful elders demonstrated significantly higher happiness, positive affect, affect balance and life satisfaction; moderately successful elders showed average levels of SWB but decreased positive affect; and highly impaired elders demonstrated dramatically lower SWB. Furthermore, such trajectories were associated with the elders’ living condition. The happiest elders were more likely to be home-dwelling elders; however, there were fewer unhappy elders among those who were institutionalised.Conclusion: A person-centred approach to assessing psychosocial and SWB configurations provides a rich picture of individual differences in the ageing processes and can help in designing interventions aimed at enhancing happiness in old age. (Publisher abstract)
Loneliness and the exchange of social support among older adults in Spain and the Netherlands
- Authors:
- RODRIGUEZ Sanchez Marta M., de JONG GIERVELD Jenny, BUZ Jose
- Journal article citation:
- Ageing and Society, 34(2), 2014, pp.330-354.
- Publisher:
- Cambridge University Press
Previous research has shown that exchanges of support within social networks reduce the loneliness of older adults. However, there is no consistent evidence on how types of support (instrumental and emotional) and the direction of that support (giving and receiving) are related to loneliness, and whether the effects are culture-specific. The aim of this study was to investigate support exchanges and their effects on loneliness in Spain and the Netherlands. The authors suggest that cultural differences, such as more interdependent cultural values in Southern Europe and more independence-related values in Northern Europe, influence social realities such as the social support exchanged. In Spain relationships with family members are determined by mutual obligations; older people expect to receive instrumental support from them. However, in Northern Europe independence is highly valued and intimacy and closeness are shown primarily by confiding about personal matters. This paper examined data from two comparable surveys, one in Spain (N=646) and one in the Netherlands (N=656). Older adults in Spain provide for, and receive, high amounts of instrumental support and this proved to be a protective factor against loneliness. An alternative pattern was found in the Netherlands where respondents provided more and received more emotional support than Spanish older adults; emotional support is a protective factor in the Netherlands (but only for support received). (Edited publisher abstract)
The effects of a computer-based cognitive and physical training program in a healthy and mildly cognitive impaired aging sample
- Authors:
- GONALEZ-PALAU Fatima, et al
- Journal article citation:
- Aging and Mental Health, 18(7), 2014, pp.838-846.
- Publisher:
- Taylor and Francis
Objectives: The Long Lasting Memories (LLM) programme concerns a newly integrated platform which combines cognitive exercises with physical activity within the context of advanced technologies. The main objective of this study was to present the preliminary results that determine the possible effectiveness of the LLM programme in the improvement of cognitive functions and symptoms of depression in healthy elderly and subjects with mild cognitive impairment (MCI). Method: Fifty healthy and MCI subjects participated in the study. All of them received one hour's physical training and 35 minutes’ cognitive training, 3 times a week, during the 12 weeks of the programme. Before and after the intervention all participants were assessed using a battery of neuropsychological tests.Results: The results showed a significant improvement after the LLM training in global cognitive function, in verbal memory, in attention, in episodic memory and symptoms of depression. Conclusion: This study indicates that LLM is a promising solution for older adults with and without cognitive impairment, maintaining their wellbeing with few professional and technical requirements. (Edited publisher abstract)
European healthcare: care homes report 2014
- Author:
- KNIGHT FRANK
- Publisher:
- Knight Frank
- Publication year:
- 2014
- Pagination:
- 12
- Place of publication:
- London
This report explores the market composition, structure and context of continental Europe’s four largest care home markets: France, Germany, Spain and Italy. Demand for elderly care is expected to rise significantly, as decreasing fertility rates, coupled with increasing overall life expectancy, are driving up the share of elderly in the population. The growing number of elderly will impact on future demand for long-term care (LTC) services. However, while all types of LTC services are set to increase, they will not do so uniformly. Homecare, the preferred service line for most European countries in recent years, will prove to be inefficient given the rising share of patients with specialised medical needs. Additionally, societal changes, including declining family size, increasing childlessness and rising non-traditional living arrangements, mean that care homes will play a crucial role in caring for the increasing elderly population. The report shows that the somewhat restrictive domestic care home market has driven French-based operators towards further expansion abroad and a greater diversification of services. In Germany, while there remains an acute shortage of beds, the market has experienced an increased level of consolidation in recent years, as well as a string of acquisitions by foreign operators and private equity firms. The recent economic revitalisation has brought greater investor interest in Spain while the Italian care home market remains ripe for new development and investment. The relatively small size of the Italian industry, coupled with the considerable level of market fragmentation, means there is substantial room for new entrants and potentially greater consolidation of private and non-profit homes. (Edited publisher abstract)
A program of positive intervention in the elderly: memories, gratitude and forgiveness
- Authors:
- RAMIREZ Encarncion, et al
- Journal article citation:
- Aging and Mental Health, 18,(4) 2014, pp.463-470.
- Publisher:
- Taylor and Francis
Objective: The main goal of this study has been to increase the quality of life in people of over 60 years through a positive psychology intervention.Method: The employed a programme which consists of training based on autobiographical memory, forgiveness and gratitude. The sample consisted of 46 participants aged 60–93 years. State and trait anxiety, depression, general memory, specific memories, life satisfaction and subjective happiness were measured.Results: The results revealed that participants who followed the programme (experimental group) showed a significant decrease in state anxiety and depression as well as an increase in specific memories, life satisfaction and subjective happiness, compared with the placebo group.Conclusion: The programme offers promising results and provides new evidence for the effectiveness of positive interventions in the field of psychogerontology, helping increase subjective well-being and quality of life in older adults by focusing interventions on the enhancement of personal and social resources for being happy. (Edited publisher abstract)
Who cares? A comparison of informal and formal care provision in Spain, England and the USA
- Authors:
- SOLE-AURO Aida, CRIMMINS Eileen M.
- Journal article citation:
- Ageing and Society, 34(3), 2014, pp.495-517.
- Publisher:
- Cambridge University Press
This paper investigates the prevalence of incapacity in performing daily activities and the associations between household composition and availability of family members and receipt of care among older adults with functioning problems in Spain, England and the United States of America (USA). The study examines how living arrangements, marital status, child availability, limitations in functioning ability, age and gender affect the probability of receiving formal care and informal care from household members and from others in three countries with different family structures, living arrangements and policies supporting care of the incapacitated. Data sources include the 2006 Survey of Health, Ageing and Retirement in Europe for Spain, the third wave of the English Longitudinal Study of Ageing (2006), and the eighth wave of the USA Health and Retirement Study (2006). Logistic and multinomial logistic regressions are used to estimate the probability of receiving care and the sources of care among persons age 50 and older. The percentage of people with functional limitations receiving care is higher in Spain. More care comes from outside the household in the USA and England than in Spain. The use of formal care among the incapacitated is lowest in the USA and highest in Spain. (Edited publisher abstract)