A Dignified Elderly Care in Denmark

Home , Aabenraa, Aalborg Municipality, Aarhus Municipality, Central Denmark Region, Favrskov Municipality, Fredericia

INNOVATING BETTER LIFE

ASSISTED LIVING A dignified elderly care in Denmark

WHITE PAPER ASSISTED LIVING A dignified elderly care in Denmark

About this white paper Danish Care, Morten Rasmussen, [email protected] This white paper presents the Danish approach to a coherent elderly care Local Government Denmark, Mie Bjerre, [email protected] and includes a broad range of innovative assisted living technologies and Municipality of Copenhagen, Monica Andersen, [email protected] solutions that help to improve quality of life for elderly citizens, and at the Municipality of Aabenraa, Anne Kathrine Pagh Kold, [email protected] same time support healthcare professionals. It is part of a series of white Municipality of Aarhus, Ivan Kjær Lauridsen, [email protected] papers that show how Danish solutions can contribute to increase efficiency in healthcare while empowering patients and staff. Contributors Danish healthcare innovation is not exclusive for the Danes: many years of Abena, Eva Tansem Andersen, [email protected], global presence show that our healthcare products and solutions create Brain+, Bjarke Langbøl Panduro, [email protected] value internationally. Danish ideas and products are used every day in hospi- Cekura, Søren Nielsen, [email protected] tals, medical clinics, ambulances, and nursing homes across the world. DigiRehab, Lisbet Jensen, [email protected] DoseSystem, Jesper K. Thomsen, [email protected] We hope to inspire you and would like to invite you to Denmark to learn Guldmann, Anders Haugaard, [email protected] more about the Danish healthcare system. Icura, Jakob Nielsen, [email protected] Healthcare DENMARK is responsible for content and publication KMD, Anders Clausen, [email protected] © 2019 Healthcare DENMARK KR, Tina Skovbo Søsted, [email protected] Medema, Christine Heggelund, [email protected] Photo credits Municipality of Copenhagen, Thit Fredens, [email protected] Foreword: Steen Brogaard (Minister for Health and Senior Citizens Magnus MusiCure, Niels Eje, [email protected] Heunicke), Danish Regions (Chairman of Danish Regions Stephanie Lose), Pressalit, Charlotte Stenner Rasmussen, [email protected] Local Government Denmark (Chairman of Local Government Denmark's Robofit, Lisa Christensen, [email protected] Health Committee Jette Skive) Sarita CareTech, Dana Ansberga, [email protected] Page 6: Systematic SOSU Syd (the School of Social and Health Sciences), Vibeke Pors Sagen, Page 7: Getty Images/sturti [email protected] Page 8: Systematic Systematic, Kenneth Veis Jensen, [email protected] Page 9: KMD UCL University College, Stina Meyer Larsen, [email protected] Page 10: Jesper K. Thomsen, DoseSystem Vendlet, Pernille Rosenbech Nielsen, [email protected] Page 11: Cekura Vikærgården, Lotte Lucia Jelnes, [email protected] Page 12: Getty Images/izusek Wavecare, Eva Wennerwald, [email protected] Page 13: Left, Getty Images/SilviaJansen. Right, Getty Images/Halfpoint WelfareTrack, Joachim Kristensen, [email protected] Page 14: Sarita CareTech ZiboCare, Tina Skaarup Blenstrup, [email protected] Page 15: Abena Group Page 16: Getty Images/goldhafen Page 17: Getty Images/sturti Page 18: DigiRehab Healthcare DENMARK’s partners : Page 19: Vikærgården - Akuttilbud og Rehabilitering Page 20: Wavecare Page 21: Icura Page 22: Emma Malmros, Robofit Page 23: DigiRehab Page 24: Anita Osk Fastrup, SOSU Syd Page 25: Vendlet Page 26: Guldmann Page 27: Anita Osk Fastrup, SOSU Syd Page 28: Lars Horn, Baghuset Page 29: Pressalit Page 30: KR Page 31: Jacqueline Panduro Page 32: ZiboCare Denmark Page 33: MusiCure/Gefion Records

Editor in Chief Healthcare DENMARK, Anne Smetana, [email protected]

Associate Editor Healthcare DENMARK, Tina Liljendal Larsen, [email protected]

Steering Committee Danish Ministry of Health, Andrea Scheutz, [email protected] Danish Regions, Mette Jensen, [email protected]

A dignified elderly care in Denmark white paper version 1, September 2019

2 INNOVATING BETTER LIFE

Executive summary

New assisted-living technology plays simple and easy to use to complex digital plat- an important role in Denmark’s elder- forms allowing data to be gathered, shared, and ly care. Every day, a range of solutions utilized in new ways, improving citizens’ quality of help improve the quality of life for el- life as well as the workflows of care professionals. derly citizens and support healthcare professionals in creating an efficient, high-quality Person-centered approach to rehabilitation framework for care, rehabilitation, and pre- In Denmark, rehabilitation interventions are per- vention. son-centered and adapted to the individual, aiming at the highest possible level of participation Denmark’s tradition of publicly funded care for and inclusion. This enables the citizen to remain elderly citizens dates back to the emergence of independent, self-reliant, and to participate ac- the welfare state in the 1930’s. But over the tively for as long as possible.Technology-driven past few decades, the approach to care has solutions are important in honoring the ambi- changed significantly. By working with targeted tion of ‘everyday rehabilitation’. These solutions efforts, elderly citizens can maintain their inde- include, among other things, intelligent rehabili- pendence and stay in their own homes for as tation equipment such as motion sensors and long as possible. Nursing homes and other care robots that help citizens train independently. facilities have also been supplemented with efforts to help improve the quality of life for resi- Improving the working environment dents. These efforts are increasingly supported for healthcare professionals by assisted-living technologies and other inno- Being known for having a safe and attractive vative solutions that bring a number of benefits working environment is a factor in attracting for both citizens and caregivers. new employees. This is a priority for most care giver organizations as the issue of workforce Innovative Danish solutions shortages is on the rise. Innovative technolo- This white paper describes some of the assistive gies can improve the working environment for technologies that are currently being imple- healthcare professionals while maintaining a mented in Denmark’s elderly care. Some are al- high level of care quality. Ceiling lifts, bathing ready commonly used by municipalities across chairs, reversing systems, sliding and turning the country while others are still in early trials. systems for beds, entry-exit beds, and hygiene Overall, these innovative solutions have been solutions support citizens in their everyday rou- developed to empower elderly citizens, giving tines, improve professionals' physical working them a more active role in their own treatment, environment and free up physical and mental re- assisting them in their daily routines, and keep- sources allowing more time for personal contact ing them connected, active, and physically safe. and primary care. These innovative solutions, which also facili- tate improved communication and information Nursing homes of the future sharing between caregivers, citizens, and their New technologies can be integrated in the de- families, are important enablers for the compre- sign of nursing homes to support the overall hensive Danish home-nursing support of elderly aim of homeliness, stimulation, mobility, and citizens in their own homes. social inclusion. This white paper describes some of the solutions that meet current and Prevention and early detection future demands for the design and interior of Data-driven solutions can assist municipalities in nursing homes. These solutions share a holistic detecting the need for preventive efforts, identi- approach to care, often addressing multiple con- fying citizens with special challenges, or reacting cerns such as functionality, safety, aesthetics, faster in cases of emergency. The specific tech- and accessibility at the same time. nologies range from wearable technology that is

3 ASSISTED LIVING A dignifieddignified elderlyelderly care care in in Denmark Denmark

Jette Skive Magnus Heunicke Stephanie Lose Chairman of Local Government Minister for Health and Senior Citizens Chairman of Danish Regions Denmark's Health Committee

