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In the Netherlands, there is a growing need for collective housing for older people to bridge the gap between ageing in place and institutional care facilities. The participation of older people in the concept and design stages is important to tune the market supply to the needs of (future) residents. However, social entrepreneurs find it challenging to involve older people. This chapter explores various ways older people can be involved in developing new housing initiatives. The ladder of citizen participation is used here to explore different roles that (future) residents could play with varying levels of influence, from non-participation to citizen power. Considerations for meaningful participation are discussed. Furthermore, a Dutch case study is presented, in which real estate was transformed based on the involvement of older people, which illustrates how by using an innovative method, partnerships could be formed between (future) residents and decision-makers. This chapter concludes that apart from housing itself, the built and outdoor environment should also be considered to improve the living conditions of older people.

This paper reports on the research methods used in five different projects aimed at supporting people living with dementia in their everyday lives and activities of daily living. In all five projects, people living with dementia and their informal carers were involved. Applied methods ranged from passive involvement in the form of observations to very active involvement consisting of consultation rounds and think-aloud sessions. The projects highlighted that people living with dementia can still contribute to the development of solutions that support them in the self-management of their symptoms and challenges, as well as technological solutions that support them in daily living. LinkedIn: https://www.linkedin.com/in/jvhoof1980/

The number of older adults is increasing rapidly, and this demographic shift places an increased level of strain and tension on the various international healthcare and welfare systems [...]

The paper provides an introduction to the public discourse around the notion of smart healthy inclusive environments. First, the basic ideas are explained and related to citizen participation in the context of implementation of a "society for all ages" concept disseminated by the United Nations. Next, the text discusses selected initiatives of the European Commission in the field of intergenerational programming and policies as well as features of the COST Action NET4Age-Friendly: Smart Healthy Age-Friendly Environments (SHAFE). The following sections are focused on studying and discussing examples of projects and methodologies that have been aimed at: empowering facilitators of smart healthy inclusive environments, empowering citizens to deal with health emergencies, and supporting older people's voices. The conclusion covers selected recommendations for entities of public policy on ageing (ageing policy) as well as potential directions for further research.

Given the growing number of older people, society as a whole should ideally provide a higher quality of life (QoL) for its ageing citizens through the concept of personalised ageing. Information and communication technologies (ICT) are subject to constant and rapid development, and can contribute to the goal of an improved QoL for older adults. In order to utilise future ICT solutions as a part of an age-friendly smart environment that helps achieve personalised ageing with an increased QoL, one must first determine whether the existing ICT solutions are satisfying the needs of older people. In order to accomplish that, this study contributes in three ways. First, it proposes a framework for the QoL of older adults, in order to provide a systematic review of the state-of-the-art literature and patents in this field. The second contribution is the finding that selected ICT solutions covered by articles and patents are intended for older adults and are validated by them. The third contribution of the study are the six recommendations that are derived from the review of the literature and the patents which would help move the agenda concerning the QoL of older people and personalised ageing with the use of ICT solutions forward. Original article at MDPI; DOI: http://dx.doi.org/10.3390/ijerph17082940 (This article belongs to the Special Issue Feature Papers "Age-Friendly Cities & Communities: State of the Art and Future Perspectives")

In the Netherlands, there is an increasing need for collective forms of housing for older people. Such housing bridges the gap between the extremes of living in an institutionalised setting and remaining in their own house. The demand is related to the closure of many residential care homes and the need for social engagement with other residents. This study focuses on housing initiatives that offer innovative and alternative forms of independent living, which deviate from mainstream housing arrangements. It draws on recent literature on healthcare &lsquo, rebels&rsquo, and further develops the concept of &lsquo, rebellion&rsquo, in the context of housing. The main research question is how founders dealt with challenges of establishing and governing &lsquo, rebellious&rsquo, innovative living arrangements for older people in the highly regulated context of housing and care in the Netherlands. Qualitative in-depth interviews with 17 founders (social entrepreneurs, directors and supervisory board members) were conducted. Founders encountered various obstacles that are often related to governmental and sectoral rules and regulations. Their stories demonstrate the opportunities and constraints of innovative entrepreneurship at the intersection of housing and care. The study concludes with the notion of &lsquo, responsible rebellion&rsquo, and practical lessons about dealing with rules and regulations and creating supportive contexts.

