The previous section focussed on elderly patients with dementia but we also wanted to feature some ideas that sought to enhance the lives of the broader older population in our communities. Activity wristbands like Fitbit and Jawbone are now commonplace amongst the fitness-conscious. Silmee W20 and W21 developed by Toshiba work on a similar principle but is aimed specifically towards the elderly. According to PSFK, the band includes a skin temperature sensor, pulse monitor, ultraviolet light sensor, accelerometer and an emergency button in case of accidents or general distress. The batteries can last for two weeks without needing to be recharged
This is just another example of a running theme from the previous few sections that show just how much thought and development the Japanese are putting into enhancing the safety and independence of their senior citizens.
So many activities that we have come across aimed at the elderly are designed with the purpose of encouraging interaction. We love the idea pioneered by the “Creature Teachers” in the UK. They are animal specialists and zoologists who visit nursing homes bringing a range of furry (and not so furry) animals with them. Residents are able to touch a snake, be tickled by a millipede’s legs, have a barn owl fly to them, and cuddle a raccoon. There have been reports of tears of joy and whoops of laughter. Unsurprisingly care home staff and family members are delighted by how much happiness these elderly patients seem to be experiencing.
For those nursing homes who don’t actually want to bring the zoo indoors – the next best thing might be some two-legged creatures. It is estimated that 43% of the elderly population in the US experiences social isolation. This does not mean that they necessarily live alone but they may experience a lack of personal attention. One retirement home in the US has come up with an ingenious idea for dealing with this. Providence Mount St Vincent in Seattle is home to more than 400 residents. It is also the location of a pre-school. The children range in ages from infants to 5-year olds. Five days a week, the children and residents come together for a variety of planned activities such as music, dancing, art, lunch, storytelling or just visiting. This so-called Intergenerational Learning Centre is now the subject of a film called “Present Perfect.” Film-maker Evan Briggs said that residents did a “complete transformation in the presence of the children. Moments before the kids came in, sometimes the people seemed half alive, sometimes asleep. It was a depressing scene. As soon as the kids walked in for art or music or making sandwiches for the homeless or whatever the project that day was, the residents came alive.”
The Providence Mount St Vincent highlights the importance and impact of meaningful social interactions. And that is one of the key principles behind Dutch not-for-profit homecare firm, Buurtzorg. It is not a new venture (it was set up in 2007) but it has recently gained a lot of press and industry attention because of the way it has structured itself in order to meet the needs of the ageing population. A District Nurse for Buurtzorg is likely to carry out a relatively small number of home visits a day but the number and type of activities carried out with the patient tend to go far beyond normal clinical tasks. On one accompanied visit with the BBC, the nurse started by cleaning up the kitchen, checking the fridge, throwing out old food, feeding the cat. She then had coffee and breakfast with the patient before discussing and preparing their medication needs for the coming week. After that she helped to wash and dress the patient and even helped them to apply their make-up. The atmosphere is not rushed in any way – it’s calm, respectful, gentle. According to the BBC reporter, the idea is that “in one single unhurried visit a highly trained nurse can accomplish much more than several health and homecare workers popping in to do their allotted tasks.” The nurses like it because not only are their tasks more varied but they have a much closer relationships with their patients.
Nurses work in teams of 10 and are entirely self-managed. They also work with GPs as well as other networks e.g. families, friends and volunteers. As one nurse says “It’s all about having contact with people, sharing experiences and that’s what people need, and it makes them feel better.” Research into this way of working has found higher levels of patient satisfaction and critically, significant reduction in the costs of care provision. These reductions in costs have come as a result of limiting managerial structure and bureaucracy. They have also managed to achieve a 50% reduction in hours of care due to reasons such as the promotion of self-care and patient independence. This is all incredibly positive but the ability to ‘lift and drop’ this solution into other countries is limited by all sorts of issues not least institutional, regulatory, financial and cultural. Guy’s and St Thomas’s NHS Foundation Trust in the UK is looking to run a pilot which many are eager to observe. There is no doubt that Buurtzorg is philosophically appealing – the challenge is how to make it work.
For the fifth section of this trendsletter click here. Alternatively you can download your full PDF edition of TMI-Spy Health Winter 2015 here or you can also email [email protected] to receive your copy straight into your inbox.