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Almevall A, Juuso P, Melander C, Zingmark K. Exploring the meaning of a good life for older widows with extensive need of care: a qualitative in-home interview study. Int J Qual Stud Health Well-being 2024; 19:2322757. [PMID: 38431864 PMCID: PMC10911179 DOI: 10.1080/17482631.2024.2322757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Accepted: 02/20/2024] [Indexed: 03/05/2024] Open
Abstract
INTRODUCTION Studies of older women's life transitions is rare but gains relevance as the aging population, with older women as the majority, expands. PURPOSE To explore the meaning of a good life for older widows with extensive home care needs. MATERIALS AND METHODS Semi-structured interviews were carried out with eleven women, aged 80 and over (82-95 years, mean 90) residing at home with extensive care needs (≥4 daily sessions, averaging 2.5-6 hours, mean 3). Data were analysed by reflexive thematic analysis. RESULTS The theme "This Day in My Home, the frame of my life" reflects the women's experience of a good life. A good day imbued them with hope, trust and security, carrying them forward with the assurance that night would usher in a new day. However, there were moments when life was merely about navigating daily challenges. During such days, the women felt trapped in time, unsafe and lonely. CONCLUSION A day at home may seem static, yet it mirrors life's dynamism, evolving with shifting circumstances. Older widows navigate challenges while maintaining their sense of self, independence, and connection to home. These findings have implications for aged care, recognizing the multifaceted aspects of life and the centrality of home.
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Affiliation(s)
- Ariel Almevall
- Department of Health, Education and Technology, Division of Nursing and Medical Technology, Luleå University of Technology, Luleå, Sweden
| | - Päivi Juuso
- Department of Health, Education and Technology, Division of Nursing and Medical Technology, Luleå University of Technology, Luleå, Sweden
| | - Catharina Melander
- Department of Health, Education and Technology, Division of Nursing and Medical Technology, Luleå University of Technology, Luleå, Sweden
| | - Karin Zingmark
- Department of Health, Education and Technology, Division of Nursing and Medical Technology, Luleå University of Technology, Luleå, Sweden
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Soofi H. What moral work can Nussbaum's account of human dignity do in the context of dementia care? JOURNAL OF MEDICAL ETHICS 2022; 48:961-967. [PMID: 35922119 DOI: 10.1136/jme-2021-108095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 07/22/2022] [Indexed: 06/15/2023]
Abstract
Appeals to the dignity of people with dementia are widespread in the current literature on dementia care. One influential account of dignity in the wider philosophical and bioethical literature that has remained underexplored in the context of dementia care is that of Martha Nussbaum. This paper critically examines Nussbaum's account of dignity and aims to determine what moral guidance this account can offer for the provision of care to people with dementia. To that end, first, I identify four possible objections to appeals to dignity in dementia care. These objections are (1) redundancy of the dignity talk, (2) exclusionary implications, (3) reliance on (suspect forms of) speciesism and (4) unclear practical implications. Then, I discuss whether, and to what extent, Nussbaum's account of dignity can overcome these objections. I argue that Nussbaum's account, in its original form, struggles to overcome the problem of exclusionary implications and consequently the problem of unclear practical implications. I argue for a modified version of Nussbaum's account of dignity. I demonstrate that this modified version can better overcome all of the four objections, and it provides relatively clearer moral guidance for the provision of care to people with dementia. The modified version of Nussbaum's account is predicated on a novel dementia-specific model of flourishing, which draws on Kitwood and Bredin's empirically informed list of indicators of well-being for people with dementia.
