Special Issue "Creating Age-friendly Communities: Housing and Technology"

A special issue of Healthcare (ISSN 2227-9032).

Deadline for manuscript submissions: closed (15 August 2019).

Special Issue Editors

Prof. Dr. Joost van Hoof
Website
Guest Editor
1. The Hague University of Applied Sciences, The Hague, The Netherlands
2. Wrocław University of Environmental and Life Sciences, Wrocław, Poland
Interests: age-friendly cities; urban ageing; technology and housing for older people; gerontechnology; design for dementia; participatory design; architecture for health
Special Issues and Collections in MDPI journals
Dr. Hannah R. Marston
Website
Guest Editor
Health and Wellbeing Priority Research Area, School of Health and Social Care, The Open University, Buckinghamshire, UK
Interests: digital games; gerontology; design and gamification; oldest old/centenarians; mobile (Health) apps; active & healthy ageing
Special Issues and Collections in MDPI journals
Assoc. Prof. Dr. Katie Brittain
Website
Guest Editor
Department of Nursing, Midwifery and Health, University of Northumbria, Newcastle, UK
Interests: social impact that illness can have on the lives of older people; the physical, social and technological environment pose challenges and opportunities for older people and their wider community
Dr. Helen Barrie
Website
Guest Editor
Hugo Centre for Population and Migration, The University of Adelaide, Adelaide, Australia
Interests: older people, community connectedness, the built environment and social networks; inter-generational family ties, ageing and migration, age friendly communities, and demographic change in rural and regional Australia

Special Issue Information

Dear Colleagues,

The number of older adults is increasing rapidly, and this demographic shift puts an increased level of stress on worldwide healthcare systems. The vast majority of older adults wish to age in place, and many make use of long-term care services, including homecare, rehabilitation services, and social support. One way to support older people to live the life they wish to live is through the age-friendly cities initiative, a world-wide program to make cities better-tuned to the needs of older citizens. Making cities more age-friendly can be done through dedicated housing facilities, home modifications and adaptations.

With advances in technology, the domain of engineering and design offers a wide range of solutions that support daily function, activities, and participation, facilitates the provision of healthcare, and offers means for leisure to older people. Too often, end-users of architectural and technological solutions are not consulted in the design processes and the implementation of the solutions in practice. Their inclusion in these processes is paramount to the success of the proposed and implemented solutions.

The purpose of this Special Issue is to publish high-quality research papers as well as review articles addressing recent advances in age-friendly cities in relation to housing (including urban planning) and technology, both in the broadest sense of the word. Original, high quality contributions that are not yet published or that are not currently under review by other journals or peer-reviewed conferences are welcomed.

Prof. Dr. Joost van Hoof
Dr. Hannah R. Marston
Assoc. Prof. Dr. Katie Brittain
Dr. Helen Barrie
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All papers will be peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Healthcare is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 1600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Assistive technologies
  • Physical environment/space
  • Social Media
  • Connected care
  • Telehealth and telecare
  • Community care
  • Wearable devices
  • Gamification
  • Rural ageing
  • Urban ageing
  • Intergenerational relationships
  • Long-term health conditions
  • Social connectedness
  • Physical activity

Published Papers (13 papers)

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Editorial

Jump to: Research, Review

Open AccessEditorial
Creating Age-Friendly Communities: Housing and Technology
Healthcare 2019, 7(4), 130; https://doi.org/10.3390/healthcare7040130 - 03 Nov 2019
Cited by 4
Abstract
Taking an international perspective of healthy ageing, people are living longer and are generally in better health than previous generations [...] Full article
(This article belongs to the Special Issue Creating Age-friendly Communities: Housing and Technology)

