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Ageing with a disability increases the risk of hospitalization and nursing home admission. Ageing in place interventions aiming to reduce disability are often not sufficiently effective and inadequately theory-based. There are many models available on disability, but it is unclear how they define disability, what their differences are, and how they evolved throughout the years. This paper aims to provide an overview of the evolution of these models and to elaborate on the causal mechanisms of disability. A literature review was conducted as part of the TRANS-SENIOR international training and research network. PubMed and Google Scholar were searched, and snowball sampling was applied to eligible publications. Data were extracted from the included publications, and a thematic analysis was performed on the retrieved data. Overall, 29 publications were included in the final sample. All included models arose from three original models and could be divided into two types: linear models and models on the interaction between the person and the environment. Thematic analysis led to three distinct evolutionary trends: (1) from a unidirectional linear path to a multidirectional nonlinear path, (2) from the consequences of disease towards the consequences of person-environment interaction, and (3) from disability towards health and functioning. Our findings suggest that by optimizing the use of personal as well as environmental resources, and focusing on health and functioning, rather than disability, an older person's independence and wellbeing can be improved, especially while performing meaningful daily activities in accordance with the person's needs and preferences.

Due to increasing age and an increasing prevalence rate of neurocognitive disorders such as Mild Cognitive Impairment (MCI) and dementia, independent living may become challenging. The use of socially assistive robots (SARs) is one solution that can enable older adults with cognitive impairment to remain independent. However, at present, there is a lack of knowledge about the attitudes of older adults with MCI and their caregivers towards SARs. This study relies on a constructivist grounded theory approach. Semi-structured interviews were conducted to gain a deeper insight into attitudes of two different stakeholder groups; older adults with MCI and their (in)formal caregivers. Forty individual semi-structured interviews were conducted with older adults with MCI (N = 30) and (in)formal caregivers (N = 10). Data revealed different perspectives on SARs in healthcare for the involved stakeholders. Two main topics could be derived: (1) perspectives on robot assistance, discussing different viewpoints on the potential value of robots as helpers, and (2) perspectives on implementation, revealing different factors that could affect implementation. Both topics may explain a positive, impartial or negative attitude towards SARs. This study identified different factors that should be taken into account when implementing a SAR in the home environment of older adults. Despite the fact that the benefits of SARs are often recognized, many older participants currently seem not ready yet to commit to the use of a SAR.IMPLICATIONS FOR REHABILITATIONThis study explores the attitudes towards a SAR, developed to stimulate and support older adults with Mild Cognitive Impairment (MCI) on a physical, cognitive and social level.The results give a deeper insight into different factors contributing to a (non-) successful implementation of SARs in the home environment of older adults with MCI. This study explores the attitudes towards a SAR, developed to stimulate and support older adults with Mild Cognitive Impairment (MCI) on a physical, cognitive and social level. The results give a deeper insight into different factors contributing to a (non-) successful implementation of SARs in the home environment of older adults with MCI.

Ageing with a disability increases the risk of hospitalization and nursing home admission. Ageing in place interventions aiming to reduce disability are often not sufficiently effective and inadequately theory-based. There are many models available on disability, but it is unclear how they define disability, what their differences are, and how they evolved throughout the years. This paper aims to provide an overview of the evolution of these models and to elaborate on the causal mechanisms of disability. A literature review was conducted as part of the TRANS-SENIOR international training and research network. PubMed and Google Scholar were searched, and snowball sampling was applied to eligible publications. Data were extracted from the included publications, and a thematic analysis was performed on the retrieved data. Overall, 29 publications were included in the final sample. All included models arose from three original models and could be divided into two types: linear models and models on the interaction between the person and the environment. Thematic analysis led to three distinct evolutionary trends: (1) from a unidirectional linear path to a multidirectional nonlinear path, (2) from the consequences of disease towards the consequences of person–environment interaction, and (3) from disability towards health and functioning. Our findings suggest that by optimizing the use of personal as well as environmental resources, and focusing on health and functioning, rather than disability, an older person’s independence and wellbeing can be improved, especially while performing meaningful daily activities in accordance with the person’s needs and preferences. ispartof: European Journal Of Ageing vol:19 issue:3 ispartof: location:Germany status: Published online

For older people living in densely populated urban neighbourhoods, walking is an important mode of everyday mobility: it allows to engage in neighbourhood social life and can mitigate physiological decline, which is emphasised in healthy ageing discourses. However, walking is also a means through which meanings about the places of one's everyday life are (re)produced and, hence, contributes to feelings of illbeing and wellbeing. In this paper, we provide a phenomenological account of older adults' place-making practices through walking. In examining this topic, we draw on twelve walking interviews with older adults living independently in two urban neighbourhoods in the Netherlands. Our findings reveal that although our respondents developed a sense of 'insideness' through their spatial and social routes and routines, these same routes and routines also acted as exclusionary mechanisms. We argue that these 'meaningful movements', characterised by ambivalence, remain underexposed in healthy ageing discourses. Paying attention to these feelings and experiences would allow for a better understanding of the facilitators and impediments of walking in later life and its effect on social and emotional wellbeing. This paper concludes by providing implications for policy and planning practice in developing age-friendly and walkable neighbourhoods.