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Affiliation(s)
- Hojjat Soofi
- Department of Philosophy, Macquarie University, Sydney, New South Wales, Australia
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Trani JF, Moodley J, Maw MTT, Babulal GM. Association of Multidimensional Poverty With Dementia in Adults Aged 50 Years or Older in South Africa. JAMA Netw Open 2022; 5:e224160. [PMID: 35333360 PMCID: PMC8956981 DOI: 10.1001/jamanetworkopen.2022.4160] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
IMPORTANCE Limited research exists investigating the association between multidimensional poverty and dementia in low-and middle-income countries (LMICs). OBJECTIVE To investigate the association between multidimensional poverty and dementia among adults aged 50 years or older living in South Africa. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional study was conducted in Soweto, Johannesburg, South Africa, between November 11, 2019, and February 28, 2020. Participants included 227 adults aged 50 years or older. Data analysis was concluded from August 1 to 30, 2021. EXPOSURES Multidimensional poverty included 7 dimensions that are central to well-being (education, health, economic activity, living standards, social participation, fair treatment, and psychological well-being) and 11 indicators of deprivation within those dimensions (limited access to education; severe limitation of activity; difficulty functioning; unemployment; deprivation of access to running water, electricity, and a flush toilet; lack of involvement in community groups; discrimination; depression; and decreased self-esteem). MAIN OUTCOMES AND MEASURES The 8-item Interview to Differentiate Aging and Dementia (Assessing Dementia 8 [AD8]) and the Rowland Universal Dementia Assessment Scale (RUDAS) were used to assess dementia. Level and depth of poverty were compared between adults with no dementia and those with a score above the threshold for either the AD8 or the RUDAS, or for both the AD8 and the RUDAS, adjusting for gender, age group, and marital status. Correlation analyses assessed the overlap of dimensions of deprivation. Associations between dementia and multidimensional poverty were investigated using a multivariable logistic regression model. RESULTS A total of 227 adults (146 women [64.3%]; mean [SD] age, 63.7 [0.5] years) were included in the study; 101 (44.5%) had dementia identified by the AD8, 14 (6.2%) had dementia identified by the RUDAS, and 50 (22.0%) had dementia identified by both the AD8 and the RUDAS. More men than women did not have dementia (26 of 81 [32.1%] vs 36 of 146 [24.7%]), and 33 of 165 adults with dementia (20.0%) compared with 6 of 62 adults (9.7%) without dementia were found to be deprived in 4 dimensions or more. The difference between adults with and adults without dementia in the Multidimensional Poverty Index for deprivation in 4 dimensions was 145.8% for dementia identified by both the AD8 and the RUDAS and 118.2% for dementia identified by either the AD8 or the RUDAS. Education, health, and employment were the main contributors to the adjusted poverty head count ratio. Multidimensional poverty was strongly associated with dementia as measured by the AD8 and the RUDAS (adjusted odds ratio [OR], 2.31; 95% CI, 1.08-4.95), with higher odds for older women (OR, 2.03; 95% CI, 1.00-4.12) or those living in large households (for each additional household member: OR, 1.27; 95% CI, 1.05-1.53). CONCLUSIONS AND RELEVANCE This study suggests that the prevalence and depth of poverty were higher among adults with dementia. A lack of education, poor health, and unemployment were major dimensions of poverty that were associated with a higher prevalence of dementia. Long-term interventions beginning early in life may affect social determinants of health through targeted structural policies (eg, access to quality education and health care) and prevent dementia later in life.
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Affiliation(s)
- Jean-Francois Trani
- Brown School, Washington University, St Louis, Missouri
- Department of Psychology, Faculty of Humanities, University of Johannesburg, Johannesburg, South Africa
- Center for Social Development in Africa, University of Johannesburg, Johannesburg, South Africa
| | - Jacqueline Moodley
- Department of Psychology, Faculty of Humanities, University of Johannesburg, Johannesburg, South Africa
| | - May Thu Thu Maw
- Department of General Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Ganesh M. Babulal
- Department of Psychology, Faculty of Humanities, University of Johannesburg, Johannesburg, South Africa
- Department of Neurology, Washington University School of Medicine, St Louis, Missouri
- Department of Clinical Research and Leadership, The George Washington University School of Medicine and Health Sciences, Washington, DC
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Examining the Availability and Accessibility of Rehabilitation Services in a Rural District of South Africa: A Mixed-Methods Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18094692. [PMID: 33924910 PMCID: PMC8125304 DOI: 10.3390/ijerph18094692] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 04/22/2021] [Accepted: 04/25/2021] [Indexed: 01/21/2023]
Abstract
Introduction: Rehabilitation services aim to optimise individuals’ functioning and reduce disability. However, people with disabilities, who represent a key population of users of rehabilitation services, continue to have unmet needs for rehabilitation services that include the provision of assistive devices. This paper examines the availability and accessibility of rehabilitation services in a rural district of South Africa in order to explore why unmet needs for rehabilitation services persist. Methods: All nine district hospitals in a rural district of South Africa were included in the study. Rehabilitation services capacity was assessed by examining the available assistive devices, consumables and human resources at the level of the health facility. Data collection was conducted using the Global Co-operative Assistive Technology [GATE] Assistive Products List, AT2030’s ATScale priority list and the South African National Catalogue of Commodities for Primary Health Care Facilities. Descriptive statistics were then used for the analysis. For the qualitative component, semi-structured interviews were conducted with adults with physical disabilities at household level to explore barriers to accessing assistive device inclusive rehabilitation services and the consequences thereof in the same rural district. An interview guide based on the WHO health system building blocks was used. Thematic content analysis guided the analysis of the interview transcripts. Findings: The findings of the research demonstrate that rehabilitation service capacity in the district was constrained as a result of low availability of assistive devices [2–22%] and consumables [2–47%], as well as, possibly, a shortage of rehabilitation providers [n = 30] with an unequal distribution across health facilities [n = 9]. In addition, people with physical disabilities reported poor referral pathways, financial constraints, transport and road consideration and equipment unavailability as barriers to accessing rehabilitation services. Moreover, these barriers to access predisposed individuals to finance-, health- and person-related harm. Conclusion: Rehabilitation service availability is constrained by a lack of service capacity in rural South Africa. In addition, the rehabilitation services in district hospitals are not adequately accessible because of existing barriers to enable key populations to achieve optimised functioning.
