Background There is emerging agreement that living in a home designed to support healthy cognitiv... more Background There is emerging agreement that living in a home designed to support healthy cognitive ageing can enable people to live better with dementia and cognitive change. However, existing literature has used a variety of outcome measures that have infrequently been informed by the perspectives of older people or of professional in design and supply of housing. The DesHCA (Designing Homes for Healthy Cognitive Ageing) study aimed to identify outcomes that were meaningful for these groups and to understand their content and meanings. Methods A presurvey of older people and housing professionals (n = 62) identified potential outcomes. These were then used in three rounds of a modified e-Delphi exercise with a panel of older people and housing professionals (n = 74) to test meanings and identify areas of agreement and disagreement. Descriptive statistics were used to present findings from previous rounds. Results The survey confirmed a wide range of possible outcomes considered important. Through the e-Delphi rounds, panellists prioritised outcomes relating to living at home that could be influenced by design, and clarified their understanding of the meanings of outcomes. In subsequent rounds, they commented on earlier results. The exercise enabled five key outcome areas to be identified-staying independent, feeling safe, living in an adaptable home, enabling physical activity and enabling enjoyed activities-which were then tested for their content and applicability in panellists' views. Conclusion The five key outcome areas appeared meaningful to panellists, whilst also demonstrating nuanced meanings. They indicate useful outcomes for future research, though will require careful definition in each case to become measures. Importantly, they are informed by the views of those most immediately affected by better or poorer home design.
International journal of environmental research and public health/International journal of environmental research and public health, Mar 5, 2024
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
cardiovascular disease have highlighted its role in this system. We investigated a relation of Pu... more cardiovascular disease have highlighted its role in this system. We investigated a relation of Pulse Pressure with 25-hydroxyvitamin D (25(OH)D) in a population of elderly subjects with diagnosis of Alzheimer’s disease. We studied the relationship between arterial stiffness and 25(OH)D assessed by pulse pressure in 122 (F 77% age 78,8+ 5,21 years) consecutive elderly patients attending our Memory Clinics with diagnosis of Alzheimer’s disease. In our population hypovitaminosis D was present in 100%; 96 patients (78,7%) had 25(OH)D serum levels inferior to 20 ng/ml; 26 (21,3%) patients between 20 and 30 ng/ml. In our study we find that pulse pressure is inversely correlated with 25 (OH)D (Figure 1, r1⁄4 0,553, P1⁄40,000). After adjustment for age, gender, systolic blood pressure, cardiovascular diseases, and antihypertensive therapy, a significant relationship was observed between pulse pressure and 25(OH) (b1⁄4 -0,524; p1⁄40,000). Our results showed a relationship between Pulse Pressure and 25(OH)D suggesting that 25(OH) D could be involved in the onset of arterial remodelling. Certainly our results need confirmation with prospective studies, but this study could open theway to perform other investigations to better explore the correlation between arterial stiffness and vitamin D.
Lifestyle monitoring systems, intelligent proactive systems incorporating passive monitoring capa... more Lifestyle monitoring systems, intelligent proactive systems incorporating passive monitoring capabilities and allowing contemporaneous remote access to data promise potential benefits to service providers, service users and their carers and families and those engaged in ageing research. Research to date has focused primarily on technical issues, generally at the expense of detailed consideration of the ethical issues raised by these systems.
