Wohlfahrtswerk für Baden-Württemberg (WBW)
The Wohlfahrtswerk for Baden-Württemberg was founded around 200 years ago. Today, it is a foundation under civil law and pursues exclusively charitable purposes without any religious affiliation.
As one of the major providers of assistance to the elderly in Baden-Württemberg (a federal state of Germany) with around 1,700 employees, they offer the entire range of services for the elderly at 19 locations: From nursing homes to assisted living and senior living communities to support for living at home.
- 14 nursing homes with over 1000 nursing places
- Assisted senior living with around 700 apartments at 16 locations
- Outpatient residential community for seniors with care needs (20 places at 2 locations)
- Day care with around 120 places at 9 locations
- Outpatient nursing and care. Around 2000 people are cared for by us at home
- Outpatient assisted living communities for the mentally ill
- Vocational schools for nursing, geriatric nursing and geriatric nursing assistance and for social care - focus on everyday care
- Every year, 2,100 people receive further training in all aspects of care for the elderly at our Wohlfahrtswerk training center - and have been doing so for over 30 years. The training center also includes a school for geriatric care and a private vocational school for training as a "service assistant in social and health care".
The two most important tasks are to maintain social services and facilities and to stimulate, test and implement innovations in the social field.
The Research and Development Department is always involved in scientific research projects. Wohlfahrtswerk is an innovator in the social field and has developed, tested and introduced numerous new ideas. Wohlfahrtswerk was a pioneer in many groundbreaking care and living services for the elderly: for example, the first assisted living in Germany and the first day care in southern Germany.
The pilot phases of the project are carried out in two different settings:
In our day care centers: Here, elderly people spend the day in community with others while being well and safely cared for. Guests are picked up from their homes by a transport service in the morning and returned to their homes in the evening. Family caregivers can thus find relaxation and freedom and combine care with work.
Day care is also well suited to people with dementia whose relatives can take over care in the evenings and at night - here it offers a good alternative to a nursing home.
In the home scenarios, the elderly people still live independently in their own apartments or in assisted living facilities and are looked after and cared for by outpatient services. The nursing staff provides medical care in accordance with a doctor's prescription.
Wohlfahrtswerk für Baden-Württemberg (WBW) is one of the end-user organizations that will ensure the involvement of primary end-users in all phases of the project. Wohlfahrtswerk can be a qualified end-user due to their long experience and large organizational structure, as they care for people with neurocognitive impairments and Parkinson's disease on a daily basis and in this course can test the ProCare4Life system in different settings.
Wohlfahrtswerk has a lot of experience regarding the needs and expectations of the users (people & caregivers) who are addressed by the project goals, so WBW will inform them and invite them to participate in the project. Wohlfahrtswerk will accompany the users during the pilot phases and will continuously monitor the use of the system and give feedback to the technical partners in order to contribute to the development and improvement of the system.
On average, patients develop Parkinson's disease at around 60 years of age. However, the onset is probably preceded by decades of changes in the body. The risk of Parkinson's disease is 2.0% for men and 1.3% for women.
The number of patients worldwide has increased from 2.5 million in 1990 to 6.1 million in 2016. The main cause is the increasing aging of the population. However, the incidence of the disease has also increased by more than 20 percent within individual age groups during this time. According to health insurance data, around 400,000 people in Germany currently suffer from Parkinson's disease (MoPED, Morbus Parkinson Epidemiology in Germany Evaluation of data from 3.7 million insured persons).
Worldwide, 3.2 million DALYS (English acronym and stands for disability-adjusted life years) - that is, symptom-free years with a good quality of life - were lost due to Parkinson's in 2016. Estimates for Germany are 100,000 DALYs. The disease recently claimed 200,000 lives per year, 7,000 of them in Germany.People involved (citizens, carers, health and care professionals)
Needs and challenges in daily living
Parkinson's disease affects many areas of life - whether work, partnership and family, or leisure activities. Even if everyday life changes little in the early stages of the disease: Many affected people are afraid of becoming dependent and in need of care over time. However, it is possible to lead a life for a long time that is not too much affected by the disease.
Nevertheless, it makes sense to prepare for the time when support becomes increasingly necessary. Good medical support is very important. Most people are also better able to cope with their illness if they do not withdraw into themselves, but share their experiences with others right from the start. It is also important to involve relatives, friends and acquaintances when help is needed in everyday life.
Many people with Parkinson's report that it is good for them to remain active as much as possible. It is crucial to recognize one's own limits and to constantly adapt physical exercise, everyday activities and occupational activities to one's own capabilities.