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Till M, Abu-Omar K, Ferschl S, Reimers AK, Gelius P. Measuring capabilities in health and physical activity promotion: a systematic review. BMC Public Health 2021; 21:353. [PMID: 33588799 PMCID: PMC7885491 DOI: 10.1186/s12889-020-10151-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Accepted: 12/29/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The capability approach by Amartya Sen and Martha Nussbaum has gained increasing attention in the field of public health. As it combines individual, social and structural factors and shifts the focus of attention from the actual behavior towards available options for health behaviors that people can actually choose from, it may help advance our understanding of complex health issues. OBJECTIVES The aim of this article is to identify and describe tools available to measure capabilities within the context of health, with a specific focus on capabilities for health-enhancing physical activity. METHOD We conducted a systematic literature review using 11 databases covering scientific journal articles published in English or German between the years 2000 and 2020 with a focus on capabilities for health or physical activity. RESULTS We found a total of 51 articles meeting our inclusion criteria. Four articles measured capabilities using qualitative methods, one combined qualitative and quantitative methods, while the rest used quantitative methods. We identified a total 11 different capability questionnaires, all showing moderate to good validity/reliability. Only one questionnaire and one interview-based tool specifically dealt with capabilities for health enhancing physical activity. CONCLUSION Although we were able to identify measurement tools for capabilities in health, this review has shown that there is no generic tool available for the measurement across all population- and age-groups, and tools focusing on physical activity are scarce. However, our results can be used as guide for future projects that aim at measuring capabilities.
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Affiliation(s)
- M Till
- Department of Sport Science and Sport, Friedrich-Alexander-University, Erlangen Nuremberg, Gebbertstraße 123b, 91058, Erlangen, Germany.
| | - K Abu-Omar
- Department of Sport Science and Sport, Friedrich-Alexander-University, Erlangen Nuremberg, Gebbertstraße 123b, 91058, Erlangen, Germany
| | - S Ferschl
- Department of Sport Science and Sport, Friedrich-Alexander-University, Erlangen Nuremberg, Gebbertstraße 123b, 91058, Erlangen, Germany
| | - A K Reimers
- Department of Sport Science and Sport, Friedrich-Alexander-University, Erlangen Nuremberg, Gebbertstraße 123b, 91058, Erlangen, Germany
| | - P Gelius
- Department of Sport Science and Sport, Friedrich-Alexander-University, Erlangen Nuremberg, Gebbertstraße 123b, 91058, Erlangen, Germany
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Trani JF, Moodley J, Anand P, Graham L, Thu Maw MT. Stigma of persons with disabilities in South Africa: Uncovering pathways from discrimination to depression and low self-esteem. Soc Sci Med 2020; 265:113449. [PMID: 33183862 PMCID: PMC7576188 DOI: 10.1016/j.socscimed.2020.113449] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Revised: 10/10/2020] [Accepted: 10/12/2020] [Indexed: 01/28/2023]
Abstract
Despite the fact that universal inclusion is a basic principle of the Sustainable Development Goals, the inclusion of persons with disabilities in humanitarian interventions and development policies remains elusive. Persons with disabilities face high risks of poverty, poor nutrition, limited inclusion in labor markets and poor mental health as a result. Stigma is likely to play a negative role in this regard and yet, no study has investigated the impact of stigma on depression and self-esteem of persons with disabilities. To address this gap in the literature, we conducted in June 2017 a random sample disability case control household study in Soweto, a township in Johannesburg, South Africa. Using propensity score analysis and structural equation modeling, we