Foreword

Denmark has come a long way in de- needs and preferences. The goal is to main- Denmark will keep continuing to develop and veloping the elderly care. Through tain their independence and gain control of expand the use of new assisted living tech- a citizen-centered approach and their own life. nologies – in collaboration and dialogue with targeted efforts including including assist assist- elderly citizens, their peers and care staff – ed living technology, the aim is to The citizens are involved in their own recov- to the benefit of citizens, healthcare profes- assure that elderly citizens more often ery with focus on their individual needs. sionals, and society. can maintain their independence and quality of life. New assisted-living technology play an im- Magnus Heunicke portant role within the sector of elderly care. The overall ambition for developing the elder- Danish municipalities and hospitals in the ly care is to improve quality of life for elderly regions are implementing innovative tech- citizens with focus on values such as influ- nologies that support citizens in their daily ence over one’s own life, respect for diver- routines, keeping them connected, physical- Stephanie Lose sity, focus on humanity, self-determination ly active, and safe. These innovative Danish and worthiness in the last part of life. solutions can help improve the quality of life for elderly citizens as well as support health- In Denmark, we have a dignified elderly care care professionals in creating an efficient, Jette Skive with focus on involving and empowering coherent and high-quality framework for every citizen with focus on their individual care, rehabilitation, and prevention.

4 INNOVATING BETTER LIFE

3 Executive summary

Index

4 Foreword 6 As long as possible 8 An intelligent ‘pill in your own home robot’ ensures accurate and timely medication

9 Digital support for 10 Digital medicine 11 Emergency call de- relatives frees up staff box reminds elderly vice enables independ- resources citizens to take their ence and self-reliance medicine

12 Motivating elderly 13 Prevention and 14 Sensor technology citizens to adopt new early detection keeps citizens active technology and prevents frailty

15 Higher quality of life 16 Monitoring assistive 17 Cross-Tracks - Early and reduced infection technologies improves interventions sup- risk with digital inconti- users’ quality of life ported by artificial nence solutions intelligence

18 A person-centered 19 Mobility Monitor 20 Sensory stimulation approach to rehabili- – an interdisciplinary improves the well-being tation approach leading to of people with dementia faster rehabilitation

21 Sensor-based reha- 22 50% sick leave 23 DigiRehab – a 12- bilitation increases el- reduction and faster week program which derly citizens’ functional recovery with new reduces the need for levels rehabilitation robot home care

24 A top-class working 25 Patient-turning 26 Innovative inclusive environment helps ad- system improves care-center planning dress shortage issues working environment

27 Educating nurses 28 Nursing homes 29 Modern and flexible and assistants to of the future put bathroom solution co-create innovative the resident first contributes to a life care solutions enhancing culture

30 Caregivers actively 31 Faster and more 32 Sens-Aid, the pursue innovative efficient treatment and blanket that hugs resi- technologies rehabilitation with the dents to improve their Brain+ solution well-being

33 A musical pillow 34 The future of elderly 35 About benefits elderly citizens care in Denmark Healthcare DENMARK

5 ASSISTED LIVING A dignified elderly care in Denmark

As long as possible in your own home

Denmark has a citizen-centered ap- nurses, and increasingly: the use of assist- In that context, physical training and assist- proach to care and rehabilitation for ed-living technology. ed-living technology play an important role. elderly citizens. The vast majority Municipalities and hospitals are increasingly of citizens wish to stay as long as implementing a range of innovative tech- possible in their own homes in fa- ”It is well-documented nologies that support citizens in their daily miliar surroundings. To accommodate their that the majority of elderly routines, keeping them connected, physical- wishes, physical training and assisted living ly active, and safe. These include anything technology are particularly important. citizens prefer to live in their from simple smart-sensor devices and other own homes for as long assisted living technologies to advanced tele- In Denmark, publicly-funded nursing homes health solutions and digital communication date back to the 1930’s and the emergence as possible.” platforms. of the Danish welfare state. Since then, Da nish governments and municipalities have pro- One commonly used assisted-living technol- vided nursing-home care for elderly citizens It is well-documented that the majority of ogy is an electronic device that reminds cit- who cannot take care of themselves. elderly citizens prefer to live in their own izens to take their medication, ensuring the homes for as long as possible. While some right dosage at the right time. Another solu- The late 1980s saw Denmark’s approach to will be admitted to nursing homes eventually, tion is a digital platform that allows relatives elderly care change significantly. The sole municipalities now focus on helping citizens to check on elderly family members. focus on nursing homes has given way to maintain – or regain – self-reliance, and on significant emphasis on empowering elder- allocating the necessary human and techno- In general, these innovative solutions im- ly citizens to remain self-reliant for as long logical resources needed to make this possi- prove the quality of care, enhance citizens’ as possible. This involves supporting them in ble. So do the hospitals, where they are inpa- independence and quality of life, and free up continuing to be healthy and allowing them tients in shorter time and can perform more the time of care staff – allowing them to use to live in their own homes, supported by a so- home controls by themselves thanks to new their time to provide direct care, training, and cial-care system, with visits from home-care technology. assistance.

6 INNOVATING BETTER LIFE

Denmark and the Danish healthcare system

Denmark has a population of about 5.8 million people, Local level: 98 municipalities are responsible for prevention spread over a geographical area of 43,094 km2. initiatives, rehabilitation, home care, and elderly care.

The Danish healthcare system is based on the principle of All citizens in Denmark, regardless of their economic means, equal and free access for all citizens. are entitled to personal and practical assistance in their own The majority of Danish healthcare services are financed by homes if they need help performing everyday routines such general taxes. as cleaning. Based on individual assessment of a citizen’s physical and mental constitution and housing conditions, The Danish healthcare system operates across the municipality determines, on a case-by-case basis, what three levels: type of help is needed. National level: The parliament and the government set the regulatory framework Each municipality politically sets its own transparent quality Regional level: Five regions are responsible for the hospitals standards for rehabilitation and home care services, defin- – both acute and psychiatric, prehospital care, delivery of ing the level of service that the citizens’ can expect to re- primary care, secondary prevention and specialized rehabili- ceive if they need assistance. tation and training.

7 ASSISTED LIVING A dignified elderly care in Denmark

An intelligent ‘pill robot’ ensures accurate and timely medication

A medication dosage solution has has been installed in her home – programmed medication, the robot will notify home-care been integrated with a user-friend- with the dosage for her various medicines. services. ly primary-care record, greatly in- The robot is integrated with the primary-care creasing citizens’ flexibility and in- record, Columna Cura, and the Shared Medi- As the solution is fully integrated, home-care volvement in their own care. cation Record, a database with updated med- professionals need only a single point-of-con- ication information shared among patients, tact, the primary-care record. They can access In Hjørring Municipality in the North Denmark doctors and other healthcare professionals. it on a tablet computer, which makes it pos- Region, Susan, an elderly woman living in her Here they can find information about all the sible for them to document health-data on own home, is about to take her medication. medicines that the patient receives through location. This makes it easier to involve Susan She has several prescriptions and needs to any prescription or pharmacy in Denmark. in discussions and decisions about her care. take her medicines 4-6 times every day. This means that when a doctor changes Su- The solution has given Susan more flexibility Earlier, she was often confused by the many san’s prescription, the pill robot is updated in in her daily life, as she no longer depends on pills, sometimes forgetting to take some of real-time. New medication is delivered to Su- home-care staff to provide the medication them, or getting them mixed up. She now san’s robot within 24 hours after it has been several times a day. participates in a project in which a ‘pill robot’ prescribed. And if Susan forgets to take her

