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

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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