Francesco Barbabella

Towards an Impact Assessment Framework for ICT-Based Systems Supporting Older People: Making Evaluation Comprehensive Through Appropriate Concepts and Metrics

Although it is internationally acknowledged that ICT-based systems have the potential to provide cost-effective services, their deployment is still limited. Through the User Centred Design, it is possible to draw up information on key concepts, such as attitude towards technology, acceptance and usability of any new products. The collected information will serve for the technological development on one side, and for the Impact Assessment Analysis on the other one, that will describe the future path of the devices. The paper describes in details the most important metrics—attitude towards technology, usability and accessibility—for conducting a prompt evaluation of a new device for the older people, suggesting common guidelines and critical issues to solve.

Towards an ambient assisted living user interaction taxonomy

Extensive research in the field of ambient assisted living (AAL) provides profound knowledge about the design of AAL systems. However, more generic design characteristics for user interaction have not been formalized for this domain yet. Thus, we propose to develop a domain specific taxonomy for the design of user interaction in AAL systems. We adopted a systematic taxonomy development approach that combines an empirical and a pseudo-conceptual strategy. Six co-researchers from different disciplines conduct the iterative research process. Next to AAL systems existing taxonomies in the field of human-computer interaction are analyzed following the Delphi method. In this paper we present our research process and preliminary results from the first iteration. The final taxonomy allows classification and should support the analysis of user interaction utilized in AAL systems. Furthermore, it can deal as a practical design guideline.

Socioeconomic Predictors of the Employment of Migrant Care Workers by Italian Families Assisting Older Alzheimer’s Disease Patients: Evidence From the Up-Tech Study

BACKGROUND The availability of family caregivers of older people is decreasing in Italy as the number of migrant care workers (MCWs) hired by families increases. There is little evidence on the influence of socioeconomic factors in the employment of MCWs. METHOD We analyzed baseline data from 438 older people with moderate Alzheimers disease (AD), and their family caregivers enrolled in the Up-Tech trial. We used bivariate analysis and multilevel regressions to investigate the association between independent variables-education, social class, and the availability of a care allowance-and three outcomes-employment of a MCW, hours of care provided by the primary family caregiver, and by the family network (primary and other family caregivers). RESULTS The availability of a care allowance and the educational level were independently associated with employing MCWs. A significant interaction between education and care allowance was found, suggesting that more educated families are more likely to spend the care allowance to hire a MCW. DISCUSSION Socioeconomic inequalities negatively influenced access both to private care and to care allowance, leading disadvantaged families to directly provide more assistance to AD patients. Care allowance entitlement needs to be reformed in Italy and in countries with similar long-term care and migration systems.

Integrated Diabetes Care Delivered by Patients – A Case Study from Bulgaria

Introduction: Increasing numbers of persons are living with multiple chronic diseases and unmet medical needs in Bulgaria. The Bulgarian ‘Diabetic care’ non-profit (DCNPO) programme aims to provide comprehensive integrated care focusing on people with diabetes and their co-morbidities. Methods: The DCNPO programme was selected as one of eight ‘high potential’ programmes in the Innovating Care for People with Multiple Chronic Conditions (ICARE4EU) project, covering 31 European countries. Data was first gathered with a questionnaire after which semi-structured interviews with project staff and participants were conducted during a site visit. Results: The programme trains diabetic patients to act as carers, case managers, self-management trainers and health system navigators for diabetic patients and their family. The programme improved care coordination and patient-centered care by offering free care delivered by a multidisciplinary team. It facilitates the collaboration between patients, volunteers, health providers and the community. Internal evaluations demonstrate reduced hospital admissions and avoidable amputations, with consequent cost savings for the health care system. Conclusion: Integrated care provided by volunteering patients can empower people suffering from diabetes and their co-morbidities and address health and social inequalities in resource-poor settings. It can also contribute to an increased trust and improved satisfaction among vulnerable patients with complex care needs.

