Explore
What is the problem/issue you are trying to address?
People with neurocognitive impairment are confronted with behavioral changes and cognitive impairments (Genoe & Dupuis, 2012). These changes are obstacles to the realization of various activities. Consequently, these elderly adults living in specialized institutions (like those belonging to AFEJI) have limited possibilities to engage in activities that typically contribute to their wellbeing. In the present explore phase, our aim is to identify activities that are feasible or that can be rendered feasible for elderly adults with dementia.
Pilot aim
More specifically, the pilot aim is to promote wellbeing of elderly adults with dementia. We are conducting personalized enquiries/interviews with each elderly adult to identify the keys elements that can contribute to his/her wellbeing. We are also conducting personalized neuropsychological evaluations and other assessments, in order to investigate on the how to maintain wellbeing despite severe neurocogntive impairements. These enquiries and evaluations are performed with validated tools.
The screening activities that could pertain to wellbeing (from the old adult's view) was performed using enquiries/interviews a specific questionnaire designed by UPJV ( QUETAL: QUestionnaire d’EvaluaTion des Activités de Loisirs) to obtain information about recreational activities during different periods of life (•During active life,,Since retirement and Since arrival in the specialized house) and to propose activities that coincide best with the lifestyle and the desires. For each elderly adult in AFEJII home and in the neigbourhood of Amiens (UPJV), We gathered information on the Nature of the activity; Frequency of the activity; Current motivation for the activity; Order of preference for the activities.
Stakeholders on your pilot
People and organisations represented, number of stakeholder meetings and total number of people at each stakeholder meeting.
Stakeholders were consulted in parallel in order to explore the possibilities of partnerships and development of innovative activities in order to stimulate activity and autonomy. Based on the identification of the needs/wishes/demands/ of elderly adults with neurocogtive disorders, the stakeholders were consulted on how to make possible the activities proposed by the elderly adults by solving possible problems limiting their implementations (matters such as financial limits, physical limits, time limits).
Pilot beneficiaries
Who will benefit from this pilot? What is the goal that you are trying to achieve with this pilot?
The pilot study targets elderly adults residing in specialized homes (AFEJI institution in lille) due to severe neurocognitive conditions. This pilot aims at providing indices regarding the possibility of providing personalized activities to promote wellbeing. Actually, activities proposed to elderly adults in many homes, are usually in-group or according to what the majority want (and not according to what he/she wants). The rationale behind comes from various studies showing the importance of personalized services on motivation and thus on wellbeing. We overall, want to have elements on the possibility of promoting wellbeing by proposing personalized and adapted activities.
Ideas generated
What ideas were generated from your stakeholder meetings?
AFEJII organised the meeting with stakeholders and UPJV gathered data from old and eldely adults from AFEJII home and also from many other elderly adults in the neigbourhood of amiens (including other homes). Data obtained from UPJV, Identified a huge number of activities pertaining to WELLBIENG and the widely desired activities by most older and elderly adults concerned (semi leisure category, outdoor category, games, Media, art,…). Like for the other pilot of mouvement and sport, Most of the identified activities (see the data from the QUETAL Questionnaire send to BU) were not those initially listed in the SAIL project. It appears that this generation of older adults valuated mostly semi leisure activities as activities that could contribute to thier wellbieng (bringing a sens of utility). It should also be noted that this generation of older adults have experienced wars and other difficult events and are not used to have free time. They take pleasure in performing handy work, gardening, cooking, caring for animals, looking after children,.....and according to social cultural groupes, activities related to art.
Values for selection
Based on the information collected at the stakeholders meetings and other interviews or conversations held in the location, what are important underlying values for your project? Such as valuing the opinions of your users or needing your project to be cost neutral at this stage for some of your partners?
The activities that old and elderly adults appeared to value most (revealed by the explore phase, see data of screening questionnaire) were unfortunately not taken into consideration by AFEJII. The initially defined activities were kept.
Acceptability
Acceptability by participants was difficult to evaluate due to severe cognitive difficulties. Participants gave their consent or legal guardians of the person gave consent. UPJV and AFEJII were to some extent in disagreement. UPJV wanted modification of the activities in the light of results of explore phase while AFEJI proposed to keep the initial activities defined in project prior to the explore phase.
Demand
Activities linked to Animal according to the questionnaire (QUETAL) administered to elderly adult were desired by less that 2% of our sample; The demand according to the data collected concerned other activities such as those linked to gardening and art.(see data from the QUETAL questionnaire).
Implementation/Practicality/Organisational/Financial Feasibility
How feasible does your project look to your team at this stage in terms of practicality, and financial feasibility?
The number of participants per activity is adapted (small groups). The activities also rely existing staff but access to animal mediation is costly. Its maintaining after the SAIL project will depend on the finanicial possibiities .
Additional assets and resources
Do you need any additional assets or resources including expertise to help you deliver your project?
No particular demand identified at this stage
Adaptation
Have you made any changes to your original plans, why did you make the change and what information did you base your new plans on? For instance any changes you made to the context, format, timing, setting or population at this stage?
We initially planned to use the world café methodology as promoted by most of the SAIL project partners. However, this was impossible with elderly adults suffering from severe neurocognitive deficits. Instead, psychologists conducted face-to-face interviews. Each interview and inquiry were conducted on weeks considering the profile of the elderly adults. As a result of this time consuming activity, the data collected are still under analysis and meeting with stakeholders have been postponed. We have requested an additional delay with the SAIL partners, all data will be accessible for the 27th of February. Actually all data have been processed.
Integration
Do you think this project will work within the current local setting/structures? What changes need to be made to integrate your new project into existing infrastructure or programs?
Activities linked to Animal according to the questionnaire (QUETAL) administered to elderly adult were desired by less that 2% of our sample. We (UPJV) suggest that animal mediation could be replaced by another activity that seemed to be more valued by older adults (activities linked to gardening and art were ranked first). It is also important to inform the the nursing staff about the projet for good engagement latter on.
Selected ideas for next phase
Based on the areas stated above, which ideas from your meetings have been selected for the phase of design and develop on SAIL?
No big change with regard to the initial project prior to the explore phase. Most activities are kept although UPJV wanted modification of the activities in the light of results of explore phase.