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 megatrendand 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
underdevelopedVappu 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, Finland65+ Population 1900-2040, Finland (Source : Statistics Finland 2004)(Source : Statistics Finland 2004)
0
5
10
15
20
25
30
1900 1950 1990 1998 1999 2000 2001 2002 2003 2004 2010 2020 2030 2040
65+ (%)
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 povertyVappu 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 inthe developed world will reach unprecedented levels.
Source: Population Division of the Department of Economic and SocialAffairs of the United Nations Secretariat, World Population Prospects: the2008 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
1978-80 2000-01
(Source: Aromaa & Koskinen 2004)
* Dressing/undressing, getting in/out of bed, moving around in the house
Percentage of people without difficulties in
ADL,1978-80 and 2000-01 %
Age
2000-01
%
100
80
60
40
20
0
55-59 60-65 66-69 70-74 75-79 80-84 85+
(Martelin et al 2004)
55-59 60-65 66-69 70-74 75-79 80-84 85+
Women Men
2000-01
1978-801978-80
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 well-being 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 thetreatment of older women and men, including
the UN Principles for Older Persons (1991)and the Madrid International Plan of Action onAgeing (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 tofollow 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
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