Author: Carina Wilkens

The external presentation of our WIPP project is a very important concern for all partners. Over the last years, we have overcome some barriers and created milestones on our way. Some of these achievements have already been made in the past and will be shared in the future with senior citizens aged 65 and older, as well as other interested people.

Already at the end of the year 2018, the Christian-Albrechts-University Kiel (CAU) used the opportunity to put the WIPP project more in the focus of the senior citizens of Kiel. In the context of the well-established and very successful lecture series “Age, health and active lifestyle”, the EU project was explained and the importance of physical, mental and social care for old age citizens was highlighted. At the beginning of the year 2020, the WIPP project will again receive much attention and the CAU will present results and reports from the districts of Kiel.

At another very eye-catching event in September 2019, the “Night of Science” in Kiel, the CAU presented the WIPP project again. With a poster presentation and practical elements (for example, testing of grip strength, testing balance, getting up from lying down, etc.), many important information of the WIPP project was disseminated on to all those interested. Many seniors with their grandchildren, but also parents with their children found the way to the CAU booth and asked questions or tested their physical abilities.

The external presentation of the WIPP project by the CAU took place not only in the Kiel area, but also at various national congresses. Among other things, on the Sports Science University Day of the Deutsche Vereinigung für Sportwissenschaft (dvs), as well as on the annual conference of the Arbeitsgemeinschaft für Sportpsychologie in Deutschland (asp).

Furthermore, the CAU presented the WIPP project several times in the past year 2018 until today to health days and health weekends of the Bundesagentur für Arbeit. The framework, the procedure and the goals of the WIPP project were presented. In addition, important areas of prevention for the 65-year-olds and older citizens were explained. At the events many different people were reached. Not only people who are about to retire, but also executives and younger colleagues. The CAU looks forward to further opportunities in the future, to provide the important issue of primary prevention for the age and give it the necessary attention.

On Monday, 24.06.2019, a press conference took place in Kiel in the district of Suchsdorf in the Anlaufstelle Nachbarschaft “anna” regarding an early summary of the participants of the WIPP project. Senior citizens of the course programs “Form Your Life” and “Train Your Form” came together in a relaxed and open round of coffee, cake and other small snacks. Among the german project partners were Kerstin Berszuck from AOK NordWest, Prof. Manfred Wegner and Daniel Pantleon from the Christian-Albrechts-Universität Kiel and Prof. Petra Hampel, Carina Wilkens and Sarina-Cathleen Marwedel from the Europa-Universität Flensburg. Fynn Okrent represented the Landessportverband Schleswig-Holstein (LSV). Also present were the course instructors and the Kieler Nachrichten. There was a lively and dynamic exchange.

The course program “Train Your Form” focuses on the fun of movement. In the movement group, certain recurring exercises accompany the entire course. Depending on the level of performance and the individual “load level”, the training is performed twice a week for 12 weeks with a training instructor trained by the LSV. In complementary units, personal goals are determined and the first steps to a more active everyday life are tested. In the second program “Form Your Life“, the participants try out their possibilities and formulate goals for a more active everyday life. This includes walks as well as the use of existing offers in the district. In addition, the participants will receive a home-based exercise program adapted to their needs.

Petra Hampel (Professor of Health Psychology and -education at the Europa-Universität Flensburg) found the introductory words, a loving and careful moderation as well as appropriate final words of the press conference. In a first round, all introduced themselves and described the things that were important to them. The participants told in an honest and open-minded way about already made experiences and about actions and emotions created during the WIPP project. So it became clear where there are still challenges to tackle in general and especially in the WIPP project and what already works very well and effectively. About the created actions, the previous participants reported on a regular joint breakfast round, at the end of the course. The participants found a lot of positive and grateful words for their instructors Tanja Maury-Butenschön (Diakonie Altholstein) and Eldrid Wollenhaupt.

Mrs. Maury-Butenschön leads the “Form Your Life” course and said enthusiastically, “The WIPP training is a great way to bring people together in the neighborhood. All participating senior citizens not only showed positive results in improving their physical well-being, but also enjoyed the community atmosphere of the courses. In many cases the participation in the district increased considerably beyond the training “.

