Periodic Reporting for period 2 - INNOVATEDIGNITY (Training the next generation of leaders to deliver innovations in dignified sustainable care systems for older people)
Reporting period: 2021-01-01 to 2023-06-30
INNOVATEDIGNITY aimed to develop a generation of thought leaders with transferable skills to deliver innovations in dignified, sustainable care systems for older people, including new care models and digital applications. INNOVATEDIGNITY’s research examines older peoples' perspectives with specific focus on dignity, investigates the potential for digital applications, and analyses gender to provide crucial, knowledge for fit for purpose care for older people to live well. INNOVATEDIGNITY addresses the European problem of how ageing people can live well in caring systems though four key areas:
1) Evaluating existing care systems and provide analyses that make use of older persons’ insights. 2) Examine conditions necessary to develop new innovations, including digital technology that offer dignity in care. 3) Provide an analysis of impacts of care models on the wellbeing of older people. 4) Examine impacts of gender on care delivery, on the leadership of caring and careers and the care workforce with focus on sustainability.
Our conclusions point to: investment in approaches that consider the whole person, which increases a sense of autonomy to ensure older people in Europe have the care support they need to live independent, fulfilling lives. Ensuring older people retain a sense of freedom to continue to engage in what is important to them in life. There is an urgent need to reframe, rethink and reflect again on the narrative that ageing is all about decline. Studies concluded that emotional support is as important to as practical support, effortless non-purposeful activities in care alongside care givers are essential.
Transitions between care settings are not sufficiently managed with negative impacts on older people, their families and professional carers.
The benefits and challenges of adopting digital technology are complex, and older people experienced digital technology as both helpful and the precise opposite, often negatively impacting identity, reinforcing stereotypes of older people as incompetent technology users and potentially increasing marginalisation. Therefore, innovations do not necessarily improve wellbeing for older generations.
Care systems need to be able to offer more than 'bare bones' care, more than observed minimum necessary aspects as care quality is found to be relational and relies on trustworthiness.
Promoting care as relationship with principles that can meet the human needs of older people (emotional and practical) requires a focus on care as relationship and this is not the same as workforce planning, staffing and skill mix. A sustainable, stable workforce is not currently available and this approach needs further investment.
Education for care leadership that is lifeworld led with training for support staff provides one potential direction for policy. Integration not fragmentation: The problems of fragmentation have manifest through several contexts and all research projects, this is a ‘red thread’ problem that is worsening. Bureaucratic splits, complex service delivery, organisational factors, divisions of responsibilities, multiple systems- some competitive, and the advent of diverse interoperable digital solutions add to this worsening complex challenge. Digital innovation can potentially add to care and wellbeing but it requires careful integration rather than simple implementation.
1) Evaluating existing care systems and provide analyses that make use of older persons’ insights. 2) Examine conditions necessary to develop new innovations, including digital technology that offer dignity in care. 3) Provide an analysis of impacts of care models on the wellbeing of older people. 4) Examine impacts of gender on care delivery, on the leadership of caring and careers and the care workforce with focus on sustainability.
Our conclusions point to: investment in approaches that consider the whole person, which increases a sense of autonomy to ensure older people in Europe have the care support they need to live independent, fulfilling lives. Ensuring older people retain a sense of freedom to continue to engage in what is important to them in life. There is an urgent need to reframe, rethink and reflect again on the narrative that ageing is all about decline. Studies concluded that emotional support is as important to as practical support, effortless non-purposeful activities in care alongside care givers are essential.
Transitions between care settings are not sufficiently managed with negative impacts on older people, their families and professional carers.
The benefits and challenges of adopting digital technology are complex, and older people experienced digital technology as both helpful and the precise opposite, often negatively impacting identity, reinforcing stereotypes of older people as incompetent technology users and potentially increasing marginalisation. Therefore, innovations do not necessarily improve wellbeing for older generations.
Care systems need to be able to offer more than 'bare bones' care, more than observed minimum necessary aspects as care quality is found to be relational and relies on trustworthiness.
Promoting care as relationship with principles that can meet the human needs of older people (emotional and practical) requires a focus on care as relationship and this is not the same as workforce planning, staffing and skill mix. A sustainable, stable workforce is not currently available and this approach needs further investment.
Education for care leadership that is lifeworld led with training for support staff provides one potential direction for policy. Integration not fragmentation: The problems of fragmentation have manifest through several contexts and all research projects, this is a ‘red thread’ problem that is worsening. Bureaucratic splits, complex service delivery, organisational factors, divisions of responsibilities, multiple systems- some competitive, and the advent of diverse interoperable digital solutions add to this worsening complex challenge. Digital innovation can potentially add to care and wellbeing but it requires careful integration rather than simple implementation.