Introduction Home adaptation can be a key contributor to successfully aging at home, allowing older adults to remain in a familiar environment while maintaining their quality of life and well-being despite progressing functional difficulties. Although several theoretical studies on home adaptations exist, the benefits of custom home adaptations remain poorly evaluated. The present study's primary aims were to explore older adults' expectations and needs regarding home adaptations and evaluate the impact of individualized home adaptations on quality of life, fear of falling, independence, and difficulties using adapted rooms. Its secondary aim was to describe the barriers and facilitators of home adaptation. Method The 15 homes in this case series were adapted using an inclusive, interdisciplinary approach. Adaptations' effects were assessed using a parallel mixed-methods design. Quantitative and qualitative data were collected using questionnaires and semi-structured interviews. An architect and a health professional visited each home twice to assess the older adult's expectations and needs, evaluate the home's technical aspects, and co-create an adaptation plan with that study participant. They assessed the older adult's perceived quality of life, fear of falling, independence, and difficulties using the rooms needing adaptations. Inhabitants received two more visits after the adaptations (one or two months and six months later) to assess their benefits. Results Most homes had their bathroom adapted. Participants reported improved safety, independence, ease of use, positive feelings, and comfort. They also reported lower perceived levels of difficulties during the activities of daily living in the adapted rooms (reductions of 93.4% [SD = 12.7] of bathrooms and 100% of kitchens), an improvement in quality of life of 9.8% (SD = 27.6), and a reduction in fear of falling of 12.5% (SD = 9.7). Conclusion Home adaptations are beneficial to older adults' activities of daily living and improve their quality of life; however, several factors hinder the implementation of those adaptations.

In general, frailty is associated with deficits and adverse health outcomes and a low quality of life. This study was designed to get more insight into older psychologically frail peoples' Quality of Life (QoL), lived experiences and personal strategies. Data of 121 community dwelling older people, were collected between November 2015 and March 2016, using a multi-actor and mixed-method approach. Of this sample, seven high psychological frail participants who experienced or expected an improvement of their QoL were selected. Psychological frailty was measured by the Comprehensive Frailty Assessment Instrument and QoL by using numeric rating scale. For the qualitative study, semi-structured interviews were conducted. The interviews were analyzed using an interpretative phenomenological approach. Respondents pointed financial resources, good health, connectedness, and meaningful activities as determinants for their QoL. Strategies to have or maintain a good QoL in later life, when confronted with frailty, were: adequate problem solving, support seeking, cognitive restructuring and religious coping mechanisms. Older people, despite being high psychologically frail, experience or can maintain or improve their QoL. As a consequence, all people involved with psychologically frail older people are encouraged to change their view towards the relationship between frailty and QoL and to focus more on individual's strengths and abilities.

In Western welfare states, notions of age-friendly communities and ageing-in-place are increasingly important in new health policies. In the Netherlands, care reforms are modifying the former welfare state to be more participatory; local governments are seeking collaborative solutions. Municipalities and housing, care and welfare organisations in the southern part of the country developed the concept of ‘lifecycle robust neighbourhoods’, envisioned as places where older people can age-in-place. Although many scholars have used the concept ageing-in-place in their studies of neighbourhoods, we aim to unravel this concept further by exploring how this particular ageing policy plays out in practice. This paper explores what the development of ‘lifecycle robust neighbourhoods’ means in relation to notions of ageing-in-place and age-friendly communities. We used ethnography (interviews, observations and focus groups) to reveal how, on the one hand, the policy makers, housing, care and welfare directors and representatives of older people, as developers of ‘lifecycle robust neighbourhoods’ and, on the other hand, older people, give meaning to places to age-in-place. It becomes clear that ageing-in-place has a different meaning in policy discourses than in practice. While developers mainly considered place as something construable, older people emotionally attached to place through lived experiences.

Although technology has the potential to promote aging in place, the use of technology remains scarce among community-living older adults with dementia. A reason might be that many stakeholders are involved who all have a different perspective on technology use (i.e., needs, wishes, attitudes, possibilities, and difficulties). We systematically searched the literature in order to provide an overview of perspectives of different stakeholders on technology use among community-living older adults with dementia. After selection, 46 studies were included. We mainly found perspectives of informal caregivers and, to a lesser extent, of persons with dementia and formal caregivers. Perspectives of suppliers of technology were not present. Shared perspectives among persons with dementia and informal and formal caregivers were, among other things, ease of use, stability and flexibility of technology, importance of privacy, and confidentiality. We also found that among older persons, fun and pleasure, in addition to enhancing freedom and independence, facilitates technology use. Informal caregivers’ peace of mind and relief of burden also appeared to be important in using technologies. Formal caregivers value the potential of technologies to improve monitoring and communication. Insight in shared, and conflicting perspectives of stakeholders are essential to enhance the use of technology.

