健康住宅 活躍老化 Prof emerita dr JEMH van Bronswijk WHO definition of Health 聯合國對 健康 的定義 Health is a state of complete physical mental ID: 815451
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Slide1
Healthy housing, Active aging健康住宅, 活躍老化
Prof. emerita dr. J.E.M.H. van Bronswijk
Slide2WHO definition of Health 聯合國對「健康」的定義
Health
is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity健康 是指生理, 心里與社會福祉的狀態, 而非只是無疾病或不衰弱The definition has not been amended since 1948此定義自1948年起, 就未修訂過
/Built environment
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14-5-2016
資料來源
:
Preamble to the Constitution of the World Health Organization as adopted by the International Health Conference, New York, 19-22 June, 1946; signed on 22 July 1946 by the representatives of 61 States (Official Records of the World Health Organization, no. 2, p. 100) and
entered into force on 7 April 1948
Slide3Meanings 含義Active aging
= Remaining an active member of society during the whole aging process
活躍老化
=在整個老化過程, 保留社會中的積極成員Healthy housing = A living environment to support human health (and to diminish disease)健康住宅=支援人類健康的生活環境 (並減少疾病)/Built environmentPAGE
2
14-5-2016
A. Zaidi: Enabling environments for active and healthy ageing
in EU countries. Gerontechnology 2014;12(4):201-208;
doi:10.4017
/
gt.2014.12.4.003.00
Slide4Healthy housing = an enabling environment健康住宅=一個有利的環境
= Supporting
physical
, mental and social wellbeing (and preventing or diminishing disease)=支援生理，心理和社會福祉 （並預防或減少疾病）/Built environmentPAGE 3
14-5-2016
Housing in a broad sense includes the whole
man-made built environment住宅在廣
義上
包括了
整個
人為的
建築
環境
Slide5European Active Ageing Index (AAI)歐洲活躍老化指數 (AAI)
Employment
僱用
(4項) 4 itemsParticipation in society 社會參與 (4項) 4 itemsIndependent, healthy and secure living 6 items
獨立、
健康、安全的生活
(6項
)
Capacity and enabling environment
6 items
容量和有利的
環境
生活
(
6
項
)
/Built environment
PAGE
4
14-5-2016
Newest
version:
http
://
www1.unece.org/stat/platform/display/AAI/Active+Ageing+Index+Home
Slide6Living (3) and enabling environments (4)生活（3）和有利環境（4）
/Built environment
PAGE
514-5-2016r=0.77Source: A. Zaidi. Enabling environments for active and healthy ageing in the EU countries. Gerontechnology 2014;12(4):201-208; doi:10.4017/gt.2014.12.4.003.00
獨立
、健康、安全的生活
有利活躍老化的
環境生活
羅馬尼亞
匈牙利
斯洛文尼亞
德國
荷蘭
丹麥
瑞典
英國
盧森堡
比利時
西班牙
葡萄牙
保加利亞
塞浦路斯
捷克奧地利馬爾他拉脫維亞
希臘斯洛伐克波蘭愛沙尼亞立陶宛
Slide7Active Ageing Index (AAI) Section 3活躍老化指數
Independent, healthy and secure living
獨立
、健康、安全的生活Physical exercise 體能鍛煉Access to health services 獲得醫療服務Independent living 獨立生活Financial security
財務安全
Physical safety 體能安全
Lifelong learning 終身學習
/Built environment
PAGE
6
14-5-2016
How will housing contribute?
住房如何有助於此項
?
Slide8Active Ageing Index (AAI) Section 3活躍老化指數
Independent, healthy and secure living
獨立
、健康、安全生活Physical exercise 體能鍛煉Access to health services 獲得醫療服務Independent living 獨立生活
Financial
security 財務安全
Physical safety 體能安全
Lifelong
learning
終身學習
/Built environment
PAGE
7
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↑
Main c
ontribution of housing
住宅的主要貢獻
Slide9Active Ageing Index (AAI) Section 4活躍老化指數
Enabling environment
for active & healthy ageing
有利環境 (活躍老化與健康老化) Remaining life expectancy 剩餘壽命 Share of healthy-life years 分享健康生活年份
Mental wellbeing
精神健康狀況 Use of ICT
使用資訊通訊技術
Social connectedness
社會網絡
Educational attainment
教育
程度
/Built environment
PAGE
8
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How will housing contribute?
