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Ageing – a Global Challenge: Needs: are we moving towards a new health paradigm?
The document discusses a shift towards a new health paradigm focusing on aging, frailty, and the role of technology in elderly care. It highlights the need for a functional approach to healthcare that addresses the lived experiences of older adults, including environmental and human rights needs. Ultimately, it emphasizes the importance of gerontechnology in enhancing quality of life and reducing caregiver burden.
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Ageing – a Global Challenge: Needs: are we moving towards a new health paradigm?
- 1. Needs: are wemoving towards a new health paradigm ? Alain FRANCO – franco.a@chu-nice.fr Professor of Internal Medicine and Geriatrics (Nice) President of the ISG President of the CNRSDA (France)
- 2. Supply • Technology &Services • ICT, • Gerontechnology, • Domotics, • Telemedicine, • ISG matrices
- 3. Gerontechnology matrices J.E.M.H. van Bronswijket al. Gerontechnology 2009;8(1):3-10
- 4. Outlook Age& generation matrix Target population Frailty & Dependence Main working phase Active retirement Formative years 2nd age 3rd age 4th age 1st age Mechanical products, hierarchical organization Technology generation Electro-mechanical products, hierarchical organization Menu driven products, layered software (‘Microsoft generation’) Gaming software with proficiency levels, relational (non- hierarchical) organization at each level J.E.M.H. van Bronswijk Gerontechnology 2009;8(1):3-10
- 5. Science Cross-fertilization Technology Communication (Bio)chemistry Mechatronics management (Bio)Physics Architecture Ergonomics Information Business Robotics Building Design Physiology Nutrition Gerontology Psychology Social psychology Sociology Demographics Medicine Rehabilitation J.E.M.H. van Bronswijk Gerontechnology 2009;8(1):3-10
- 6. Engineering Impact on application domains Application domain Communication Governance Self-esteem Daily living Transport Housing Mobility Leisure Health Work Enrichment Satisfaction Main goal Prevention Engagement Compensation Substitution Care support Care organization J.E.M.H. van Bronswijk Gerontechnology 2009;8(1):3-10
- 7. Demand • Needs •Disability and compensation • Frailty and prevention • Users
- 9. Female longevity isunavoidable, my Dear…!
- 10. Healthy Aging www.eugms2008.org
- 12. Nexter older generation Baby-boomers becoming« Papy-Boomers »
- 14. Future natural and professional care givers Children become care givers
- 15. Demographic transition (WHO) •> 10% of the 65+ • Europe 2000 15%, World’s number one • Developed countries in 2020 20% • Chronic diseases > acute diseases
- 16. Philip Wood’s Sequence (ICIDH-WHO1980) Disease • Impairment (organ/function) • Disability (activity/ person) • Handicap (social life) Dependency
- 17. Philip Wood’s Sequence (ICIDH-WHO1980) Disease • Impairment (organ/function) • Disability (activity/ person) • Handicap (social life) Dependency
- 18. Interactions between thecomponents of the ICF (International Classification of Functioning – WHO 2001) Health condition (disorder or disease) Body Functions & Structures Activities Participation (Limitations) (Restrictions) (Impairments) Environmental Personal Factors Factors
- 19. Interactions between thecomponents of the ICF (International Classification of Functioning – WHO 2001) Health condition (disorder or disease) Body Functions & Structures Activities Participation (Limitations) (Restrictions) (Impairments) Environmental Personal Factors Factors
- 20. Interactions between thecomponents of the ICF (International Classification of Functioning – WHO 2001) Health condition (disorder or disease) Body Functions & Structures Activities Participation (Limitations) (Restrictions) (Impairments) Environmental Personal Factors Factors
- 21.
