Bepresel.eu



center1282100-5272838579700August 2019 STRATEGY LAUNCHING EDUCATIONAL PROGRAMS TO PROMOTEA BETTER PREPARATION FOR SENIOR LIFE KA204-2017-012 Project title: BepreselGrand Agreement Number: KA204-2017-012 Publisher: BEPRESEL Partnershipcenter24721600For the publisher: Niels Vestergaard SOSU ?stjylland We hope that we, with this Strategy document and all the belonging materials produced during the EU granted project BEPRESEL, will be able to inspire all stakeholders and people of interest in the field of senior health, to reflect on the question:“Is it not the time to start educating our senior citizens?andcitizens becoming seniorsto become more knowledgeable and competent about the aging process”.INDEX TOC \o "1-2" \h \z \u 1.Introduction PAGEREF _Toc17186946 \h 01.1 statement(s) for a start PAGEREF _Toc17186947 \h 11.2 ambition PAGEREF _Toc17186948 \h 21.3 It requireS a strategy PAGEREF _Toc17186949 \h 31.4 The references of this document PAGEREF _Toc17186950 \h 41.5 primary target groups PAGEREF _Toc17186951 \h 52.new approach to ageing PAGEREF _Toc17186952 \h 62.1 new and broader approach to active ageing PAGEREF _Toc17186953 \h 73.it pays of PAGEREF _Toc17186954 \h 193.1 EDUCATING SENIORS – IT PAYS OFF PAGEREF _Toc17186955 \h 203.1 It pays of 1 PAGEREF _Toc17186956 \h 223.2 IT pays of 2 PAGEREF _Toc17186957 \h 284.cost and payment PAGEREF _Toc17186958 \h 324.1 cost of courses PAGEREF _Toc17186959 \h 335.Reaching out to PAGEREF _Toc17186960 \h 40senior learners PAGEREF _Toc17186961 \h 405.1 build up a strong informative web-page PAGEREF _Toc17186962 \h 415.2 Influence public understanding PAGEREF _Toc17186963 \h 425.3 1 day events PAGEREF _Toc17186964 \h 435.4 public advertising - brochures PAGEREF _Toc17186965 \h 465.5 placing brochures. PAGEREF _Toc17186966 \h 505.6 Go for relatives PAGEREF _Toc17186967 \h 515.7 Go for the companies PAGEREF _Toc17186968 \h 555.8 Go for the children and youth PAGEREF _Toc17186969 \h 565.9 Immigrant seniors PAGEREF _Toc17186970 \h 585.10 Tv program PAGEREF _Toc17186971 \h 606.who is the teacher PAGEREF _Toc17186972 \h 616.1 Profile of educators. PAGEREF _Toc17186973 \h 613.2 Make it free to all – a cost benefit analyse PAGEREF _Toc17186974 \h 623.5 MODULE 5: FACILITATOR'S EDUCATIONAL PLAN – PAGEREF _Toc17186975 \h 627.Appendix PAGEREF _Toc17186976 \h 64introduction1.1 statement(s) for a startThe significantly increasing awareness and understanding among seniors of the importance of integrating the concept of "active aging" as one of the central elements in their everyday life, does not give the expected effect of maintaining their physical skills and decreasing the demand for care later in life.This statement is based on a Danish study published in January 2019 and on the collection of 40 years of data concerning the effect of senior health promotion. (read more page xxx)This disappointing conclusion is probably caused by several things. It is obvious to conclude that a central cause might be;A failed and incomplete launch of the concept"active aging"from public authoritiesand thus, also a failed access to and understanding of the concept"active aging" from the target group.Too many seniors believe that being active is enough. They believe that the activities they do in their everyday active life are equally valuable in preserving their independent living and level of physical functionality.Many of the seniors who have incorporated physical activities into their everyday lives don’t know that it isn’t the physical activity, that ensures the maintenance of their physical competencies, but the degree of intensity in their performance of these activities.Our approach is that the seniors lack of knowledge and understanding of the basic physiological laws and mechanisms plays the decisive role in why so many seniors aren’t gaining greater benefits. We also believe that an increasing number of seniors want to make a conscious effort to prevent the loss of their independence later in life.1.2 ambitionWe would argue that it should be a health policy ambition for the future, that all older than 65 will receive a mandatory offer to carry out a short knowledge-based course to BE Better Prepared for Senior Life. A course which presents the updated knowledge we have regarding the physiological aging processes, including an option to be tested twice to clarify their statues in selected physical key competence, and easy ways to maintain these competences in their daily life. All in order to strengthen the seniors’ abilities to remain independent and self-governing for longer.14890751270000A more precise description and proposal to the objectives and contents of such a course are presented in the Senior Health Curricula, uploaded at Bepresel.eu.1.3 It requires a strategyIt requires a strategy to reach the described goals. We do not believe that we can determine what the right strategy will be in different countries or regional and local areas.Our hopes and intentions with this document are to contribute with ideas, calculations and considerations which;Will inspire potential stakeholders to start offering senior citizens and pre-senior citizens short termed educational programs to make them better prepared for the years and life period to come. Present different aspects that we believe future providers of senior health courses must include in their strategical considerations, prior to deciding to offer short course-based educational programs to senior citizens and future senior citizens.We believe that a final local strategyNeeds to be based on a common understanding of why systematic education of seniors is needed, and that the key staff needs to be involved inside the organizations that are considering starting to offer senior health courses on a regularly basis. We will like to contribute to this common understanding with the content ofChapter 2; New approach to ageing. Needs to clear up the financial challenges and perspectives before starting to offer this kind of courses on a