investigated the relationship between disability, stigma, depression and self-esteem controlling for socioeconomic covariates. Our main empirical results showed that stigma significantly mediates the association between disability and higher depression on the one hand and between disability and lower self-esteem on the other. This mediating effect exists even after controlling for age, gender, marital status, education, employment and wealth. We also found strong direct associations between disability and depressive mood, somatic indicators and negative feelings such as unhappiness and low self-esteem. Unemployment aggravates depression and low self-esteem while low education worsens self-esteem only. In addition, depression exacerbates low self-esteem. Both unemployment and low education are more common among persons with disabilities aggravating the disability, depression, poor self-esteem nexus. Similarly, persons with disabilities who are more likely to be depressed are also at higher risk of low self-esteem. These results point to a vicious reinforcing circle of exclusion from society, despair and self-deprecation, which could prove difficult to break. Substantial psycho-social support and anti-stigma policies anchored in local cultural values, engaging persons with disabilities and their communities, are required to break this vicious circle.
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Affiliation(s)
- Jean-Francois Trani
- Brown School and Institute of Public Health,Washington University in St Louis, 1 Brookings Drive, St Louis, MO, 63130, USA.
| | - Jacqueline Moodley
- Department of Psychology, University of Johannesburg, Johannesburg, South Africa
| | | | - Lauren Graham
- Centre for Social Development in Africa, University of Johannesburg, Johannesburg, South Africa
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Corpas R, Griñán-Ferré C, Palomera-Ávalos V, Porquet D, García de Frutos P, Franciscato Cozzolino SM, Rodríguez-Farré E, Pallàs M, Sanfeliu C, Cardoso BR. Melatonin induces mechanisms of brain resilience against neurodegeneration. J Pineal Res 2018; 65:e12515. [PMID: 29907977 DOI: 10.1111/jpi.12515] [Citation(s) in RCA: 52] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Accepted: 06/06/2018] [Indexed: 12/20/2022]
Abstract
Melatonin is an endogenous pleiotropic molecule which orchestrates regulatory functions and protective capacity against age-related ailments. The increase in circulating levels of melatonin through dietary supplements intensifies its health benefits. Investigations in animal models have shown that melatonin protects against Alzheimer's disease (AD)-like pathology, although clinical studies have not been conclusive. We hypothesized that melatonin induces changes in the brain that prevent or attenuate AD by increasing resilience. Therefore, we treated healthy nontransgenic (NoTg) and AD transgenic (3xTg-AD) 6-month-old mice with a daily dose of 10 mg/kg of melatonin until 12 months of age. As expected, melatonin reversed cognitive impairment and dementia-associated behaviors of anxiety and apathy and reduced amyloid and tau burden in 3xTg-AD mice. Remarkably, melatonin induced cognitive enhancement and higher wellness level-related behavior in NoTg mice. At the mechanism level, NF-κB and proinflammatory cytokine expressions were decreased in both NoTg and 3xTg-AD mice. The SIRT1 pathway of longevity and neuroprotection was also activated in both mouse strains after melatonin dosing. Furthermore, we explored new mechanisms and pathways not previously associated with melatonin treatment such as the ubiquitin-proteasome proteolytic system and the recently proposed neuroprotective Gas6/TAM pathway. The upregulation of proteasome activity and the modulation of Gas6 and its receptors by melatonin were similarly displayed by both NoTg and 3xTg-AD mice. Therefore, these results confirm the potential of melatonin treatment against AD pathology, by way of opening new pathways in its mechanisms of action, and demonstrating that melatonin induces cognitive enhancement and brain resilience against neurodegenerative processes.