住房如何有助於此項
?
Slide10Active Ageing Index (AAI) Section 4活躍老化指數
Enabling environment
for active & healthy ageing
有利環境 (活躍老化與健康老化) Remaining life expectancy 剩餘壽命 Share of healthy-life years 分享健康生活年份 Mental wellbeing 精神健康狀況 Use of ICT 使用資訊通訊技術
Social connectedness 社會網絡 Educational attainment
教育程度
/Built environment
PAGE
9
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↑
Main
contribution of housing
住宅的主要貢獻
Slide11‘Global Age Watch Index’ (GAWI)
全球老化觀察指數
Income security
收入保障 (4項) 4 itemsHealth status 健康狀況 (3項) 3 itemsEmployment and education 就業與教育 (2項)
2 itemsEnabling environment
有利環境 (4項)
4 items
/Built environment
PAGE
10
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Newest
version
:
http://www.helpage.org/global-agewatch
/
Slide12GAWI rankings 全球老化觀察指數排名/Built environment
PAGE
11
14-5-2016Index rankings 1 10 20 30 40 50 60 70 80 91Source: V. Taipale. The Global AgeWatch
index, GAWI, 2013. Gerontechnology 2014;13(1):16-20; doi:10.4017
/gt.2014.13.1.010.00
Newest version: http://www.helpage.org/global-agewatch/population-ageing-data/global-rankings-map
/
指數排名
,
以顏色區分
Slide13‘Global Age Watch Index’ (GAWI) & Housing
全球老化觀察指數
與 住房2. Health status 健康狀況 Life expectancy at 60 預期壽命 60歲
Healthy life expectancy at 60 健康期
望壽命命
60歲
Psychological well-being
心理
健康
4. Enabling environment
有利
環境
Social connections
社會網絡
Physical safety
體能安全
Civic freedom
公民自由 Access to public transport 使用大眾交通運輸
/Built environment
PAGE 12
14-5-2016
How will housing contribute?
住房如何有助於此項
?
Slide14‘Global Age Watch Index’ (GAWI) & Housing全球老化觀察指數
與
住房2. Health status Life expectancy at 60 預期壽命 60歲 Healthy life expectancy at 60 健康期望壽命命 60歲
Psychological well-being 心理健康
4. Enabling environment 有利環境
Social connections 社會網絡
Physical safety
體能安全
Civic freedom
公民自由
Access to public transport
使用大眾交通
運輸
/Built environment
PAGE
13
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↑ Main
contribution of housing
住宅的主要貢獻
Slide15AAI+GAWI: Healthy housing – Active Aging活躍老化指數＋全球老化觀察指數: 健康住宅-
活躍老化
(AAI 3)
Independent living 獨立生活(AAI 3, GAWI 4) Physical safety 體能安全
(GAWI
4) Access to public transport
使用大眾交通
運輸
(
GAWI
2)
Psychological
well-being
心理健
康
=
(AAI 4)
Mental
wellbeing
精神健康狀
況
+
(AAI 4) Social connectedness 社會網絡/Built environmentPAGE 14
14-5-2016Situation in the Sinophone world? 全球華人世界的情況?
Slide16AAI+GAWI: Healthy housing – Active Aging活躍老化指數＋全球老化觀察指數: 健康住宅-活躍老化
/Built environment
PAGE
1514-5-2016Source: Y-L. Hsu, A Chinese response to the aging society. Gerontechnology 2016;14(4):187-190; doi:10.4017/gt.2016.14.4.011.00
Situation in the
Sinophone
world
全
球華人世界的情
況
Adding
1.
Xiào
(Filial piety)
增加了孝道
2. Independent
living
獨立生活
3. Physical
safety
體能安全
4. Access
to public transport 使用大眾交通運輸5. Psychological well-being 心理健康 (= Mental wellbeing 精神健康狀況 + Social connectedness 社會網絡)
Slide17Adding Xiào (Filial piety) 增加了孝道
“… findings suggest to young people how to choose their usage pattern of non-Face-to-Face contact with their parents wisely”.