8 INNOVATING BETTER LIFE

Digital support for relatives frees up staff resources

Relatives of elderly citizens have accessible via a cell phone, tablet or desktop fewer ‘routine’ phone calls from relatives embraced a new platform that al- computer and is particularly popular among who want to know how things are. This has lows them to check on the health relatives who account for 75 percent of the freed up time and added resources to devel- and well-being of their family users. op new service initiatives. members. “Relatives are incredibly happy with the pos- An analysis published in co-operation with The municipality of Fredericia in the Region sibilities this solution offers. In particular, the DaneAge Association concludes that, on of Southern Denmark has had a very positive they use the portal to check on their elderly a national level, the majority of relatives de- response to a new digital platform for elderly family members as not everyone has the op- mand more digital tools in everyday life to citizens and their relatives. portunity to visit their family frequently, for support their elderly family members. The example due to geographical distances.” – learnings from Fredericia will now be used to The web-based solution, KMD Nexus Citizen Bodil Grøn, Project Manager in Care in the further develop digital solutions in the rest portal, enables elderly citizens and their rela- Municipality of Fredericia. of Denmark. tives to check on a number of care-related issues – from medical prescriptions to sched- The solution has made everyday life easier uled visits by home-care staff. The portal is for the home-care staff, because they get

9 ASSISTED LIVING A dignified elderly care in Denmark

Digital medicine box reminds elderly citizens to take their medicine

Digitized medicine manage- a call or a visit to check on the citizen. The means that the municipal home-care staff ment for all types of packed and solution improves citizens’ adherence to can log in to just one platform and have only pre-measured medication reduc- treatment and helps them to be self-reliant. one system to maintain. es care costs while improving citi- Finding the optimal working procedures for zens’ self-reliance and safety. the medicine box was a long process. To In the new setup, citizens will get an intro- implement the solution, the municipality de- duction to the solution and learn to use it at Gladsaxe Municipality in the Capital Region cided to organize and simplify a number of one of the municipality’s 67 so-called tem- of Denmark and the company DoseSystem processes. porary homes where citizens can stay during have collaborated to pilot, test, and imple- their rehabilitation process. ment the medicine box, DoseCan. “We went from four teams to a few professionals who now have the complete re- The medicine box can contain all types of sponsibility. We have been able to use our packed and pre-measured medication, dos- resources in a more efficient and effective • National surveys reveal that when a age boxes and additional medical supplies manner.” – Camilla Lynge Ellitsgaard, Health- medicine box solution is used, the such as ointments, patches, and drops. The tech Consultant, Gladsaxe Municipality. average municipality saves approx- lid has a display that reminds the user, with imately EUR 4,000 per year. beeps and blinks, when it is time to take Gladsaxe Municipality has invested in inte- • It is expected that Gladsaxe Munici- the medicine. The user confirms taking the grating the medicine box with their primary pality will have 150 medicine boxes medicine by pressing an OK button. If the care record, which ensures that the solution in operation by the end of 2020. button is not pressed, the municipal home- is set up automatically, and direct advice care staff are immediately alerted and make on lack of receipt in the care system. This

10 INNOVATING BETTER LIFE

Emergency call device enables independence and self-reliance

Personal alarms notify healthcare professionals in emergency situations, creating a safe environment for citizens and empowering them to live an independent life in their own homes.

The Danish company CEKURA offers citizens a personal-alarm service that combines the latest technology with care provided by a caregiver.

At the core of the service is a wireless button that can be installed in the private homes of elderly citizens or at municipal rehabilitation centers and nursing homes. For instance, the service has been implemented successfully in all nursing homes and home-care services in Svendborg Municipality in the Region of South- ern Denmark.

The alarm is a wireless device that allows the user to contact a central monitoring station with a single click of a button.

If the citizen experiences an emergency situation, such as a fall or heart attack, or feels un- well, pressing the button will immediately alert a healthcare professional, who will then be shown a complete action plan on his or her screen, including the citizen’s profile, location, disease history, and emergency contact. This enables the healthcare team to provide the right help as quickly as possible.

The monitoring station provides more than just emergency help. One of its core tasks is to support citizens in other aspects of everyday life, such as reminding or motivating them to do their daily exercises and having their meals and medicines on time. The staff is also available when a citizen is feeling sad or would just like to talk.

This type of support increases citizens’ sense of well-being, reduce anxiety, and motivate them to do daily tasks – in turn supporting them to remain independent and self-reliant in their own homes.

11 ASSISTED LIVING A dignified elderly care in Denmark

Motivating elderly citizens to adopt new technology

According to a research study, nologies. How they play out, is highly influ- experiences in adopting the technology and many elderly citizens go through enced by family and friends. can provide a purposeful support to the user five psychological phases when as- in the process. sistive technologies are introduced In the first phase, the elderly citizen evaluates in their daily lives. Understanding the need for the particular technology and As such, the citizens seem to acknowledge this process is important to successfully weighs its positive aspects, such as more inde- the preventive nature of assistive technology, implement assisted-living solutions. pendence, against the potential negative ones. in that having the assistive technology means that they are well equipped for an independ- When elderly citizens begin to use assistive The next phase is acknowledging the need ent life in the future. technology, it is a process characterized by for the technology. Here, the attitude typically complexity and ambivalence. changes from ambivalence to belief that the technology will enable a less restricted life. The 5 phases in becoming How well healthcare professionals under- users of assistive technology stand this process and address the challeng- The citizen then begins to incorporate the 1 Evaluating the need for the es it presents, will influence the success of solution into his/her life; establishing new rou- assistive technology any new assisted-living solution. tines and abandoning or modifying old ones. 2 Acknowledging the need for the technology A Danish research study conducted in 2018 Positive experiences enhance the citizen’s 3 Incorporating the technology at the Health Sciences Research Centre, UCL trust in the technology and increase the feel- into daily life University College and the Unit of Rehabilita- ing of being competent when using it in dif- 4 Using the assistive technology tion, University of Southern Denmark, identi- ferent situations and settings. By understand- 5 Future use of the assistive fies five different phases that elderly citizens ing this psychological process, healthcare technology go through when they adopt assistive tech- professionals gain insight into the citizen’s

12 INNOVATING BETTER LIFE

Prevention and early detection

In 2017, the Danish Health Authority published a number of recommendations to strengthen municipalities' workflows, competences, and tools related to early detection. These recommendations also include innovative technology such as digital support and integration between applications, triage boards, and digital-care records.

Danish municipalities and regions vice and guidance on activities and support- citizen reports having a particular challenge, make targeted efforts to identify el- ing opportunities to maintain and improve additional questions will unfold to further de- derly citizens with special challeng- well-being and functional ability in elderly termine the need for help, paving the way for es or needs, resulting in concrete citizens. The municipality can decide that the specific preventive efforts. preventive propositions to the citi- preventive efforts should focus on specific zens. Preventive measures increasingly in- themes, for example loneliness, fall preven- Wearable technology clude innovative technologies that empow- tion, security, nutrition, physical activity, etc. Preventive efforts can also involve assist- er citizens to live an independent life in their ed-living technologies that support citizens own homes for as long as possible. At the same time, elderly citizens can ask in living independently and enable them to their municipality for advice or information manage everyday activities themselves. In the Danish care sector, the regions provide on specific preventive offers to improve their patient-oriented prevention in the context health and overall well-being. For instance, These technologies include intuitive solu- of hospital services and medical practices, many citizens express a desire to be more tions, uniquely adapted to specific needs of while the municipalities offer preventive and socially and physically active. elderly citizens and their caregivers. For ex- health-promoting services to all their citizens. ample, a small device designed as a person- Over the past few years, the municipality of alized brooch has integrated fall detection, Municipalities make targeted efforts to de- Odense has made preventive home visits more GPS, and a call button that works as a direct tect risks of impaired functional, physical or structured in order to get a better empirical link between the citizen and the caregivers. social capacity among their elderly citizens – foundation for further collaboration with citi- so that they can take the relevant preventive zens. This includes a structured questionnaire For citizens suffering from incontinence, an- measures. implemented on a digital platform (the online other wearable technology can improve their mailbox, e-Boks, which all Danish citizens use quality of life. Equipped with a unique digital For more than 20 years, all municipalities to communicate with public authorities). sensor and wireless connection, the changes in have offered their elderly citizens preventive wetness levels are continuously registered and home visits. Such visits improve prevention The questionnaire can be filled out by the cit- the information can be shared with caregivers and health promotion efforts by providing ad- izen either prior to or during a visit. If the in real time via an app on their mobile devices.