regularly basis. We will like to contribute with a cost benefit approach and some basis reflections regarding senior citizens willingness to pay for this kind of course inChapter 3; It pays off. Needs to present ideas and how to reach the very diverse customer group the senior citizens of today represent. We will like to contribute to this process of launching senior health courses in Chapter 4; Ideas to reach allNeeds to contain awareness for the many aspects and potential answers. We will like to contribute to some of these areas of awareness in Chapter 5; Reaching out to senior learners Needs some basic reflections and decisions about who the teachers are, the form of the course and more. We will like to contribute to these different issues inChapter 6; Areas of awareness1.4 The references of this documentThe following reflections/calculations and suggestions presented in this strategy document are based on; The mutual discussions and reflections that took place between the 4 partners during the 2 years the BEPRESEL project was open 01.10.2017 – 30.09.2019. The discussions and reflections are based on national experiences regarding preparing senior citizens for the years to come, gathered and shared by the 5 partners and with important contributions from the involved senior citizens from the 4 participating countries; Poland, Denmark, Italy and Slovenia All the experiences and learning outcomes are gathered by planning, offering and completing 4 x 2 courses of 12 to 16-lesson for more than 96 seniors in the 4 partner countries, initiated in Marts to June 2019 in different pedagogical formats.The tested courses introduced and explained 8 physical competences and areas, pointed out by the Danish National Health Board.The physical condition. What it tells and how to maintain or develop your condition. Physical strength in fingers, hands and arms and how to maintain or develop strength.Physical strength in back thigh muscles and legs in general and how to maintain or develop strength.The balance. How to maintain or develop your balance.Blood pressure. How to measure it and what it means.BMI. How to measure it and what it means.Fat percentage. How to measure it and what it means.Waist circumference. How to measure it and what it means.According to the Danish National Health board the slow and unnecessary decline of these physical competences is the reason why a rising number of senior citizens slowly develop a need for practical and personal support.The courses all start with a general introduction to create reflections and discussions amongst the senior learners of how and why we look and understand the ageing process the way we do.The senior learners were all offered to be tested according to the 8 physical parameters. All learners accepted this opportunity. All learners were offered a retest 4 to 6 month later.1.5 primary target groupsWe define and communicate primarily to 2 target groups in this document.Target group 1: Private commercial educational providers.Target group 2: The final payers of the care services. Approximately 50% of senior citizens will develop a need for care after age 65.In some countries, it will be the public bodies, the social and health authorities at municipality level, regional or national level. In some countries it will be insurance companies, pension companies and other private based initiatives offering social and health insurance services in different forms.It can be said that the elderly themselves and their families are an important target group. In many countries, it is still the family who are responsible when it comes to taking care of their elderly family members financially and practically.In this document, we have chosen to consider the elderly and their families as clients/users of public care services or customers/users of private insurance-based services.It is obvious, that a group 1 provider (private commercial educational providers), must base a potential investment in this educational area by a direct cost-benefit calculation. How big is the market of seniors? How many seniors are willing to pay the required fee, to make the courses profitable? For a group 2 actor, (the final payer of the required care/treatment later in life) it might be more relevant to consider their potential involvement in educating seniors to be better prepared for later life, based on a cost-benefit approach. What can be the potential effect of educating all seniors to be more knowledgeable and better prepared for senior life? What effect will it have on their need and requirement for care, rehabilitation and treatment later in life?new approach to ageing2.1 new and broader approach to active ageingAt the beginning of this document we stated:5930904445The significantly increasing awareness and understanding among seniors of the importance of integrating the concept of "active aging" as one of the central elements in their everyday life, does not give the expected effect of maintaining their physical skills and decreasing the demand for care later in life.00The significantly increasing awareness and understanding among seniors of the importance of integrating the concept of "active aging" as one of the central elements in their everyday life, does not give the expected effect of maintaining their physical skills and decreasing the demand for care later in life.We will like to pay a little more attention to this statement.There is undoubtedly a general and increasing awareness and focus on the importance of the Active Ageing concept in most European countries. It is not only the seniors themselves (for personal reasons) and the health authorities (for budget reasons) who have this focus. 