Joost van Hoof

Factors influencing acceptance of technology for aging in place: A systematic review

PURPOSE To provide an overview of factors influencing the acceptance of electronic technologies that support aging in place by community-dwelling older adults. Since technology acceptance factors fluctuate over time, a distinction was made between factors in the pre-implementation stage and factors in the post-implementation stage. METHODS A systematic review of mixed studies. Seven major scientific databases (including MEDLINE, Scopus and CINAHL) were searched. Inclusion criteria were as follows: (1) original and peer-reviewed research, (2) qualitative, quantitative or mixed methods research, (3) research in which participants are community-dwelling older adults aged 60 years or older, and (4) research aimed at investigating factors that influence the intention to use or the actual use of electronic technology for aging in place. Three researchers each read the articles and extracted factors. RESULTS Sixteen out of 2841 articles were included. Most articles investigated acceptance of technology that enhances safety or provides social interaction. The majority of data was based on qualitative research investigating factors in the pre-implementation stage. Acceptance in this stage is influenced by 27 factors, divided into six themes: concerns regarding technology (e.g., high cost, privacy implications and usability factors); expected benefits of technology (e.g., increased safety and perceived usefulness); need for technology (e.g., perceived need and subjective health status); alternatives to technology (e.g., help by family or spouse), social influence (e.g., influence of family, friends and professional caregivers); and characteristics of older adults (e.g., desire to age in place). When comparing these results to qualitative results on post-implementation acceptance, our analysis showed that some factors are persistent while new factors also emerge. Quantitative results showed that a small number of variables have a significant influence in the pre-implementation stage. Fourteen out of the sixteen included articles did not use an existing technology acceptance framework or model. CONCLUSIONS Acceptance of technology in the pre-implementation stage is influenced by multiple factors. However, post-implementation research on technology acceptance by community-dwelling older adults is scarce and most of the factors in this review have not been tested by using quantitative methods. Further research is needed to determine if and how the factors in this review are interrelated, and how they relate to existing models of technology acceptance.

Supportive living environments: A first concept of a dwelling designed for older adults with dementia

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.

Designing Leisure Products for People With Dementia: Developing ‘‘the Chitchatters’’ Game

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.

The integrated and evidence-based design of healthcare environments

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.

Designing a “Think-Along Dwelling” for People With Dementia: A Co-Creation Project Between Health Care and the Building Services Sector

Ageing-in-place is the preferred way of living for older individuals in an ageing society. It can be facilitated through architectural and technological solutions in the home environment. Dementia poses additional challenges when designing, constructing, or retrofitting housing facilities that support ageing-in-place. Older adults with dementia and their partners ask for living environments that support independence, compensate for declining and vitality, and lower the burden of family care. This study reports the design process of a demonstration home for people with dementia through performing a literature review and focus group sessions. This design incorporates modifications in terms of architecture, interior design, the indoor environment, and technological solutions. Current design guidelines are frequently based on small-scale studies, and, therefore, more systematic field research should be performed to provide further evidence for the efficacy of solutions. The dwellings of people with dementia are used to investigate the many aspects of supportive living environments for older adults with dementia and as educational and training settings for professionals from the fields of nursing, construction, and building services engineering.

Understanding the Nintendo Wii and Microsoft Kinect consoles in long-term care facilities

In recent years video game consoles, such as the Nintendo Wii TM and the Microsoft Kinect TM , have been introduced into residential facilities. This paper presents a review of current studies documenting the benefits and detriments the Wii could have on adults aged 60 years and over in residential facilities, concentrating on the common uses of the Wii in care facilities: maintaining physical fitness, promoting mental well-being, encouraging social interaction and both physical and mental rehabil- itation. Furthermore, this paper discusses the potential use of the Microsoft Kinect in care for older persons. The Wii can have a positive impact on the physical and mental health of older adults living in care facilities, but additional work should still be conducted, including assessing the use of games outside of Wii Sports and Wii Fit and possible non-gaming application of the Wii in care for older adults. Results for the Wii display potential for use of the Kinect in care facilities but further exploration is required to assess the potential physical impact and interaction viability.

Handbook of Smart Homes, Health Care and Well-Being

Smart homes, home automation and ambient-assisted living are terms used to describe technological systems that enrich our living environment and provide means to support care, facilitate well-being and improve comfort. This handbook provides an overview of the domain from the perspective of health care and technology. In Part 1, we set out to describe the demographic changes in society, including ageing and diseases and impairments which lead to the needs for technological solutions. In Part 2, we describe the technological solutions, ranging from sensor-based networks, components, to communication protocols that are used in the design of smart homes. We also deal will biomedical features which can be measured and services that can be delivered to end-users as well as the use of social robots. In Part 3, we present best practices in the field. These best practices mainly focus on existing projects in Europe, the USA and Asia, in which people receive help through dedicated technological solutions being part of the continuum of the home environment and care.

Shedding a light on phototherapy studies with people having dementia: a critical review of the methodology from a light perspective

Light therapy is applied to older people with dementia as a treatment to reset the biological clock, to improve the cognitive functioning, and to reduce behavioral symptoms. Although the methodological quality of light therapy studies is essential, many aspects concerning the description of the lighting applied are missing. This study reviewed light therapy studies concerning the effects on people with dementia as a way to check the methodological quality of the description of light from a light engineering perspective. Twelve studies meeting the inclusion criteria were chosen for further analysis. Each study was scored on a list of aspects relevant to a proper description of lighting aspects. The overview demonstrates that the overall quality of the methodologies is poor. The studies describe the lighting insufficiently and not in the correct metrics. The robustness of light therapy studies can be improved by involving a light engineer or specialist.

Dynamic lighting systems in psychogeriatric care facilities in the Netherlands : a quantitative and qualitative analysis of stakeholders’ responses and applied technology

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.

Real Estate for the Ageing Society – the Perspective of a New Market

Abstract Currently, one of the key challenges on a global scale is the issue of an ageing society. The UN predicts that the number of people aged 60 and over will double by 2050 and treble by 2100. In the coming years, the demand for real estate that addresses the specific needs of older people will increase both qualitatively and quantitatively. Therefore, two main questions arise: What are the architectural features of real estate required to accommodate for the needs of an ageing society? Which European Union countries seem to have the highest and lowest potential to create a segment of the real estate market focused on older people? This paper contains a research overview in the field of the built environment for older people and case studies of different policies established by public authorities from past decades. The potential for real estate for an ageing society in EU countries was determined on the basis of variables collected by the UNECE. The results also enable assumptions to be made on which factors may influence future development in this area. Due to global climate changes combined with the urbanization process and resulting deterioration of air quality, heat island effect or poor accessibility to open areas, the ageing society will have to face the problem of adapting to these new conditions. Therefore, the authors assume that this will have a significant impact on the relocation of this age group on the real estate market in the future. The conclusions of the research contribute to general discussion on new trends in the real estate market and the assessment of future investments in real estate.