Research

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Open AccessArticle
Using Citizen Science to Explore Neighbourhood Influences on Ageing Well: Pilot Project
Healthcare 2019, 7(4), 126; https://doi.org/10.3390/healthcare7040126 - 01 Nov 2019
Cited by 2
Abstract
Outdoor and indoor environments impact older people’s mobility, independence, quality of life, and ability to “age in place”. Considerable evidence suggests that not only the amount, but also the quality, of public green spaces in the living environment is important. The quality of [...] Read more.
Outdoor and indoor environments impact older people’s mobility, independence, quality of life, and ability to “age in place”. Considerable evidence suggests that not only the amount, but also the quality, of public green spaces in the living environment is important. The quality of public green spaces is mostly measured through expert assessments by planners, designers and developers. A disadvantage of this expert-determined approach is that it often does not consider the appraisals or perceptions of residents. Daily experience, often over long periods of time, means older residents have acquired insider knowledge of their neighbourhood, and thus, may be more qualified to assess these spaces, including measuring what makes a valued or quality public green space. The aim of this Australian pilot study on public green spaces for ageing well was to test an innovative citizen science approach to data collection using smart phones. “Senior” citizen scientists trialed the smart phone audit tool over a three-month period, recording and auditing public green spaces in their neighbourhoods. Data collected included geocoded location data, photographs, and qualitative comments along with survey data. While citizen science research is already well established in the natural sciences, it remains underutilised in the social sciences. This paper focuses on the use of citizen science with older participants highlighting the potential for this methodology in the fields of environmental gerontology, urban planning and landscape architecture. Full article
(This article belongs to the Special Issue Creating Age-friendly Communities: Housing and Technology)
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Open AccessFeature PaperArticle
Perspectives of Healthcare Professionals on Meaningful Activities for Persons with Dementia in Transition from Home to a Nursing Home: An Explorative Study
Healthcare 2019, 7(3), 98; https://doi.org/10.3390/healthcare7030098 - 19 Aug 2019
Cited by 2
Abstract
Meaningful activities can enhance quality of life, a sense of connectedness, and personhood for persons with dementia. Healthcare professionals play an important role in maintaining meaningful activities, but little is currently known about the impact of the transition from home to nursing home [...] Read more.
Meaningful activities can enhance quality of life, a sense of connectedness, and personhood for persons with dementia. Healthcare professionals play an important role in maintaining meaningful activities, but little is currently known about the impact of the transition from home to nursing home on these activities. This study explored the experiences of professionals in four Dutch nursing homes, identifying facilitators and barriers to the maintenance of meaningful activities during the transition. A qualitative explorative design was used. Data were collected using focus groups and analyzed using thematic analysis. Twenty-two professionals participated in four focus groups, and three themes were identified: (1) a lack of awareness and attention for meaningful activities; (2) activities should be personalized and factors such as person characteristics, interests, the social and physical environment, and specific information such as roles, routines, activities, and personal issues play an important role in maintaining activities; (3) in the organization of care, a person-centered care vision, attitudes of professionals and interdisciplinary collaboration facilitate maintenance of meaningful activities. Healthcare professionals felt that meaningful activities are difficult to maintain and that improvements are needed. Our study provides suggestions on how to maintain meaningful activities for persons with dementia prior, during and after the transition. Full article
(This article belongs to the Special Issue Creating Age-friendly Communities: Housing and Technology)
Open AccessFeature PaperArticle
Older Adults’ Perceptions of ICT: Main Findings from the Technology In Later Life (TILL) Study
Healthcare 2019, 7(3), 86; https://doi.org/10.3390/healthcare7030086 - 04 Jul 2019
Cited by 13
Abstract
Technology is entwined in 21st Century society, and within the lives of people across all ages. The Technology In Later Life (TILL) study is the first piece of work contributing to the impact, behavior, and perception of technology use, by adults aged ≥70 [...] Read more.
Technology is entwined in 21st Century society, and within the lives of people across all ages. The Technology In Later Life (TILL) study is the first piece of work contributing to the impact, behavior, and perception of technology use, by adults aged ≥70 years, residing in rural and suburban areas. TILL is an international, multi-centred, multi-methods study investigating and conceptualizing how various technologies impact the lives of older adults; residing in urban and rural locations in the United Kingdom (UK) and Canada. This in-depth study recruited 37 participants via a multi-methods approach. Analysis of the findings ascertained two overarching themes: facilitators of technology use (i.e., sharing of information and feeling secure), and detractors of technology (i.e., feelings of apprehension of use). Proposed recommendations include promotion of technology from a strengths-based perspective focusing on positive opportunities technology to improve health and wellbeing, creating a peer support network to assist with learning of new technology, and the need to examine further how intergenerational relationships may be enhanced through the use of technology. The distinction of these themes narrates to the originality of this initial study and milieu of recruited participants, intersecting across the fields of gerontology, geography, social sciences, and gerontechnology. Full article
(This article belongs to the Special Issue Creating Age-friendly Communities: Housing and Technology)
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Open AccessFeature PaperArticle
Perspectives of Stakeholders on Technology Use in the Care of Community-Living Older Adults with Dementia: A Systematic Literature Review
Healthcare 2019, 7(2), 73; https://doi.org/10.3390/healthcare7020073 - 28 May 2019
Cited by 7
Abstract
Although technology has the potential to promote aging in place, the use of technology remains scarce among community-living older adults with dementia. A reason might be that many stakeholders are involved who all have a different perspective on technology use (i.e., needs, wishes, [...] Read more.
