Long-term Care in Motion

Transcription

1 Long-term Care in Motion Katrin Claßen 1, Hans-Werner Wahl 1, Carl-Philipp Jansen 1,2 & Klaus Hauer 1,2 1 Department of Psychological Ageing Research, Heidelberg University 2 Agaplesion Bethanien Hospital, Heidelberg & Heidelberg University European Forum on Social Innovations for Healthy and Active Life Expectancy , Lund

2 Overview Long-term Care in Motion (LTCiM) as part of INNOVAGE Healthy and active ageing in LTC residents Physical activity (PA) as fundament of LTCiM Overall ambition of LTCiM Social innovative component of LTCiM Current state and interim findings

3 INNOVAGE and LTCiM Overall goal of INNOVAGE: [ ] develop and test as well as survey and catalogue, social innovations that will have a solid impact on improving the quality of life and well-being of older people. WP 2 User-driven Housing for Older People WP 6 Knowledge exchange and transfer WP 3 ICT-based Social Support for Carers of Older People WP 1 Increasing Healthy Life Expectancy WP 4 Improving Obesity Related Outcomes in Old Age WP 5 Long-term Care in Motion WP 7 Management

4 Background of LTCiM Project Background Despite the positive effects of PA even in very old age, LTC residents are at high risk of inactivity and respective negative consequences LTC residents may have the lowest likelihood to be addressed by social innovations (therapeutic pessimism; incarnation of negative ageing ) Novel approach based on combined PA training and psychosocial intervention and latest motion tracking technologies Use of cutting-edge tracking technology as a means for assessing user needs in the LTC setting Goal: Improve healthy and active ageing in a vulnerable population at high risk of inactivity, decreased Quality of Life (QoL), isolation, and impaired healthy life expectancy

5 What does healthy and active ageing mean for the specific group of LTC residents? - Maintaining mental capacity and mental well-being at the highest level possible - Maintaining physical functioning at the highest level possible - Maximizing autonomy, participation, quality of life and well-being but how to reach this? PA as fundament

6 PA as fundament Motor Status Emotional Status Physical Activity Cognitive Status Quality of Life, Autonomy, Participation

7 Research Gaps PA training literature mostly focuses on normally ageing older adults living in the community and thus focuses on those being still rather well in physical and cognitive functioning (Motor) Performance is primary study endpoint in previous LTC-studies. No systematic review available, assessment methodology limited It remains unclear how increased activity (risk reduction vs. risk exposition) will influence risk of falling Psychologically based social-ecological intervention components have so far not been widely established in RCTs using physical training/activity promotion in LTC settings Research on PA promotion in LTC limited and in need of innovative future directions

8 Ambitions of LTCiM Goal 1: Reviewing existing research in the domain of PA in LTC Systematic review(s) on PA-interventions as well as psychosocial interventions in long-term care Goal 2: Establish a natural lab to learn more about motor behaviour LCT settings State of the art measurement of activity behaviour and life-space with high-end sensor technology in one specific nursing home as natural lab State of the art measurement of psychosocial constructs (e.g. personality, quality of life)

9 Ambitions of LTCiM Goals 3: To get the whole LTC facility in motion with particularly increasing LTC residents PA. Evaluate effects based on an innovative combination of outcome methodology Implement various strategies of end-user tailored physical activity interventions targeting heterogeneous subgroups of residents living in a large long-term care setting Involvement of staff members (and relatives) in a psychologically based social-ecological intervention Enrich environment to create activity motives (Serious Games) Accounting for residents wishes and needs (pre test) Evaluate feasibility and effectiveness of interventions with a unique set of assessments (pre-post mixed methods evaluation)

10 LTCiM and social innovativeness? Answers from LTCiM

11 LTCiM and social innovativeness? Documentation and exact mapping of PA in LTC as well as residents life space Quantitative data on PA in LTC; barriers and facilitators for PA Objective assessment of residents psychosocial constructs Quantitative data allowing for more extensive analysis on PA in LTC

12 LTCiM and social innovativeness? Supervised evidence-based training groups aiming at the activation and increase in motor and cognitive performances which are most relevant of mobility and motor security Realization in LTC setting (Sub)group specific approach according to motor and cognitive status as well as individual preferences

13 LTCiM and social innovativeness? Implementation of Serious Games Component Motivation of persons not addressed by established groups programs; possibility for trial and error; giving back autonomy to residents

14 LTCiM and social innovativeness? Setting approach Behaviour changes at multiple levels Creation of activity motives Relatives Common agenda for staff and relatives; joint groups Possibility of feedback-loops Organisation Environment Residents Staff Staff as interactive partners Significant Others Inclusion of further stakeholders Process orientation

15 Current state and interim findings Systematic review(s) considering existing research on interventions in long-term care with impact on physical activity (PA) as well as psychosocial interventions Exchange and cooperation with experts in the field of implementation research (e.g. Prof. Schäufele, Prof. Kempen, Prof. Becker, Dr. Notthoff) Cooperation with Farseeing Preparation of Research Setting (e.g. planning discussions with nursing home director and other responsible persons, on-site visits and participation in residents group offers) Preparation of intervention programme (PA promotion and psychosocial component) and compilation of self- and proxy structured questionnaire Selection of motion/tracking sensors, implementation

16 Project Components and Project Flow Content Preparation of intervention setting and research update Time Line 1/13 2/13 3/13 4/13 1/14 2/14 3/14 4/14 1/15 2/15 3/15 4/15 Preparation of intervention program and assessment methodology Establishing outcome assessment Intervention related training Implementation of intervention Implementation of follow-up assessments Data analysis and dissemination/ implementation of findings

17 Thank you for your attention