13 ASSISTED LIVING A dignified elderly care in Denmark

Sensor technology keeps citizens active and prevents frailty

A new sensor-based solution with automatic fall detection and GPS has made it easier and safer for nursing-home residents to take walks by themselves.

Taking walks, even short ones, are essential for sustain- ing balance and, in turn, confidence among elderly citizens. Frequent walking leads to a healthier lifestyle and is a key factor in avoiding falls.

With increasing strain on staff resources, it is often a challenge for nursing homes to offer accompanied walks. To address this challenge, the nursing home Kristians- gaarden in the Central Denmark Region has introduced a new wearable solution, Sarita Pearl, with consent from the residents. Based on sensor technology and supported by GPS, it gives residents the freedom to move around without compromising their own safety or losing contact with caregivers.

The wearable solution allows residents to contact healthcare professionals wherever they are. This makes it possible for caregivers to assist the elderly even when they are away from the nursing home. Whenever residents fall, an automatic notification is sent to a healthcare professional via mobile phone. The healthcare professional will then locate the residents and call them, calm them down and assure them that help is on the way.

“Once, we went to the cinema, and one of the residents disappeared. With the new technology, we could easily find the person because the technology works both in- side the nursing home and in the city”. – Lisbeth Thing- holm, Manager of Kristiansgaarden nursing home.

This model of care ‘on-demand’ is beneficial for care institutions and supports elderly citizens in remaining independent in their daily lives.

According to a WHO (World Health Organization) report (Global Report on Falls Prevention in Older Age, 2007), falls often trigger a ‘post-fall syn- drome’, characterized by increased dependence, loss of autonomy, confusion, immobilization and/or depression, all of which further restrict daily activities. However, if quick assistance can be provided, the long-term mental and physical damages can often be prevented.

14 INNOVATING BETTER LIFE

Higher quality of life and reduced infection risk with digital incontinence solutions

Digital aid helps ensure individu- Continence care can be notoriously difficult alized continence care for elderly to fit into conventional care routines, due Findings from the trial at citizens in nursing homes. to the unpredictability of urination patterns. Lergården nursing home in 2019 This can also result in unwanted side effects, • Fewer manual diaper checks: In January 2019, the nursing home including leakages and interrupted sleep. residents were checked 85 Lergården in Aabenraa in the Region of percent less. Southern Denmark completed a 90-day trial, ”With this solution, we can more accurately • Better sleep at night: diaper testing and implementing a digital inconti- predict when diapers need to be changed. changes were reduced by 39 nence-aid system. Now the staff can spend time on other im- percent. portant tasks for the residents.” – Betina • Timely diaper changes: leakag- Evaluations showed that it had released 32 Schlüter Schrøder, Manager at Lergården es were reduced by 73 percent. minutes of daily care per resident due to Nursing Home. fewer checks, fewer diaper leaks and fewer unnecessary diaper changes. The nursing home estimates that the quality of care has improved by 23 percent due The digital incontinence aid, Abena Nova, is to individualized care; increased quality of intended for everyday use to ensure individu- sleep; and increased odor control. alized continence care. It looks and feels like a regular incontinence product but has built- In addition to other measurable results, the in sensors to collect data in real-time. Care trial also indicated a reduction in urinary tract givers are able to view the data via an app. infections and skin problems commonly experienced by residents with incontinence. The nursing home already had a particular focus on good continence care but wanted to offer even better and more personalized continence care to its 84 residents.

15 ASSISTED LIVING A dignified elderly care in Denmark

Monitoring assistive technologies improves users’ quality of life

When people are dependent on In a study from 2018 on intelligent assistive Replacing the charger could be considered a assistive devices, early detection devices, a datalogger was installed on an preventive act due to its impact on the qual- systems must be applied to the electric wheelchair to measure how often ity of life of the user. If the problem had not technology itself. and how much the individual functions of been discovered, the user would have been the wheelchair were used. Among other given a temporary standard wheelchair with- Preventive and early-warning technologies things, it recorded the current and voltage out the ergonomic padding and customized are not limited to the physical signals from draw on the battery, providing real-time in- settings – increasing the risk of bad posture, citizens in need of care. New solutions that formation about the need for charging. sitting sores, and other healthcare issues, measure the usage and functionality of the along with general inconvenience to the user. assisted-living technologies themselves can improve the lives of senior citizens that are ”This will be an important The datalogger solution can also be independent on assistive devices, increasing way for us to structure our stalled on other electronic assistive devices. their safety and their confidence in their For example, nursing homes can install the electronic and digital aids. work in the future.” solution on toilets with douche and drying functions, on ceiling lifts, and even on ex- “These solutions give us a better under- After a few nights with unsuccessful charg- ercise and rehabilitation equipment for the standing of the general use and the specific es (the battery was never charged to full ca- residents with the purpose to measure the needs for service or repair. This will be an im- pacity), the service provider was contacted. usage and functionality of the devices. portant way for us to structure our work in Initial tests showed that the battery was fully the future.” – Malene Arnfast Bruun, Special functional, and further checks quickly identi- Consultant, Department of Social Services, fied and solved the problem: a faulty battery Municipality of Copenhagen. charger.

16 INNOVATING BETTER LIFE

Cross-Tracks - Early interventions supported by artificial intelligence

At Horsens Regional Hospital, arti- almost two million cases a year. 12 percent social benefits and other welfare payments ficial intelligence can help predict of hospital patients are re-admitted within 30 from 2012-2017. unplanned admissions and re-ad- days, and 20 percent are re-admitted within missions, enabling early interven- 90 days. The objective of the cohort study is The prediction algorithms enable screening tions in patient care. to identify these people before they require of each individual citizen at high intervals, acute treatment, by using artificial intelli- determining which patients might require In 2017, Horsens Regional Hospital and four gence to predict unplanned admissions and early interventions and assistance. They are municipalities in the Central Denmark Region re-admissions. integrated into a clinical decision-support (Odder, Horsens, Hedensted, and Skander- system to assist healthcare professionals’ borg) established a five-year cohort study Machine-learning experts and clinical profes- decision-making. called Cross-Tracks with support from Inno- sionals from the hospital, general practices, vation Fund Denmark. The study covered and municipalities develop an AI-supported The system aims to reduce the number of 185,000 adult citizens (18+ years). system that combines healthcare data from unplanned admissions while also introducing both primary care (general practice and mu- a link to other clinical aspects such as early Today, 31 percent of all contacts with Danish nicipalities) and secondary care with data screening, preventive care, and diagnostics. hospitals are unplanned, which amounts to from national registers such as prescriptions,

17 ASSISTED LIVING A dignified elderly care in Denmark

The future of senior fitness A Danish research study from 2000 among women aged 80-89 years shows that elderly citizens can achieve significant results both physically and functionally by doing physical exercise. • Strength training keeps elderly citizens up to 20 years younger biologically. • Cardio training keeps elderly citizens up to 10 years younger biologically. • With training of the muscles, elderly citizens can prevent falls and improve their functional ability in everyday life. • Training makes participants feel healthier, more energetic, and more self-reliant, while also reducing the risk of diseases.