Although technology has the potential to promote aging in place, the use of technology remains scarce among community-living older adults with dementia. A reason might be that many stakeholders are involved who all have a different perspective on technology use (i.e., needs, wishes, attitudes, possibilities, and difficulties). We systematically searched the literature in order to provide an overview of perspectives of different stakeholders on technology use among community-living older adults with dementia. After selection, 46 studies were included. We mainly found perspectives of informal caregivers and, to a lesser extent, of persons with dementia and formal caregivers. Perspectives of suppliers of technology were not present. Shared perspectives among persons with dementia and informal and formal caregivers were, among other things, ease of use, stability and flexibility of technology, importance of privacy, and confidentiality. We also found that among older persons, fun and pleasure, in addition to enhancing freedom and independence, facilitates technology use. Informal caregivers’ peace of mind and relief of burden also appeared to be important in using technologies. Formal caregivers value the potential of technologies to improve monitoring and communication. Insight in shared, and conflicting perspectives of stakeholders are essential to enhance the use of technology. Full article
(This article belongs to the Special Issue Creating Age-friendly Communities: Housing and Technology)
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Open AccessArticle
Living Alone Among Older Adults in Canada and the U.S.
Healthcare 2019, 7(2), 68; https://doi.org/10.3390/healthcare7020068 - 07 May 2019
Cited by 3
Abstract
Increasing proportions of people, including older adults, live alone. Studying living arrangements of the elderly is important because these affect and reflect general well-being of the elderly and inform communities’ response to elderly housing needs. We analyze data from the 2006 Canadian Census [...] Read more.
Increasing proportions of people, including older adults, live alone. Studying living arrangements of the elderly is important because these affect and reflect general well-being of the elderly and inform communities’ response to elderly housing needs. We analyze data from the 2006 Canadian Census and the 2006 American Community Survey to examine living alone among non-married older adults aged 55 and older in Canada and the U.S. The paper has two parts. First, we compare native- and foreign-born elderly to see if immigrants are less likely to live alone. Second, we examine factors associated with living alone among older immigrants. While older immigrants in both countries are less likely to live alone, the large differences are substantially reduced once various explanatory variables are considered. Comparisons of four gender/country groups of older immigrants show the positive role of economic and acculturation factors on living alone among older immigrants. With few exceptions, predictors of living alone are similar for older immigrants in Canada and the U.S.: living alone is mainly explained by a combination of economic and acculturation factors, taking demographic variables into account. Findings underline the need for age-friendly housing with innovative design and technology that can accommodate older people who live alone, including older immigrants who may have different needs and cultural preferences. Full article
(This article belongs to the Special Issue Creating Age-friendly Communities: Housing and Technology)
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Open AccessArticle
Technology to Support Aging in Place: Older Adults’ Perspectives
Healthcare 2019, 7(2), 60; https://doi.org/10.3390/healthcare7020060 - 10 Apr 2019
Cited by 17
Abstract
The U.S. population over 65 years of age is increasing. Most older adults prefer to age in place, and technologies, including Internet of things (IoT), Ambient/Active Assisted Living (AAL) robots and other artificial intelligence (AI), can support independent living. However, a top-down design [...] Read more.
The U.S. population over 65 years of age is increasing. Most older adults prefer to age in place, and technologies, including Internet of things (IoT), Ambient/Active Assisted Living (AAL) robots and other artificial intelligence (AI), can support independent living. However, a top-down design process creates mismatches between technologies and older adults’ needs. A user-centered design approach was used to identify older adults’ perspectives regarding AAL and AI technologies and gauge interest in participating in a co-design process. A survey was used to obtain demographic characteristics and assess privacy perspectives. A convenience sample of 31 retirement community residents participated in one of two 90-min focus group sessions. The semi-structured group interview solicited barriers and facilitators to technology adoption, privacy attitudes, and interest in project co-design participation to inform technology development. Focus group sessions were audiotaped and professionally transcribed. Transcripts were reviewed and coded to identify themes and patterns. Descriptive statistics were applied to the quantitative data. Identified barriers to technology use included low technology literacy, including lack of familiarity with terminology, and physical challenges, which can make adoption difficult. Facilitators included an eagerness to learn, interest in co-design, and a desire to understand and control their data. Most participants identified as privacy pragmatics and fundamentalists, indicating that privacy is important to older adults. At the same time, they also reported a willingness to contribute to the design of technologies that would facilitate aging independently. There is a need to increase technology literacy of older adults along with aging literacy of technologists. Full article
(This article belongs to the Special Issue Creating Age-friendly Communities: Housing and Technology)
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Open AccessArticle
Citizens’ Juries: When Older Adults Deliberate on the Benefits and Risks of Smart Health and Smart Homes
Healthcare 2019, 7(2), 54; https://doi.org/10.3390/healthcare7020054 - 01 Apr 2019
Cited by 4
Abstract
Background: Technology-enabled healthcare or smart health has provided a wealth of products and services to enable older people to monitor and manage their own health conditions at home, thereby maintaining independence, whilst also reducing healthcare costs. However, despite the growing ubiquity of [...] Read more.
Background: Technology-enabled healthcare or smart health has provided a wealth of products and services to enable older people to monitor and manage their own health conditions at home, thereby maintaining independence, whilst also reducing healthcare costs. However, despite the growing ubiquity of smart health, innovations are often technically driven, and the older user does not often have input into design. The purpose of the current study was to facilitate a debate about the positive and negative perceptions and attitudes towards digital health technologies. Methods: We conducted citizens’ juries to enable a deliberative inquiry into the benefits and risks of smart health technologies and systems. Transcriptions of group discussions were interpreted from a perspective of life-worlds versus systems-worlds. Results: Twenty-three participants of diverse demographics contributed to the debate. Views of older people were felt to be frequently ignored by organisations implementing systems and technologies. Participants demonstrated diverse levels of digital literacy and a range of concerns about misuse of technology. Conclusion: Our interpretation contrasted the life-world of experiences, hopes, and fears with the systems-world of surveillance, efficiencies, and risks. This interpretation offers new perspectives on involving older people in co-design and governance of smart health and smart homes. Full article
