|Friday, June 26|
Community Elderly Care Service Models in China and Western Welfare Countries
* Zehua Wei, Tongji University, China
Jingmin Zhou, Tongji University, China
The increasing population of elderly people in recent years, put forward higher requirements for the construction of elderly daily care and spiritual comfort facilities. The realization about paying attention to the demands of the elderly is becoming an important change that is conducive to the sustainable development of society. Unlike china, Europe and America entered an aging society earlier, and the development and construction of elderly care facilities started several decades ago. The author investigated different types of elderly apartments in Canada, Netherlands, Sweden, Denmark and Shanghai, to highlight the commonalities and differences in the pension system and service models. The research methods include field investigation and interviews to examine the current status of elderly care facilities in selected countries. Compared with Ruijin Street Elderly Home in Shanghai, the research summarizes the characteristics of elderly care service models from multiple levels of functional facilities, service systems and site layout, and then analyzes experiences and shortcomings . It was found that elderly care facilities in Canada recruited and organized volunteers to provide services, which could reduce the labor costs and improve the cost-effectiveness of elderly living. The Nordic countries have effectively organized the relationship between elderly care facilities and surrounding residences, providing services through clustered care and home-based care in the communities. The elderly care facilities in Shanghai are located at the upper level of the community service center, its funding depends on continuous government’s input, and the sustainability needs to be tackled. The results of this survey can be further utilized to provide suggestions and inspirations for the construction of China's elderly care service mode and also provide references for the western countries’ care facilities design. Keywords: elderly care facilities, service models, pension system
'The reflexive researcher': a retrospective examination of processes for developing age-friendly places in India
* Mei Lan Fang, University of Dundee, United Kingdom
Judith Sixsmith, University of Dundee, United Kingdom
Ryan Woolrych, Heriot-Watt University, United Kingdom
Deborah Menezes, Heriot-Watt University, United Kingdom
Urban areas in India offer ‘transformational’ environments given the challenges and opportunities raised by rapid urbanisation and population growth, rural-urban migration and the concomitant need for institutional and infrastructural supports. Yet, the process of gathering evidence in different urban locales can be challenging––often associated with both individual and socio-cultural / environmental level factors including: socio-economic position, gender, age, socio-cultural norms, behaviours and expectations as well as neighbourhood socio-economic status, climate and the built environment. To enhance qualitative understandings of age-friendly places, this research explores individual and socio-cultural / environmental factors that can influence the evidence gathering and data interpretation phases of research, by applying reflexive and meta-reflexive techniques in the research process. Individual reflexive exercises across the research team, resulted in eight reflective summaries, which were subsequently discussed and analysed during two group meta-reflexive workshops (2-hour sessions with 17 researchers from the UK and India). Thematic analysis revealed several individual level research challenges shaped by gender issues (e.g. difficulties for women to collect data) and age discrimination (e.g. difficulties gaining trust and acquiring informed consent from older people by younger researchers); structural challenges that surround income / class disparity (e.g. discrepancies in willingness to engage across class groups); and socio-environmental challenges (e.g. gated communities, poor transportation and humid weather). Overall, applying a 2-stage individual to group reflexive analysis helped to provide for more critical understandings on how the research process, resultant data and data interpretation can be influenced by socio / structural / cultural / environmental level factors that vary across place contexts. Reflexivity is an analytical process that was demonstrated as a useful method to help researchers better understand the complex relationships that exist in the social world and how this relationship can impact place-based research.
How to identify services, amenities and features needed to create age friendly communities in Brazil
Sinval Cantarelli Xavier, Federal University of Rio Grande, Brazil
* Adriana Portella, Federal University of Pelotas, Brazil
Celina Britto Corrêa, Federal University of Pelotas, Brazil
Ryan Woolrych, Heriot-Watt University, United Kingdom
This report focuses on the presentation and analysis of data collected in cities investigated in Brazil during the second year (2018) of the project “Place-making with Older Adults: Towards Age-Friendly Communities”. Year 02 of the investigation seeks to respond to the following research question: What services, amenities and features are needed to create age friendly communities that promote healthy cities and active ageing in different urban and cultural contexts? Three World Cafe workshops were applied in the study, one in each cities of Pelotas, Belo Horizonte and Brasilia in Brazil. World Cafe is a method used for participatory research and the formation of public policies that involve local communities. Through shared activities and intersubjectivity among participants, the method seeks positive responses to problems and challenges. 20 people participated of each workshop section. The results attained through the collection of data in three Brazilian cities demonstrates that the elderly population still lack very basic ambience and urban infrastructure. In observance of the Maslow pyramid, one notes that the residents involved in participatory mapping and World Cafe still call for questions located at the base of the pyramid for human well-being, such as safety. Factors like respect, self-esteem and memory are very often weakened by the force that a lack of fundamental needs has on human beings. In all cities, the lack of security - fear of walking down the street at night, of being robber while walking or at the bus stop, is the leading issue in discussions. Many participants feel there is little need to discuss other issues, as they feel that without security, nothing else can happen in city spaces. As part of this, we note that safety, walkability, public transport, health and memory are, in this order of priority, fundamental requirements in having an age-friendly city and neighbourhoods.
