DRIVE 2017 | 25 October - Future Health - Antonio A-Tjak
â˘Download as PPTX, PDFâ˘
1 likeâ˘175 views
Context | A healthcare perspective on balanced living Balanced living is build on nurturing patterns. Most of our behaviour is subconsious and largely automated. Some of our behavioural patterns are intrinsicly harmfull. To maintain and restore balance we need to redesign the bad patterns in our life. Antonio shares insights in how a combination of personalized care and the concept of vitality can give relevant cues for care services that aim at supporting healthy behaviour.
Recommended
Recommended
More Related Content
What's hot
What's hot (20)
Similar to DRIVE 2017 | 25 October - Future Health - Antonio A-Tjak
Similar to DRIVE 2017 | 25 October - Future Health - Antonio A-Tjak (20)
More from CLICKNL
More from CLICKNL (20)
Recently uploaded
Recently uploaded (20)
DRIVE 2017 | 25 October - Future Health - Antonio A-Tjak
- 2. DESIGN 4 HEALTHY BEHAVIOUR A HEALTHCARE PERSPECTIVE ON BALANCED LIVING
- 3. Instruments for diagnostics and therapy Medical design ⢠Narrow focus: pathology - patterns in cells & organs Vitality Care design ⢠Broad focus: pathology â patterns in the way we live BETTER TOOLS EXAMINE THE INVISIBLE Antonio A-Tjak 1957 Instruments 4 Healthcare
- 4. âYou canât expect relevant answers if you donât ask relevant questionsâ END USER LEARNING FROM IMBALANCE
- 5. Empowers our autonomy ⌠to do what we want and can do ourself (now + future) ⢠From left to right: Less vitalising support Fewer innovations VITALISING CARE
- 6. VITALITY A conceptual framework ⢠Organizing principle ⢠Needs <Questions > Solutions ⢠All aspects are HEALTH related Purpose: how do we organize new aids and interventions, so they will be found and used.
- 7. JORAM PARTICIPANT (19) 7 A true story
- 8. SNAPSHOT JORAMâS VITALITY Client Joram ParticipantVitality score chart
- 9. Patterns that donât work well Part 1 Healthy Diet PRACTICE VITALIZING JORAM
- 10. Patterns that donât work well PRACTICE VITALISING JORAM Part 2 Social Behaviour childhood present time
- 11. Personalized care An approach ⢠6 simple questions, 4 typifications ⢠4 tailored Support Styles ⢠Determined by percieved CONTROL over health and ACCEPTANCE of health status ⢠High impact of chronic desease and low SES on typification Finding fitting support is a problem EMPOWERMENT CUSTOMISATION 11 - Percieved CONTROL over health + -ACCEPTANCEofhealthstatus+ Planning & structure Offer practical help 72%/37%6%/7% 10%/33% 12%/23% Subjectively Experienced Health (Bloem&Stalpers 2012) Information Stimulate ride Personal coaching Create hope Emotive support Offer peace of mind
- 13. client at center stage ⢠Mindset Make the client feel able, self motivated ⢠Unfocus Not the pathology but focus on the patterns ⢠Fitting solutions Must feel comfortable. Pick solutions tailored ⢠Available Must be within reach: close, affordable ⢠Adaptable Shortterm-longterm RESTORING BALANCE
- 14. Consortium for validation of the Vitality Scan (3rd generation) ⢠Context: help empoyees, absent of work due to a crisis in their life, back to work before itâs too late ⢠Validation: compare effect to current alternatives (for a specified problemset) CALL 4 PARTICIPATION Potential partners ⢠Employer (>1000 workers) ⢠Research institute ⢠Potential implementation partner more @ vizir.org/index.php/call atjak@vizir.org
Editor's Notes
- PLEASE Note: This presentation contains material that is original and copyright protected. Patent pending
- PLEASE Note: This presentation contains material that is original and copyright protected. Patent pending BETTER TOOLS EXAMINE THE INVISIBLE Introducing Antonio the designer of tools that make the invisible visible What is common, what is different: Focus: from details inside towards the big picture, large as life itself Good morning I like to intruduce the theme of balance of living with a few perspectives from my own work, I am a designer by training and started my career some thirty years ago at Philips Medical, Designing instruments to make the invisible visible. I am talking about X-ray, Ultrasound and PET scanners, for diagnostics and therapy. Today I am still designing instruments to maken the invisible visible, but I have changed my focus from very narrow to very broad. This broad focus is rather important to understand the complexity balanced living can have.
