JETSAN 2019Technological Services in Shared Housing: Needs Elicitation Method from Home to Living Lab
Graphical abstract
Introduction
In France, 41% of the persons living at home and receiving a Personal Independence Payment Funding is awarded to those with a significant handicap measured with a GIR (Iso Resource Group scale)1 lower or equal to 32 (meaning they are handicapped in their daily duties both at home and outdoors). The onset of handicap often results in living in housing structures for dependant elderly people. According to The WHO International Classification of Functioning,3 the loss of social participation is closely linked with deficiency. The social organization can either facilitate or inhibit social participation. In the current context of the alternative housing initiatives for the elderly [1], these housing forms have in common the value of social integration, but this is variously achieved. The concept of housing can increase a dual social representation with, on the one hand, ordinary housing for the autonomous elderly population, and on the other hand, collective housing for the frail or dependent population.
The existing offer of home care support or social nursing accommodation: nursing homes (EHPAD),4 other retirement homes, family homes or the commercial offer for the elderly (senior citizen's residence…) is not enough to prevent handicap. Thus, on our territories, the elderly often face a dilemma: staying at home, withing a familiar environment, however facing the fear of becoming disabled or leaving home and going to a retirement home or institution and fearing to lose independence. In rural territories, frail older people face:
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The decrease of family solidarity and neighbourly relations;
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Solitude and /or social isolation;
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The loss of local services (care, shopping facilities, public services);
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Low income compared to the cost of assistance or accommodation services;
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Too expensive retirement homes for families who do not wish to mortgage the family property (rural culture).
Various studies carried out on interviews during field surveys have illustrated the extent to which these forms of housing based on social ties make it possible to break down solitude and isolation, and to give a meaning to one's life experience by sharing it with others. This is their primary goal, whatever the concept of housing proposed, more or less participative, more or less collective [2]. The image of the dependent elderly person being cared for in a specialised structure is replaced by that of a pensioner who chooses to keep control of his life and of his usual or new social networks. But the person has to accept the constraints of living in a community and who to cohabit with other social networks, already in place and with other needs that place him/her in a social inhibition position [1].
In 2008, an association, Âges Sans Frontières (ASF)5 created an alternative concept to the usual housing solutions on a shared housing organization. The inhabitants are co-tenants of a house equipped with support services and an assistant, who can provide mediation. The co-tenants support one another while still living in a private housing.
In accordance with the Aging Population and Habitat Workshop,6 we have studied the “needs in terms of new technologies for residents in a shared home, in a rural area” within a True Live Lab (TTL) [3], a method of deployment of innovations which were codesigned in an “ecological” environment. The expression of the technology needs was first collected on-site, in the shared house of Montredon. It was then studied in depth in a monitored environment -Living-Lab type- the Blagnac Smart Home (Maison Intelligente de Blagnac), in order to put forward new technologies so that interactions between the person and his or her environment could be facilitated.
In this article, we will identify different types of housing for the elderly. Then, we will develop the shared housing concept designed by Âges sans frontières. The method of testing is next described on a practical case. It consists of: 1) a series of narrative interviews, followed by a focus group with the co-tenants of the shared house, in Montredon (Tarn, France), 2) a visit of the Blagnac smart home and the performing of a usage scenario -based on the use of technological tools- by the residents of the shared house, and a second focus group. The results, in terms of needs and acceptability will be developed and discussed. Outlooks will be proposed.
Section snippets
Senior citizens' housing
In the work coordinated by P. Pitaud [4], he addressed the issue of loneliness experienced or felt as such, isolation and the physical and moral suffering that results from it. Clément et al. [5] studied the neighbourly relations of the elderly as a mean of overcoming some of the loneliness. In “La solitude du chez soi: Un territoire sans partage”, Campéon [6] discusses the link between loneliness and the type of housing.
Loneliness together with economic insecurity can worsen the loss of
ASF shared house used as a setting of the experiment
The “ASF shared house” describes a shared house with a median position on the support habitat/self-managed housing [10]. Residents get support for cattering and benefit from an assistant who helps them organizing. They are in charge of household tasks and nightime safety. They get regular care from local primary care providers when needed.
Montredon is a small town in rural setting; the residents are of local origin. The shared house is for six residents. Each resident has a room en suite.
Material and method
In this article, we want to propose a method of expressing needs that can be replicated in other shared habitats of the same type. This method consists in describing the population and its living conditions, and then the needs that these people express in these living conditions. The methodology is unconventional because we are dealing with each resident but who lives within a group of residents in the same house. The socio-technical approach must be adapted.
When we deployed our method, we had
Description of the study population
The 6 residents (see Table 2) and the two assistants participated in the first phase of the study within the shared housing. One of the residents did not want to be filmed and therefore did not take place in the focus group. Among the five residents who took place in the study, two were unable to travel to the Blagnac smart home.
The average length of time of the interview was about one hour for each inhabitant. The interviews allowed to define the population of the Montredon shared house: 90
Population
The population of this shared house matches the demography of the elderly rural population with a predominance of women, linked to higher male mortality. It includes people of rural origin with low means and one person coming back to her geographical origins. The widowhood rate is age-related. It causes isolation, leading to join the shared housing. We notice that all residents have at least one disability: the most common is loss of mobility followed by loss of hearing. In a study carried out
Conclusion
The concept of shared house is an alternative way of living for frail elderly persons, or handicapped persons, particularly in rural areas. The methodology, for this first research, is based on an ecological function unit. The on-site phase enabled the researchers to identify parts of the needs and provided an initial consensus among the residents. In accordance with this consensus, a visit of a smart home -Living Lab type- was organized. It was followed by the performing of two scenarios. Then
Human and animal rights
The authors declare that the work described has been carried out in accordance with the Declaration of Helsinki of the World Medical Association revised in 2013 for experiments involving humans as well as in accordance with the EU Directive 2010/63/EU for animal experiments.
Informed consent and patient details
The authors declare that this report does not contain any personal information that could lead to the identification of the patient(s).
The authors declare that they obtained a written informed consent from the patients and/or volunteers included in the article. The authors also confirm that the personal details of the patients and/or volunteers have been removed.
Funding
This work did not receive any grant from funding agencies in the public, commercial, or not-for-profit sectors.
Author contributions
All authors attest that they meet the current International Committee of Medical Journal Editors (ICMJE) criteria for Authorship.
CRediT authorship contribution statement
P. Rumeau: Observation method design, Implementation of the observation method, Data analysis, Writing: First submission and re-submission version;
N. Vigouroux: Observation method design, Implementation of the observation method, Bibliographical research, Writing: First submission and re-submission version;
E. Campo: Observation method design, Implementation of the observation method, Bibliographical research, Writing: First submission and re-submission version;
E. Bougeois: Qualitative
Declaration of Competing Interest
The authors declare that they have no known competing financial or personal relationships that could be viewed as influencing the work reported in this paper. There is no conflict of interest.
Acknowledgement
We are thankful to the association Âges Sans Frontières, for giving us access to the shared house in Montredon, organizing the arrival of the co-tenants and the assistants to the Blagnac smart home and cooperating with us for an optimal collection of data.
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