In-depth findings, informed by listening to and describing older peoples' everyday experiences, span several European countries, data is available in multiple languages and our analysis offers over 30 working papers with results arising from their research projects, many published as scientific papers. Studies were redesigned taking account of COVID-19 impacts in care services relevant to each country in the consortium, methodologies have been ethically approved by national level ethical bodies. Data was collected face to face and not remotely where the national situation allowed.
1. Older people are subject to demands from society, expected to know how to use digital technological systems and are thrown into situations where they have to acquire new skills promptly, which they struggle to achieve. Technical aspects(design features, malfunctions, intrusiveness), individual aspects (strong desire to use, learning or non-adoption) and personal aspects (lack of human connection, touch or ‘face’ in technology ) and lack or older peoples’ inclusion in design) got in the way or promoted the use of technology. The phenomenon of sense of dignity, how expectations and needs are met within digitally led healthcare, indicates a sense of feeling lost in the digital world for older people and this is ethically challenging.
2. Care environments including transitions from hospital to home reveal meanings of care that are trustworthy and human relationship focused with possibilities for well-being structured by the institutional care environment. The cultural ideals around well-being in older age centre on the “successful ageing” values of independence, activeness, mobility and productivity however, dependence itself is not experienced as difficult or problematic, but the quality of the caring relationship is crucial to well-being. Retaining mobility and agency through supportive relations is key. A new sense of control was paramount and professionals can prioritise and offer control rather than take it away.
3. Studies reported ways gender impacts experiences of well-being and dignity for residents in care home and through care from a spouse. Just because we age does not mean that gender is not important. However, we do not have a better understanding of the ways gender and age nuance one another into old age, and how this shapes experiences of care.
1. Older people are subject to demands from society, expected to know how to use digital technological systems and are thrown into situations where they have to acquire new skills promptly, which they struggle to achieve. Technical aspects(design features, malfunctions, intrusiveness), individual aspects (strong desire to use, learning or non-adoption) and personal aspects (lack of human connection, touch or ‘face’ in technology ) and lack or older peoples’ inclusion in design) got in the way or promoted the use of technology. The phenomenon of sense of dignity, how expectations and needs are met within digitally led healthcare, indicates a sense of feeling lost in the digital world for older people and this is ethically challenging.
2. Care environments including transitions from hospital to home reveal meanings of care that are trustworthy and human relationship focused with possibilities for well-being structured by the institutional care environment. The cultural ideals around well-being in older age centre on the “successful ageing” values of independence, activeness, mobility and productivity however, dependence itself is not experienced as difficult or problematic, but the quality of the caring relationship is crucial to well-being. Retaining mobility and agency through supportive relations is key. A new sense of control was paramount and professionals can prioritise and offer control rather than take it away.
3. Studies reported ways gender impacts experiences of well-being and dignity for residents in care home and through care from a spouse. Just because we age does not mean that gender is not important. However, we do not have a better understanding of the ways gender and age nuance one another into old age, and how this shapes experiences of care.
A range of media for non-specialist audiences, the public and advocacy organisations for practice and policy influence eg online materials, exhibits, web pages, film and video clips. INNOVATEDIGNITY is committed to the creation of film & video clips some created using older peoples' own words, supplemented by public engagement events, and includes a long standing exhibition. Our outcomes impact societal implications and focus on these challenges:
1. If care is to be both technologically innovative and appropriate for older people, then it is important to understand dignity as a foundation for care of older people, and how technology may enhance or detract from dignity in care. Findings share older peoples’ experiences which will inform new developments that enhance dignity.
2. If care is to meet human need, challenges of living within care systems open up new directions for care that is up to the task of supporting older people to live well in care systems.
3. If care is to be sustainable, it is important to understand gender imbalances and implications of these with in-depth investigation of issues in care delivery to older people.
A stakeholder analysis guides our dissemination to communities beyond universities, use of social media, participation in community and distribution of animated films share findings. We also scoped cross-national care challenges in gender and in workforce planning and strategies for engaging with older people at a national level through NGO’s and leadership issues in care of older people to facilitate future research impact.
1. If care is to be both technologically innovative and appropriate for older people, then it is important to understand dignity as a foundation for care of older people, and how technology may enhance or detract from dignity in care. Findings share older peoples’ experiences which will inform new developments that enhance dignity.
2. If care is to meet human need, challenges of living within care systems open up new directions for care that is up to the task of supporting older people to live well in care systems.
3. If care is to be sustainable, it is important to understand gender imbalances and implications of these with in-depth investigation of issues in care delivery to older people.
A stakeholder analysis guides our dissemination to communities beyond universities, use of social media, participation in community and distribution of animated films share findings. We also scoped cross-national care challenges in gender and in workforce planning and strategies for engaging with older people at a national level through NGO’s and leadership issues in care of older people to facilitate future research impact.