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Demand Driven Care and Technology for
Independently Living Older Persons

• Dr. Helianthe S.M. Kort,
• Associate Professor Demand Driven Care
• Hogeschool van Utrecht, University of
  Professional Education
• Hilly.kort_at_hvu.nl

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Demand Control

• Demand control is a package of measures in order
  to enhance the authority of civilians in relation
  to the available supply.
• Demand driven processes such as a free market
  system is also seen in education, day care,
  housing and health care .

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Demand Driven Care

• (Health) Care used to be supply driven only
• Transition process
• Bureaucratic centrally driven and planning
• towards
• Empowerment of Quality of care and Quality of Live

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Demand Driven Care

• Enhancement of the position of patients and
  clients
• Development of measures of freedom and a
  stimulating care structure
• Implementation of an equal playing ground for
  care suppliers
• Creation of a sufficient care supply

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Context of the Transition process

• Ageing of the population
• Institutionalization -gt Socialization
• Increasing care demand
• Patients -gt Empowerment of Clients
• Institutional related funding -gt Performance
  related funding
• More freedom of choices
• Free market-basis system
• Limited availability of professional carers
• Application of Technology

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Ageing of the population

• Ageing
• Growth in 55-pluss
• Hazing
• Potential working force decreases
• Ageing in the Netherlands
• Felevoland approx. 20 (65 plus)
• In 2050 increase to 100
• Highst 65 plus in Europe
• Belgium and Germany (16,9)
• France (16,2)
• UK (15,9)
• The Netherlands (13,6)

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Increasing care demand

• Elderly deteriorating health
• Diseases increases
• Dementia, COPD, Diabetes mellitus, angiopathy,
  several Cancers
• Mental disorders
• Limitation in ADL
• Domestic work
• Mobility
• Personal Care

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Increasing care demand

• The potential demand is expected to increase by
  almost 50.
• This demand almost equals the growth of the
  population of 65 years and over.
• The potential demand for care at home increases
  more rapidly (53) compared to the demand for
  institutional care (42).
• The type of the potential demand for care by
  elderly, varies from 40 - 80 for personal care
  and supporting care respectively

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Availability of professional carers

• The need for professional care givers increases
  every year, by 2 on average.
• More than one out of ten people of the
  professional population work in the care- and
  welfare sector
• of which 78 are women working part time.
• Approximately 22 of the work force should be
  employed in the care- and welfare sector by the
  year 2025

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Application of Technology

• 93 of the elderly (2.2 mil of 65 plus) lives
  indepentenly
• 33 of the elderly with a sever physical disorder
  has no appropriate house
• Appliance Technology
• Adaptation of houses
• stair elevators
• Houses without a threshold
• 0-floor houses
• personal alarming

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Smart Homes related with bio-sensors

• Health Smart Homes
• Permit return at home
• Stay at home
• Generic -gt specific sensors
• Human daily activities (telemonitoring)
• Physiological processes (cardiac / respiratory
  rhythm)
• Specific disorder sensors -gt alarm triggering
• Asthma
• Angiopathy
• Mental disorders

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Tele-healthcare

• Telemonitoring
• Telecare
• Telemedicine
• Not always cost effective
• patients experience an improvement of the quality
  of care
• Teledermatology is more cost effective when
  patients are living remotely.
• Teledermatology has an effect on long waiting
  lists, impact on job satisfaction, cost of return
  visits and less time off work
• Teleconsultation
• Videolinked support
• Informal carers (Alzheimers disease)
• Routine procedure for welcoming and conducting
  the assessment

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Stefanov, D.H., Bien, Z., and Bang, W.-C.
(2004). The Smart House for Older Persons and
Persons With Physical Disabilities Structure,
Technology Arrangements, and Perspectives. IEEE
Transactions on Neural Systems and Rehabilitation
Engineering, 12(2), 228-250.
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