A person-centered approach to rehabilitation

Person-centered ‘everyday rehabili- While home-care staff would typically be in- The rehabilitation program is highly inter- tation’ supports independent living volved in solving tasks for citizens, the staff disciplinary; it applies relevant interventions and increases motivation and satis- in everyday rehabilitation focus on helping based on individual tests and assessments faction among elderly citizens. citizens to solve the tasks themselves. This of each patient’s specific situation. has been documented to improve their per- Denmark has a long-standing tradition for ceived quality of life as well as significantly The technologies include intelligent, measur- high-quality, publicly-funded care for the reduce their need for assistance and sup- able, and motivational rehabilitation equip- elderly, the disabled, and the socially chal- port. Studies find that 81 percent of the cit- ment such as motion sensors and robots lenged. For the past two decades, care ef- izens are generally satisfied with their every- that help citizens train independently. forts have put an increasing emphasis on day rehabilitation program. physical training and exercise, at the same Live feedback during training helps motivate time applying a holistic objective of enabling Individualized rehabilitation programs citizens and reassure them that they are per- meaningful and independent life for each in- with assistive technology forming their exercises correctly. dividual. The Danish care sector – public institutions, private companies and citizen-driven initia- This allows for accurately adjusted training Today, rehabilitation interventions in the mu- tives – emphasizes coherence between treat- and ensures that the process is fully docu- nicipalities are person-centered and adapted ment, care, health promotion, prevention, mented. Both citizens and healthcare pro- to the individual, aiming at the highest possi- and rehabilitation. fessionals can access information about the ble level of participation and inclusion. training programs and monitor progress via In the municipality of Aarhus in the Central an app on a tablet computer. The basic idea of this ‘everyday rehabilitation’ Denmark Region, a rehabilitation and emer- approach, originally conceived at the Munici- gency unit, Vikærgaarden, offers treatment Acknowledging that rest is often a crucial pality of Fredericia in the Region of Southern and rehabilitation to citizens who have been factor in any rehabilitation process, ambient Denmark, is to enable the individual citizen to hospitalized or have experienced loss of applications use sound, light, and images to remain independent, self-reliant and actively function. The rehabilitation stay is short and create a peaceful and safe environment that participate in his or her own life for as long aimed at citizens moving back into their own supports the rehabilitation process. as possible. homes.

18 INNOVATING BETTER LIFE

Mobility Monitor – an interdisciplinary approach leading to faster rehabilitation

Sleep is very important for overall she finally went to bed, she would often well-being and rehabilitation. In- wake up again shortly due to pain from an Vikærgården Rehabilitation and novative technology makes it pos- old hip fracture. Emergency Unit sible to analyze sleeping patterns • Vikærgården offers short rehabil- and improve the quality of sleep. The caregivers contacted her GP with this itation stays to citizens who have specific knowledge. The data from the been hospitalized or have experi- At Vikærgården, a rehabilitation and emer- monitoring solution, demonstrating micro enced loss of function at home. It gency facility in the Municipality of Aarhus, activity and a very short time in bed, com- takes an interdisciplinary approach in Central Denmark Region, an 86-year old bined with her own statements about pain to the assessment and treatment woman arrived, after a long hospital stay, and unrest, made the doctor respond imme- of their condition. to recover from pneumonia. At the hospital, diately. • The rehabilitation stay lasts up she had trouble finding the peace to sleep to five weeks. Afterwards, the during the night, and the problems persisted A temporary pain treatment was prescribed, citizens move back to their own at Vikærgården. along with melatonin tablets to help her homes or to new accommodation. sleep in the evening. The staff placed a monitoring solution in her bed to analyze her sleeping pattern. The solu- The monitoring solution enabled the care tion, Mobility Monitor, found that she was givers to assess and analyze the woman’s only lying in bed for three hours, from 1-4 sleeping patterns and take the necessary ac- am. This information provided an opportuni- tions to improve her sleep quality and overall ty to have a closer dialogue with the woman well-being. about her inconsistent sleeping pattern. After her first treatment, she got out of bed As it turned out, the woman felt restless. the next morning and took a shower on her She was not tired in the evening, and when own – for the first time in 2 months.

19 ASSISTED LIVING A dignified elderly care in Denmark

Sensory stimulation improves the well-being of people with dementia

Ambient application of sound, light, natural scenery, and “One of our residents is very restless and extremely sensitive to ex- other images can create a peaceful environment in nursing ternal impulses and stimuli. She often needs professional help to homes and improve the well-being of residents with de- rest during the day. This ambient device creates moments of peace- mentia. fulness, making her calmer and improving her quality of life.” – Sigrid Rindom, Group Leader, Dementia Department, Kærdalen, Vejen In Vejen Municipality, the nursing home Kærdalen has experienced Municipality. how a mobile device for sensory stimulation, that displays relaxing nature-scenery films, has improved the quality of life for its residents ”This ambient device creates moments of with dementia. peacefulness, making her calmer The device is a cabinet on wheels mounted with a projector, a sound and improving her quality of life” system, and a control panel to navigate the different films/programs. While it is mostly used in the public areas of the nursing home, its port- ability allows it to be used in the residents’ own apartments as well. Overall, the device has had a significant effect on residents who feel restless. Relatives have also made positive observations, stressing that The displays and music are specially designed to calm and stimulate the natural images and sounds work as a calming catalyst and a sub- people suffering from anxiety, creating a positive distraction. ject for conversations.

20 INNOVATING BETTER LIFE

Sensor-based rehabilitation increases elderly citizens’ functional levels

Sensor-based technology helps elderly citizens set rehabilitation goals and keep track of their activities. The program improves self-empower- ment, physical activity, and functional levels in daily life.

In Næstved Municipality, in Region Zealand, a rehabilitation center has implemented a new sensor-based rehabilitation program to encourage elderly citizens to be more physically active. When citizens are referred to rehabilitation, physiotherapists at the center decide whether they are likely to benefit from the program, which includes an app and a motion sensor to support home training.

Citizens enrolled in the program only visit the center once a week (compared to twice a week earlier). At this weekly visit, the physiotherapists use data from the citizen’s home exercises/activity from the previous week to adjust the program.

The consistent accumulation of data ensures that the staff at the rehabilitation center always have an updated profile of the individual citizen’s compliance and progress.

The assisted-living technology has been designed for people with limited digital experience – a common challenge associ- ated with digital solutions for the elderly.

“The technology is often the biggest hurdle, but this solution is so simple that most people can use it. All of our patients are extremely happy with the solution – despite initial skepticism. They almost won’t let go of it.” – Louise Rommel Nielsen, Physiotherapist.

Sensor-based home training can have a large impact. Some citizens live far away from training facilities, and many are not used to doing daily exercises. With digitally-enhanced training, more citizens are able to find the time for training in their everyday lives.

The program in Næstved Municipality is tailored to each individual’s needs and possible impairments. It includes a series of exercises and an activity log that monitors both the exercises and basic daily movement, including step count. The program is visualized on a simple user interface that gives a clear overview of the daily activities and goals.

21 ASSISTED LIVING A dignified elderly care in Denmark

50% sick leave reduction and faster recovery with new rehabilitation robot

Digital training improves motiva- robot based on state-of-the-art technologies. zens and therapists, which has increased the tion for patients with shoulder in- The robot assists patients and therapists in value for everyone.” – Ida Munk Sandegaard juries, enabling a faster recovery maintaining a motivating, intelligent, and Skyt, Project Manager in Aarhus Municipality. process. measurable rehabilitation process. It is an example of assisted-living technology, Recovering from shoulder injuries typically in- Measuring continued progress has a tremen- which both provides value to the end users, volves a rehabilitation process that combines dous impact on motivation, enhancing the adds a valuable tool the therapists’ toolbox self-training and supervised training sessions quality and frequency of training and ulti- and has a positive impact on the municipali- with a physiotherapist. mately ensuring faster rehabilitation. ties’ expenses.

