As part of SCI’s vision to drive authentic conversations about quality-of-life for the elderly, we will publish posts throughout the year that focus on best-in-class organizations that are equally committed to a future of healthy and happy seniors.

To understand how people living with dementia can be supported to age actively and how people with a diagnosis can be helped to slow the progression of the disease through an active lifestyle, we worked with Kristina Silverarfve, Divisional Manager, Coordination Center, of Nyköping municipality, Sweden, and Åsa Trolle, Divisional Manager, Technique and Service, of Östersund municipality, Sweden, to learn about their experience of the Doro Secure 480, a GPS-alarm device brought to you by Doro AB.

There is a multitude of research which points to the physical and psycho-social benefits of being outdoors for people with dementia. Being outdoors is beneficial not only for the mitigation of the symptoms and effects of dementia but also for reducing the risk of developing the disease. The World Health Organization recommends at least 150 minutes of physical activity such as walking, dancing, gardening, hiking, swimming, etc, per week, in adults aged 18–64. In the WHO’s guidelines for dementia risk reduction, launched at Dementia Forum X, physical activity has been strongly recommended to adults with normal cognition to reduce their risk of cognitive decline. 

Being outdoors

Image courtesy: Doro AB

For people with dementia, being outdoors has shown to increase sleep, diet, and appetite, reduce restlessness, increase verbal expression and show improvements in memory (depending on the stage and progression of the disease). A 2014 study in the UK (Whear et. al) deduced a reduction in the level of agitation in people with dementia who spent even as little as 30 minutes a day in the garden. In another study conducted in three nursing homes in the United States, exposure to natural light showed an improvement in the quality of sleep and several positive behavioral changes such as “less grabbing”, “fewer strange noises” and better expression of requests such as wanting to get out of bed (Calkins et. al, 2008). 

From a caregiver or loved one’s perspective, the idea of having a person living with dementia outdoors may be worrisome. After all, ensuring their safety is our number one priority. However, we cannot let our fears become inhibitors of a person’s ability to live an active and healthy life after a diagnosis. How then can caregivers have peace of mind while ensuring that the person living with dementia is able to enjoy time outdoors?

One way to do so is through the use of safety devices. There are devices that detect motion, those that can play set reminders, and those which can be accessed remotely in order to facilitate communication. There are also wearable devices which can be used to track the location of a person. One example is the Doro Secure 480, a GPS-watch which can be used for location tracking purposes, calling, sending alarm signals and be specially customized to meet the needs of people living with dementia. 

seniors outdoors active

We at SCI spoke with Kristina Silverarfve, Divisional Manager, Coordination Center, of Nyköping municipality, Sweden, and Åsa Trolle, Divisional Manager, Technique and Service, of Östersund municipality, Sweden, to learn about their experience with the Doro Secure 480.

With a background as an assistant nurse, Kristina Silverarfve has worked in her present role for 10 years. Nyköping municipality has been cooperating with  Doro for 4 years, but the GPS-watch has only been used since fall 2018. There are about 30 people using it today. At the time of writing the device was only given out to people with a diagnosis for the disease. Its primary role is to help people living with dementia feel safe and empowered to be outdoors independently. Kristina says, “eventually, if the politicians in Nyköping allow, there is a hope that this will be provided to anyone who wants it, regardless of diagnosis.”

When asked about the potential of using modern technology in caregiving, she responded, “We don’t have the manpower to fulfill the roles in the care sector, and the “customers” have increasing demands and requirements. I believe that flexible technology will be important to honor the needs and lifestyles of individuals regardless of the kind of diagnosis. It is critical to encourage people to stay active for as long as possible. The longer they stay active and independent, the later they will need formal care services or support from professionals.”

With a comprehensive national strategy in place to ensure a high quality of life for people living with dementia and their families, Sweden is a global leader in elderly and dementia care. A core element of this strategy is the advocacy and provision of person-centered care which has a strong focus on respecting the person’s choices and putting them at the center of the decision-making process. In this regard, Kristina made an interesting point when she said, “the person living with dementia must decide for herself if she wants to have any kind of alarm or service. Sweden is unique in that we uphold personal integrity to a high degree. Even if family members see value in a safety device, we cannot do anything unless there is a power of attorney in place for the person with a diagnosis.”

 

Åsa Trolle of Östersund municipality also agrees in this regard saying, “the customer today really has a strong idea of what they want and need, and they are always welcome to call us to discuss this so we can find solutions together.” Åsa has worked in her present role since 2011. Approximately 420 people in Östersund use Doro Secure 480 today of which 35-40 have a dementia diagnosis. In contrast to Nyköping municipality,  Östersund already distributes the GPS-alarm to anyone who requests it or is at the risk of developing dementia. 

She adds, “the citizens of the municipality must decide for themselves if it is suitable for their lifestyle, but it is encouraged so that everyone stays as active as possible. It is important that any device such as this watch is issued as early on in the diagnosis as possible so that the user may become accustomed to it as quickly as possible. It provides freedom – whether it’s being able to gather berries and mushrooms during the summer and fall seasons; skiing at close-by resorts or just socializing with others  – anyone should be able to do this whenever they want, with dignity and safety in mind.”

By empowering people to spend time outdoors independently, the municipalities are promoting healthier and more active lifestyles. This, in turn, lowers disease progression, improving overall health and reducing larger healthcare costs of disease-treatment. In addition, compared to the cost of finding a missing person, the investment in such a device is significantly lower. As Åsa stated, “if someone goes missing and they don’t have a GPS-alarm, then the costs jump immediately because the police, fire department, or coast guards have to get involved.” 

Perhaps the biggest benefit, however, is the peace-of-mind it brings to the loved ones of the person in question. Åsa tells us the story of a couple who went to Spain for holidays and received support from the Doro service center to adjust the base-station coordinates to match their hotel. This allowed them to enjoy their vacation without having to constantly worry about the husband’s safety. The wife said that it was their best holiday ever. 

Åsa ends by saying that people are very thankful when they gain access to such devices, with many expressing gratitude for technology helping them to “get their lives back.”