Highlights
- •This paper presents a human-rights based approach toward inclusive housing with care arrangements for older persons with mental health conditions and psychosocial disability (MHC-PSD)
- •Green care farms and a community-based model of housing with care (Livv-Inn) are presented as care alternatives that fulfill the human-rights of older persons to a better extent than traditional care settings. They are focused on key values such as reciprocity, building on remaining strengths and capacities, dignity and fostering inclusion and participation within the broader social context.
- •These innovative forms of collective living arrangements are promising as they support the human rights of older persons, are inclusive and use a neighborhood approach to long-term care.
Abstract
Although older persons wish to age at home, many older persons with mental health
conditions and psychosocial disability (MHC-PSD) spend the last few years of their
life in residential facilities. This paper will examine the impact of ageism and human
rights violations manifested in environmental design, specifically regarding social
isolation, loneliness, inadequate psychosocial, environmental, recreational and spiritual
support. This is compounded by failure to meet basic care needs-nutrition, hydration,
pain and medication support. This paper highlights two innovative initiatives from
the Netherlands, which show that older persons’ rights can be maintained in innovative,
collective living arrangements. It is concluded that the creation of inclusive and
safe environments for older persons with MHC-PSD can facilitate the enjoyment of Human
Rights.
Key Words
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References
- Age-friendly cities and communities: state of the art and future perspectives.Int J Environ Res Public Health. 2021; 18: 1644
- The Global Network for Age-Friendly Cities and Communities: Looking Back over the Last Decade, Looking forward to the Next.World Health Organization, Geneva, Switzerland2018
- Towards inclusive built environments for older adults.in: Sharf T Keating N From Exclusion to Inclusion in Old Age: A Global Challenge. 2012
- Use of space and human rights: planning dementia friendly settings.J Gerontol Soc Work. 2016; 59: 181-204
Wisdem. (2011). Dementia and environmental design discussion paper. Available at: www.wisdem.org
- Advocacy for the human rights of older people in the COVID pandemic and beyond: a call to mental health professionals.Int Psychogeriatric. 2020; 32: 10
- Dementia and Human Rights.British Policy Press, Bristol2018
- “A piece of paper is not the same as having someone to talk to”: accessing post-diagnostic dementia care before and since COVID-19 and associated inequalities.Int J Equity Health. 2021; 20: 76
- ‘We have become prisoners of our own age’: from a continuing care retirement community to a total institution in the midst of the COVID-19 outbreak.Age Ageing. 2021; : afab013https://doi.org/10.1093/ageing/afab013
- Ending confinement and segregation: barriers to realising human rights in the everyday lives of people living with dementia in residential aged care.Austr J Human Rights. 2020; 26: 308-328
- Questioning segregation of people living with dementia in Australia: an international human rights approach to care homes.Laws. 2019; 8: 18
- Ecology and the Aging Process.1973
- Preferences and predictors of aging in place: longitudinal evidence from Melbourne, Australia.J Housing Elderly. 2017; 31: 259-271
- Mobility limitations and cognitive deficits as predictors of institutionalization among community-dwelling older people.Gerontology. 2006; 52: 359-365
- The homestead: developing a conceptual framework through co-creation for innovating long-term dementia care environments.Int J Environ Res Public Health. 2021; 18: 57
- Long-term care for people with dementia: environmental design guidelines.Int Psychogeriatr. 2010; 22: 1084-1096
- The influence of the physical environment on residents with dementia in long-term care settings: a review of the empirical literature.Gerontologist. 2017; 58: 325-337
- The relationship between the quality of the built environment and the quality of life of people with dementia in residential care.Dementia. 2016; 15: 663-680
- Architectural factors influencing the sense of home in nursing homes: an operationalization for practice.Front Archit Res. 2017; 6: 111-122
- A Good Life in Old Age? Monitoring and Improving Quality in Long-term Care.OECD Health Policy Studies, OECD Publishing, 2013
- Re-design of aged care environments is key to improved care quality and cost-effective reform of aged and health system care.Appl Health Econ Health Policy. 2019; 17: 127-130
- Staff and family attitudes to fences as a means of detaining people with dementia in residential aged care settings: the tension between physical and emotional safety.Austr J Soc Issues. 2019; 53: 107-108
- Locked mental health wards: the answer to absconding?.J Law Med. 2014; 22: 17-21
- Risk factors for inactivity in patients in long-term care with severe mental illness.Tijdschr Psychiatr. 2013; 55: 83-91
- Daily (in)activities of nursing home residents in their wards: an observation study.J Am Med Dir Assoc. 2015; 16: 963-968