Contains fulltext : 191038.pdf (Publisher’s version ) (Open Access) Studies among people with dementia demonstrated that the sleep quality and rhythm improves significantly when people are exposed to ambient bright light. Since almost half of the healthy older people also indicate to suffer from chronic sleep disorders, the question arises whether ambient bright light can be beneficial to healthy older people. Particularly the effect on sleep/wake rhythm in relation to the exposure to natural light is the focus. It was hypothesised that the sleep quality would be worse in winter due to a lower daylight dose than in summer due to the lower illuminance and exposure duration. A field study was conducted to examine the relationship between daylight exposure and sleep quality in 14 healthy older adults living independently in their own dwellings in the Netherlands. All participants were asked to take part of the study both during the summer period as well as during the winter period. Therefore, they had to wear an actigraph for five consecutive days which measured sleep, activity and light exposure. Results confirmed that people were significantly longer exposed to high illumination levels (>1000 lx) in summer than in winter. Sleep quality measures, however, did not differ significantly between summer and winter. A significant, positive correlation was found between exposure duration to high illuminance from daylight during the day and the sleep efficiency the following night in summer, implying that being exposed to high illuminance for a longer time period has a positive effect on sleep efficiency for the individual data. There was also a tendency of less frequent napping in case of longer exposure duration to light for both seasons. Sleep quality does not differ between summer and winter but is related to the duration of the exposure to bright light the day prior to the night. 7 p.

The adaptation of urbanised areas to climate change is currently one of the key challenges in the domain of urban policy. The diversity of environmental determinants requires the formulation of individual plans dedicated to the most significant local issues. This article serves as a methodic proposition for the stage of retrieving data (with the PESTEL and the Delphi method), systemic diagnosis (evaluation of risk and susceptibility), prognosis (goal trees, goal intensity map) and the formulation of urban adaptation plans. The suggested solution complies with the Polish guidelines for establishing adaptation plans. The proposed methodological approach guarantees the participation of various groups of stakeholders in the process of working on urban adaptation plans, which is in accordance with the current tendencies to strengthen the role of public participation in spatial management. https://doi.org/10.12911/22998993/81658

PurposeOlder people with dementia (OPD) have specific housing and technology-related needs, for which various design principles exist. A model for designing environments and its constituting items for people with dementia that has a firm foundation in neurology may help guide designers in making design choices. The paper aims to discuss these issues.Design/methodology/approachA general design model is presented consisting of three principles for OPD, namely designing for ageing people; designing for a favourable state and designing for beautiful moments. The neurosciences as a whole give shape to an eminent framework explaining the behaviour of OPD. One of the objectives of this paper is to translate the design principles into design specifications and to show that these specifications can be translated in a design.FindingsPhilosophical concepts are introduced which are required to understand design for OPD. Four case studies from Dutch nursing homes are presented that show how the theory of modal aspects of the philosopher Dooyeweerd can be used to map design specifications in a systematic way.Research limitations/implicationsThese examples of design solutions illustrate the applicability of the model developed in this article. It emphasises the importance of the environment for supporting the daily life of OPD.Originality/valueThere is a need for a design model for OPD. The environment and technology should initiate positive behaviours and meaningful experiences. In this paper, a general model for the designing of environments for OPD was developed that has a firm foundation in neurology and behavioural sciences. This model consists of six distinct steps and each step can be investigated empirically. In other words, this model may lay the foundation for an evidence-based design.

In Western countries the health care system faces numerous challenges. We explore the potential of the normative practice approach to analyze the present system, to provide new insights in the redesign of the health care network, and to offer new concepts to understand the needs and wishes of patients. We present a case study of assistive devices in orthopaedics. This article shows that the Triple I variant of the practice model is very fruitful to understand the organizational embedding of professional practices, to understand the health care system as chains of professional practices, and to understand the influence of stakeholders. In this study we introduce the idea of user practices to investigate the social environment of patients and to make the needs and wishes of patients explicit.