- 22. Growing and aging Function Decompensation threshold Life
- 23. Growing and aging Function Decompensation threshold Life
- 24. Growing and aging Function 1 2 Decompensation threshold Life
- 25. Aging means adecrease in functioning Function Decompensation threshold Life
- 26. Aging means lessreserve for functioning Function Reserve Decompensation threshold Life
- 27. Aging means lessreserve for functioning Function 1 2 Reserve Decompensation threshold Life
- 28. Aging means lessreserve for functioning Function Reserve Frailty threshold Decompensation threshold Life
- 29. Functioning Decompensation treshold Life
- 30. Handicap Situation Functioning Decompensation treshold Life
- 31. Decompensation - Compensation Functioning Decompensation treshold Life
- 32. Prevention Functioning Decompensation treshold Life
- 33. Prevention Functioning Decompensation treshold Life
- 34. Compensation Functioning Decompensation treshold Life
- 35. Needs Housing Mobility solut. Functioning Accessibility Inf.Technology Drugs Care Employement Education Fun Leisure Decompensation treshold Life
- 36. Needs Housing Mobility solut. Functioning Housing Accessibility Mobility solut. Inf.Technology Accessibility Drugs Inf.Technology Care Drugs Employement Care Education Employement Fun Leisure Education Fun Leisure Decompensation treshold Prevention !... Life
- 37. Needs Housing Mobility solut. Functioning Housing Accessibility Mobility solut. Inf.Technology Accessibility Drugs Inf.Technology Care Drugs Employement Care Education Employement Fun Leisure Education Fun Leisure Decompensation treshold Prevention !... Life
- 38. Rights Housing Mobility solut. Functioning Housing Accessibility Mobility solut. Inf.Technology Accessibility Drugs Inf.Technology Care Drugs Employement Care Education Employement Fun Leisure Education Fun Leisure Decompensation treshold Prevention !... Life
- 39. Expression of theneeds by • The disease • Diagnostic, Treatment • Monopathology • Patients’ group or association or lobby • The consequences of the disease(s) • Pain, palliative care • Polypathology (ageing) • Disability, handicap
- 40. Expression of theneeds by • The disease • Diagnostic, Treatment • Monopathology • Patients’ group or association or lobby • The consequences of the disease(s) • Pain, palliative care • Polypathology (ageing) • Disability, handicap
- 41. Expression of theneeds by • The disease • Diagnostic, Treatment • Monopathology • Patients’ group or association or lobby • The consequences of the disease(s) • Pain, palliative care • Polypathology (ageing) • Disability, handicap
- 42. Disease & Casemanagement Disease management Monopathology Young & Adult Health issues Drugs Groups
- 43. Disease & Casemanagement Disease management Case management Polypathology Comorbidity Monopathology Frailty Young & Adult Disability Health issues Older person Drugs Functioning Social issues Groups Care Individual
- 44. Thus, from theWHO • ICD (10) fits with the traditional medical model, the disease-treatment model • ICF (1) fits with the new functioning model
- 45. Unifying conceptual modelthat shared risk factors may lead to geriatric syndromes, then to frailty, with feedback mechanisms. Poor outcomes. J Am Geriatr Soc 55:780–791, 2007.
- 46. Towards a newhealth paradigm • Moving from the hippocratic classical paradigm: • acute disease, diagnostic, treatment, hospital, prim. prevention, medical power, pharmacy • To a new functional paradigm: • case issues, personal functioning, chronical diseases, handicap, compensation, sec or tert. prevention, home care, shared power, technology
- 47. Needs for olderpeople • Environmental needs: housing, mobility, nutrition, inclusion,… Community, family, personal means, professionals, regions, EU,… good practices, quality of care • Human rights needs: security, equity in accessibility, no discrimination, minimal income, health & aid,… State guaranty, European initiative, International Convention under United Nations auspices, ….
- 48. Conclusions 1. Technology isan example of domain addressing needs in a new functioning paradigm 2. Technology takes place beside biology and human sciences as a major field of research in geriatrics and gerontology 3. Gerontechnology concerns aging or elderly user, either healthy, frail or diseased.
- 49. Conclusions 4. Gerontechnology impliesa common language between health professionals, methodologists, psycho-sociologists, technologists and a method to work together commonly practiced in gerontologic activities 5. In the future technology should efficiently contribute to prevention, assist aging physically and/or mentally handicapped persons, and contribute to reduce the burden of caregivers.
- 50. Take Home Messages •Technologies & services face multiple needs • There is a lack of caregivers in a close future • Should the market for healthy aging be the same or different from the market for diseased and frail persons ? • Who will pay in the routine ? • Needs for a clinical gerontechnology ?
- 52. Thèmes: • Méditerranée • Gérontechnologie •Thérapeutique