Self-training is usually the most challenging The solution has been co-developed by the part, especially in the early stages, when company Robofit and Aarhus Municipality. A report from 2017 shows that many patients suffer from high levels of pain From the very first prototype, they have col- implementing the rehabilitation and low mobility. They often feel that they laborated extensively on testing, establishing technology in Aarhus Municipality are improving very little and very slowly. This user cases, and generating relevant feed- has: reduces their motivation and sometimes cre- back. • increased compliance from 30 ates uncertainty about whether they are do- percent to 86 percent ing their exercises right. “It has been an interesting process for us at • reduced the duration of users’ sick Aarhus Municipality; developing an innovative leave by up to 50 percent To improve motivation and compliance to solution that will support the actual practice. • added crucial data to improve the training, Aarhus Municipality, in Central Den- It is not just a desktop project conceived far rehabilitation process mark Region, has introduced a rehabilitation from reality. It has been shaped by our citi-

22 INNOVATING BETTER LIFE

DigiRehab – a 12-week program which reduces the need for home care

Vejen Municipality experiences instructional videos and supervision by the great results with digital training caregiver. 118 citizens in Vejen have that helps improve quality of life completed the 12-week exercise for the elderly and decreases their “The exercises make elderly citizens more program conducted in collabo- need for home care in just 12 weeks. self-reliant and improve their quality of life. ration between DigiRehab and At our municipality, the overall need for home Vejen Municipality. Physical exercise has a great impact on elderly care has not increased despite a growing • 72 percent of users experienced citizens’ quality of life. It increases their abili- number of elderly citizens. This initiative is part reduced need for home care ty to master everyday life and can reduce the of the reason. It has also changed the way after the program (average need for home-care assistance. both staff and citizens think about rehabilita- reduction: 36 percent). tion. Elderly citizens have learned how training • 18 percent had the same need In Vejen Municipality, in the Region of South- can improve their quality of life.” – Line Ballis- for help after the program. ern Denmark, a cost effective digital-training ager Juhl, Team Leader of Home Care in Vejen • 10 percent experienced in- platform, DigiRehab, for at-home rehabilita- Municipality. creased need for help (average tion and physical exercise has been imple- increase: 9 percent). mented. After 12 weeks of exercise with the tailored programs, the average citizen’s need for home The tablet-based solution tests citizens’ care decreases with 45 minutes per week. physical ability and provides them with a tailored exercise program, supported by an algorithm. The exercises are performed twice a week in citizens’ own homes, assisted by

23 ASSISTED LIVING A dignified elderly care in Denmark

Working environment is an essential part of the education at schools of social and health sciences.

A top-class working environment helps address shortage issues

Denmark is increasingly imple- To address this challenge and to tackle labor Care staff is consistently getting better at menting innovative technologies shortage issues, the Danish care sector is matching citizens’ needs with the available to help improve the working en- implementing a number of technologies that technology. Due to practice-based learning vironment for healthcare profes- support the daily interaction between citizens and living labs, professionals have a unique sionals with physically demanding and healthcare professionals. And to ensure opportunity to explore and try new technolo- tasks, while maintaining a high level of care the best match between citizens' needs and gies before they are implemented as part of quality. Knowledge about these technol- the available technology, healthcare manage- daily routines. ogies improves healthcare professionals’ ment at both institutional and municipal lev- awareness of their working environment els focus on the skill levels of healthcare staff Knowledge about the way specific technol- and helps them reduce physically stressful when it comes to mastering new technologies. ogies are used also increases staff’s aware- postures. ness of assisted-living technology in general. New technologies benefit both citizens This means that they are more aware of their The vast majority of elderly citizens have a and professionals physical working environment and are better strong desire to be able to take care of every- Technologies such as ceiling lifts, bathing able to reduce physically stressful postures. day routines themselves – such as getting in chairs, reversing systems, sliding and turning and out of bed, taking a bath, and staying in systems for beds, entry-exit beds, and hy- A study from Copenhagen Municipality from touch with family and friends. Some manage giene solutions both support citizens in their 2017 shows that the application of some this on their own, while others need some de- everyday routines and improve healthcare assisted-living technologies allows for bet- gree of support. Regardless of the degree of professionals' physical working environment. ter postures, relieving the physical strain help, it is important to consider the needs of on healthcare professionals, and reducing both citizens and professionals. Systematic support is vital to ensure that work-related pain and injuries. both users and professionals will reap the Whether they live in their own homes or stay full benefits of assisted-living technologies. As such, they relieve both citizens and pro- in hospitals, rehabilitation centers, or nursing The municipality of Copenhagen has applied fessionals, physically as well as mentally, al- homes, citizens’ care and treatment needs a technological implementation model which lowing more time for personal contact and are becoming increasingly complex while ensures that the introduction of new tech- other care tasks. healthcare professionals remain a limited re- nologies will always be complemented by the source. appropriate development of staff skills.

24 INNOVATING BETTER LIFE

Patient-turning system improves working environment

Mechanical turning systems for fer, the caregiver does not need to push, pull, proportion of caregivers’ daily routines, and transferring, moving, and handling or lift the patient. In addition to being a gentler handling patients is very stressful on their patients have improved the working transfer for the patient, the system is proven back, neck, and shoulders. As a result, patient environment and the safety of res- transfers have traditionally accounted for a idents in nursing homes in Hillerød ”This technology makes large number of work injuries. Municipality. transfers smoother and “This technology makes transfers smoother Hillerød Municipality, in the Capital Region of gentler for the patients and and gentler for the patients and has signifi- Denmark, has vigorously pursued assisted-liv- cantly reduced the number of injuries among ing technologies, which improve the working has significantly reduced the care staff. Not a single transfer-related work environment and safety of employees as well number of injuries among injury has been reported since we implement- as the efficiency and quality of care. One of ed the system.” – Maria Westh Bernburg, these solutions is the Vendlet patient-turning care staff.” Physiotherapist and Area Manager at Skovhu- system. set Nursing Home in Hillerød. to have positive impact on caregivers’ working The system consists of two motorized bars environment and their overall health. Hillerød Municipality has implemented the mounted on each side of the bed. Connected new system in all nursing homes and works by a sheet, the bars turn the patient from side It plays a significant role in preventing work-re- continuously to ensure that all employees are to side using a hand control. During the trans- lated injuries. Bedside care is a significant properly trained in using it.

25 ASSISTED LIVING A dignified elderly care in Denmark

Innovative inclusive care-center planning

At nursing homes, installing ceiling ”Having ceiling lifts installed of working and a good working environment, hoists as part of the basic struc- with tremendous benefits in terms of ergo- ture improves the working envi- just about everywhere gives nomics, health, and safety. It allows residents ronment, ensures safer patient us a much more efficient to be assisted in personal tasks and needs transfers, and makes facilities ac- as quickly and as gently as possible.” – Jette cessible to all residents. way of working and a good Laumann, Head of Section for the Nursing working environment, with Homes in Silkeborg Municipality. Ceiling hoists are a great care tool for both staff and residents at nursing homes. Tradi- tremendous benefits in Common rooms such as the TV room, the tionally, they are installed only in bedrooms terms of ergonomics, health, sensory room, the spa, and the ‘man cave’, and bathrooms. But at the Marienlund Nurs- are equipped with hoists, allowing them to be ing Home in Silkeborg Municipality, in Cen- and safety.” used by all residents – including wheelchair tral Denmark Region, they have been more users. widely integrated into a new nursing-home basic structure. Walls and hoists can be design. moved and adapted to the needs of resi- In the residents’ own apartments, the rail dents and caregivers at all times. system has been integrated discreetly. The All individual apartments, group areas, and structure does not take up much space and specialist facilities have been fitted with “Having ceiling lifts installed just about every- thus prevents any undesirable “hospital feel” room-covering ceiling hoists as part of the where gives us a much more efficient way in private residential spaces.

