Person-centred care in aging populations in the Kristiansen Group
The primary goal of the interdisciplinary research conducted in this group is to enhance person-centred, diversity-sensitive healthcare provision in the context of population aging. This will contribute towards addressing societal challenges as well as opportunities caused by population aging that has implications for healthcare policy and practice.
In order to identify innovative approaches to ensuring healthcare services that are accessible, acceptable and of high quality for the increasing number of older adults, we work within an overall frame of interdisciplinary, multi-methods and co-created science.
Studies are often co-created with key societal partners, e.g. municipalities, hospitals, patient associations, entrepreneurs and international organizations, to enhance relevance and transferability.
“There is a need for insight into how healthcare services can accommodate for the growing number of persons living longer lives in longevity but also with functional decline and diseases. Person-centred and coordinated care that is sensitive to diversity in older adults – e.g. related to type of disease, gender, socioeconomic background or ethnicity – is important, also from a societal perspective. We aim to understand needs of citizens, patients, relatives and healthcare providers, and to help identify innovative approaches for future care delivery,” says Associate professor and Group Leader Maria Kristiansen.
We focus on multimorbidity as a key challenge but also on specific diseases of key importance to aging populations, in particular cardiovascular diseases, cancers, Parkinson’s disease and Age-related Macular Degeneration.
- A key finding across most disease categories is the importance of addressing inequity in access to and quality of healthcare for older adults, in particular those living with multimorbidity. The ability to negotiate care that is timely, acceptable and person-centred is shaped by a range of individual (e.g. socioeconomic background, gender, social networks) but also system-related factors (e.g. time, mono- or multidisciplinary teams, competencies in patient-engagement) as well as overall policies on disease specific care trajectories.
- Variations in health behaviours, disease patterns, well-being and psychosocial circumstances among older migrants and refugees in Europe have implications for adaptation of supportive environments and healthcare services. In particular, informal barriers (e.g. language barriers, lack of awareness of available services) and structural constraints (related to availability, timing and distance) affect access to timely, coordinated and person-centred health and long-term care services for older refugees and migrants. Diversity-sensitive policies and practices are therefore needed across the range of health and long-term care sectors for older adults.
- Interventions adapted to specific target groups and settings hold potentials to enhance person-centred healthcare and well-being at old age. Examples have been developed, implemented and evaluated for process and short-term outcomes. This includes community-based participatory approaches to enhance health, well-being and social relations in a so-called deprived housing community undergoing large-scale structural changes. Other examples include preventive home visits targeted to ethnic minorities and ethnic Danes in social housing areas; narrative approaches to enhance social relations among residents at nursing homes; and organizational and technological changes to facilitate coordinated care for frail older adults under and following hospital admissions.
Person-centred rehabilitation for patients with Parkinson's disease
A mixed methods study of opportunities and barriers for delivering person-centred rehabilitation for patients with Parkinson’s disease funded by the Parkinson Association explores the organization of rehabilitation in Danish municipalities and identifies possibilities for delivering person-centred rehabilitation of persons with Parkinson’s disease and their relatives across sectors. A combination of survey and qualitative interview is used.
Inequalities in waiting times among older patients with colorectal cancer: A national study of waiting times after referral to a cancer treatment plan
A study funded by the Danish Cancer Society entitled “Inequalities in waiting times among older patients with colorectal cancer: A national study of waiting times after referral to a cancer treatment plan” explores social inequality in waiting times among patients above 65 years referred to the cancer treatment plan for colorectal cancer. Specifically, it examines whether and how socio-demographic factors affect waiting times to diagnosis and initiation of treatment, and identifies high-risk groups at particular risk of prolonged waiting times.
Innovating healthcare for older adults: unfolding needs and resources through narratives and community engagement
Two EIT Health projects are currently investigating innovative approaches to healthcare provision in the context of population aging and geographical, social and ethnic diversity. The project “Healthy Lifestyle Innovation Quarters for Cities and Citizens” brings healthcare services out to underserved communities in different European countries through a mobile approach uniting citizens, entrepreneurs, services providers and researchers. The other, entitled “A narrative approach to improve citizens' ageing and well-being” develops a narrative-based educational format for healthcare and welfare professionals based on seniors' personal stories, thereby placing citizens’ desires and needs at the heart of healthcare.
Decreasing preventable hospital admissions and contacts to acute medicine facilities in older adults: high risk groups and help-seeking behaviours underlying hospital utilization
Preventable hospital admissions and contacts to acute medicine facilities for older adults with preventable conditions are two key challenges for healthcare systems. In a registry-based study, we investigate regional differences in the risk of preventable hospital admissions, and we identify high risk groups according to sex, birth year, cohabitation, income and level of education based on a national cohort of older adults. This allows for later targeted interventions. To extend this further, we are collaborating with emergency medicine researchers and clinicians in a mixed-methods study exploring characteristics and help-seeking behaviour of older patients with infections contacting the medical helpline 1813.