According to the latest epidemiological estimates, around 1.6 million people in Germany live with dementia. Most of them are affected by Alzheimer's disease. On average, around 900 new cases occur every day. As a result of demographic changes, there are far more new cases than deaths among those already suffering from the disease. For this reason, the number of dementia patients is continuously increasing. Unless there is a breakthrough in prevention and therapy, the number of patients will increase to 2.4 to 2.8 million by 2050, according to various projections of population development. This corresponds to an average increase in the number of patients of 25,000 to 40,000 per year or 70 to 110 per day. In the elderly population without German citizenship, there are about 51,000 people with dementia. The number of people affected who have not yet reached the age of 65 is more than 25,000.
Needs and challenges in daily living
In the case of dementia, it is not only the memory that deteriorates, but also other abilities. It is therefore often difficult for affected people to cope with everyday life on their own. Depending on the form and severity of dementia, various complaints can arise.
For example, people with dementia can no longer remember what they have recently done or eaten. They may also find it difficult to orient themselves. As a result, they can no longer find their way around unfamiliar surroundings or get lost, for example. In addition, dementia can make itself felt through speech problems. People with dementia often can no longer remember even simple words. Conversations are then difficult.
Behavior can also change: Some dementia patients are listless, anxious or have outbursts of anger. Others withdraw from conversations or from their circle of friends.
Is it possible to prevent Dementia?
Many circumstances and diseases can contribute to the development of dementia. Some can be influenced or treated, such as high blood pressure, diabetes, obesity or smoking.
If you live an active life, you may be able to prevent the disease. This includes a balanced diet, exercise and mental activities such as reading or making music. Friendships or contact with other people can also reduce the risk.
An important component of treatment is procedures that challenge the memory and help to better manage everyday life. Doctors can offer the following, for example:
- Procedures that awaken memories or stimulate mental abilities (technical term: cognitive stimulation).
- Occupational therapy
- physical activity
- listening to music, singing or playing instruments
As reported by the Federal Statistical Office (Destatis), at the end of 2019, 2.1 million people in Germany more than half of all 4.1 million people in need of care (51.3%), were cared for at home by relatives alone. 72,700 of them had the highest care level (5) and thus had the most severe impairments with special requirements for nursing care. (Source: https://www.destatis.de/DE/Presse/Pressemitteilungen/2020/12/PD20_N083_224.html;jsessionid=968E4443BC0F6ED7A2E5B39C51428A30.live711 )
Needs and challenges in daily living:
An increasing number of working relatives have to cope with multiple tasks in work, family and care. The average duration of care is more than eight years and more than one in four employees spend more than two hours a day on so-called care work. And even in the post-work phase, partners take care of the spouse in need of care.
About two-thirds of family caregivers are women. They often care for (small) children at the same time and have left their jobs to do so. They, and - not to be forgotten - the 30 percent of men who are caregivers, must be supported with good reconciliation solutions that prevent them from leaving their jobs.
In 2020, 1.7 million formal caregivers in Germany were employed in nursing and geriatric care subject to social insurance contributions. Unlike employment as a whole, it continued to grow in the Corona year. Nursing professions continue to be a female domain: A large proportion of employees are female. Part-time employment is widespread.
Demographic developments, as well as medical progress, have already led in the past to an increasing need for nursing staff. The forecasts of the expected supply gap vary. This poses a challenge for securing professional nurses in the future. It is exacerbated by the fact that there is already a nationwide shortage of skilled workers among registered nurses in both geriatric and nursing care. Nurses and geriatric care workers account for just under one-third of the more than 5 million employees subject to social insurance contributions in the entire health care and social services sector.
Work package 2
Task 2.2: Online surveys: Patients with dementia; caregivers of patients with dementia; patients with PD + caregivers of PD.
Task 2.4: Evaluation strategy and pilot implementation roadmap: the evaluation strategy and pilot implementation roadmap will guide the implementation of the PROCare4Life project.
Task 2.5: Identify cultural and social implications in the care setting.
- 1 patient with dementia +
1 caregiver of person with dementia +
3 decision makers +
1 market actor
1 media actor
- Total = 7 interviews
Understanding health limitations, living conditions, family structure, income, ability to use technology, and different cultural expectations of healthcare as it relates to the concept of integrated care, which is shaped by the perspectives and expectations of different users of the healthcare system.
Work package 6
Pilot 1 - Phase 1 (focused on the feasibility of the technology, including installation procedures and enrolment phase).
- 3 People in home scenario with dementia disease: first real data collection with Fitbit + smartphones +sensors.
- 5 Health and care professionals: initial user feedback on Fitbit and smartphone use.
- Total = 8 participants
The implementation in home settings was limited and no implementation was possible in day care centers due to COVID-19 restrictions.
Work package 6
Pilot 1 - Phase 2 (focused on usability as assessed by user groups, including user preferences of different components of the PROCare4Life solution). We planned to recruit 60 service users, 10 carers in rehabilitation and home care scenarios.
Pilot 2 (focused on evaluating the properties of the metrics generated by the Procare4life platform in real-life conditions). We will recruit 38 individuals in day care, 38 individuals in home care scenarios, and recruit 10 professionals and nurses in day care and home care scenarios