In order for other citizens to be able to use the offers after the end of the WIPP project from 2020, important requirements have already been created, according to Mrs. Berszuck (AOK NordWest): “The exercise program was adapted in collaboration with LSV in such a way that sports club coaches with a B-license can offer. The target is to recognize the courses in order to allow support for the statutory health insurance. In the future, the participants could then get the costs paid back. ”

The newspaper article of Kieler Nachrichten can be found and read under the following link:

https://www.kn-online.de/Nachrichten/Schleswig-Holstein/Kieler-testen-im-deutsch-daenischen-Projekt-WIPP-So-bleiben-Senioren-fit

The Howe-Fiedler-Stiftung has been offering a movement program in the district of Kiel Gaarden since mid-2015, which is very well accepted by older citizens. A trained physiotherapist and sports teacher leads the program. It includes activities from Monday to Thursday for one hour and takes into account of each individual citizen. In the first “sniff”, a health check is performed so that difficulties with the health situation can be identified and considered directly. The participating senior citizens are receptive and open-minded to new offers. For example, an hour of stand-up paddling was offered last year. With lots of fun and joy, the boards were tested in an outdoor pool.

Another project, where we successfully encourage seniors to be active is the “walkerdance”. Many of the participants were skeptical at first and did not dare to dance with the walker and develop some elegance. Today, the weekly dance lesson is a popular and important event. Not only the movement, but also the society is promoted and for many of the participants it has a positive life-influence.

These are just two of the different offers the Howe-Fiedler-Stiftung offers to promote an active and healthy aging. We are aware of the importance of activation, physical activity, physical and mental health. The foundation’s mission is to increase the quality of life of the senior citizens of Kiel, who live in old-age poverty.

Preventive home visits promote the individual approach and targeted offers can be used to get people out of retreat and fragility.

More than 300 citizens in Esbjerg Municipality, Denmark, have now answered WIPP’s questionnaire. The questionnaire ensures that the prevention consultants come around all relevant parameters and on this basis can talk about what is most important to the citizens.

Previously, the goal of the preventive home visits was that the citizens could talk with the consultant about the living situation and the general well-being in everyday life. In Denmark, there is a legislation for the preventive home visits, which the consultants have to follow (Servicelov §79a). It contains guidelines for the target group, but does not have an associated questionnaire for the detection of risk areas. The consultants in Esbjerg Municipality have different education and experience in health care, and have not previously had a standardized questionnaire for home visits. It has always been the citizen’s individual wishes and needs that govern the conversation, but with WIPP’s questionnaire, the consultants have the opportunity to remember to ask all the way around the person. The questionnaire ensures a higher degree of uniformity in questions to the citizens. This promotes the early detection of high-risk areas, such as the tendency to fall, nutritional status and incontinence.

By standardizing the talks, it is possible to identify more risk factors at an early stage. In the long term, this gives the opportunity to move money from rehabilitation to prevention and to ensure more healthy life years for the citizens.

In the term of the WIPP project, the idea is that the citizen himself in advance via a link in the digital mailbox „e-Boks“ can complete the questionnaire. The prevention consultants then receive the result and have the opportunity to talk about the result and the wishes and needs of the citizens during the preventive home visit.

Experiences from practice

Some of our prevention consultants have shared their experience with the questionnaire:

“As a prevention consultant, it was an exciting and sometimes challenging project to hold 300 talks with the citizens. We met citizens who only said, “yes” to a preventive home visit because they could be part of a research project. We met citizens who got tired of too many questions during the visit. And we’ve met couples who have competed, who did better in the physical tests.

We have experienced that the use of the questionnaires has given rise to some discussions about things that we often did not address during a regular preventive home visit. With the many questions that have been asked, we have come a long way around. Especially the question of how many hours the individual sits down has left some people with an awareness of how little they are moving. After all, we have motivated most people to maintain their good exercise habits after being tested, as they help the body and also keep going for chronic illnesses. ”

“With the WIPP-questionnaire, you get around the citizens’ daily lives and get more issues up, including sleep, social activities and networks. And in this context, one is forced to ask the difficult questions, such as how much do you drink, and are you incontinent. All in all, you come very far around and thus have a tool in WIPP that you otherwise do not have at regular home visits.