- PLEASE Note: This presentation contains material that is original and copyright protected. Patent pending END USER LEARNING FROM IMBALANCE I am still in the scanning business, but today It I do not help analyse tissues and bone structures, The object of analyses is what people do and donât do. I donât use exotic waves but normal observation and language. The instruments I develop help reveal why peoples lifes are not in balance On the bottom of this slide you see 3 generations scan tools. On the left to help people in nursing homes get a more vital life, in the middle to do the same for old people living a secluded life at home And to the right to help people of all ages who have temporarily lost the ability to work (for non medical reasons) All three scan are design for use by a trained nurse. The one on the right is intended for aided self reflection.
- PLEASE Note: This presentation contains material that is original and copyright protected. Patent pending VITALISING CARE - Organising solutions In the early versions of the scan we had a focus in increasing self management of residents in nursing homes. It was an important ingredient in our aim to reactivate these residents. We involved the nurses that are providing care in the institution in the search for additional and alternative care. They hardly could find any because they looked at care that is just as they are used to which is care that leaves the client passive: The handson care on the right. To the right is traditional care where a caregiver does things for you, with you and on the left you are doing it yourself. When we searched for solutions that weren about handson care we did find all kind of aids and interventions that are directly or indirectly relate to health. They are often good clever solutions, scientifically validated, but hardly used. So in order to change the nature of the caregiving in nursing homes you also have to make care providers feel comfortable with applying the alternatives on the left. Because those are the solutions that empower the client and promote autonomy. This is a helpful flow chart in our search for new interventions and practical aids of all sorts. The more to the left in the chart we we searching, the more solutions we found.
- PLEASE Note: This presentation contains material that is original and copyright protected. Patent pending VITALITY â A framework When we had a lot of nice solutions we needed a way to organize them. We tried existing models and tinkered them until we were satisfied. This flower is a symbolic representation of how we have created a catalog We ended up with 8 stacks of elements that relate more to oneanother than to others So the flower represents a neat cupboard for storage - it is not a new definition - it is not a believe - it is not a new religion This cupboard has 8 drawers and in each drawer we 3 stacks: 1 on the left we see the needs that a client might experience 3 on the right the solutions that will address these needs And ⌠2 inbetween the questions that connects one to another Needs: Needs are the most abstract in the framework. We talk about the of friendship, financial means, fulfulling obligations, feeling meaningful, feeling save and so on Questions: The questions are about are you satisfied at present, what is going wrong with this aspect if you feel it is not good enough. And for more indepth investigation of consequenses, coping, your knowledge about alternatives etc. Solutions: Solutions can by therapies, physical, electronics or software aids, knowledge like quidelines, anything that helps fulfilling a need. Solutions are in categories and within those you can find variations based on the flowchart So to adhere to a schedule for your medicins you might have a solution in all sections af that flow chart. Some solutions might be in more places, because it they are not so discretely tied to one need. We call the solutions vitalines and we have multi-vitalines for solutions that address multiple needs . But you can forget that. It is just symbolism for the communication. Let me give you some sketchy describtions of the contents of the 8 drawers which we call vitality domains and just a few examples of what is in each of the domains Body Is basically what we think of as physical or somatic health Just as Think and Feel is more or less what we think of as mental health In body you wil find all the systems, organs, senses, As solutions you will find in our drawers mostly lesser known therapies for eg incontinence, eHealth therapies for, new devices that help you with drinking, new kinds of prothesis, the quantified self stuff. Etc Autonomy Is about control over your life It covers your daily self care, Dealing with administration, Here you will for instance different kinds of coaching to promote and informal care amongst the solutions Think & Feel I just said Examples are new therapies Cohabit Is about the social side of ourselves, relationships, and expectations towards each other So you find your family, friends, colleagues and support groups in here, and Environment Is about the place where you live, the place where you work Is it safe, clean, what is the quality Behave Is about healthy behaviour. There is a lot of knowledge based stuff like what is the benefit of less sugar or other ingredients. You will find aids to adhere to sound patterns and daily routines for better rest and sleep, ehealth and conventional therapies for that and of weight control, getting enough exercice during the day Purpose Is about what make get out of your bed. Things that are really important, your values, beliefs, hobbies, your bucketlist This domain is an important source for finding motifation to make a change in destructive behaviour. Develop Develop is about learning new things. It contains the stuff Prof Eric Scherder talks and writes about. It als on contains what you do to improve your outlook on what you can do with your life, like education and training. We have come full circle I hope this give you an idea, this will be enough for now TIME FOR SOME PRACTICE
- JORAM PARTICIPANT - introduction This is Joram. Joram is participant in our pilot, we gave him a new name. Joram participated as volunteer. He knew nothing more than it was about a new instrument with a lot of questions, And it would take 2 to 3 hours of his time. Joram was 19 years old, he just turned 20. Joram has 3 jobs. Joram is good looking, quite muscular, cheerful and comes across as a healthy and vital person.