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Affiliation(s)
- Rubén Corpas
- Institut d'Investigacions Biomèdiques de Barcelona (IIBB), CSIC and IDIBAPS, Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Christian Griñán-Ferré
- Faculty of Pharmacy and Food Sciences, Institut de Neurociències, Universitat de Barcelona and CIBERNED, Barcelona, Spain
| | - Verónica Palomera-Ávalos
- Faculty of Pharmacy and Food Sciences, Institut de Neurociències, Universitat de Barcelona and CIBERNED, Barcelona, Spain
| | - David Porquet
- Institut d'Investigacions Biomèdiques de Barcelona (IIBB), CSIC and IDIBAPS, Barcelona, Spain
| | - Pablo García de Frutos
- Institut d'Investigacions Biomèdiques de Barcelona (IIBB), CSIC and IDIBAPS, Barcelona, Spain
| | - Silvia M Franciscato Cozzolino
- Department of Food and Experimental Nutrition, Faculty of Pharmaceutical Sciences, University of São Paulo, São Paulo, Brazil
| | - Eduard Rodríguez-Farré
- Institut d'Investigacions Biomèdiques de Barcelona (IIBB), CSIC and IDIBAPS, Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Mercè Pallàs
- Faculty of Pharmacy and Food Sciences, Institut de Neurociències, Universitat de Barcelona and CIBERNED, Barcelona, Spain
| | - Coral Sanfeliu
- Institut d'Investigacions Biomèdiques de Barcelona (IIBB), CSIC and IDIBAPS, Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Bárbara R Cardoso
- Institute for Physical Activity and Nutrition Research (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Vic., Australia
- The Florey Institute of Neuroscience and Mental Health, Melbourne, Vic., Australia
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Disability as deprivation of capabilities: Estimation using a large-scale survey in Morocco and Tunisia and an instrumental variable approach. Soc Sci Med 2018; 211:48-60. [PMID: 29890357 DOI: 10.1016/j.socscimed.2018.05.033] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2017] [Revised: 05/15/2018] [Accepted: 05/16/2018] [Indexed: 11/22/2022]
Abstract
The capability approach pioneered by Amartya Sen and Martha Nussbaum offers a new paradigm to examine disability, poverty and their complex associations. Disability is hence defined as a situation in which a person with an impairment faces various forms of restrictions in functionings and capabilities. Additionally, poverty is not the mere absence of income but a lack of ability to achieve essential functionings; disability is consequently the poverty of capabilities of persons with impairment. It is the lack of opportunities in a given context and agency that leads to persons with disabilities being poorer than other social groups. Consequently, poverty of people with disabilities comprises of complex processes of social exclusion and disempowerment. Despite growing evidence that persons with disabilities face higher levels of poverty, the literature from low and middle-income countries that analyzes the causal link between disability and poverty, remains limited. Drawing on data from a large case control field survey carried out between December 24th, 2013 and February 16th, 2014 in Tunisia and between November 4th, 2013 and June 12th, 2014 in Morocco, we examined the effect of impairment on various basic capabilities, health related quality of life and multidimensional poverty - indicators of poor wellbeing-in Morocco and Tunisia. To demonstrate a causal link between impairment and deprivation of capabilities, we used instrumental variable regression analyses. In both countries, we found lower access to jobs for persons with impairment. Health related quality of life was also lower for this group who also faced a higher risk of multidimensional poverty. There was no significant direct effect of impairment on access to school and acquiring literacy in both countries, and on access to health care and expenses in Tunisia, while having an impairment reduced access to healthcare facilities in Morocco and out of pocket expenditures. These results suggest that public policies in Morocco and Tunisia must create additional and targeted opportunities for persons with disabilities through innovative social arrangements to improve wellbeing.
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Melander C, Sävenstedt S, Wälivaara BM, Olsson M. Human capabilities in advanced dementia: Nussbaum's approach. Int J Older People Nurs 2017; 13:e12178. [PMID: 28990351 DOI: 10.1111/opn.12178] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Accepted: 09/14/2017] [Indexed: 11/29/2022]
Abstract
AIMS AND OBJECTIVES To explore how Martha Nussbaum's approach to human capabilities can apply to dignity in the lives of people with advanced dementia living in nursing homes. BACKGROUND Challenges experienced when supporting people with advanced dementia who express problematic behaviours include understanding their needs and ensuring a dignified life for them. DESIGN AND METHODS Data were gathered using an ethnographic approach based on participatory observation. Nussbaum's capability approach was then used as a framework for the analysis. Four women diagnosed with advanced dementia who also expressed problematic behaviours were recruited from a nursing home in Northern Sweden. The data collection was performed during 2015. FINDINGS Individuals with advanced dementia had difficulties in participating in the planning of their lives and achieving the human capability of practical reasoning. They were also at risk of being placed outside the social group, thus hindering them from attaining the human capability of affiliation. A dignified life for individuals with advanced dementia requires nursing staff to be present and to provide adapted support to ensure that the individual can actually pursue human capabilities. CONCLUSION Creating opportunities for the human capabilities of practical reasoning and affiliation is essential as they permeate all other human capabilities. For these individuals, it was crucial not only to create opportunities for human capabilities but also to attend to their expressions and needs and to guide and steer them towards a dignified life. IMPLICATIONS FOR PRACTICE The normative structure of the capability approach described by Nussbaum can ensure that nursing staffs move beyond fulfilling patients' basic needs to consider other capabilities vital for a dignified life.
