Demand Driven Care and Technology for Independently Living Older Persons Dr. Helianthe S.M. Kort, Associate Professor Demand Driven Care Hogeschool van Utrecht, University of Professional Education Hilly.kort@hvu.nl

Demand Control Demand control is a package of measures in order to enhance the authority of civilians in relation to the available supply. Demand driven processes such as a free market system is also seen in education, day care, housing and health care .

Demand Driven Care (Health) Care used to be supply driven only Transition process Bureaucratic centrally driven and planning towards Empowerment of Quality of care and Quality of Live

Demand Driven Care Enhancement of the position of patients and clients Development of measures of freedom and a stimulating care structure Implementation of an equal playing ground for care suppliers Creation of a sufficient care supply

Context of the Transition process Ageing of the population Institutionalization -> Socialization Increasing care demand Patients -> Empowerment of Clients Institutional related funding -> Performance related funding More freedom of choices Free market-basis system Limited availability of professional carers Application of Technology

Ageing of the population Growth in 55-pluss Hazing Potential working force decreases Ageing in the Netherlands Felevoland approx. 20% (65 plus) In 2050 increase to 100% Highst 65 plus in Europe Belgium and Germany (16,9%) France (16,2%) UK (15,9%) The Netherlands (13,6%)

Increasing care demand Elderly deteriorating health Diseases increases Dementia, COPD, Diabetes mellitus, angiopathy, several Cancers Mental disorders Limitation in ADL Domestic work Mobility Personal Care

Increasing care demand The potential demand is expected to increase by almost 50%. This demand almost equals the growth of the population of 65 years and over. The potential demand for care at home increases more rapidly (53%) compared to the demand for institutional care (42%). The type of the potential demand for care by elderly, varies from 40% - 80% for personal care and supporting care respectively

Availability of professional carers The need for professional care givers increases every year, by 2% on average. More than one out of ten people of the professional population work in the care- and welfare sector of which 78% are women working part time. Approximately 22% of the work force should be employed in the care- and welfare sector by the year 2025

Application of Technology 93% of the elderly (2.2 mil of 65 plus) lives indepentenly 33% of the elderly with a sever physical disorder has no appropriate house Appliance Technology Adaptation of houses stair elevators Houses without a threshold 0-floor houses personal alarming

Smart Homes related with bio-sensors Health Smart Homes Permit return at home Stay at home Generic -> specific sensors Human daily activities (telemonitoring) Physiological processes (cardiac / respiratory rhythm) Specific disorder sensors -> alarm triggering Asthma Angiopathy Mental disorders

Tele-healthcare Telemonitoring Telecare Telemedicine Teleconsultation Not always cost effective patients experience an improvement of the quality of care Teledermatology is more cost effective when patients are living remotely. Teledermatology has an effect on long waiting lists, impact on job satisfaction, cost of return visits and less time off work Teleconsultation Videolinked support Informal carers (Alzheimer’s disease) Routine procedure for welcoming and conducting the assessment

Stefanov, D. H. , Bien, Z. , and Bang, W. -C. (2004) Stefanov, D.H., Bien, Z., and Bang, W.-C. (2004). The Smart House for Older Persons and Persons With Physical Disabilities: Structure, Technology Arrangements, and Perspectives. IEEE Transactions on Neural Systems and Rehabilitation Engineering, 12(2), 228-250.

References De Klerk, M.M.Y. (ed.) (2004). Zorg en Wonen voor Kwetsbare Ouderen. Den Haag, the Netherlands: Sociaal en Cultureel Planbureau. Demongeot, J., Virone, G., Duchêne, F., Benchetrit, G., Hervé, T., Noury, N., and Rialle, V. (2002). Multi-sensors acquisition, data fusion, knowledge mining and alarm triggering in health smart homes for elderly people. Comptes Rendues Biologies, 325(6), 673-682. Harringtin T. en Harrington M. Gerontechnology Why en How. Eindhoven, Herman Bouma foundation for Gerontechnology, 2000 Kammen J. (red) . Zorgtechnologie Kansen voor innovatie en gebruik,. Den Haag, STT, 2002 Kort HSM en Bakker E. Kwetsbare mensen op de stoep van de thuiszorg. Aard en omvang van de problematiek, van kwetsbare mensen die huishoudelijke zorg ontvangen vanuit de thuiszorg en de samenwerking tussen thuiszorg en GGZ op dit terrein. Utrecht NIZW 2004. Krijger E. Handleiding. Kleinschalig groepswonen voor mensen met dementie. Inhoudelijke en praktische adviezen.Utrecht, Amstelring / IWZ 2004 Lange de J. en Staa van A. Transities in ziekte en zorg. Op zoek naar een nieuw evenwicht. Rotterdam, oratie Hogeschool Rotterdam, 2003. Overbeek van R. en Schippers A (red). Ouder worden we allemaal. Trendstudies en toekomstdebatten over de vergrijzing in Nederland. Utrecht, NIZW, 2004 Raad voor de volksgezondheid en Zorg. Technologische innovatie in de zorgsector. Zoetermeer: RVZ 2001. Schuurmans MJ en Duijnstee MSH. Ouder worden Blijvend in balans een dagelijkse zorg. Utrecht, oratie Hogeschool van Utrecht, 2003 Snijders MCL. Indoor Air quality and physical independence. An innovative view on healthy dwellings for individuals with chronic lung disease. Eindhoven, dissertatie TU Eindhoven, 2001Stefanov, D.H., Bien, Z., and Bang, W.-C. (2004). The Smart House for Older Persons and Persons With Physical Disabilities: Structure, Technology Arrangements, and Perspectives. IEEE Transactions on Neural Systems and Rehabilitation Engineering, 12(2), 228-250. Tyrell, J., Couturier, P., Montani, C., Franco, A. (2001). Teleconsultation in psychology: the use of videolinks for interviewing and assessing elderly patients. Age and Ageing 30, 191 – 195 Van den Bergh Jeths, A., Timmermans, J.M., Hoeymans, N., and Woittiez, I.B. (2004). Ouderen Nu en in de Toekomst. Bilthoven, the Netherlands: Rijksdienst voor Volksgezondheid en Milieu.