The WIPP-questionnaire has many questions and with the very talkative citizen it can sometimes be a challenge to stick to the questions. In addition, WIPP has also included physical testing where we examine the balance of citizens, test getting up and sitting down, and performing memory tests. Most of the citizens have participated. When the physical test is part of the questionnaire, I have had to assess the citizen’s physical condition before we started using the WIPP-questionnaire, as I will not do physical tests with citizens who cannot implement them.

Today, the WIPP visits are over, and I can conclude that for most preventative home visits, some of my questions still emerge from the WIPP-questionnaire, including: how much do you drink or how many hours did you sit today? It is just as natural for me to do balancing exercises with the citizens, if the conversation leads to it. ”

Read more about:

Preventive home visit in Esbjerg

https://www.esbjergkwommune.dk/borger/%C3%A6ldre/hj%C3%A6lp-og-pleje/forebyggende-hjemmebes%C3%B8g.aspx

Preventive home visits by the National Association of SUFO (Landsforeningen for ansatte i Sundhedsfremmende Forebyggende hjemmebesøg)

http://www.sufo.dk/

Legislation for Preventive Home Visits in Denmark

https://www.retsinformation.dk/Forms/R0710.aspx?id=177812

In Korsør town, Slagelse Municipality, the WIPP project’s interventions are well underway and this with great success. Citizens in both courses respectively. CALSTI (“train your form”) and SEMAI (“form your life”) are very happy with the progress and content. After the first 12 of a total of 24 weeks of intervention, citizens in both courses experience major improvements in both their physical functioning, but also in their perceived quality of life.

“In the beginning I could hardly move, and I was daily afflicted by violent pain. Through the training, my pain and movement have improved”, says Bente Ravn age 65. Bente is a participant in one of the project’s SEMAI courses (“form your life”) and has through this found both motivation and other elderly she can be physically active with. “I have met so many sweet people, whom I can make pleasant appointments with. It has made a big difference in my mood”, Bente Ravn explains.

Another participant is 82-year-old Ebba Jensen, who participates in one of the CALSTI courses (“train your form”). Before she started training, Ebba had to take eight painkillers daily to get through the day. But today she is pain-free. “I simply had to take them (the pills),” says Ebba Jensen to Tv2 East, Denmark, and elaborates; “I train twice a week and now I am able to walk much better and longer – that means a lot to me.”

You can find, view and read both newspaper articles and feature from Tv2 East on the links below (though only in Danish)

https://www.tveast.dk/nyheder/21-11-2018/1930/en-bedre-alderdom?autoplay=1
https://sn.dk/Slagelse/Alle-over-60-i-Korsoer-kan-faa-gratis-hjaelp/artikel/791315
https://www.vdonline.dk/Slagelse/AEldre-i-Korsoer-skal-proeve-bedre-liv-af/artikel/10967

During our partner and networkpartner meeting in Esbjerg we discussed from all perspectives: What exactly does sustainability mean for WIPP? How do we find a way to continue the successful WIPP-elements even after the project ended? What conditions must be created to continue elements of the WIPP project successfully? How do we find the right key to increase the Healthy Life Years?

Sustainability in the sense of health promotion is considering on two levels: On the one hand, the interventions should have a sustainable effect on the individual. Even after the end of the intervention, participants can continue on their own personal path to a better quality of life and well-being. On the other hand, conditions in their immediate environment are created. So they are able to go their own way. Further citizens should receive support and take part in health-promoting interventions in the districts and get started as well. But what has to happen that this can be continued after the end of the WIPP-project in the districts?