- PLEASE Note: This presentation contains material that is original and copyright protected. Patent pending SNAPSHOT JORAMâS VITALITY This is Joramâs Vitality Snapshot (Vitality Score Chart) We have selected a set of near 100 topics for this scan and added a introduction question to each: How do you rate your satisfaction about this topic? This gives a set of scores that are visualised in this picture. Before going into detail: What is your first impression to this? Keep that in your mind. You see a lot of coloured balls. The colors of the balls represent the domains of the previously shown model. Same colour, same domain. Each ball respresents a set of scores to a set of questions from the Vitality Scan. The vertical position represents the value in terms of satisfaction. Example: Top left Domain Body, first ball contains results of10 questions all scoring 5 meaning very satisfying, The total set of this domain contains 21 topics in total. Ask audience I told you that Joram looks healthy as a fish, Is this what you would have expected? Discussion No, this is not what you would expect. If heâs health as a fish, there is a particular smell to this fish. The diagram shows a very dispersed arrangement of scores. I am talking about the vertical distribution. The scores are widely spread in 5 out of the 8 vitality domains. I havenât seen any chart so far that shows only balls in the top line, or even in the top two. Everybody has something. But this is serious. Is Joram faking it? Is he a fraud? No not at all the scan is made for his sake, it is an instrument for selfreflection. Who would he be faking for? Joramâs situation is definitely not a good at all. He is totally aware of this, but does not know how to get adequate support. He also experiencing tuff obstacles in important vitality domain of healthy behaviour. Some more details about Joramâs Snapshot: Most negative domain as a whole the orange one: Autonomy Most positive domain as a whole the green one: Purpose Positive: arrow up is large improvement on one item The curvy arrows that are in e sequence indicate there is a faulty pattern We will come to that in a minute Alarmbells: -- housing situation and experienced inadequate aid for mental problems Feather: ++ very good smelling and tasting capabilities
- PLEASE Note: This presentation contains material that is original and copyright protected. Patent pending PRACTICE VITALIZING JORAM Joram has a congenital defect: he was born with a heart condition. This means he in particular needs to take care of his diet and do propper physical exercise. In his case that is not easy. Take healthy food as an example. Joram eats a lot of junk food. He knows he should not. He knows enough about bad substances. Joram states he has no money and no means to cook. He has several odd jobs, but these vary a lot. When he has money he spends it all and usually he overspents in more florishing periods. At his stable job in a fast food restaurant (delivering and cleaning) he can have free food, which is fast food only. The long term solutions are the dotted lines they were addressed by practical coaching Joram, We will see shortley why that will work for him. The short term solutions were also very practical and more or less about finding smarter alternatives. As a resource of cheap fresh food Joram started to visit his grandparents 2 times a week. Grandma gives him a box with fresh stuff for the days in between.
- PLEASE Note: This presentation contains material that is original and copyright protected. Patent pending PRACTICE VITALISING JORAM This is a more complex example You see here a chain of events that started in Joramâs childhood. The summary of the complete pattern is in the 2 Yellow Circles: cause and effect This is an important recurring pattern. Joram has a certaing way of behaving when he has a conflict. He involves other people, who should not be involved, and does not talk constructive to those who are involved. So conflicts tend to be explosive and leading to the end of relationships. We see that Joram has serious problems with keeping jobs, friends and partners But when you meet Joram you see a kind, friendly, helpful young man Joram did not have caring parents. They were far too young when he was born. Joram made up his own set of guidelines to life and with no one to correct him they became more and more rigid. And now they cause him to encounter numerous conflicts. During the scan it dawned to Joram that he found the cause of his instable relationships by reflecting on his coping in difficult situations This was dazzling, but also make him wonder if this could mean he could do somthing about it. Etc.
