From Mattering to Mattering More: ‘Goods’ and ‘Bads’ in Ageing and Innovation Policy Discourses
2. Theoretical Approach: How Goods and Bads Come to Matter
4. Results: A ‘Good’ Ageing Life for Maria
4.1. Meeting Maria
“Maria has a basic education level, although she is able to read and write. Maria needs to take better care of herself, when it comes to personal and house hygiene. Her daughter and grandchild do not participate much in her care due to their own circumstances.The main factor that has contributed to this serious episode of hypoglycaemia is undoubtedly the lack of knowledge of the caregiver, Maria’s daughter. She has assumed responsibility for caring for her mother without adequate knowledge and possibly without psychological stability, which has led her to misinterpret the situation and act in an unreflective way. Neither she, nor Maria, understand how to administer Insulin correctly or how to use a glucometer. Putting the handling of rapid insulin in June’s hands may have not been wise and, without the person having appropriate training, can be considered a risk factor. The endocrinologist had not been aware of the psychosocial conditions of Maria and her daughter. Given that situation and the age of the patient, the general practitioner would have proposed the setting of less exhausting control goals for Maria’s care plan. Both communication and coordination were inadequate.” (p. 14)
“There has not been a care network established around Maria. Maria feels isolated. She has difficulty in doing daily shopping and cooking meals for the family. The meals she prepares are not really healthy. In addition, she faces financial difficulties which do not improve the situation. Her niece does not take part in any decision making about health or social care. A social worker has visited Maria twice but she has rejected help. She is afraid that she will be taken to a nursing home and her daughter and grandchild institutionalized. She is alone for most of the day and does not want to leave her house to go to a nursing home, but clearly she needs help. Home support with cleaning, shopping and cooking would greatly improve Maria’s condition.” (p. 14)
“All the key actors, including Maria, her daughter, her niece, home support and healthcare professionals, need to exchange secure information among themselves. They need to coordinate their goals, actions and avoid redundant and potentially harmful interventions. An information system that collects relevant data and information to enable monitoring of care plan related activity status and progress is needed, i.e., information to support the exchange of glucose level data and information about symptoms would be helpful. Alerts could be handled by the eHealth 24/7 centre, primary care and/or emergency services.It would be necessary to make sure that all the key actors understand correctly the relevance of proper diet habits, handling insulin and using a glucometer. A health education program, customized to Maria’s basic literacy skills and June’s conditions, should be implemented via a Patient Empowerment Platform. The aim is to recommend, implement and have all the actors adhere to Maria’s personalized treatment goals and interventions…” (p. 15)
“Recently, her niece has been increasingly involved in helping Maria to maintain a healthy diet and helping her with the new ICT tools that Maria has started to use. Maria’s niece photographs her daily meals, which are analysed by her nutritionist—part of a multidisciplinary nursing team responsible for her health—for nutrient content and quantities. A new digital wristband tracks Maria’s physical activity, glucose and insulin levels, determines the timing and dosage of her insulin intake, and transmits the information to her niece, who is able to make informed decisions for Maria. She also helps Maria to understand her health on a simple level. The data collected by the portable monitoring device is transmitted to a local 24/7 call centre, which evaluates Maria’s values when critical observations are made and thus provides her multidisciplinary nursing team with important decision support. In difficult situations, a member of the nursing team can either immediately give instructions to the niece or advise Maria at her next appointment.It is a completely new experience for Maria to learn how to get health, lifestyle and treatment advice from a patient empowerment platform. She does not really understand the medical background, but her niece has told her that she could trust the information on the platform because it comes from the joint results gathered by her multidisciplinary care team, who all access her personal data and set new recommendations and treatment goals for her for the benefit of her health. She gets access to the platform through a tablet designed specifically for older patients. Through this platform, a health education programme tailored to the (health) literacy skills of Maria and her daughter improves the understanding of the relevance of having correct eating habits, and insulin and glucometer use.” (p. 19)
4.2. Mode One: ‘Good Ageing’ and Key Enabling Technologies
“Four initial key topic areas have been chosen that were identified jointly by EU actors on both the demand and supply sides prior to the first Blueprint Call for Engagement under WE4AHA. These four areas were selected to represent digital health and care priorities and have undergone various cycles of discussions and reviews.” (p. 10, italics added)
- “Citizens’ secure access to and sharing of health data.
- Better data to advance research, disease prevention and personalised health and care.
- Digital tools for citizen empowerment and person-centred care.”  (p. 3).
4.3. Mode Two: ‘Good Ageing’ and Attending to Patients, Carers and Healthcare Professionals
“The aim of this call is to enlarge the group of contributors to the Blueprint’s further development and strengthen the demand side representation. We seek to activate participation of demand side representatives who are investing in or implementing digital health and care solutions at scale between now and end of 2018.” (p. 67)
- “Relevant expertise of the candidate matching the topic area.
- Relevance of the digital health solutions, which the region/organisation is investing in or has implemented at scale, to the selected topic area”.  (p. 11)
4.4. Mode Three: ‘Good Ageing’ and Values, Interactions and Complex Human Lives
“While traditional persona profiles do not recognise psychological or psycho-social forces within people and their health care choices and outcomes, research has shown that ‘failing to recognise such cognitive and behavioural patterns of perception and action can affect both short-term and long-term success with interventions directed toward managing a disease or adopting wellness’. The Blueprint work on personas therefore took behavioural characteristics into consideration by including descriptions such as people’s trust (or lack of) in care professionals, their self-management capabilities, and specific details on their character (e.g., prone to aggressive behaviour or tendencies to reject outside support), among others.” (p. 22)
“The creation of personas is one of the proven successful concepts that enable companies to understand their potential users more, by considering their needs, aspirations, attitudes, dreams, and other relevant characteristics. Within the context of the Blueprint work and objectives, personas were developed to envision realistic health and care needs of certain groups in the society.” (p. 26)
5. Discussion: Dynamics of Mattering and Mattering More
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
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Greubel, C.; Moors, E.H.M.; Peine, A. From Mattering to Mattering More: ‘Goods’ and ‘Bads’ in Ageing and Innovation Policy Discourses. Int. J. Environ. Res. Public Health 2021, 18, 7596. https://doi.org/10.3390/ijerph18147596
Greubel C, Moors EHM, Peine A. From Mattering to Mattering More: ‘Goods’ and ‘Bads’ in Ageing and Innovation Policy Discourses. International Journal of Environmental Research and Public Health. 2021; 18(14):7596. https://doi.org/10.3390/ijerph18147596Chicago/Turabian Style
Greubel, Carla, Ellen H. M. Moors, and Alexander Peine. 2021. "From Mattering to Mattering More: ‘Goods’ and ‘Bads’ in Ageing and Innovation Policy Discourses" International Journal of Environmental Research and Public Health 18, no. 14: 7596. https://doi.org/10.3390/ijerph18147596