This review explores debates concerning the costs of long-term care for older people, and aims to... more This review explores debates concerning the costs of long-term care for older people, and aims to give an overview of the recent and current research agenda in this area, referring primarily to work published 2000-2006. The focus of much work is on the identification of costs, their distribution and the contexts of policy and delivery of services in which these operate. Live debates concern future costs, their control and related issues of social justice and equity. A particular focus of recent work has been potential international lessons. For example, Harrington et al. (2002) and Schunk and Estes (2001) consider the transferability of the German long-term care financing model to the USA and a number of cross national surveys have been published (e.g. OECD, 2005). There are of course significant issues attached to comparability of research findings and the potential transferability of policies between different welfare and fiscal regimes. The most fruitful comparisons to date have involved countries more similar in terms of economic development, and this review focuses on OECD countries. In low-income, less developed economies, issues are significantly different (HelpAge International, 2002). Predicting future costs Uncertainties in predicting the future costs of long-term care have been a recurrent theme. OECD (2005: 31) describes prediction as an 'art', whilst indicating that recent work is increasingly identifying key drivers of changing costs. For example, Comas-Herrera et al.'s (2006) projections for Germany, Italy, Spain and the UK suggest that costs may double between 2000 and 2050, but they caution that the figures are sensitive to a number of key factors, including numbers of older people, levels of disability, the availability of informal care, the real costs of services and models of care in operation. Furthermore, they emphasise that calculating the full costs of care is a complex matter. Their study built on earlier work in England (Pickard et al., 2000; Wittenberg et al., 2001) which concluded that the sensitivity of future long-term care expenditure projections to a wide range of factors meant that policy makers needed to 'plan for uncertainty' (Wittenberg et al. 2001: 15). In addition, it is important to note that researchers have varied in their consideration of total costs as compared with costs to the public purse. Most frequently, the concern is with the latter. Jagger et al. (2006) in background research conducted for the Wanless (2006) review of social care in the UK note a key issue in cost prediction, that of assumptions about
We would like to thank the participants in this project for their contributions, including the pa... more We would like to thank the participants in this project for their contributions, including the participants in interviews and focus groups, who gave generously of their time and experience. Professor Cherry Rowlings provided specialist input on adult protection issues. BMEEG (the Black and Minority Ethnic Elders Group) Scotland were supportive throughout, and the Research Advisory Group, Ann Ferguson, Helena Scott, Sue Tester and Pek Yeoung Berry, provided invaluable advice. Jennifer Gordon provided secretarial support, for which we are most grateful. The research was funded by the Big Lottery Fund. Age Concern Scotland were the lead organisation. We are most grateful for this essential support.
Except where otherwise noted, this work is licensed under a Creative Commons Attribution 4.0 Lice... more Except where otherwise noted, this work is licensed under a Creative Commons Attribution 4.0 Licence (CC BY 4.0). Anyone may reproduce, distribute, translate and create derivative works of this book (for both commercial and noncommercial purposes), subject to full attribution to the original publication and authors. The full terms of this licence may be AAL technologies, 28 Activities of daily living (ADLs),
Despite much emphasis on the potential of assistive technologies of many varieties to deliver cos... more Despite much emphasis on the potential of assistive technologies of many varieties to deliver cost effective ways of supporting people with dementia, and clear indications of this potential, rigorous cost-effectiveness studies of these technologies for this group remain largely absent. The review includes consideration of the indicative evidence. This report describes the process and results of the literature review. Extensive searches identified a large literature, of which 59 items were systematically reviewed and quality assessed.
Except where otherwise noted, this work is licensed under a Creative Commons Attribution 4.0 Lice... more Except where otherwise noted, this work is licensed under a Creative Commons Attribution 4.0 Licence (CC BY 4.0). Anyone may reproduce, distribute, translate and create derivative works of this book (for both commercial and noncommercial purposes), subject to full attribution to the original publication and authors. The full terms of this licence may be AAL technologies, 28 Activities of daily living (ADLs),
Increased physical activity is widely promoted as beneficial for older people, but previous resea... more Increased physical activity is widely promoted as beneficial for older people, but previous research indicates this may be difficult to implement in care homes, especially for people with dementia who form an increasing proportion of residents. Care home cultures can mitigate against physical activity for residents, but there is also scope for them to embed personalised physical activity. They are under-researched, but significant in terms of outcomes and quality of life for residents. This paper builds understanding of care home cultures of physical activity through qualitative, empirical research in five care homes. Key findings are that culturally framed views about physical activity, sometimes reflecting stereotypical views of dependency, can be seen in care homes. Managers, staff and residents may be invested in or resistant to physical activity and dominant managerial or societal views may be reflected or contested. The relatively closed boundaries of care homes reinforce sede...
The data consists of outputs from the network activity which describe the project and summarise t... more The data consists of outputs from the network activity which describe the project and summarise the lessons learned. Please check related resources.
The collaborative network who carried out this study would like to thank the PANICOA customer gro... more The collaborative network who carried out this study would like to thank the PANICOA customer group and advisory group for commissioning the work and for their interest and helpful input to the project. The network gratefully acknowledge the generous contributions of time, interest, support and experiences from all the organisations and individuals involved in contextual interviews and in recruiting care homes. We are very grateful for the considerable commitment of people living in care homes, relatives of people living in care homes, care staff, care home managers and care home owners. Without their interest, time, effort and help this research would not have been possible. We would like to thank the people who took part, as relatives and carers, care home residents and care providers, in the Panel Groups.