26 INNOVATING BETTER LIFE

Educating nurses and assistants to co-create innovative care solutions

Assisted-living technologies are Studies in Denmark show that students in tions. This approach is emphasized in both evolving rapidly, constantly chang- vocational training often lack digital skills. school learning and internships. ing the daily routines of social and As a frontrunner in care, the School of Social healthcare professionals. A new ed- and Health Sciences (SOSU Syd) has collab- ”One of the keys to address the challenges of ucation program provides health- orated with the local municipalities of Had- the social and healthcare sector is to co-cre- care workers with digital skills, giving them erslev, Aabenraa, Tønder, and Sønderborg to ate scalable and sustainable digital solutions a new role in implementing innovative solu- develop a new education program, DIGI-Tech, that create value for the individual. These tions. which takes a technical-innovative approach students will be a vital resource in this en- to care. deavor.” – Søren Lorenzen, Director, Social & Patients and their relatives increasingly ex- Health Care, Municipality of Aabenraa. pect digital and technological solutions that Students not only learn the traditional skills support independence, flexibility, and quality of social and healthcare professionals, they The program is also designed to attract a of life. also obtain a level of technological know- new type of student, those with digital inter- how. This allows them to communicate with ests, and possibly increase the recruitment This calls for care employees with skills and developers of assisted-living technology solu- of male students at the same time. learning abilities that can support the imple- tions, participate in complex processes, and mentation of new technologies. become co-creators of innovative care solu-

27 ASSISTED LIVING A dignified elderly care in Denmark

Nursing homes of the future put the resident first

Nursing homes in Denmark focus on high-quality nursing Nursing Home of the Future care, assistive technologies, architecture, and design to im- The Nursing Home of the Future in Aalborg, in the North Denmark Re- prove residents’ quality of life and overall well-being. gion, has implemented a number of assistive technologies to support the everyday life of the residents. All nursing homes in Denmark are designed to enhance care practice. Nursing homes are designed as real homes that give the resi- The apartments are equipped with pressure-sensitive flooring that – if dents a sense of living an ordinary everyday life. Parks and gardens often the resident permits it – can alert the nursing staff automatically in the invite them to engage in outdoor activities, while a range of individual case of fall accidents. Flush/dry toilets make it possible for some of and social activities stimulate the senses, support the mobility of resi- the residents to go to the bathroom without assistance, while electronic dents, and encourage social inclusion. information boards in the hallways keep the residents updated with important information. When Danish municipalities build new nursing homes, they are built to support care practice and a socially active life, while also acknowledging The Nursing Home of the Future in Aalborg also serves as a so-called the wide range of residents’ needs. The new nursing homes often in- ‘Living Lab’, where new ideas, new technologies, and new workflows can clude the implementation of innovative assisted-living technologies and be tested, evaluated, and implemented for the benefit of both residents sensory stimulation, which can improve residents’ overall well-being and and staff. quality of life.

28 INNOVATING BETTER LIFE

Modern and flexible bathroom solution contributes to a life enhancing culture

Albertshøj Nursing Home has in- justable toilet, and should preferably include highly-flexible quality solution that benefits stalled a modern and flexible bath- the ability to tailor the installations to individ- both citizens and caregivers. room solution to benefit both resi- ual needs. It must also allow for freedom of dents and their caregivers. movement for caregivers. ”Even if this comes to be When the Albertshøj Nursing Home in Al- The overall functionality is supported by a your last home in life, it still bertslund Municipality, in the Capital Region number of aesthetic design choices. of Denmark, opened in 2016, the bathroom needs to have substance, design had been given thorough considera- One example is the importance of colors energy, and quality. Life is for tion. and contrasts for cognitively challenged residents who sometimes struggle to find their living, also in the late years.” A taskforce of employees, management, way around a room with no contrasts. municipality representatives, architects, and the Danish company Pressalit had collabo- At Albertshøj, the tiles are designed in two “Even if this comes to be your last home in rated to analyze and identify the needs and contrasting colors. The wall-mounted grab life, it still needs to have substance, energy, requirements of the 108 residents. bar in the shower is dark grey so that it clear- and quality. Life is for living, also in the late ly stands out against the bright tiles. This en- years.” – Bjarne Webb, Nursing Home Man- The design process merged aesthetical and ables residents to navigate more freely and ager at Albertshøj. functional considerations, aiming to create retain their orientation in the bathroom. the ‘ideal bathroom’ for both residents and For the management at Albertshøj, the bath- caregivers. Before construction began, a model of the room design process has facilitated a cultural bathroom was created to allow the task transition as well – from a traditional ‘caring From a functional point of view, the ideal force and users to test the equipment and culture’ to a much broader ‘life-enhancing’ bathroom must be flexible, with a horizontal- provide input. This process has ensured that culture, focused on supporting residents’ in- ly and vertically adjustable sink, a height-ad- the nursing home now has a modern and dividual life possibilities.

29 ASSISTED LIVING A dignified elderly care in Denmark

Caregivers actively pursue innovative technologies

The combined dedication of staff management, who consider whether it is fit making it easier for the staff to re-position the and management in Hvidovre Mu- for implementation. residents with minimum effort. nicipality, in the Capital Region of Denmark, has led to the intro One such technology is a new type of multi- duction of new multifunctional functional care bed, three of which are now “I can now assist a resident beds. installed at Torndalshave. in his morning routines by

The increase in the number of elderly citizens The bed, the ‘OPUS 5’, makes it possible for myself. Before, we were makes innovative technological solutions to the resident to get out at the foot of the bed. always a team of two.” assist caregivers in their daily routines very At the touch of a button, the bed moves into important. an upright seating position and is then lowered to the ground, allowing the resident to exit it “I can now assist a resident in his morning At Torndalshave, a nursing home for people without exerting himself or the caregiver. routines by myself. Before, we were always a with dementia in the municipality of Hvid team of two.” – Lisbeth Pabst, Caregiver at ovre, the staff has, with the management’s The bed can also be tilted to each side, ena- Torndalshave. blessing, taken a pro-active approach to this bling staff to turn and reposition the resident challenge. At trade fairs and on the internet, gently. The height of the bed can be controlled The implementation of the new beds has they actively pursue new technologies rele- with practical add-on foot controls allowing been driven by the combined enthusiasm of vant to their field. When they come across staff to keep their hands free. The bed has a staff and management, ultimately benefit- something interesting, they present it to the number of other pre-programmed positions, ting the residents at Torndalshave.

30 INNOVATING BETTER LIFE

Faster and more efficient treatment and rehabilitation with the Brain+ solution

A digital tool improves the cogni- To expand their approach to rehabilitation, “Our citizens experience increased autonomy, tive functions of elderly citizens Lejre has implemented a new experimental confidence, and participation. The self-train- with cognitive impairment, allow- digital app developed by Brain+ to ensure ing aspect means we can offer rehabilitation ing for faster and more efficient faster, more efficient treatment, and to re- and prevention options to more citizens with- treatment and rehabilitation. duce the burden on staff. out increasing the strain on staff. The app is fun to use, adapts to the individual’s ability, For many years, Lejre Municipality in Region The app encourages participants to auton- and can be offered to anyone with a smart- Zealand has had a targeted, caring, and effi- omously exercise fundamental cognitive phone or tablet. Our citizens are very pleased cient approach to rehabilitation. This includes functions such as attention, memory, prob- with this additional opportunity to optimize rehabilitation for a wide range of cognitive lem-solving, and planning. This is done using their cognitive training at home.” – Signe W. issues, from brain trauma and Parkinson’s both automatically generated and individual- Jeppesen, Physiotherapist, co-responsible for disease to depression and other mental dis- ly-tailored training plans. assisted-living technologies in Lejre Munici- orders. pality. The training platform does not require the There is an increasing need for accurate involvement of healthcare professionals but and adaptable tools that support cognitive allows them to track patients’ activity and treatment and rehabilitation. This is due to progress. To ensure adherence and long-term the increasing number of elderly citizens and benefits, the app combines gamified cogni- earlier patient discharge from hospitals. tive exercises and behavioral therapy.