- PLEASE Note: This presentation contains material that is original and copyright protected. Patent pending EMPOWERMENT - Customisation I like to bring a 3rd element in that helps in the process of restoring balance. It is about the way you organise support for the behavioural change. I find this model helpful. It is developed by Bloem and Stalpers It shows 4 styles of support With simple questions one can determine a persons mindset in terms of percieved control over his or her health and how he or she is accepting it. Based on that you can determine the supporting style to use Joram is a Type 2 client in terms of the previous shown SEH-segmentation This means Joram needs practical help in finding new solutions for his problems and how to go about it. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - With simple questions we can determine how self-supporting one is and how that can be empowered. To illustrate the meaning I have 2 aunts: aunt Carla and aunt Janet, both had a stroke, both lost their ability to speak Aunt Carla is an optimist, felt she could turn it around. She excercised hard and speaks again Aunt Janet felt overcome, could imaging to turn it around and canât really communicate. Aunt Carlaâs initial functional loss was more severe, but she had more reserves to deal with it. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Calculated size of the 4 quadrants: Research Bloem 2012 High acceptance and high control 72% High acceptance and low control 6% Low acceptance and high control 12% Low acceptance and low control 10% Research GGD Zuid-Oost NoordBrabant 2015 High acceptance and high control 36% High acceptance and low control 12% Low acceptance and high control 16% Low acceptance and low control 36% Expressed need for Coaching (Bloem) Total 10% Chronic desease: 22% Chronische desease and low SES (Social Economic Status): 33% Expressed need for Personal Coaching (GGD Z-O NB) Total 26% of the respondents feels a need for extra support (according definition positive health) Total 34% of the respondents feels a need for personal coach (absolute 9%) With respondents with low income, without job, low income the expressed need for a personal coach is up to 3 times greater. Datasources: (Posititeve) gezondheid bevorderen vanuit de beleving van burgers Resultaten van onderzoek naar de gezondheidsbeleving en ondersteuningsbehoeften in Zuid-Oost Brabant GGD Brabant-Zuidoost november 2015 Bloem, J.G. Gepersonaliseerde zorg de juiste richting. Inaugurele rede 24 oktober 2012. Brekelen: Nyenrode University Press, 2012.
- PLEASE Note: This presentation contains material that is original and copyright protected. Patent pending PRACTICE EMPOWERING JORAM Now I like to conclude Joramâs case by a short reflection Was the support effective and appropriate according to prof Bloem? Joram made some dramatic improvements regarding his vitality. His life is far more in balance. He moved about a week to a place of his own. He has his budget back under control Joram received a minimal amount of personal coaching to train him to manage his financial situation and to learn how to obtain better housing The approach to his mental/social problems was also very practical. Joram needs to recognize situations that can escalate He then uses a set of helping thoughts. These thought help him reframe his mindset at that particular moment. Joram informed his friends and colleages about his autism and asked them to help before things escalate. Time will tell how he will maintain his renewed vitality, but Joram feels stronger then ever
- PLEASE Note: This presentation contains material that is original and copyright protected. Patent pending RESTORING BALANCE - conclusion What are we learning from these scans and the process of supporting people in regaining their vitality? The learnings I like to share are universal for people experiencing serious problems. They apply to situations in which the client would receive coaching, but also for situations in which the client would manage the process him or herself It all starts with the client. MINDSET Understanding his or her current mindset and coaching it is really the first step. If there is not some form of intrinsic motivation it is hard to change. Creating a mindset in which the client can imagine the change in behaviour is key. You need to go beyond the single problem get UNFOCUSED Joram found the patterns that caused behaviour that is not promoting his vitality He found things he could and should change in the short and long run Joram found Fitting solutions he could imagine doing And he found solutions he could afford and were nearby He thought of the club manager as a coach And the suggestion of dining with someone of his inner circle made him think of his grand parents to get acces to fresh food. Adaptable In the process you should be working on short term and longterm solutions at the same time Short solutions should help you find succes and give you more control and raise the feeling of acceptance The longterm solutions you seek should make the change in your patterns durable. I have come to conclude my introduction to BALANCED LIVING by making an appeal to you.
- This presentation contains material that is original and copyright protected. Patent pending CALL 4 PARTICIPATION I like to invite you to work with me to validate the Vitality Scan and the coaching process that goes with it. We like to prove its value in the domain of prolonged absenteeism. It is a means to help people overcome a complex problems that obstruct their ability to function, amongst which the function to work. Several occupational doctors have confirmed they would like to apply it as one of the interventions they use. The scan and coaching is done by a experienced nurse with additional training. 1 in 3 employers has employees who are not able to work over a period longer that 21 days, for healthcare employers it is even 2 out of 3. The approach qualifies for about 1 in 3 employees that are prolonged inable to work. We know interventions should start as early as possible, to prevent serious damage. This could be the one that helps. My call to participate is for organisations, researchers and possible implementaiton partners If you are interested more info on our site or send me an email