Background There is emerging agreement that living in a home designed to support healthy cognitiv... more Background There is emerging agreement that living in a home designed to support healthy cognitive ageing can enable people to live better with dementia and cognitive change. However, existing literature has used a variety of outcome measures that have infrequently been informed by the perspectives of older people or of professional in design and supply of housing. The DesHCA (Designing Homes for Healthy Cognitive Ageing) study aimed to identify outcomes that were meaningful for these groups and to understand their content and meanings. Methods A presurvey of older people and housing professionals (n = 62) identified potential outcomes. These were then used in three rounds of a modified e-Delphi exercise with a panel of older people and housing professionals (n = 74) to test meanings and identify areas of agreement and disagreement. Descriptive statistics were used to present findings from previous rounds. Results The survey confirmed a wide range of possible outcomes considered important. Through the e-Delphi rounds, panellists prioritised outcomes relating to living at home that could be influenced by design, and clarified their understanding of the meanings of outcomes. In subsequent rounds, they commented on earlier results. The exercise enabled five key outcome areas to be identified-staying independent, feeling safe, living in an adaptable home, enabling physical activity and enabling enjoyed activities-which were then tested for their content and applicability in panellists' views. Conclusion The five key outcome areas appeared meaningful to panellists, whilst also demonstrating nuanced meanings. They indicate useful outcomes for future research, though will require careful definition in each case to become measures. Importantly, they are informed by the views of those most immediately affected by better or poorer home design.
International journal of environmental research and public health/International journal of environmental research and public health, Mar 5, 2024
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
cardiovascular disease have highlighted its role in this system. We investigated a relation of Pu... more cardiovascular disease have highlighted its role in this system. We investigated a relation of Pulse Pressure with 25-hydroxyvitamin D (25(OH)D) in a population of elderly subjects with diagnosis of Alzheimer’s disease. We studied the relationship between arterial stiffness and 25(OH)D assessed by pulse pressure in 122 (F 77% age 78,8+ 5,21 years) consecutive elderly patients attending our Memory Clinics with diagnosis of Alzheimer’s disease. In our population hypovitaminosis D was present in 100%; 96 patients (78,7%) had 25(OH)D serum levels inferior to 20 ng/ml; 26 (21,3%) patients between 20 and 30 ng/ml. In our study we find that pulse pressure is inversely correlated with 25 (OH)D (Figure 1, r1⁄4 0,553, P1⁄40,000). After adjustment for age, gender, systolic blood pressure, cardiovascular diseases, and antihypertensive therapy, a significant relationship was observed between pulse pressure and 25(OH) (b1⁄4 -0,524; p1⁄40,000). Our results showed a relationship between Pulse Pressure and 25(OH)D suggesting that 25(OH) D could be involved in the onset of arterial remodelling. Certainly our results need confirmation with prospective studies, but this study could open theway to perform other investigations to better explore the correlation between arterial stiffness and vitamin D.
Lifestyle monitoring systems, intelligent proactive systems incorporating passive monitoring capa... more Lifestyle monitoring systems, intelligent proactive systems incorporating passive monitoring capabilities and allowing contemporaneous remote access to data promise potential benefits to service providers, service users and their carers and families and those engaged in ageing research. Research to date has focused primarily on technical issues, generally at the expense of detailed consideration of the ethical issues raised by these systems.
