Transcript No Slide Title

Gerontechnology
for mental health and wellbeing of older
people
Vappu Taipale, Professor
Honorary President, International Society for
Gerontechnology
Nan Kai University of Technology, Taiwan, 14.4.2010
Gerontechnology is engineering and design
for ensuring good health,
full social participation
and independent living up to a high age
Gerontechnology constitutes an
excellent partner for innovation
policies
• From the very beginning of the concept of
gerontechnology, the user perspective
has been strongly involved
• One of the leitmotives has been to listen
to the needs of an ageing person and to
communicate her/his needs to a wider
community
Gerontechnology constitutes an excellent
field for future developments
with increased opportunities of networking,
connecting people more effectively,
creating more leisure and pleasure,
and more communality between people –
providing elements of good mental health in old age
Vappu Taipale 2010
In drafting scenarios and
studying the future, the only
thing that can be taken for
granted is ageing
Vappu Taipale 2010
Population ageing is one of humanity’s
greatest triumphs.
It is also one of our greatest challenges
and places increasing economic and
social demands on all countries.
Vappu taipale 2010
Ageing is a global megatrend
and so is the development of
technology
Why do these two concepts feel
uncomfortably in each other`s company?
Vappu Taipale 2010
Ageing in Taiwan?
An excellent laboratory?
• Increase in life expectancy
• Rapid ageing of the population
• Rapid economical growth
• Very high saving rates
• Rapid transition from high to low population
growth
• The fraction of the elderly who live with their
children is declining
• The welfare programmes are estimated to be
underdeveloped
Vappu Taipale 2010
The Information Society is here
The industrial mode of production gave
rise to the concept of life cycle
Retirement was an industrial innovation…
In the information societies…
• mode of production changes the
everyday life
• family structures are changing
• people are ”connected” 24/7
• life cycle takes a new shape
Vappu Taipale 2010
Information society challenges?
Skills and competence have become
a major capital asset
The life cycle in an industrial society
has changed: youth is eating up
both childhood and early adulthood,
ageing brings along ” the crown of
life”
The information society …
• will require mental capacities:
flexibility, innovativeness,
creativity, connectivity, social
skills, learning…
• as such it will not be dependent
on technical devices
• but a mental construction
Vappu Taipale 2010
The information society … (cont´d)
and the biggest threats will be
• exclusion
• poverty
• mental disorders and addiction &
substance problems
• and negligence of the potential of
ageing people
Vappu Taipale 2010
65+ Population 1900-2040, Finland
(Source : Statistics Finland 2004)
65+ (%)
30
25
20
15
10
5
0
1900
1950
1990
1998
1999
2000
2001
2002
2003
2004
2010
2020
2030
2040
Ageing is a resource, but this requires
shifts in attitudes from a medicalised
approach to a socio-cultural approach
Wellbeing in old age
Ageing well in all policies
• Independent living is a characteristic
shared by both individuals and society.
• It requires a multisectoral,
transdisciplinary approach
• It is generated by all policies, in all
sectors.
• Responsibility for ageing well must be
adopted everywhere, in R & D & I, in
transportation, commerce, community
planning, education, culture, national
security and in combating exclusion.
Vappu Taipale 2010
The future older people will…
• be better and better educated
• have better level of general health and
wellbeing
• live increasingly alone
• have more reasonable pensions
• be more active politically
• become more demanding
• be an utmost heterogeneous group
• have an increased risk of dementia
• have an increased risk of marginalisation
and poverty
Vappu Taipale 2010
The number of older people over 60 years is expected
to increase
from about 600 million in 2000 to over 2
billion in 2050.
This increase will be greatest and the most rapid in
developing countries, where the number of older
people is expected to triple during the next 40
years.
By 2050, over 80 per cent of older people
worldwide will be living in developing
countries.
At the same time, the number of ‘older old’persons in
the developed world will reach unprecedented levels.
Source: Population Division of the Department of Economic and Social
Affairs of the United Nations Secretariat, World Population Prospects: the
2008 Revision: http://esa.un.org/unpp
How to create good strategies for an
ageing world?
•
•
•
•
•
•
to empower older people (participation)
to extend working life (level of pensions)
to increase the quality of life (promotion)
to support independent living (prevention)
to create innovative solutions (services)
to diminish the costs of old age
(comprehensive policies)
Vappu Taipale 2010
Gerontechnology is needed
everywhere
•
•
•
•
•
•
In participation – connecting people
in working life - age management
in promotion - fun technology etc
in prevention of loss of function
in economy - supporting ageing in place
in policies – comprehensive approach
Vappu Taipale 2010
Wellbeing means opportunities for
• Security
• Social relations
• Meaningful life
• Mental wellbeing
• Physical activity
• Leisure and pleasure
• …..
and gerontechnology is needed here
Vappu Taipale 2010
Age diversity vs biodiversity?
No age group is as heterogeneous as older
persons
They differ
• socially,politically
• culturally
• ethnically
• in education, mentality, preferences etc
Mass individualisation is needed!
Vappu Taipale 2010
Wellbeing is multifacetted
Research reports:
• Physical excercise prevents depression
and dementia
• Walking is healthy! It promotes cardiac
health and positive mood
• Social group activities decrease mortality
(Kaisu Pitkälä 2008)
• Tai Chi prevents falls and promotes
functional ability
(Sattin 2005)
Vappu Taipale 2010
Age-adjusted prevalence of good and fairly good
self-reported health
(Source: Aromaa &
Koskinen 2004)
1978-80
2000-01
Percentage of people without difficulties in
ADL,1978-80 and 2000-01
%
Women
Men
100
2000-01
80
2000-01
60
1978-80
1978-80
40
20
0
55-59 60-65
66-69
70-74 75-79 80-84
85+
55-59 60-65
66-69
70-74 75-79 80-84
* Dressing/undressing, getting in/out of bed, moving around in the house
85+
(Martelin et al 2004)
Age
Integration into society helps
enhance health
• Both theoretically and
methodologically, health research
has recently increasingly focussed
on cohesion in communities and
societies, people’s integrative
needs and action models that
promote integration.