The WIPP-team has come up with four main topics to answer these questions, to examine more closely:

• Reaching people over the age of 65 who are able to increase their well-being through a more active and healthy lifestyle: How do we reach people who were previously inactive and who do not seek supportive services?
• Recording of the personal risk profile as well as the needs of these people as a requirement of a needs-based recommendation of suitable interventions to increase the quality of life: Which interventions are needed and how can these be mediated into account of the actual needs?
• Suitable interventions for a more active everyday life for people over the age of 65: Which contents, structures and processes are suitable for promoting a more active everyday life?
• Conditions for a healthy and active aging in the immediate living environment: What is necessary to create living conditions for an active aging at the place of residence?

For these main topics the factors for the creation of sustainability will be elaborated in the further course: What are the success factors? Which obstacles appear and how can these be overcome?

Kerstin Berszuck, project partner AOK NORDWEST

The age structure of the city Lübeck has changed increasingly since 2009: The amount of people at an advanced age rised significantly. As a result, it is necessary to offer much more preventive interventions for elderly people, which ensure a healthy and active aging. According to the Deutschen Institut für angewandte Pflegeforschung in Köln (2012), there is a need for improvement for the following aspects in elderly citizens’ work:

• Low awareness of existing offers and local contacts for elderly people.
• Suitable, early support for older people in need of support which is so far only provided by self-initiative.
• Result: Offers are requested too late if the need for support has already set.
• Entry into the nursing care system takes place only after being classified in the long-term care insurance

The goal of prevention in elderly citizens’ work is therefore to inform, educate and sensitize citizens to their health through counseling and support services. Based on these findings, a common additionally report from the department for social security and the health department to the overall concept of life and housing in old age / specifically on prevention in old age followed. The result of the Social Committee of 02.06.2015 called for the concept of “prevention in old age / preventive home visits” to be pursued.

In order to be able to use digital devices, the citizens’ survey mentioned, issues like the acquisition of devices, the opportunities of digitization in terms of contact, but also the need for help for people explaining the equipment to elderly people. Without professional help, digitization can not be implemented. Digitization also matters in the “WIPP project”, in which the city of Lübeck is a network partner. The Interreg5a funded WIPP project aims to promote healthy and active aging in North Germany and South Denmark. The project uses an innovative digital training as a single intervention to promote the health of elderly people. Furthermore, the citizens expressed their wishes to receive information about municipality management, neighborhood assistance and about offers for everylife in the municipality. They want to know about the use of public facilities and special offers, too. The concept of living and housing in old age will continue in the future to pursue the goal of “enabling a self-determined, but also co-responsible aging in your own apartment in the municipality” (Hansestadt Lübeck, 2018). The suggestions of the citizens are taken into account by the results of the survey.

Contact:

Hansestadt Lübeck, Bereich Soziale Sicherung, Matthias Wulf, matthias.wulf@luebeck.de, Telefon 0049 451 122 5170

Hansestadt Lübeck, Gesundheitsamt, Dr. Michael Hamschmidt, michael.hamschmidt@luebeck.de, Telefon 0049 451 122 5300

In advance to the implementation of the WIPP-Intervention, there was a lot of back and forth thinking, there were many discussions and ideas exchanged, but now it’s finally time:

The startsignal sounded in Kiel Suchsdorf on 22.11.2018.

In close cooperation with the AOK NordWest, the Landessportverband Schleswig-Holstein, the Diakonie Altholstein as well as the Anlaufstelle Nachbarschaft with its seat at the Arbeiterwohlfahrt Kiel, the foundation to activate the senior citizens of Kiel was laid.

For both Kiel districts, Suchsdorf and Gaarden, suitable rooms and qualified trainers could be found. The trainers received an introduction to the contents of the respective intervention-forms in November and are now ready to join in the implementation together with the participants.

An initial survey of physical functioning took place in Suchsdorf in the same rooms in which later the intervention-sessions executes. Therefore, the citizens were able to get to know the place of the implementation in advance and at the same time try out the accessibility. In both districts, the training-rooms are located on main roads and are easily accessible by bus.

The test ran smoothly and was perceived by the participants as very pleasant. In Kiel-Gaarden, the start will be delayed for a short time, but then it says:

Come on, let’s go!