This review explores debates concerning the costs of long-term care for older people, and aims to... more This review explores debates concerning the costs of long-term care for older people, and aims to give an overview of the recent and current research agenda in this area, referring primarily to work published 2000-2006. The focus of much work is on the identification of costs, their distribution and the contexts of policy and delivery of services in which these operate. Live debates concern future costs, their control and related issues of social justice and equity. A particular focus of recent work has been potential international lessons. For example, Harrington et al. (2002) and Schunk and Estes (2001) consider the transferability of the German long-term care financing model to the USA and a number of cross national surveys have been published (e.g. OECD, 2005). There are of course significant issues attached to comparability of research findings and the potential transferability of policies between different welfare and fiscal regimes. The most fruitful comparisons to date have involved countries more similar in terms of economic development, and this review focuses on OECD countries. In low-income, less developed economies, issues are significantly different (HelpAge International, 2002). Predicting future costs Uncertainties in predicting the future costs of long-term care have been a recurrent theme. OECD (2005: 31) describes prediction as an 'art', whilst indicating that recent work is increasingly identifying key drivers of changing costs. For example, Comas-Herrera et al.'s (2006) projections for Germany, Italy, Spain and the UK suggest that costs may double between 2000 and 2050, but they caution that the figures are sensitive to a number of key factors, including numbers of older people, levels of disability, the availability of informal care, the real costs of services and models of care in operation. Furthermore, they emphasise that calculating the full costs of care is a complex matter. Their study built on earlier work in England (Pickard et al., 2000; Wittenberg et al., 2001) which concluded that the sensitivity of future long-term care expenditure projections to a wide range of factors meant that policy makers needed to 'plan for uncertainty' (Wittenberg et al. 2001: 15). In addition, it is important to note that researchers have varied in their consideration of total costs as compared with costs to the public purse. Most frequently, the concern is with the latter. Jagger et al. (2006) in background research conducted for the Wanless (2006) review of social care in the UK note a key issue in cost prediction, that of assumptions about
We would like to thank the participants in this project for their contributions, including the pa... more We would like to thank the participants in this project for their contributions, including the participants in interviews and focus groups, who gave generously of their time and experience. Professor Cherry Rowlings provided specialist input on adult protection issues. BMEEG (the Black and Minority Ethnic Elders Group) Scotland were supportive throughout, and the Research Advisory Group, Ann Ferguson, Helena Scott, Sue Tester and Pek Yeoung Berry, provided invaluable advice. Jennifer Gordon provided secretarial support, for which we are most grateful. The research was funded by the Big Lottery Fund. Age Concern Scotland were the lead organisation. We are most grateful for this essential support.
Except where otherwise noted, this work is licensed under a Creative Commons Attribution 4.0 Lice... more Except where otherwise noted, this work is licensed under a Creative Commons Attribution 4.0 Licence (CC BY 4.0). Anyone may reproduce, distribute, translate and create derivative works of this book (for both commercial and noncommercial purposes), subject to full attribution to the original publication and authors. The full terms of this licence may be AAL technologies, 28 Activities of daily living (ADLs),
Despite much emphasis on the potential of assistive technologies of many varieties to deliver cos... more Despite much emphasis on the potential of assistive technologies of many varieties to deliver cost effective ways of supporting people with dementia, and clear indications of this potential, rigorous cost-effectiveness studies of these technologies for this group remain largely absent. The review includes consideration of the indicative evidence. This report describes the process and results of the literature review. Extensive searches identified a large literature, of which 59 items were systematically reviewed and quality assessed.
Except where otherwise noted, this work is licensed under a Creative Commons Attribution 4.0 Lice... more Except where otherwise noted, this work is licensed under a Creative Commons Attribution 4.0 Licence (CC BY 4.0). Anyone may reproduce, distribute, translate and create derivative works of this book (for both commercial and noncommercial purposes), subject to full attribution to the original publication and authors. The full terms of this licence may be AAL technologies, 28 Activities of daily living (ADLs),
Increased physical activity is widely promoted as beneficial for older people, but previous resea... more Increased physical activity is widely promoted as beneficial for older people, but previous research indicates this may be difficult to implement in care homes, especially for people with dementia who form an increasing proportion of residents. Care home cultures can mitigate against physical activity for residents, but there is also scope for them to embed personalised physical activity. They are under-researched, but significant in terms of outcomes and quality of life for residents. This paper builds understanding of care home cultures of physical activity through qualitative, empirical research in five care homes. Key findings are that culturally framed views about physical activity, sometimes reflecting stereotypical views of dependency, can be seen in care homes. Managers, staff and residents may be invested in or resistant to physical activity and dominant managerial or societal views may be reflected or contested. The relatively closed boundaries of care homes reinforce sede...
The data consists of outputs from the network activity which describe the project and summarise t... more The data consists of outputs from the network activity which describe the project and summarise the lessons learned. Please check related resources.
The collaborative network who carried out this study would like to thank the PANICOA customer gro... more The collaborative network who carried out this study would like to thank the PANICOA customer group and advisory group for commissioning the work and for their interest and helpful input to the project. The network gratefully acknowledge the generous contributions of time, interest, support and experiences from all the organisations and individuals involved in contextual interviews and in recruiting care homes. We are very grateful for the considerable commitment of people living in care homes, relatives of people living in care homes, care staff, care home managers and care home owners. Without their interest, time, effort and help this research would not have been possible. We would like to thank the people who took part, as relatives and carers, care home residents and care providers, in the Panel Groups.
Uploads
Papers by Alison Bowes