Lehoux et al provide a highly valid contribution in conceptualizing value in value propositions for new health technologies and developing an analytic framework that illustrates the interplay between health innovation supply-side logic (the logic of emergence) and demand-side logic (embedding in the healthcare system). This commentary brings forth several considerations on this article. First, a detailed stakeholder analysis provides the necessary premonition of potential hurdles in the development, implementation and dissemination of a new technology. This can be achieved by categorizing potential stakeholder groups on the basis of the potential impact of future technology. Secondly, the conceptualization of value in value propositions of new technologies should not only embrace business/economic and clinical values but also ethical, professional and cultural values, as well as factoring in the notion of usability and acceptance of new technology. As a final note, the commentary emphasises the point that technology should facilitate delivery of care without negatively affecting doctorpatient communications, physical examination skills, and development of clinical knowledge., peer-reviewed

Taking an international perspective of healthy ageing, people are living longer and are generally in better health than previous generations [...]

The World Health Organization (WHO) strives to assist and inspire cities to become more &ldquo, age-friendly&rdquo, and the fundamentals are included in the Global Age-Friendly Cities Guide. An age-friendly city enables residents to grow older actively within their families, neighbourhoods and civil society, and offers extensive opportunities for the participation of older people in the community. Over the decades, technology has become essential for contemporary and future societies, and even more imperative as the decades move on, given we are nearly in our third decade of the twenty-first century. Yet, technology is not explicitly considered in the 8-domain model by the WHO, which describes an age-friendly city. This paper discusses the gaps in the WHO&rsquo, s age-friendly cities model in the field of technology and provides insights and recommendations for expansion of the model for application in the context of countries with a high human development index that wish to be fully age-friendly. This work is distinctive because of the proposed new age-friendly framework, and the work presented in this paper contributes to the fields of gerontology, geography urban and development, computer science, and gerontechnology.

Ageing brings about physiological changes that affect people&rsquo, s thermal sensitivity and thermoregulation. The majority of older Australians prefer to age in place and modifications to the home environment are often required to accommodate the occupants as they age and possibly become frail. However, modifications to aid thermal comfort are not always considered. Using a qualitative approach this study aims to understand the thermal qualities of the existing living environment of older South Australians, their strategies for keeping cool in hot weather and warm in cold weather and to identify existing problems related to planning and house design, and the use of heating and cooling. Data were gathered via seven focus group sessions with 49 older people living in three climate zones in South Australia. The sessions yielded four main themes, namely &lsquo, personal factors&rsquo, &lsquo, feeling&rsquo, knowing&rsquo, and &lsquo, doing&rsquo, These themes can be used as a basis to develop information and guidelines for older people in dealing with hot and cold weather.

Population ageing has become a domain of international discussions and research throughout the spectrum of disciplines including housing, urban planning, and real estate. Older people are encouraged to continue living in their homes in their familiar environment, and this is referred to as “ageing-in-place”. Enabling one to age-in-place requires new housing arrangements that facilitate and enable older adults to live comfortably into old age, preferably with others. Innovative examples are provided from a Dutch social housing association, illustrating a new approach to environmental design that focuses more on building new communities in conjunction with the building itself, as opposed to the occupational therapeutic approaches and environmental support. Transformation projects, referred to as “Second Youth Experiments”, are conducted using the Røring method, which is based on the principles of co-creation. De Benring in Voorst, The Netherlands, is provided as a case study of an innovative transformation project. This project shows how social and technological innovations can be integrated in the retrofitting of existing real estate for older people. It leads to a flexible use of the real estate, which makes the building system- and customer preference proof. Original article at: https://doi.org/10.3390/buildings8070089 © 2018 by the authors. Licensee MDPI.

The design of healthcare facilities is a complex and dynamic process, which can be supported by design support models. This process involves a large number of stakeholders, of whom some have specific health-related needs. Evidence-based design is an emerging approach for the design of healthcare facilities, basing design choices on scientific data. Apart from the problems accompanying the limited access to, and limited availability of, scientific evidence, the design of a building itself is characterised by dimensional, technological and stakeholder complexities that are derived from technology philosophy. This article deals with the derivation of performance indicators and design solutions for healthcare facilities and links this search to the foundations of evidence-based building. The In2Health design model is elaborated as a framework to steer this process and support architects, programmers and process managers. The applicability of the model in the evaluation and design processes of buildings is illustrated by two case studies concerning (i) the evaluation of the indoor environment for older people with dementia and (ii) the design process of the redevelopment of an existing hospital.