The employment of migrant workers in Italy’s elder care : Opportunities and challenges

Welfare states are nowadays being challenged in numerous ways. Population ageing places new demands on the welfare institutions that cater to the needs of a growing number of older people. After a unified German Empire had been established in 1871, the public debate on migration in Germany concentrated on the aspect of new arrivals. The construction of homogeneity that lays behind ius sanguinis survived in legislation right up into the Federal Republic of Germany. Public controversy has undoubtedly influenced the societal climate on how migration is perceived, so that a populist vein has prevailed, where migration is seen essentially as a strain on society rather than a potentially valuable influence. Female educational background showed differences between and inside both migrant groups. In order to develop care arrangements that cater to older migrants, several working groups now exist which favour culturally sensitive old age care.

Validation of the Italian Version of the Caregiver Abuse Screen among Family Caregivers of Older People with Alzheimer's Disease

Introduction. Elder abuse is often a hidden phenomenon and, in many cases, screening practices are difficult to implement among older people with dementia. The Caregiver Abuse Screen (CASE) is a useful tool which is administered to family caregivers for detecting their potential abusive behavior. Objectives. To validate the Italian version of the CASE tool in the context of family caregiving of older people with Alzheimers disease (AD) and to identify risk factors for elder abuse in Italy. Methods. The CASE test was administered to 438 caregivers, recruited in the Up-Tech study. Validity and reliability were evaluated using Spearmans correlation coefficients, principal-component analysis, and Cronbachs alphas. The association between the CASE and other variables potentially associated with elder abuse was also analyzed. Results. The factor analysis suggested the presence of a single factor, with a strong internal consistency (Cronbachs alpha = 0.86). CASE score was strongly correlated with well-known risk factors of abuse. At multivariate level, main factors associated with CASE total score were caregiver burden and AD-related behavioral disturbances. Conclusions. The Italian version of the CASE is a reliable and consistent screening tool for tackling the risk of being or becoming perpetrators of abuse by family caregivers of people with AD.

Effectiveness of Web-Based Psychosocial Interventions for Family Caregivers of Older People: What Do We Know?

The contribution of family caregivers to long-term care of older people is a relevant issue. Family caregivers may face different psychological and social needs arising from the challenging caregiving situation. In this respect, webbased psychosocial programs are progressively being refined and demonstrating they can be effective in supporting caregivers. This commentary describes the main types of web-based interventions for family caregivers of older people and available evidence on their effectiveness. Psychoeducational, peer and multicomponent programs have been the main object of research so far and can improve, under certain conditions, psychological wellbeing and social inclusion of caregivers. General integration, user and transferability issues are also discussed and call for future research in the field.

Launching an Interdisciplinary "International Summer School on Ageing" (ISSA): Aims, Methodology, and Outcomes.

ABSTRACT Despite the increasing availability of gerontological training programs, knowledge of their contents, characteristics, methods, and outcomes remains limited. However, the transition from multidisciplinarity to interdisciplinary orientations is now fundamental to such training, providing participants from diverse academic orientations and professional backgrounds with opportunities to interact across boundaries. In response to recommendations of the European Union Futurage A road map for European ageing research (FUTURAGE, 2011) concerning training and career-development needs of future cohorts of practitioners and scholars in aging, an International Summer School on Ageing (ISSA) was developed in 2012. Its aim was to initiate the practical implementation of some of the capacity building goals identified by Futurage. The design and structure of the ISSA was informed by the experience of Canada’s Summer Programme in Ageing—run by the Institute of Aging of the Canadian Institutes of Health Research—and by the cross-border academic training activities organized by Lund University (Sweden) in Scandinavian countries. As Italy has lacked a tradition of comprehensive, interdisciplinary training programs in gerontology, the Italian National Institute of Health and Science on Ageing undertook to launch the inaugural ISSA. In this article, the core aims and methodology of the ISSA are presented, together with an analysis of its main outcomes, as measured by participant evaluations. These are discussed in the context of international debate on this topic.

Using eHealth to improve integrated care for older people with multimorbidity : Francesco Barbabella

IssueThe exploitation of eHealth tools in integrated care practices addressing multimorbidity might be a strong driver for facilitating access to the services provided to people with multiple chron ...

Filling the gap in long-term professional care through systematic migration policies : Synthesis Report

Many EU countries face the challenge of providing elderly care in the context of shortages of trained personnel. The Peer Review in Berlin (23-24 October) provided the opportunity for peer countrie ...