Q & A
Thresholds and the intimate in domestic architecture: an historical approach of socio-spatial dynamic of the home apply to institutional environment
* Virginie LaSalle, Université de Montréal, Canada
This research addresses the meaning of domestic space and investigates the challenge of understanding the sense of home. The initial problem is the lack of signification in architectural type of institutional environment as long-term care. The main objective of the study is to propose a conceptual model of home’s dynamic providing home meaning and then elaborate strategies that operationalize the sense of home inspired by spatio-architectural characteristics. These model and strategies are then transferable through the study and conception of specialized environment. Historical models of domestic architecture lead the study, with it overarching theme of threshold as spatial device of the intimate. In this context, the character of the intimate is defined by considering the way people are engaged in social process inherent to dwelling, first in the relation of the inhabitant to the self, and second in relation with others and the architectural space. This research posits a poststructuralist orientation, which is applied to the interpretation of sense and use of architectural space of the house, from a socio-historic perspective. The meaning of home is examined through the significance of lived spaces from past and Modern eras. These spaces suggest spatial systems that represent the intimate character of domestic space, interpreted through contemporary social values at the time. A sequencing of thresholds is presented in relationship with the level of interiority of dwellings and how these become vehicles of communication as people move to and from the domestic environment. This research contributes to knowledge by formulating principles of spatial disjunction and inter-territorial mediation in domestic architecture, as fundamental device of the intimate. The research also highlights the necessity to consider institutional environment as dwelling spaces, by thinking spatial distribution and architectural composition as a threshold system supporting contemporary social values, protecting intimate spaces and supporting the sense of home.
The Effects of Spatial Continuity at Elderly Facility on the Social Participation: A Research on Behavior Setting in Dining Space
* Maiko Nagamine, Waseda University / Nagamine Architecture Office, Japan
The purpose of this study is to open the elderly facilities to the local community. In Japan's declining birthrate and aging society, the Ministry of Health, Labor and Welfare, has integrated a service that has been provided for each target, such as the elderly, disabled, and children, to realize a ` local symbiosis society. This paper is to clarify the information about behavioral settings in the two dining spaces, i.e. the dining space with spatial continuity and the conventional one. The dining spaces in elderly facilities where residents stay for a long time, can be related to local community outside the facilities. We carried on the survey from 7am to 7pm for 2 days in each facility. Here are the three important points we have concluded: (1) Residents stayed in the dining space throughout the day. (2) In the facility with a high degree of independence, the positive mutual relationships were evident among a.) the residents and b.) both staff and residents. In the facility interacting with the community regularly, behavioral scenes involving outsiders were observed in the dining space. (3) In the facility wherein they need more care, a few limited behavioral settings were distinguished. This is all about a case study of two facilities, managed by the same social welfare corporation with a view to relate with local community. In the facility A with the spatial continuity to the outside and the facility functions, there is a possibility to stimulate the elderly such as to enjoy the open space concept in the dining area. For example, they can smell the foods from the kitchen and look out through the windows. In this sense, this type of dining space can be related socially as a common space in elderly facilities.
A study on home modification needs and issues arising due to ageing residents
* Akiko Nishino, The University of Tokyo, Japan
Junichiro Okata, The University of Tokyo, Japan
With age, the resident’s physical condition also changes to the point where they start to feel inconveniences arising in homes. Thus, with the passage of time, barriers arise between the environment and people. These particular barriers can be eliminated by improving the environment with home modifications,so that residents can continue living comfortably in their homes. Therefore this study will first clarify in terms of environmental aspects, the housing issues that arise due to the ageing of residents and the contents of modification as a solution to these issues. The second aim is to clarify in terms of human factors, the problematic movements that arise from the environment improved by modifying the home. The subjects of the survey were from municipality C with 20 people (6 men and 14 women who need mild nursing care), who had applied for the nursing care insurance system between April 2018 and December 2019. In terms of environmental aspects, the results of the survey indicated issues with the toilets, bathroom, staircase, living room, entrance, and entrance approach. As a solution to these issues, it was revealed that the environment was improved by modifying the home by installing handrails (88.3%), changing the flooring (2.6%), changing the doors (5.2%), and eliminating steps (3.9%). Next, after analysing spots where movements were occurring where the home was modified, issues were found pertaining to vertical movement (27.3%), straddling (23.4%), opening and closing of doors (20.8%), standing and sitting (11.7%), horizontal movement (10.4%), maintaining posture (5.2%), and attaching and detaching (1.3%).In this study, we were able to clarify home modification needs and seven movement issues caused by the ageing of residents who need mild nursing care. Future studies would need to clarify the needs and issues of elderly people who are severely dependent on care.