Background Most seniors wish to live independently for as long as possible. Gerontechnologies such as personal alarms or remote control systems, have the potential to help them age in place. For seniors, assessing what is the most appropriate technology for their aging in place needs can be difficult. Professionals specifically tasked with matching seniors’ needs with technology solutions can greatly help here. Yet not much is known about the challenges these professionals face or how they can optimize their matchmaking service. Methods Participatory action research was conducted in the Netherlands, in two phases. In phase one, ten matchmaking dialogues between municipal technology consultants and seniors were observed, followed by interviews with both technology consultants and seniors to understand the current matchmaking service. In phase two, a new matchmaking tool was co-created with technology consultants and other professionals over the course of four co-creation session. Variants of the tool were tested out in nine additional matchmaking dialogues. The Cycle of Technology Acquirement by Independent-Living Seniors (C-TAILS) model, which can be used to understand both origins and consequences of technology acquirement by independent-living seniors, was used as a theoretical lens. Results Important challenges for municipal technology consultants in their current matchmaking practice are: making the matchmaking service more demand oriented and creating an accurate and complete overview of relevant factors within the seniors’ individual situation so that an optimal match can be made. Together with technology consultants and other professionals, a new Gerontechnologies Matchmaking (GTM) tool was created to help overcome these challenges. Evaluation of the tool showed that it better includes each senior’s personal, social, physical and technological context, within the matchmaking service. Conclusion Professionals who help seniors match gerontechnology to their aging in place needs experience a variety of challenges in the delivery of their service. Currently, few tools are available for them to overcome these challenges. The newly developed GTM tool can help overcome challenges and optimize matchmaking services. Further testing of the tool in different contexts is needed to determine its generalizability. Electronic supplementary material The online version of this article (10.1186/s12913-018-3848-5) contains supplementary material, which is available to authorized users.

Although technology has the potential to promote aging in place, the use of technology remains scarce among community-living older adults with dementia. A reason might be that many stakeholders are involved who all have a different perspective on technology use (i.e., needs, wishes, attitudes, possibilities, and difficulties). We systematically searched the literature in order to provide an overview of perspectives of different stakeholders on technology use among community-living older adults with dementia. After selection, 46 studies were included. We mainly found perspectives of informal caregivers and, to a lesser extent, of persons with dementia and formal caregivers. Perspectives of suppliers of technology were not present. Shared perspectives among persons with dementia and informal and formal caregivers were, among other things, ease of use, stability and flexibility of technology, importance of privacy, and confidentiality. We also found that among older persons, fun and pleasure, in addition to enhancing freedom and independence, facilitates technology use. Informal caregivers' peace of mind and relief of burden also appeared to be important in using technologies. Formal caregivers value the potential of technologies to improve monitoring and communication. Insight in shared, and conflicting perspectives of stakeholders are essential to enhance the use of technology

ObjectiveTo evaluate the effects of the population-based, person-centred and integrated care service 'Embrace' at twelve months on three domains comprising health, wellbeing and self-management among community-living older people.MethodsEmbrace supports older adults to age in place. A multidisciplinary team provides care and support, with intensity depending on the older adults' risk profile. A randomised controlled trial was conducted in fifteen general practices in the Netherlands. Older adults (>= 75 years) were included and stratified into three risk profiles: Robust, Frail and Complex care needs, and randomised to Embrace or care as usual (CAU). Outcomes were recorded in three domains. The EuroQol-5D-3L and visual analogue scale, INTERMED for the Elderly Self-Assessment, Groningen Frailty Indicator and Katz-15 were used for the domain 'Health.' The Groningen Well-being Indicator and two quality of life questions measured 'Wellbeing.' The Self-Management Ability Scale and Partners in Health scale for older adults (PIH-OA) were used for 'Self-management.' Primary and secondary outcome measurements differed per risk profile. Data were analysed with multilevel mixed-model techniques using intention-to-treat and complete case analyses, for the whole sample and per risk profile.Results1456 eligible older adults participated (49%) and were randomized to Embrace (n(T0) = 747, n(T1) = 570, mean age 80.6 years (SD 4.5), 54.2% female) and CAU (n(T0) = 709, n (T1) = 561, mean age 80.8 years (SD 4.7), 55.6% female). Embrace participants showed a greater-but clinically irrelevant-improvement in self-management (PIH-OA Knowledge subscale effect size [ES] = 0.14), and a greater-but clinically relevant-deterioration in health (ADL ES = 0.10; physical ADL ES = 0.13) compared to CAU. No differences in change in wellbeing were observed. This picture was also found in the risk profiles. Complete case analyses showed comparable results.ConclusionsThis study found no clear benefits to receiving person-centred and integrated care for twelve months for the domains of health, wellbeing and self-management in community-living older adults.

‘Ageing in place’ policies presuppose that growing old in one’s own home and neighbourhood is in the best interests of older adults, as a familiar and predictable environment fosters autonomy and well-being in old age. However, discontinuities of place can challenge the relationship between older adults and their neighbourhood. This paper addresses the impact of neighbourhood transitions on older adults’ sense of belonging in the Netherlands by exploring how they deal with changes in the neighbourhood in their everyday life. The context of this qualitative research is a former working-class neighbourhood in the process of urban renewal. Our findings show how a sense of belonging is negotiated in relation to everyday places and interactions within the neighbourhood, providing a sense of continuity despite neighbourhood change.