| Due to the aging of the population and developments in medical technology, the number of older persons with (chronic) health problems will increase substantially during the next decades. Nowadays, the proportion of persons of 65 years of age and older is twelve to eighteen percent in most western societies. We expect that this will be nearly doubled in the next four decades what inevitably has consequences on the health care system, in particular on (services and facilities in) home care and care in nursing homes. Although (biological) age in itself is considered as an important risk factor for processes of disablement and need of care in older persons and patients with chronic health problems, research suggested that environmental and psychosocial factors may be at work as well. Two main challenges for the future in this area of research are to disentangle the role of medical, environmental and psychosocial factors in trajectories of disablement in older persons and to develop innovative, demand-driven, and targeted health care arrangements which maximizes independence, social participation, quality of life and quality of care and reduces disablement in older persons with (chronic) health problems. The second challenge is inevitable related to the first one The mission in this research program is therefore two-folded: (1) we develop and disseminate knowledge and expertise on psychosocial and environmental determinants (including organization of - health care arrangements) of health problems, need of care, social participation, independency and quality of life among older persons, and (2) we develop, implement and evaluate related innovative health care programs and interventions for older persons to slow down processes of disablement and to improve socialization of health care. The implementation of research evidence in home care and nursing homes, and the place of these institutions in the chain of care, has our special attention. The main perspective, however, is that of the individual older person in all its diverse aspects. We emphasize here the role of differential vulnerability to identify groups of older people who are particularly at risk. Differences in health, need of care, social participation, independency and quality of life in older persons may be at least partly reduced to psychosocial resources; in addition psychosocial resources may modify the effect of health care programs for older persons. Our research program will include observational research (particularly related to the first part of the mission) as well as intervention research (second part of the mission). The program includes a typical multi-disciplinary, gerontological approach, and therefore different basic disciplines are involved such as nursing science, sociology, psychology, health promotion, epidemiology, and medicine. |