Long-term care facilities are currently installing dynamic lighting systems with the aim to improve the well-being and behaviour of residents with dementia. The aim of this study was to investigate the implementation of dynamic lighting systems from the perspective of stakeholders and the performance of the technology. Therefore, a questionnaire survey was conducted with the management and care professionals of six care facilities. Moreover, light measurements were conducted in order to describe the exposure of residents to lighting. The results showed that the main reason for purchasing dynamic lighting systems lied in the assumption that the well-being and day/night rhythmicity of residents could be improved. The majority of care professionals were not aware of the reasons why dynamic lighting systems were installed. Despite positive subjective ratings of the dynamic lighting systems, no data were collected by the organizations to evaluate the effectiveness of the lighting. Although the care professionals stated that they did not see any large positive effects of the dynamic lighting systems on the residents and their own work situation, the majority appreciated the dynamic lighting systems more than the old situation. The light values measured in the care facilities did not exceed the minimum threshold values reported in the literature. Therefore, it seems illogical that the dynamic lighting systems installed in the researched care facilities will have any positive health effects.

BACKGROUND: At present, persons with dementia and their family caregivers in the Netherlands are not adequately supported to modify their dwellings to match their personal needs. OBJECTIVE: To facilitate aging-in-place for persons with dementia, a website was designed. METHODS: The website was designed with persons with dementia and their spouses. In consultation sessions existing websites were discussed. Based on this discussion, a demonstration website was created and then discussed with and judged by the participants. Visits to the website were monitored using Google Analytics. RESULTS: Participants prefer a website that is easy to print. In addition, the navigation menu should have a maximum of three levels, and the website menu should be positioned on the left. Participants dislike the use of meaningless photographs because these do not add any value to the information given. CONCLUSIONS: Participants prefer a website that is as accessible as reading a book. Some differences are related to culture, such as the participants dislike for the use of English terms. Therefore, preferences or dislikes of items on a website could not be generalized as such. However, the preferences and dislikes may provide useful input for the design process of an appropriate website.

Over 40% of nursing home residents in the Netherlands are estimated to have visual impairments. In this study, light conditions in Dutch nursing homes were assessed in terms of horizontal and vertical illuminances and colour temperature. Results showed that in the seven nursing homes vertical illuminances in common rooms fell significantly below the 750 lx reference value in at least 65% of the measurements. Horizontal illuminance measurements in common rooms showed a similar pattern. At least 55% of the measurements were below the 750 lx threshold. The number of measurements at the window zone was significantly higher than the threshold level of 750 lx. Illuminances in the corridors fell significantly below the 200 lx threshold in at least three quarters of the measurements in six of the seven nursing homes. The colour temperature of light fell significantly below the reference value for daylight of 5000 K with median scores of 3400 to 4500 K. A significant difference in colour temperature was found between recently constructed nursing homes and some older homes. Lighting conditions of the examined nursing homes were poor. With these data, nursing home staff have the means to improve the lighting conditions, for instance, by encouraging residents to be seated next to a window when performing a task or during meals.

The vast majority of older adults want to remain living independently at home, with or without a sufficient amount of professional home care, even when overall health is starting to decline. The ageing of society and the increase in the number of very old elders goes together with an increase in the number of people with dementia. About two thirds of the diagnosed people in the Netherlands live at home. Dementia has severe implications to the quality of daily life, in particular to independent functioning. This sets extra demands to living environments. Older adults with dementia and their partners ask for living environments that support independence, compensate for declining vitality, and lower the burden of family care. For this purpose, a first concept of a design for a dementia dwelling is presented in this paper, which incorporates modifications in terms of architecture, interior design, the indoor environment, and technological solutions. These design features were derived from literature search and focus group sessions. Current design guidelines are frequently based on practical experience only, and therefore, more systematic field research should be carried out to find evidence for the various design modifications. Also, it needs to be studied how the design features of the dementia dwelling can be incorporated into the existing housing stock.

