Feeling controlled or being in control? Apps for self-management among older people with neurological disability

Purpose: The aim of this paper was to describe how people living with a neurological disability such as multiple sclerosis, Parkinson’s disease and stroke reason regarding using apps to facilitate self-management in everyday life.Material and methods: A qualitative research approach with a focus group methodology was used. The sample comprised 16 participants, 11 men and 5 women, with an average age of 64 years (ranging from 51–80 years). Six participants were diagnosed with multiple sclerosis, six with Parkinson’s disease and four with stroke. Data were analyzed using thematic analysis, which is a method for identifying, analyzing and reporting patterns.Results: The results formed two themes. The first theme “using apps to have control of my health” comprises two subthemes; “monitor and take responsibility for a healthy lifestyle” and “compensate to facilitate everyday life”. The second theme “using the app as a tool and means for communication” also comprised two subthemes; “dare to trust the app” and “feeling safe when sharing information with health care professionals”.Conclusions: The use of apps put increased responsibility on the person and had the possibility to make them more involved in their own care. The use of an app can facilitate a healthy lifestyle and help to monitor disease-specific symptoms. In order to be able to use apps for communication with the health care sector legislation and safety issues need to be considered. Implications for rehabilitation Apps can be used for self-management if they are safe and can be trusted. People with neurological disabilities want to be involved in their healthcare and needs to be addressed by health care professionals. The use of apps grasp over a wide variety of areas this is something that may be considered in health care and something that can be addressed by interdisciplinary approaches. Ordinary health-oriented apps and disease-specific apps were used differently and for different purposes

Assistive Devices in Everyday Life for Very Old People - Use, Non-use and Opportunities for Use

The overarching aim of this thesis was to contribute to the existing knowledge on the use of assistive devices in everyday life, by adding the perspective of very old single living people in a European context, namely Latvia and Sweden. The aim was to investigate the socio-demographics and environmental and health aspects that impact on device use in the two national contexts. A further aim was to explore the prerequisites for use according to different aspects of the physical and institutional environment. The thesis builds on four studies in which a variety of study designs have been employed. The data derived partly from a European project on home and health – the ENABLE-AGE Project – and additional data were collected for two of the studies. Quantitative data from the Latvian and Swedish sub-samples of the ENABLE-AGE Survey Study comprising well-established instruments and study-specific questionnaires designed to capture objective and subjective aspects of home and health were used (Study I, II, IV), and additional qualitative interview data were collected through semi-structured interviews in Latvia (Study III) and Sweden (Study II, III). Study I: In a Swedish subsample no differences were seen between users and non-users of assistive devices according to socio-demographic or environmental variables at baseline or follow-up. The significant differences seen were related to aspects of health. The number of users increased over the study period and barriers in the outdoor environment turned out to predict use of mobility devices. Study II: In a Swedish subsample of three very old men using mobility devices, it was shown that the social and physical environment impacted on device use. Well-designed devices facilitated device use, while poor street conditions, crowded public transports and bad weather hampered mobility device use. Study III: Both differences and similarities were shown between Latvia and Sweden regarding the organisation and operationalization of the national service delivery systems for assistive technology. The utilisation of professional competences and national financial circumstances affected very old people’s opportunities to be provided with assistive devices. Study IV: In Latvian and Swedish subsamples, national differences were seen in number and type of reported leisure activities outside the home. Differences were also seen for the number of activities reported between users and non-users of mobility devices in relation to their self-rated physical mobility. Conclusion: The use of assistive devices increases with age and supports very old people in everyday life activities, even though there are differences between Latvia and Sweden. In order to ensure equal opportunities for activity and participation for very old people across Europe, it is important to understand what lies behind personal and environmental prerequisites for the use of assistive devices within as well as between countries

Housing accessibility for senior citizens in Sweden : Estimation of the effects of targeted elimination of environmental barriers

Aim: To estimate the effects of targeted elimination of environmental barriers (EB) in the ordinary housing stock in Sweden, and to explore the estimated effects on accessibility at a population level in relation to (a) residents with different functional profiles, (b) different housing types and (c) building periods. Method: Data on dwellings from existing Swedish research databases were utilized. EB and accessibility were assessed by means of the Housing Enabler instrument. In simulations of EB removal, five items that correspond to the most common housing adaptations were selected. The simulations were applied to four functional profiles of different complexity. Result: EB known to be commonly removed by housing adaptations exist in large proportions of the existing ordinary housing stock. Estimated targeted elimination of selected barriers would have the largest accessibility effects for the more complex functional profiles. The effects would be consistently larger for one-family houses, and for all types of dwellings built before 1960. Conclusions: The elimination of the EB most commonly addressed by housing adaptations could result in a reduction of the housing accessibility problems that community-living older people are facing. For society to solve the housing situation for the ageing population well-informed and efficient upgrading of ordinary housing is imperative