The second day at Foritaal 2017 continued with another round table on Ambient Assisted Living and Healthcare, with experts with different backgrounds:

M. Malavasi – Ausilioteca Bologna
A. Pilotto – Geriatrician, Galliera Hospital, Genoa
Giovanni Abbruzzese – Neurologist, Genoa University
Lorenzo Bertorello – Liguria Region
Barbara Bavastro – IPASVI
Claudio Puppo – Consulta Regionale Handicap

The round table started by pointing out that nowadays, rehabilitation is a crucial problem, and chronic diseases pose significant challenges in the field of rehabilitation: one main problem is that rehabilitation actvities take place in hospitals or other institutionalized places, so one pressing challenge is to move the rehabilitation from institutions to individual homes. A second problem is that rehabilitation takes time, and for this reason it requires a vast amount of resources. Technology, and especially the increasing availability of low-cost sensors, can help us to face these challenges. Prof.

Giovanni Abbruzzese talked about a recent European project, aimed at preventing the the falls among older adults, in which they used technology to help people to carry out exercises that play an important role in preventing the likelihood of falls. The results were very promising and showed that these systems helped to significantly reduce the costs of rehabilitation, while allowing to therapists to follow the progress of the patients.

Barbara Bavastro, talked about the caring of older people at home, especially with regard to the treatment of lesions due to excessive pression. In this case, technology can help by allowing people at home to take pictures of the interested regions of the body, send the pictures to professional cargivers, who can efficiently monitor and promptly guide the treatment of this kind of lesions.

Lorenzo Bertorello, officer of the Liguria Region, talked about the experience of the Region in the European Innovation Partnership (EIP) on active ageing. This is a pilot project under the H2020 programme, which brings together private and public institutes to face important challenges, such as improving the health and quality of life of older people, preventing falls (and thus saving healthcare resources), and developing services for ageing well by involving industry partners. The project focused on physical and mental wellbeing, and allowed its members to establish a fruitful dialogue with the European commission.

Claudio Puppa of the Liguria Region talked about the incident he had years ago, since when he has been using a wheelchair, and brought his personal experience to the discussion. He stated that about 10% of population in Italy has some kind of disabilities and 12% of families has at least one person with disabilities. So, what does a disabled person need? First of all, simple tools (like wheels), and technology that has to be designed taking into account the characteristics and the needs of the final users. The user on a wheelchair needs to go out, to socialize. We also need to think about the design of accommodations with a perspective on the future, starting now to make our homes more accessible.

Massimiliano Malavasi (Settore Progetti e Innovazione at AIAS Bologna onlus, ProACT team) talked about the need to rethink health and social services for the ageing population. The ProAct project was funded under H2020 in 2016, and deals with this problem. Malavasi focused on two main issues: first, services to seniors need to be better integrated, to guarantee a continuum in the healthcare of senior citizens. And second, they need to answer real problems and desires of the users. This requires, on the one hand, a good and efficient organization of different bodies and sectors, from the social services to institutions such as hospitals, to the peers and the formal and informal caregiver. This can be done by improving the communication between these actors, and by sharing information efficiently, by collecting and analysing great amounts of information, and allowing the people to take care of their own health in their private homes.

Alberto Pilotto, geriatrician at the Galliera Hospital in Genoa, talked about the MPI_Age project, which aimed at developing multidimensional indices that can predict mortality, and are based on a Comprehensive Geriatric Assessment (CGA). Pilotto started his speech by pointing out an aspect that is too often overlooked: the older population is not at all a homogeneous group. On the contrary, it is extremely heterogeneous. There are 80-years-old people who are still very active, can walk without particular problems and climb stairs, but there are also people of the same age who live on a wheelchair, have significant disabilities and need assistance 24/7. The way in which we age depends on multiple factors related to genetics, diseases, social ties, cognitive aspects, income, education, family support. The Multidimensional Assessment, or Comprehensive Geriatric Assessment, is a questionnaire that combines information from different items related to a heterogeneous bunch of aspects, and can improve the cost-effectiveness of health interventions in older individuals with multimorbidity and polypharmacy. It has been shown that ICT systems maximize their efficacy in the prevention, that is, in the management of chronic diseases during the early stages of the illness, especially for patients between 75 and 84 years old who are still active and relatively in good health. For these reasons, there is a crucial need for an efficient early assessment of fraily. The early assessment of problematic conditions can allow healthcare institutions and stakeholders to reduce the unnecessary use of resources, employing an appropriate and tailored, integrated, multi-professional, and planned set of interventions and services for the older populations.

Following the round table, an interested discussion among the speakers and the audience took place, with a special attention to the costs, both regarding the income of older adults, which needs to allow them to access the services they need, and the resources that are necessary to develop useful and efficient services to these users. What’s crucial is also a complex cultural change at all the hierarchical levels, from the politics to the management to the development, in order to start building innovative service models.

That’s all from my side on Foritaal 2017, which was an interesting venue bringing together a variety of people with heterogeneous expertises and perspectives on ageing, and on ageing “well”. I really hope to participate again in the future!