- Exploring the prevalence and variance of cognitive impairment, pain, neuropsychiatric symptoms and ADL dependency among persons living in nursing homes; a cross-sectional study.BMC Geriatr. 2016; 16: 154
- Systematic review: effective characteristics of nursing homes and other residential long-term care settings for people with dementia.J Am Ger Soc. 2013; 61: 1399-1409
- Use of physical restraint in nursing homes in Spain and relation with resident characteristics: a retrospective multi-centre cohort study with a self-organised maps approach.Ageing Soc. 2019; 40: 1-19
- Modifiable factors associated with neuropsychiatric symptoms in nursing homes: the impact of unmet needs and psychotropic drugs.Arch Gerontol Geriatr. 2020; (doi.org/)103919https://doi.org/10.1016/j.archger.2019.103919
- Loneliness in care homes: a neglected area of research?.Aging Health. 2020; 8: 637-646
- A systematic review and meta-analysis of interventions designed to prevent or stop elder maltreatment.Age Ageing. 2016; 45: 216-227
- The physical environment of nursing homes for people with dementia: traditional nursing homes, small-scale living facilities, and green care farms.Healthcare. 2018; 6: 137
- Affordances of the care environment for people with dementia—an assessment study.HERD. 2012; 5: 118-138
- Long-term care settings in the times of COVID-19: challenges and future directions.Int Psychogeriatr. 2020; 32: 1239-1243
- Social connection in long-term care homes: a scoping review of published research on the mental health impacts and potential strategies during COVID-19.J Am Med Direc Assoc. 2021; 22: 228-237
- Effectiveness of person-centered care on people with dementia: a systematic review and meta-analysis.Clin Interv Aging. 2017; 12: 381
- Changing the culture of long-term care through narrative care: individual, interpersonal, and institutional dimensions.J Aging Stud. 2017; 40: 44-48
- Care farming for people with dementia; what can healthcare leaders learn from this innovative care concept?.J Healthc Leadersh. 2020; 12: 11-18
- Farming for Health: Green-Care Farming Across Europe and the United States of America.Springer, Berlin/Heidelberg, Germany2006
- Green care farms as innovative nursing homes, promoting activities and social interaction for people with dementia.J Am Med Dir Assoc. 2017; 18: 40-46
- Rethinking dementia care: the value of green care farming.J Am Med Dir Assoc. 2017; 18: 200-203
- Green care farms: an innovative type of adult day service to stimulate social participation of people with dementia.Gerontol Geriatr Med. 2015; : 1-10https://doi.org/10.1177/2333721415607833
- Physical activity in people with dementia attending farm-based dementia day care—a comparative actigraphy study.BMC Geriatr. 2020; 20: 219
- The relation between mood, activity, and interaction in long-term dementia care.Aging Ment Health. 2018; 22: 26-32
- Experiences of family caregivers in green care farms and other nursing home environments for people with dementia: a qualitative study.BMC Geriatr. 2019; 19: 149
- Relatives’ experiences of everyday life when receiving day care services for persons with dementia living at home—“It's good for her and its good for us”.Health. 2013; 5: 1227-1235
- Quality of care and quality of life of people with dementia living at green care farms: a cross-sectional study.BMC Geriatr. 2017; 17: 155
Fleming R, Zeisel J, Bennet K. World Alzheimer's Report 2020. Design, Dignity, Dementia: Dementia-related design and the built environment. Alzheimer's Disease International: London, UK.
- Environmental design for an ageing population.in: Phelan A O'Shea D Changing Horizons in the 21st Century: Perspectives on Ageing. Cambridge Scholars, 2020
- The meaning of home. A qualitative metasynthesis.Res Gerontol Nurs. 2010; 3: 291-307
- The factors influencing the sense of home in nursing homes: a systematic review from the perspective of residents.J Aging Res. 2016; : 6143-6645https://doi.org/10.1155/2016/6143645
- Remaining at home with dementia: not ‘one size fits all’.B J Psych Bull. 2018;
- "There's no place like home": a scoping review on the impact of homelike residential care models on resident-, family-, and staff-related outcomes.J Am Med Dir Assoc. 2016; 17: 685-693
- An ecological framework to support small-scale shared housing for persons with neurocognitive disorders of the Alzheimer's and related types: a literature review.Hong Kong J Occup Ther. 2017; 29: 26-38
- Effects of small-scale, home-like facilities in dementia care on residents' behavior, and use of physical restraints and psychotropic drugs: a quasi-experimental study.Int Psychogeriatr. 2014; 56: 657-668
- Dementia care redesigned: a quasi-experimental study into the effects of small-scale living facilities on residents, their family caregivers and staff.J Am Med Dir Assoc. 2010; 11: 662-670
- Innovating dementia care; implementing characteristics of green care farms in other long-term care settings.Int Psychogeriatr. 2018; 30: 1057-1068
- Towards responsible rebellion: how founders deal with challenges in establishing and governing innovative living arrangements for older people.Int J Environ Res Public Health. 2020; 17: 6235
Article info
Publication history
Published online: June 08, 2021
Accepted:
May 28,
2021
Received in revised form:
May 27,
2021
Received:
May 19,
2021
Identification
Copyright
© 2021 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.