The design of healthcare facilities is a complex and dynamic process, which involves many stakeholders each with their own set of needs. In the context of healthcare facilities, this complexity exists at the intersection of technology and society because the very design of these buildings forces us to consider the technology-human interface directly in terms of living-space, ethics and social priorities. In order to grasp this complexity, current healthcare design models need mechanisms to help prioritize the needs of the stakeholders. Assistance in this process can be derived by incorporating elements of technology philosophy into existing design models. In this article, we develop and examine the Inclusive and Integrated Health Facilities Design model (In2Health Design model) and its foundations. This model brings together three existing approaches: (i) the International Classification of Functioning, Disability and Health, (ii) the Model of Integrated Building Design, and (iii) the ontology by Dooyeweerd. The model can be used to analyze the needs of the various stakeholders, in relationship to the required performances of a building as delivered by various building systems. The applicability of the In2Health Design model is illustrated by two case studies concerning (i) the evaluation of the indoor environment for older people with dementia and (ii) the design process of the redevelopment of an existing hospital for psychiatric patients.

Purpose Worldwide, there are 30 million people with dementia (PWD) in 2009 and 100 million in 2050, respectively.These numbers show the need for a change in care for PWD. Leisure is one of these care aspects. Leisure activities can support PWD in several ways: meeting basic needs, providing comfort and social interaction, and reducing boredom, agitation, and isolation1. An exemplary activity targeted at meeting these needs is ‘De Klessebessers (KB)’ (The Chitchatters), which aims to stimulate social interaction among PWD and provide comfort with supporting technology2. This is innovative since technology for PWD generally concentrates on safety and monitoring activities3 . The activity comprises a radio, television, telephone, and treasure box. Method This study’s focus follows from the original aim of the KB-designers; to stimulate social interaction. In a nursing home and day care centre, the KB game was played with different groups of PWD (n=21: 12 females, 9 males, mean MMSE=17, range 3-28). In the morning KB (with technology), and in the afternoon an activity called ‘Questiongame’ (without technology) were played for 45 minutes. These activities were played twice in a two-month period, and outcomes were compared in terms of impact on social interaction. Group sizes ranged from 3 to 8 PWD assisted by 1 or 2 activity therapists. Two researchers observed the players during the activity with the Oshkosh Social Behavior Coding (OSBC) scale, which encompasses both verbal and nonverbal social and nonsocial behaviour. These behaviours can have a person-initiated and otherinitiated character (quantitative study)4. A total of 6 activity therapists were interviewed on the KB afterwards (qualitative study). Results & Discussion The quantitative results showed significantly higher scores for KB for the total of social interaction compared to Questiongame. Most of the behaviour is other-initiated (activity therapist). PWD with a lower MMSE score showed more non-verbal behaviour. For PWD with a MMSE score below 7, there was no difference in social interaction between the two activities. According to the qualitative research, KB triggered more social interaction, since the movies and music were stimulating the players to initiate a conversation, to which other players responded. The results of this research correspond with earlier research, which concludes that leisure activities with technology can show positive results on well-being5.

Thermal comfort -the state of mind, which expresses satisfaction with the thermal environment- is an important aspect of the building design process as modern man spends most of the day indoors. This paper reviews the developments in indoor thermal comfort research and practice since the second half of the 1990s, and groups these developments around two main themes; (i) thermal comfort models and standards, and (ii) advances in computerization. Within the first theme, the PMV-model (Predicted Mean Vote), created by Fanger in the late 1960s is discussed in the light of the emergence of models of adaptive thermal comfort. The adaptive models are based on adaptive opportunities of occupants and are related to options of personal control of the indoor climate and psychology and performance. Both models have been considered in the latest round of thermal comfort standard revisions. The second theme focuses on the ever increasing role played by computerization in thermal comfort research and practice, including sophisticated multi-segmental modeling and building performance simulation, transient thermal conditions and interactions, thermal manikins.

Providing leisure to people with dementia is a serious challenge, for health care professionals and designers and engineers of products used for activity sessions. This article describes the design process of ‘‘the Chitchatters,’’ a leisure game for a group of people with dementia in day care centers. The game aims to stimulate social interaction among people with dementia. Different stakeholders, such as older adults with dementia, their relatives and care professionals were involved in the design process via qualitative research methods as participant observation and the use of probes. These methods were applied to give the design team insight into the experiential world of people with dementia. This article presents how design insights from practice and literature can be translated into a real design for a leisure product for group use by older people with dementia, and shows designers how to work with, and design for, special groups.