研究結果建議年輕人
, 如何明智地選擇與父母非面對面的聯絡時的使用模式(From: K. Sun, M-Y. Zuo, D. Kong. Communication with children for older adults’ life satisfaction: Non-face-to-face and/or face-to-face? Gerontechnology 2016;14(4):191-203; doi:10.4017/gt.2016.14.4.002.00)This approach should also be taught to daughters and sons in the Western World這樣盡孝道方式也應該建議西方世界為人子女者使用
/Built environment
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Slide18Housing relevance of needs for home care according to home care experts on
Taiwan
居家照護需求的住宅相關項目
(根據台灣居家照護專家的意見)
/Built environment
PAGE
17
14-5-2016
Physiological
基本生理
0.296
Extending old
age
延展晚年
0.034
Acclimatizing to natural
aging
馴化自然老化
0.052
Facing non-natural
aging
面對非自然老化
0.045
Food
食物
0.091
Clothing
服裝
0.031
Housing
居家
0.044
Security
安全
0.276
Health and security
健康與安全
0.088
Safety
and
happiness
安全
與快樂
0.026
Economic
security
經濟安全
0.055
Household
security
家庭安全
0.050
Personal
safety
人身安全
0.056
Love and
belonging
愛與歸屬
0.153
Psychological adjustment to natural
aging
心理調適自然老化
0.048
Overcoming psychological stress of
illness
克服疾病的心理壓力
0.057
Adjustment to a new
life
調整並產生一個新的生活
0.049
Esteem
自尊
0.172
How others view
oneself
別人如何看待自己
0.054
Elderly’s view on themselves and
life
高齡者對自己
&
人生的看法
0.070
Bidding farewell to
life
告別生活
0.048
Self-
actualization
自我需求
0.103
Learning and
creativity
學習與創意
0.051
Societal responsibilities and
obligations
社會責任與義務
0.052
Source:
K.H
. Wang, H-C. Chen, G. Chen.
Gerontechnology 2016
; 14(4):239-243;
doi:10.4017
/
gt.2016.14.4.006.00
Slide19Housing relevance of needs for home care according to home care experts on Taiwan
/Built environment
PAGE
18
14-5-2016
Physiological
0.296
Extending old age
0.034
Acclimatizing to natural aging
0.052
Facing non-natural aging
0.045
Food
0.091
Clothing
0.031
Housing
0.044
Security
0.276
Health and security
0.088
Safety
and happiness
0.026
Economic security
0.055
Household security
0.050
Personal safety
0.056
Love and belonging
0.153
Psychological adjustment to natural aging
0.048
Overcoming psychological stress of illness
0.057
Adjustment to a new life
0.049
Esteem
0.172
How others view oneself
0.054
Elderly’s view on themselves and life
0.070
Bidding farewell to life
0.048
Self-actualization
0.103
Learning and creativity
0.051
Societal responsibilities and obligations
0.052
GREEN = housing related
Source:
K.H
. Wang, H-C. Chen, G. Chen.