In October 2018, many WIPP activities took place, including the WIPP partner- and networkpartner- meeting in Esbjerg. In this context, 4 participants of the 2 different WIPP interventions by Carina Wilkens and Petra Hampel were interviewed in the framework of the WIPP Work Package 2 (WP2) of the European University of Flensburg in the Østerby Health Center in Esbjerg. It was about the experiences of senior citizens participating in WIPP.

Peer Christensen thanked as one of the participants of the intervention “Form Your Life” (Red.: called in WIPP “CALSTI”) to increase the physical activity for the interview and wrote about today’s meeting and the interview:

 “During the meeting we had a visit from two ladies from Germany, who had to evaluate what we did at our meetings, one spoke only German, the other spoke and understood excellent Danish …”

Peer further reports that WIPP has been a very good start for him and that the course was well received. What the course brings in the long term, he can hardly say. Against this background, Peer has already reached the first interim target. The week before, the group had discussed the “small changes” of each participant. The “small changes” are the focus of the intervention. It enables citizens to improve their well-being and health with their own goals as a guiding principle, especially with the aim of bringing more exercise into everyday life. Small goals that can lead to significant health benefits in the long term. For Peer this was to change his routine in everyday life. There was a talk about an activity he had given up; to use the rowing machine every day at home. This goal has been achieved today:

“The two sworn Pernille and Anne Marie (Red.: trainer and other participant) have supported me and I’m glad, so I thank you for it.”

WIPP puts the focus on early detection and prevention of loss of functionality. The interventions help older citizens to find activities that can be carried out as independently as possible and that prevent inappropriate behavior. Peer relies on his walker, but he knows that the muscles need to be preserved so the walker can continue to support him. He knows that physical activity is very important to him. Peer therefore believes that the WIPP intervention “Forms Your Life” can make a difference for this particular aspect and writes about it:

“Physical activity and training for + 65-year-olds, I do not think we do much in our daily lives, if we do not get a kick or understand how much it means for health, I think we just sit back and say that we have lived a life, we want to relax now, we know that it is not so difficult, but we need the helping hand to get started.”

Peer is glad that the intervention has taken him out of the routines and out the door. He will undoubtedly continue until the end of the intervention and discover ways to find new social communities. The meeting with Petra and Carina has highlighted the sincerity of the project for Peer and the other participants, and Peer is motivated to achieve more “small changes”:

“Likewise, I think that WIPP allows me to achieve a few more good years of life with this effort.”

Picture: Activity in “Form your life” – walk in the area. Peer tells and shows the coaches and participants the way into the beautiful nature.

Developing innovative action plans that meet the needs, preferences and prerequisites of the older citizen is a key aspect of the WIPP-project. Digital training, as a single intervention as well as a supplement to group-based interventions, indeed offers its users an exercise platform, which is flexible, calls for no transportation and, once developed, is very low cost. Though many older citizens are today not accustomed to use a computer, tablet or smartphone, the segment that is familiar with digital devices and using the internet as a part of their everyday life, is growing explosively, and therefore there is an urgency to increase the focus on digital solutions.

Work package 4.1 and 5.2 are excited to tell, that we are now cooperating with Welfare Denmark (WD) in the development and implementation of WP 4.2. WD is an innovative welfare technology company that provide a very user-friendly virtual training platform that is simple and intuitive to use for both the citizen and the health care professional operating it. The WD approach makes it very easy to translate the virtual training into different languages and some of their existing products already exists in German. WD virtual training has been used by rehabilitation professionals since 2010 and the solutions are applied in various Danish municipalities and the insurance business. The company won Microsoft’s Global Innovation Award in 2013. The cooperation between WIPP and WD is now entering a very interesting phase were new customized features for the WIPP project are investigated and developed into the platform.

For instance, the WD virtual training has an integrated feedback system, which has the potential to provide us highly valuable data for the scientific evaluation of the intervention if tailored for the purpose. Also, the intervention content in terms of exercise videos are currently being revised by the SDU workgroup members to fit the platform, so that the production of professional exercise sessions can be initiated. We look very much forward to presenting the work package 4.2 Virtual Preventive Home Training to all of you.