Project "Long-term Care in Motion"
The project is a sub-project of the EU–funded multidisciplinary project “Social Innovations Promoting Active and Healthy Ageing”(INNOVAGE). It sets out to investigate social innovations for the enhancement of quality of life and well-being—especially the healthy life expectancy—for older people.
The project acts on the assumption that despite strong evidence for activity promotion in elderly people in institutional settings, increased and diversified activity is currently only implemented at a rudimentary level. Therefore, the primary objective of this sub-project is to increase and systematically promote the implementation and understanding regarding various aspects of activity patterns, physical fitness, and social participation of nursing home residents; staff members and environmental setting will also be addressed.Instead of a rigorous design, however—such as a randomized, control-trial intervention study—we will pursue an innovative, partially controlled pilot project accounting for content and methodology.
Specific aims of the project are:
- Systematic review of the current state of research about mobility and activity promotion in long-term care settings
A systematic review of the existing research will be conducted preparing the psychosocial and physical interventions. Based on this review, the project intervention actions will be planned and pre-tested in the institutional context.
- Monitoring of nursing home residents’ activity
In order to objectively assess their daily activity, nursing home residents will be monitored with unobtrusive, highly sensitive accelerometer-based activity sensors; these will be worn at the hip for approximately three consecutive days. We will use cutting-edge technological solutions in the field of mobility monitoring, pursuing four endpoints: (1) To demonstrate the exhaustive feasibility and usability of this methodologically sophisticated assessment for the general population of nursing home residents; (2) To collect data allowing a better understanding of mobility patterns of nursing home residents in general; (3) To carry out a pre-, post-, and a 6-month follow-up measurement based on this methodology, in the context of the predicted mobility and activity promotion; (4) To show that these kinds of technologies may provide practical knowledge for professionals in institutional settings about nursing home residents’ mobility patterns, demonstrating that they can be helpful to implement and supervise mobility-promoting measures in institutional settings.
Accelerometer-based activity sensors
- Physical activity intervention
The standardized group trainings which were developed and evaluated by the work group of Prof. Klaus Hauer in previous research will mainly comprise resistance training and functional exercises tailored to the needs of older adults with and without cognitive impairment. The exercise program will focus on the improvement of key motor skills (such as gait, posture, sit-to-stand ability) essential for mobility, autonomy, and movement security. These training components will be complemented by specific cognitive tasks (i.e., dual task).
Besides activity-based parameters, health-related and psychological aspects will enrich the training. In addition to the physical exercise program, a psychosocial intervention is intended to create incentives and activity occasions, respectively (e.g., finding an activity partner; comprehension of elements concerning one’s own aging process, reduction of age stereotypes, or improvements of self-efficacy). This component will be structured in a way that will be suited for healthy and cognitively impaired seniors (e.g., persons with dementia) alike.Furthermore, staff members as well as family members, will be included.
Serious games: virtual gaming
Unfortunately, conventional exercise programs seldom motivate persons to achieve higher rates of physical activity. This demographic of person in particular can profit from virtual activity programs that integrate movement tasks into a game setting and thus provide opportunity to address other motives of movement (acting jointly in a play-like way). The so called “serious games” can be understood as an advancement allowing training of the movements required for a target-oriented training (e.g., walking or keeping posture while solving memory tasks), while keeping a gaming component. In the course of a pilot study, the “serious games” approach will be investigated regarding its ability to promote activity in institutional settings in order to integrate this concept into the physical activity intervention.
Assessment of Effectiveness of Interventions
The central aim of the study is to enhance physical activity of nursing home residents in the short-term as well as long-term through the implementation of physical and psychosocial interventions; the study should contribute to the healthy life expectancy and independence of nursing home residents. In order to assess whether the residents’ activity was increased immediately after the interventions, their pre- and post-intervention activity levels will be compared using mobility-monitoring, questionnaires, and proxy ratings. For the assessment of long-term effects, the residents’ activity will be reassessed after 6 months and compared to the activity levels at baseline and immediately after the intervention phase. In addition, the results will be compared to a control nursing home of equitable nature, in which no such intervention has been accomplished yet.
Diegelmann, M., Jansen, C.-P., Wahl, H.-W., Schilling, O. K., Schnabel, E.-L., & Hauer, K. (2017). Does a physical activity program in the nursing home impact on depressive symptoms? A generalized linear mixed-model approach. Aging and Mental Health. Advance online publication. https://doi.org/10.1080/13607863.2017.1310804
Diegelmann, M., Wahl, H.-W., Schilling, O. K., Jansen, C.-P., Claßen, K., & Hauer, K. (2017). A new look at nursing home residents’ depressive symptoms: The role of basic versus expanded everyday competence. International Psychogeriatrics, 29(1), 165–175. https://doi.org/10.1017/S1041610216001563
Jansen, C.-P., Diegelmann, M., Schnabel, E.-L., Wahl, H.-W., & Hauer, K. (2017). Life-space and movement behavior in nursing home residents: Results of a new sensor-based assessment and associated factors. BMC Geriatrics, 17, 36. https://doi.org/10.1186/s12877-017-0430-7
Schnabel, E.-L., Jansen, C.-P., Diegelmann, M., Wahl, H.-W., & Hauer, K. (2016). Mobil und motiviert - Bewegungsprogramme in Pflegeheimen. ProAlter, 02/2016, S: 56-59.
Wingerath, C. (2016). Auswirkungen einer 12-wöchigen Trainingsintervention auf die motorische Leistungsfähigkeit von Pflegeheimbewohnern [Effects of a 12-week training on nursing home residents' motor functioning] (Zulassungsarbeit zum ersten Staatsexamen). Ruprecht-Karls-Universität, Heidelberg.
Jansen, C.-P., Claßen, K., Schnabel, E.-L., Diegelmann, M., Hauer, K., & Wahl, H.-W. (2015). Long-term care in motion (LTCMo): A guidebook. Retrieved from http://www.innovage.group.shef.ac.uk/assets/images/D5.1%20Guidebook_Final%20Version%202.0.pdf
Jansen, C.-P., Claßen, K., Wahl, H.-W., & Hauer, K. (2015). Effects of interventions on physical activity in nursing home residents. European Journal of Ageing, 12(3), 261–271. https://doi.org/10.1007/s10433-015-0344-1
Mittwede, S. (2015). Activity in Nursing Home Residents: The Role of Self-Efficacy and Control Beliefs (Master’s Thesis). Ruprecht-Karls-Universität, Heidelberg.
Jansen, C.-P., Claßen, K., Hauer, K., Diegelmann, M., & Wahl, H.-W. (2014). Assessing the effect of a physical activity intervention in a nursing home ecology: A natural lab approach. BMC Geriatrics, 14, 117. https://doi.org/10.1186/1471-2318-14-117
- Apl. Prof. Dr. Klaus Hauer (Bethanien-Hospital Heidelberg & Heidelberg University)
- Prof. Dr. Hans-Werner Wahl
Scientific Project Staff
- Eva-Luisa Schnabel
- Carl-Philipp Jansen, sport scientist (M.A.) (Bethanien-Hospital Heidelberg)
- Mona Diegelmann
- Prof. Dr. Martina Schäufele, Psychologist; Chair of Gerontology and Social Work with Older People, Hochschule Mannheim - University of Applied Sciences
- Matthias Hoben, Diploma in Nursing Management; M.Sc. in Nursing (Network Aging Research)
European Commission (INNOVAGE - “Social Innovations Promoting Active and Healthy Ageing“) [HEALTH.2012.3.2-3])
December 1, 2012-November 30, 2015