Gerontechnology 2016
; 14(4):239-243;
doi:10.4017
/
gt.2016.14.4.006.00
Slide20Housing evaluation by 385
Taiwanese older adults
385
台灣高齡者認為住宅應改善的地方
/Built environment
PAGE
19
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A-
Entrance
入口
A1 No steps
A3
Wheelchair can turn around
A2
No thresholds
A4
Easy to open and lock doors
B-
Corridor
走廊
B1
Wheelchair operates with ease
B4
Even surface
B2
No thresholds in door entrances
B5
Anti-slip
B3
No stacking things, no rubble
C-Stairs
樓梯
C1
Step height appropriate
C3
Handrail appropriate
C2
Step edge anti-slip
C4
Lighting appropriate
D-Room
房間
D1
Parents' bedroom on first floor
D3
Sliding doors
D2
Bathroom next to bedroom
E-Toilet and
bathroom
浴廁
E1
Bath and shower separated
E4
Anti-slip chair in bathroom
E2
No threshold at bathroom entrance
E5
Handrails in bathroom
E3
Anti-slip floor
E6
Wheelchair operates with ease
F-
Kitchen
廚房
F1
Floor anti-slip
F5
Kitchen sink height appropriate
F2
Kitchen-table
height appropriate
F6
Safety switches on gas stove
F3
Wheelchair use with
table
F7
Smoke detector present
F4
Cupboard height appropriate
Each element evaluated for importance and performance
Source: C-S. Lin, H-J. Lee, J.L. Fozard Gerontechnology 2016;14(4):218-223;
doi:10.4017
/
gt.2016.14.4.009.00
Slide21Housing evaluation by 385
Taiwanese older adults
/Built environment
PAGE
20
14-5-2016
Source: C-S. Lin, H-J. Lee, J.L. Fozard Gerontechnology 2016;14(4):218-223;
doi:10.4017
/
gt.2016.14.4.009.00
Green
Red
Orange
重要度
性能
優勢保持區
次要改善區
優先改善區
過度重視區
Slide22Housing evaluation by 385
Taiwanese older adults
/Built environment
PAGE
21
14-5-2016
A-Entrance
A1 No steps
A3
Wheelchair can turn around
A2
No thresholds
A4 Easy to open and lock
doors
方便開門與關門
B-Corridor
B1 Wheelchair operates with
ease
方便輪椅操作
B4 Even surface
即使表面
B2
No thresholds in door entrances
B5 Anti-
slip
止滑
B3 No stacking things, no
rubble
無堆積物或碎石
C-Stairs
C1 Step height
appropriate
台階高度
適宜
C3 Handrail
appropriate
適當扶手
C2 Step edge anti-
slip
台階邊緣防滑
C4 Lighting
appropriate
燈光合宜
D-Room
D1
Parents‘
bedroom on first
floor
長者房設在一樓
D3
Sliding doors
D2
Bathroom next to bedroom
E-Toilet and bathroom
E1
Bath and shower separated
E4
Anti-slip chair in bathroom
E2
No threshold at bathroom entrance
E5
Handrails in bathroom
E3 Anti-slip
floor
防滑地板
E6
Wheelchair operates with ease
F-Kitchen
F1 Floor anti-
slip
防滑地板
F5
Kitchen sink height appropriate
F2
Kitchen-table
height
appropriate
廚房檯面高度適宜
F6 Safety switches on gas
stove
燃氣灶安全開關
F3
Wheelchair use with
table
F7
Smoke detector present
F4
Cupboard height appropriate
Source: C-S. Lin, H-J. Lee, J.L. Fozard Gerontechnology 2016;14(4):218-223;
doi:10.4017
/
gt.2016.14.4.009.00
Green: keep-up the good work (high performance, high importance)
綠色代表
優勢保持區
Slide23Housing evaluation by 385
Taiwanese older adults
/Built environment
PAGE
22
14-5-2016
A-Entrance
A1 No steps
A3
Wheelchair can turn around
A2
No thresholds
A4
Easy to open and lock doors
B-Corridor
B1
Wheelchair operates with ease
B4
Even surface
B2
No thresholds in door entrances
B5
Anti-slip
B3
No stacking things, no rubble
C-Stairs
C1
Step height appropriate
C3
Handrail appropriate
C2
Step edge anti-slip
C4
Lighting appropriate
D-Room
D1
Parents' bedroom on first floor
D3
Sliding doors
D2
Bathroom next to bedroom
E-Toilet and bathroom
E1
Bath and shower separated
E4
Anti-slip chair in bathroom
E2
No threshold at bathroom entrance
E5
Handrails in bathroom
E3
Anti-slip floor
E6
Wheelchair operates with ease
F-Kitchen
F1
Floor anti-slip
F5
Kitchen sink height appropriate
F2