(This article belongs to the Special Issue Creating Age-friendly Communities: Housing and Technology)
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Open AccessArticle
A Review of Age Friendly Virtual Assistive Technologies and their Effect on Daily Living for Carers and Dependent Adults
Healthcare 2019, 7(1), 49; https://doi.org/10.3390/healthcare7010049 - 21 Mar 2019
Cited by 10
Abstract
Many barriers exist in the lives of older adult’s, including health, transport, housing, isolation, disability and access to technology. The appropriate integration of technology within age-friendly communities continues to offer possible solutions to these barriers and challenges. Older adults and disabled people continue [...] Read more.
Many barriers exist in the lives of older adult’s, including health, transport, housing, isolation, disability and access to technology. The appropriate integration of technology within age-friendly communities continues to offer possible solutions to these barriers and challenges. Older adults and disabled people continue to be affected and marginalized due to lack of access to the digital world. Working collaboratively with planners, policy makers and developers, social and living spaces in the future will ensure that residents are equipped to live in an era that continues to be led by, and is dependent upon, access to technology. This review paper uniquely draws together the small volume of literature from the fields of gerontology, gerontechnology, human computer interaction (HCI), and disability. This paper examines the national and international age-friendly frameworks regarding older adults who are carers of dependent people with disabilities. Full article
(This article belongs to the Special Issue Creating Age-friendly Communities: Housing and Technology)
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Open AccessArticle
Making Homes More Dementia-Friendly through the Use of Aids and Adaptations
Healthcare 2019, 7(1), 43; https://doi.org/10.3390/healthcare7010043 - 16 Mar 2019
Cited by 2
Abstract
The majority of people with dementia live in their own homes, often supported by a family member. While this is the preferred option for most, they often face multiple challenges due to a deterioration in their physical and cognitive abilities. This paper reports [...] Read more.
The majority of people with dementia live in their own homes, often supported by a family member. While this is the preferred option for most, they often face multiple challenges due to a deterioration in their physical and cognitive abilities. This paper reports on a pilot study that aimed to explore the impacts of aids and adaptations on the wellbeing of people with dementia and their families living at home. Quantitative data were collected using established measures of wellbeing at baseline, 3 months and 9 months. In-depth case studies were carried out with a sample of participants. Findings from the pilot suggest that relatively inexpensive aids can contribute towards the maintenance of wellbeing for people with dementia in domestic settings. The project also increased the skills and confidence of professionals involved in the project and strengthened partnerships between the collaborating organisations across health, housing and social care. Providing aids that can help people with dementia to remain living at home with a good quality of life, often with the support of a family member, is an important element in the development of age-friendly communities. Full article
(This article belongs to the Special Issue Creating Age-friendly Communities: Housing and Technology)
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Open AccessArticle
Two-Year Use of Care Robot Zora in Dutch Nursing Homes: An Evaluation Study
Healthcare 2019, 7(1), 31; https://doi.org/10.3390/healthcare7010031 - 19 Feb 2019
Cited by 6
Abstract
The use of the Zora robot was monitored and evaluated in 14 nursing care organizations (15 locations). The Zora robot, a Não robot with software, is designed as a social robot and used for pleasure and entertainment or to stimulate the physical activities [...] Read more.
The use of the Zora robot was monitored and evaluated in 14 nursing care organizations (15 locations). The Zora robot, a Não robot with software, is designed as a social robot and used for pleasure and entertainment or to stimulate the physical activities of clients in residential care. In the first year, the aim was to monitor and evaluate how the care robot is used in daily practice. In the second year, the focus was on evaluating whether the use of Zora by care professionals can be extended to more groups and other type of clients. Interviews, questionnaires and observations were used as instruments to reveal the progress in the use of the robot and to reveal the facilitators and barriers. Care professionals experienced several barriers in the use of the robot (e.g., start-up time and software failures). The opportunity they had to discuss their experience during project team meetings was seen as a facilitator in the project. Furthermore, they mentioned that the Zora robot had a positive influence on clients as it created added value for the care professionals in having fun at work. Full article
(This article belongs to the Special Issue Creating Age-friendly Communities: Housing and Technology)
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Open AccessArticle
The Physical Environment of Nursing Homes for People with Dementia: Traditional Nursing Homes, Small-Scale Living Facilities, and Green Care Farms
Healthcare 2018, 6(4), 137; https://doi.org/10.3390/healthcare6040137 - 26 Nov 2018
Cited by 12
Abstract
It is well recognized that the physical environment is important for the well-being of people with dementia. This influences developments within the nursing home care sector where there is an increasing interest in supporting person-centered care by using the physical environment. Innovations in [...] Read more.
It is well recognized that the physical environment is important for the well-being of people with dementia. This influences developments within the nursing home care sector where there is an increasing interest in supporting person-centered care by using the physical environment. Innovations in nursing home design often focus on small-scale and homelike care environments. This study investigated: (1) the physical environment of different types of nursing homes, comparing traditional nursing homes with small-scale living facilities and green care farms; and (2) how the physical environment was being used in practice in terms of the location, engagement and social interaction of residents. Two observational studies were carried out. Results indicate that the physical environment of small-scale living facilities for people with dementia has the potential to be beneficial for resident’s daily life. However, having a potentially beneficial physical environment did not automatically lead to an optimal use of this environment, as some areas of a nursing home (e.g., outdoor areas) were not utilized. This study emphasizes the importance of nursing staff that provides residents with meaningful activities and stimulates residents to be active and use the physical environment to its full extent. Full article
(This article belongs to the Special Issue Creating Age-friendly Communities: Housing and Technology)