Q & A
Environment-related factors of elderly falls: Text mining analysis of caregivers near miss accident and incident reports
* Rei Nara, Ochanomizu University, Japan
Natsuko Nagasawa, Ochanomizu University / Tohoku University, Japan
Elderly falls are one of the biggest causes of declining activities of daily living and becoming bedridden, and even a single fall may lower an older person’s quality of life. Moreover, in today’s aging society, maintaining the activity levels and health of older people is essential for the effective use of limited social resources and establishing a sustainable society. Therefore, we explored the factors of elderly falls to develop ideas for the improvement of environmental factors in housing and welfare facilities. Our final objective was to ensure that older people experience comfort and meaning in the remainder their lives, by understanding the cause of falls, along with preventative measures, from an environmental perspective. First, we carried out a text mining analysis of near miss accident and incident reports complied by caregivers in nursing homes for the elderly - social welfare centers for people over 65 years old, certified as needing long-term care – to clarify the factors contributing to falls. Text mining is a method of analysis for non-modeled text data, used to determine the correlation or frequency of specific words, among others. Furthermore, to develop preventive measures, we interviewed caregivers who have dealt with inpatient falls and compared the interview data with the results of the text mining analysis. Our results show that elderly falls are caused not only by simple environmental factors such as steps and lighting, but also by the distractions posed by surrounding sounds and objects. This suggests that falls occur due to complex cognitive and environmental aspects, as well as older people’s physical characteristics. By interviewing caregivers, we could infer that improvements in environmental factors, informed by the characteristics of older people’s cognitive skills, are needed; addressing direct environmental factors alone is insufficient for the prevention of elderly falls.
Study on the Effect of the Small Care Unit on Residents and Staff in Nursing Homes
* Tatsuya Mitsushima, Kindai University, Japan
Yuri Yasaki, Kindai University, Japan
Mizuki Hayashi, Tohoku Institute of Technology, Japan
Satoshi Ishii, Tohoku Institute of Technology, Japan
Kentaro Yamaguchi, Kindai University, Japan
Ken Miura, Kyoto University, Japan
Since 2000, the residential environment of Japanese elderly facilities (nursing homes) has improved significantly. The resident’s private room has changed from a multi-bed room to a single-bed room, and the scale of care unit has changed from large care unit type to small care unit type. On the other hand, the introduction of the single-bed room has not been made sufficiently, and there is a problem that the residents are becoming more severe in their physical condition than 20 years ago. Therefore, the purpose of this study is to clarify the effect of small care units based on the case of moving from "multi-bed room/large care unit type" to "single bed room/small care unit type". The surveyed facility was a nursing home built in 1977 and was rebuilt in July 2019. In this study, we investigated the situation before and after the rebuilding and compared them. The survey method is a behavioral observation survey for residents and staff members. The residents were observed every 10 minutes from 7:00 to 19:00, and we were recorded (1) where they stayed, (2) details of actions, and (3) attitudes. As for the staff members, we observed their behavior every minute during the working hours of 8 hours and recorded same contents of the resident survey. The results are as follows; (1) the staff and the residents stayed longer in the living space, finding out their own roles and watching over other people closely. (2) The actions of residents in the living room has more diverse. (3) The distance traveled by staff members was reduced and their fatigue was reduced. On the other hand, (4) There was no change in life in severe people.
Integrated Environmental Information Platform for Active Seniors through Augmented Reality
* Young Hee Min, Yonsei University, Korea, Republic of (South Korea)
Mikyoung Ha, Yonsei University, Korea, Republic of (South Korea)
South Korea is one of the fastest growing old countries in the world. By 2060, the ratio of aging population above 65 years of South Korea is prospected to be 40.1% which is assumed to be the second largest aged population ratio in the world. More than 40% of buildings are aged, and have poor legibility problems for the elderly. Aging decline of visual perception and spatial cognition cause wayfinding difficulties. Lifestyle of Korean seniors has also largely shifted with ICT, and senior smartphone users are also on the rise. Using Augmented Reality, we can easily merge environmental information of urban environment which can be affordable and beneficial for senior citizens. This research aims to suggest AR based application platform to provide essential environmental information for active seniors in Seoul. First, by literature review, lifestyle shifts of active seniors and their environmental information needs will be investigated. Utilizing open API data of ‘Smart Seoul Map’, multiple layers of environmental information will be integrated and designed for senior citizens to facilitate healthy, self-independent and active lifestyle.
Q & A