Kitchen-table
height appropriate
F6
Safety switches on gas stove
F3
Wheelchair use with
table
F7
Smoke detector present
F4
Cupboard height appropriate
Green: keep-up the good work (high performance, high importance)
Orange: low performance, but low priority
Red: Priority measure (low performance, high importance}
Source: C-S. Lin, H-J. Lee, J.L. Fozard Gerontechnology 2016;14(4):218-223;
doi:10.4017
/
gt.2016.14.4.009.00
優勢保持區
次要改善區
優先改善區
Slide24Housing evaluation by 385
Taiwanese older adults
/Built environment
PAGE
23
14-5-2016
A-Entrance
A1 No steps
A3
Wheelchair can turn around
A2
No thresholds
A4
Easy to open and lock doors
B-Corridor
B1
Wheelchair operates with ease
B4
Even surface
B2
No thresholds in door entrances
B5
Anti-slip
B3
No stacking things, no rubble
C-Stairs
C1
Step height appropriate
C3
Handrail appropriate
C2
Step edge anti-slip
C4
Lighting appropriate
D-Room
D1
Parents' bedroom on first floor
D3
Sliding doors
D2
Bathroom next to bedroom
E-Toilet and bathroom
E1
Bath and shower separated
E4
Anti-slip chair in bathroom
E2
No threshold at bathroom entrance
E5
Handrails in bathroom
E3
Anti-slip floor
E6
Wheelchair operates with ease
F-Kitchen
F1
Floor anti-slip
F5
Kitchen sink height appropriate
F2
Kitchen-table
height appropriate
F6
Safety switches on gas stove
F3
Wheelchair use with
table
F7
Smoke detector present
F4
Cupboard height appropriate
Green: keep-up the good work (high performance, high importance)
Orange: low performance, but low priority
Red: concentrate improvement here, high importance, low performance
Black: Possible overkill, high performance, low priority
Source: C-S. Lin, H-J. Lee, J.L. Fozard Gerontechnology 2016;14(4):218-223;
doi:10.4017
/
gt.2016.14.4.009.00
過度重視區
優勢保持區
次要改善區
優先改善區
Slide25Housing evaluation by 385
Taiwanese older adults
/Built environment
PAGE
24
14-5-2016
A-Entrance
A1 No steps
A3
Wheelchair can turn around
A2
No thresholds
A4
Easy to open and lock doors
B-Corridor
B1
Wheelchair operates with ease
B4
Even surface
B2
No thresholds in door entrances
B5
Anti-slip
B3
No stacking things, no rubble
C-Stairs
C1
Step height appropriate
C3
Handrail appropriate
C2
Step edge anti-slip
C4
Lighting appropriate
D-Room
D1
Parents' bedroom on first floor
D3
Sliding doors
D2
Bathroom next to bedroom
E-Toilet and bathroom
E1
Bath and shower separated
E4
Anti-slip chair in bathroom
E2
No threshold at bathroom entrance
E5
Handrails in bathroom
E3
Anti-slip floor
E6
Wheelchair operates with ease
F-Kitchen
F1
Floor anti-slip
F5
Kitchen sink height appropriate
F2
Kitchen-table
height appropriate
F6
Safety switches on gas stove
F3
Wheelchair use with
table
F7
Smoke detector present
F4
Cupboard height appropriate
To support ‘Active Aging’ by preventing tripping and falling
Take care of
RED
and
ORANGE
!
(and keep both
GREEN
and BLACK at good performance)
Source: C-S. Lin, H-J. Lee, J.L. Fozard Gerontechnology 2016;14(4):218-223;
doi:10.4017
/
gt.2016.14.4.009.00
為了支援活躍老化
,
預防高齡者絆倒或跌倒
儘快改善
紅色
與
橘色
部分
(
但維持
綠色
和黑色
,
以維護照護品質
)
Slide26Conclusion 結論
Healthy housing
contributes to
Active aging健康住宅有利於活躍老化 byEnabling a happy and active aging-life 擁有快樂與活躍的老年生活Preventing / compressing morbidities & accidents
預防/壓縮
發病率與意外 e.g. Falling and tripping accidents
意外跌倒與絆倒 House-dust allergy
屋
塵過敏
Veteran’s disease
退伍
軍人症
Dengue Fever
(mosquito vectors)
登
革熱
e.t.c
.
/Built environment
PAGE
25
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Slide27/Built environment
PAGE
26
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Thank you for your attention !
謝謝聆聽