Review

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Open AccessReview
Mobile Self-Monitoring ECG Devices to Diagnose Arrhythmia that Coincide with Palpitations: A Scoping Review
Healthcare 2019, 7(3), 96; https://doi.org/10.3390/healthcare7030096 - 16 Aug 2019
Cited by 8
Abstract
The use and deployment of mobile devices across society is phenomenal with an increasing number of individuals using mobile devices to track their everyday health. However, there is a paucity of academic material examining this recent trend. Specifically, little is known about the [...] Read more.
The use and deployment of mobile devices across society is phenomenal with an increasing number of individuals using mobile devices to track their everyday health. However, there is a paucity of academic material examining this recent trend. Specifically, little is known about the use and deployment of mobile heart monitoring devices for measuring palpitations and arrhythmia. In this scoping literature review, we identify the contemporary evidence that reports the use of mobile heart monitoring to assess palpitations and arrhythmia across populations. The review was conducted between February and March 2018. Five electronic databases were searched: Association for Computing Machinery (ACM), CINHAL, Google Scholar, PubMed, and Scopus. A total of 981 records were identified and, following the inclusion and exclusion criteria, nine papers formed the final stage of the review. The results identified a total of six primary themes: purpose, environment, population, wearable devices, assessment, and study design. A further 24 secondary themes were identified across the primary themes. These included detection, cost effectiveness, recruitment, type of setting, type of assessment, and commercial or purpose-built mobile device. This scoping review highlights that further work is required to understand the impact of mobile heart monitoring devices on how arrhythmias and palpitations are assessed and measured across all populations and ages of society. A positive trend revealed by this review demonstrates how mobile heart monitoring devices can support primary care providers to deliver high levels of care at a low cost to the service provider. This has several benefits: alleviation of patient anxiety, lowering the risk of morbidity and mortality, while progressively influencing national and international care pathway guidelines. Limitations of this work include the paucity of knowledge and insight from primary care providers and lack of qualitative material. We argue that future studies consider qualitative and mixed methods approaches to complement quantitative methodologies and to ensure all actors’ experiences are recorded. Full article
(This article belongs to the Special Issue Creating Age-friendly Communities: Housing and Technology)
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