Ageing – a Global Challenge: Needs: are we moving towards a new health paradigm?
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Ageing – a Global Challenge: Needs: are we moving towards a new health paradigm?. Franco A. eHealth week 2010 (Barcelona: CCIB Convention Centre; 2010)
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Ageing – a Global Challenge: Needs: are we moving towards a new health paradigm?
- 1. Needs: are we moving 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 Bronswijk et 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 is unavoidable, 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-WHO 1980) Disease • Impairment (organ/function) • Disability (activity/ person) • Handicap (social life) Dependency
- 17. Philip Wood’s Sequence (ICIDH-WHO 1980) Disease • Impairment (organ/function) • Disability (activity/ person) • Handicap (social life) Dependency
- 18. Interactions between the components 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 the components 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 the components 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
- 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 a decrease in functioning Function Decompensation threshold Life
- 26. Aging means less reserve for functioning Function Reserve Decompensation threshold Life
- 27. Aging means less reserve for functioning Function 1 2 Reserve Decompensation threshold Life
- 28. Aging means less reserve 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 the needs 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 the needs 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 the needs 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 & Case management Disease management Monopathology Young & Adult Health issues Drugs Groups
- 43. Disease & Case management 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 the WHO • ICD (10) fits with the traditional medical model, the disease-treatment model • ICF (1) fits with the new functioning model
- 45. Unifying conceptual model that 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 new health 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 older people • 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 is an 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 implies a 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