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Affiliation(s)
- Catharina Melander
- Division of Nursing, Department of Health Sciences, Luleå University of Technology, Luleå, Sweden
| | - Stefan Sävenstedt
- Division of Nursing, Department of Health Sciences, Luleå University of Technology, Luleå, Sweden
| | - Britt-Marie Wälivaara
- Division of Nursing, Department of Health Sciences, Luleå University of Technology, Luleå, Sweden
| | - Malin Olsson
- Division of Nursing, Department of Health Sciences, Luleå University of Technology, Luleå, Sweden
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Kenigsberg PA, Aquino JP, Bérard A, Brémond F, Charras K, Dening T, Droës RM, Gzil F, Hicks B, Innes A, Nguyen SM, Nygård L, Pino M, Sacco G, Salmon E, van der Roest H, Villet H, Villez M, Robert P, Manera V. Assistive Technologies to Address Capabilities of People with Dementia: From Research to Practice. DEMENTIA 2017; 18:1568-1595. [PMID: 28699364 DOI: 10.1177/1471301217714093] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Assistive technologies became pervasive and virtually present in all our life domains. They can be either an enabler or an obstacle leading to social exclusion. The Fondation Médéric Alzheimer gathered international experts of dementia care, with backgrounds in biomedical, human and social sciences, to analyze how assistive technologies can address the capabilities of people with dementia, on the basis of their needs. Discussion covered the unmet needs of people with dementia, the domains of daily life activities where assistive technologies can provide help to people with dementia, the enabling and empowering impact of technology to improve their safety and wellbeing, barriers and limits of use, technology assessment, ethical and legal issues. The capability approach (possible freedom) appears particularly relevant in person-centered dementia care and technology development. The focus is not on the solution, rather on what the person can do with it: seeing dementia as disability, with technology as an enabler to promote capabilities of the person, provides a useful framework for both research and practice. This article summarizes how these concepts took momentum in professional practice and public policies in the past 15 years (2000-2015), discusses current issues in the design, development and economic model of assistive technologies for people with dementia, and covers how these technologies are being used and assessed.
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Affiliation(s)
| | | | | | | | | | - Tom Dening
- Institute of Mental Health, University of Nottingham, UK
| | - Rose-Marie Droës
- Department of Psychiatry, VU University Medical Center, Amsterdam, The Netherlands
| | | | - Ben Hicks
- Bournemouth University Dementia Institute, UK
| | - Anthea Innes
- Salford Institute for Dementia University of Salford, Salford, United Kingdom
| | - Sao-Mai Nguyen
- Lab-STICC, Institut Mines-Télécom Bretagne, Brest, France
| | - Louise Nygård
- Department of Neurobiology, Care sciences and Society, Karolinska Institute, Stockholm, Sweden
| | - Maribel Pino
- Laboratoire Lusage, Hôpital Broca, Assistance publique-Hôpitaux de Paris, France
| | - Guillaume Sacco
- Centre Mémoire de Ressources et de Recherche, CHU de Nice; Université Côte-d'Azur, CoBTeK, Nice, France
| | - Eric Salmon
- Department of Neurology, Liège University Hospital, Belgium
| | - Henriëtte van der Roest
- Department of General Practice and Elderly Care Medicine, Amsterdaù Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands
| | | | - Marion Villez
- Laboratoire LIRTES, Université Paris-Est-Val de Marne, Créteil, France
| | - Philippe Robert
- Université Côte-d'Azur, CoBTeK, & Innovation Alzheimer Association, Nice, France
| | - Valeria Manera
- Université Côte-d'Azur, INRIA STARS & CoBTeK, Nice, France
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