31 ASSISTED LIVING A dignified elderly care in Denmark

Sens-Aid, the blanket that hugs residents to improve their well-being

A new solution increases calmness and well-being of residents with physical or mental impairments in nursing homes.

Sensory solutions are increasingly being applied in Danish nursing homes to promote social interaction and well-being of residents.

At Sølund village in Skanderborg Municipali- ty, in Central Denmark Region, the staff has implemented a new tool in their daily activities with residents who are mainly elderly citizens with physical or mental impairments.

The tool is a weighted blanket, called Sens- Aid, with six ‘wings’ that embrace the resident when seated. The wings stimulate the so-called tactile and proprioceptive senses; the body's sense of touch and position. They leave the resident with the feeling of being hugged, which triggers the hormone oxytocin, also called the ‘cuddle hormone’. When this hormone is released, the resident immediately senses a positive change in well-being, energy, calmness, and peace of mind.

As such, the solution creates a comfort zone for the resident, and the staff have observed significant positive impact on the behavior of residents, some of whom are in their 80s. Many of them have developmental disabili- ties and are often very restless, and sometimes self-damaging, mostly in situations where they feel under pressure, such as the daily brushing of teeth.

When residents use the stimulating blanket, they are much calmer, more tolerant, and able to participate in social activities with other residents and staff.

32 INNOVATING BETTER LIFE

A musical pillow benefits elderly citizens

A special pillow, with built-in Niels Eje. It helps them relax in troubled or adapting workflows and approaching the sound and evidence-based mu- agitated situations and remain relaxed after residents about using the pillow, which was sic, has significantly improved the therapy sessions. a significant factor for the results achieved.” perceived state of citizens with – Lærke Kaae Pedersen, Project Worker at dementia. Based on the positive individual experiences the Department for Assisted-living Technol- with the MusiCure pillow, the nursing home ogy in Favrskov Municipality. Music has an incredible ability to influence conducted a user survey in 2018 to examine people’s mood, awaken memories, induce the benefits of the pillow more closely. The pillow can be used as a stimulating tool emotions, reduce anxiety, create calmness, to create peace for individual citizens – im- alleviate sleep problems, and in some cases The overall positive results suggest that a proving the daily lives of elderly citizens, their even pain. This makes music, and musical in- large proportion of dementia patients will be relatives, and healthcare professionals. The tervention, particularly suitable to caring for able to benefit from the music interventions. technology, however, can neither be a stand- people with dementia. The survey also concluded that the staff's alone solution nor replace other solutions. knowledge of the individual citizen is instru- At Tinghøj, a dementia nursing home in Favr- mental to achieving good results. skov Municipality, in Central Denmark Region, residents have been able to use a special- "All the employees and management of ly developed pillow with built-in high-quality the nursing home supported the user sur- sound and specially composed music by vey. The employees participated actively in

33 ASSISTED LIVING A dignified elderly care in Denmark

The future of elderly care in Denmark

Adequate and timely care for all elderly citi- Technology-supported solutions in the fields of elderly zens has been a cornerstone of the Danish wel- care, prevention, and rehabilitation generally empower fare state in a long time. Innovative technolo- and encourage elderly citizens to play a more active role, gies and artificial intelligence continue to be a often enabling a higher degree of information-sharing priority in future efforts to improve the quality and joint decision-making between citizens and caregiv- of life and care for our elderly citizens. ers. Also, a great number of technologies relieve caregivers of time-consuming, physically or mentally demanding Across generations, citizens’ rights to enjoy a meaningful tasks. This frees up time for personal contact and other and dignified life in their senior years, regardless of their care tasks. economic means, has been embraced across the political spectrum. But while the underlying values of elderly care Denmark continues to explore the possibilities that tech- have remained intact, the practical approach and particu- nological advances bring and their potential benefits to lar efforts and tools continue to evolve. both citizens and healthcare professionals. This includes artificial intelligence and other new digital technologies Like many other countries, the Danish care sector feels that make it possible to utilize health data to more ac- the pressure of demographic change – one that puts a curately determine, or predict, the need for help among severe strain on both the human and the financial re- specific groups of citizens. sources required to maintain a high quality of elderly care. To learn more about the Danish approach to elderly care, As this white paper demonstrates, technological innova- feel free to contact Healthcare DENMARK. If you want to tion plays a key role in meeting this challenge in collabo- visit Denmark to study its innovative solutions in detail, ration with citizens, enabling solutions that are sustain- you can request a delegation visit through the Healthcare able, viable, and do not compromise the quality of care. DENMARK website.

34 INNOVATING BETTER LIFE

About Healthcare DENMARK

Healthcare DENMARK is the inter- national gateway to Danish healthcare expertise and innovation. Our aim as a non-profit public-private partnership is to internationally benchmark Danish best practices within healthcare.

The goal of Healthcare DENMARK is not to HRH Crown Princess Mary of Denmark sell or promote any specific products or solu- patron of Healthcare DENMARK tions, but to communicate the strongholds of Danish healthcare. We do Healthcare DENMARK has a national and po- this by attract- litical mandate to provide this service to pol- ing health pol- iticians, relevant top and management level iticians, deci- professionals, and journalists working with sion-makers, healthcare. and journalists to experience Backing this public-private initiative is a part- Danish health- ner group of both public and private key ac- care solutions tors within Danish healthcare, including the in practice Ministry of Health, the Ministry of Industry, and meet the Business and Financial Affairs, the Ministry of people behind. Foreign Affairs of Denmark, Danish Regions,

Hans Erik Henriksen Our network is Region of Southern Denmark, North Denmark Chief Executive Officer an extensive Region, Aalborg Municipality, University of pool of public Southern Denmark, Aalborg University, School sector, private of Social and Health Sciences, the Confedera companies, and other actors in the area of tion of Danish Industry, the Danish Chamber healthcare – all dedicated to providing excel- of Commerce, Danish Export Association, Da lent and efficient healthcare as well as shar- nish Care, Falck, Systematic, KMD, Intelligent ing best practices across borders and profes- Systems, OpenTeleHealth, Lyngsoe Systems, sions. Wavecare, PDC, and Icura.

’’In Denmark our focus on putting the patient Her Royal Highness Mary, Crown Princess of first – combined with efforts to improve effi- Denmark is patron of Healthcare DENMARK. ciency and quality – has resulted in a wide array of innovative solutions. I sincerely believe Da Visit www.healthcaredenmark.dk to learn more nish solutions and expertise can have a positive about some of the world’s best and most inno- impact on global health.” - Her Royal Highness vative healthcare providers and companies or Crown Princess Mary of Denmark to request meetings with the stakeholders who are future-proofing healthcare sectors around If you would like to learn more about our the world. world-renowned healthcare, we can assist you with tailoring a visiting program, setting up meetings, and arranging access to otherwise Stay updated with off-limits areas and people within both the our newsletter Visit our website public and private sectors, as well as assist healthcaredenmark.dk you with local accommodation and transpor- and sign up! tation.

35 Healthcare DENMARK ASSISTED LIVING Forskerparken 10H Phone: +45 23 84 00 56 INNOVATING BETTER LIFE A dignified elderly care in Denmark DK-5230 Odense M [email protected]