Vappu Taipale 2010
What is mental health?
Mental health is…
• A renewable natural resource
• It is a charcteristic of all human
beings and human societies
• It has physical, psychological, social
and spiritual elements
• During everyday life it is used and
renewed
Vappu Taipale 2010
Where is mental health
produced?
• Mental health is produced by all policies,
all people, all civil society actors
• It is produced in various settings: in
societies, schools, workplaces, natural
surroundings, sports, hobbies
• Health creates social capital and social
capital creates health and mental health
• Mental health promotion is the best way to
increase population mental health
• Mental health requires intersectorality,
interdisciplinarity, interprofessionality
Vappu Taipale 2010
Our competitive edge?
A sound level of mental health,
• high self-esteem,
• vitality,
• resilience
• and a sense of coherence in
one´s life,
form our basis of success.
Vappu Taipale 2010
There is no health
without mental health
• Our natural, social, cultural and built
environment contribute to our mental health:
• We need beauty, harmony, stimulation, social
networks, access to nature and silence
• Older people contribute to mental health of
families and societies
Vappu Taipale 2010
Mental health
• has to be included in all policies
• is an integral part of all policies
Vappu Taipale 2010
How do psychosocial factors affect?
• Mental health has a strong social element
where the emphasis is on justice
• Social justice is just now important
because of the global economical crisis
• Psychosocial factors gain importance with
the information society development
• Psychosocial factors are always both
societal and interpersonal, connected with
relations between people
Vappu Taipale 2010
Promotion and prevention in the
field of mental health?
Sceptical reactions are common
• Wishful thinking?
• Poorly defined field
• Difficult to understand how to promote
• No scienticif knowledge
• We do not know if it works
Vappu Taipale 2919
…but there are main
developments in start 21st century
• Prevention and mental health promotion are
recognized priorities of WHO and European Union,
thus also of national governments
• Translated in policy documents and action plans (e.g.
EU`s Green Paper)
• Fast growing knowledge on mental health, social and
economic outcomes of intervention
• Databases with evidence- based programmes, best
practices and guidelines, systematic dissemination
efforts
Clemens Hosman 2009
What is the situation?
• Regrettably, investment in
mental health has been low,
while the population´s mental
health level is far from
satisfactory.
• Finland has been striving for
mental health issues in the
European Union
Vappu Taipale 2009
The European Union
European Union Member States (27) have
signed Mental Health Pact in 2008
There are four different issues in the Pact:
• Prevention of Depression and Suicide
• Mental health in Workplaces
• Promotion of Mental Health and Wellbeing of
Children and Young People
• Mental Health of Older People –
• Meeting of Member States 19.-20.4. 2010
Key Messages/EU
•
•
•
Policy: Policies in multiple sectors should be formulated with
consideration to factors which have an impact on the healthy
ageing, well-being, autonomy and capacity of older adults.
Mental Health Promotion: A healthy lifestyle, safe living
environment and meaningful, active participation in society and
the community are important protective factors for mental wellbeing in older age. Support from families and peers play a key role
in promoting the mental health of older people. Prevention of
loneliness and isolation is one of the most powerful strategies to
promote mental health and well-being in old age. Mental health
promotion measures are also important for improving physical
health and successful ageing.
Mental Disorder Prevention: Prevention of the most common
mental disorders involves addressing the risk factors for mental
health problems in old age, such as physical impairment, and
improving help seeking (for example, through combating stigma),
early detection and intervention, before mental health problems
emerge.
Vappu Taipale 2010
Rights of Older People
Promoting 'healthy
ageing' also means
fighting the roots of
inequalities which lie in
socio-economic
circumstances earlier and later - in life.
United Nation´s work
• A draft Convention of
Older People´s Rights
has been created in
2010
• Published by IFA,
GAA, AARP, HelpAge
International, etc
Soft laws
There is also a body of ‘soft’ law guiding the
treatment of older women and men, including
the UN Principles for Older Persons (1991)
and
the Madrid International Plan of Action on
Ageing (MIPAA 2002).
Although human rights underpin the recommendations in
these soft
laws, they are not legally binding.
States are under a moral rather than a legal obligation to
follow their recommendations.
The Rights of Older People in
Asia
The creation of a new human
rights body under the 2008 Association of
South East Asian Nations (ASEAN) Charter
may provide an opportunity for considering
older people’s rights in South East Asia.
The Rights of Older People in Asia. Niti Saxena, International
Symposium on the Rights of Older People, London, January
2009.
Gerontechnology can promote mental health of
older people
New global solutions?
Research-based, user-friendly solutions
will be needed to feed into social and
technical innovation on a massive scale,
not only in terms of products and systems
for disability and rehabilitation,
or innovations for prevention and care,
but also for enabling participation and
supporting higher standards of living
and a better quality of life for senior citizens.
Vappu Taipale 2009
A well- informed ageing citizen?
• If the world sees a positive development,
we will be faced with an operating model
based on which a well-informed ageing
citizen, the consumer of services,
becomes a driver of development
• There are interesting opportunities for
everyday life, self care, and proactive
prevention, as well as to create better
living environments in social, financial
and human terms
Vappu Taipale 2009
Ethical questions
• Ageing will need to be understood
to a much broader extent
• Ageing people themselves have to
become partners of the research
and development
• They must have a say of the global
development
• Ethical questions will emerge more
powerfully in the context of new
innovation policies.
Vappu Taipale 2009