2987040536575[Fang l?serens opm?rksomhed med et citat fra dokumentet, eller brug denne plads til at fremh?ve nogle n?glepunkter. Du kan tr?kke dette tekstfelt til andre steder p? siden.]00[Fang l?serens opm?rksomhed med et citat fra dokumentet, eller brug denne plads til at fremh?ve nogle n?glepunkter. Du kan tr?kke dette tekstfelt til andre steder p? siden.]293624055816500Television, newspapers and magazines have an increasing number of articles pointing out the different important areas of attention for senior citizens who wants to stay independent for longer. It can be illustrated by this article published in the Danish newspaper Jyllands-Posten, in the section named Lifestyle the 16th of April written by Cecilie Lyngberg. The title states;Elderlies should lift weights and challenge their balanceThe caption: Training strength, team training and balance are keyword, when you are training an ageing body. And you don’t have to fear training balance or working with heavy weights.A rising number of commercial stakeholders have become aware of the increasing number of senior citizens who are aware of their health conditions and represent a fast-growing group of potential readers and customers. However, for every serious article about senior health, there seems to be 5 advertisements disguised as serious knowledge-based articles that doesn’t always stick to the truth.It creates confusion about what is right and wrong, and these “sales articles” often conveys and maintains myths about the ageing period. The articles try to sell products such as internet based mental training programs, vitamins and a huge number of other nutritional substitutes. In many countries there are senior organizations, who systematically try to present new scientific based knowledge about staying fit and healthy on their homepage. 373824517081500373253086995[Fang l?serens opm?rksomhed med et citat fra dokumentet, eller brug denne plads til at fremh?ve nogle n?glepunkter. Du kan tr?kke dette tekstfelt til andre steder p? siden.]00[Fang l?serens opm?rksomhed med et citat fra dokumentet, eller brug denne plads til at fremh?ve nogle n?glepunkter. Du kan tr?kke dette tekstfelt til andre steder p? siden.]In the present day information is also very easy to look up on the internet in most countries. If seniors make a search including words like; “getting old, “Senior Health”, “Prevent ageing process” etc. thousands of links show up.In this example the search was “what happens to the body when you become old” in Danish and 44.800 links showed up.There is a lot of information/misinformation offered and spread to seniors about senior health and how to stay fit later in life. It might be time to ask “does it work”?402131026219100Do senior citizens become healthier and do they stay fit for longer in life?right2540000We might find some of the answers to these questions in a report published by the Danish National Health Board in January 2019 named; Elderlies health and well-beingSubtitle: The profile of elderlies 2019 is based on health and morbidity studies, the national health profiles and elected records.The reason this Danish report and particularly the results of the report and the collected research data, from almost 4o years of practicing “Active Ageing Concept” , is of interest or could be of interest to other EU countries, is caused by the fact that; Denmark was one of the first countries to focus and implement the concept of Active Aging back at the end of the 1970s and the beginning of the 1980s. Denmark is one of the countries who have invested the most in implementing the concept of Active Ageing Many countries in Europe are in the process of building up capacity, opportunities and competences to implement and strengthen their senior citizens' opportunities to stay active. Some are even inspiration on visits to Denmark.From the beginning of the 1980s, it was ordered by the Danish law that all municipalities should strengthen the opportunities for their senior citizens to become and stay active in senior life. Billions of euros have been invested in implementing the Concept of Active Aging, offering a huge diversity of opportunities to stay and become active during senior life. Local Senior Activity Centers were established. In average almost 1 center per 5.000 to 15.000 senior inhabitants. Thousands of professionals were contracted to provide and offer an uncountable number of activities to local senior citizens.Financial support to remove or limit fees to be paid by senior citizens, visiting or taking part in cultural and creative activities provided by private and public stakeholders, were and are still budgeted by Danish municipalities.The political intention of this huge investment was to support a good and high life quality for senior citizens. The overall objective and expectation of this approach and huge investment were and are still:To reduce senior citizens need and requirement for care and nursing homesThere are probably only a few countries, who have invested as much as Denmark in building up capacity and competencies to make Active Aging possible for its senior citizens.few seniors in Europe have understood and are aware of the importance of the Active Ageing concept and to have an active approach to life during the senior life period.That’s why it was a negative surprise to many, that the overall conclusion of this 144 pages report stated:5943603175”Even though 3 out of 4 elderly claims to have a good health, the figures of the research show that a huge number of seniors are lonely, overweight, exercise to little, smoke and drink too much”.020000”Even though 3 out of 4 elderly claims to have a good health, the figures of the research show that a huge number of seniors are lonely, overweight, exercise to little, smoke and drink too much”.277304580645006165858890The Danish National Health Board concludes that, “Many elderlies have a good health and assumes, that they can do what they like. But the research shows that there is a general inequality in health among seniors, and that the seniors’ health condition has not improved since 2010”, among other things regarding the research.00The Danish National Health Board concludes that, “Many elderlies have a good health and assumes, that they can do what they like. But the research shows that there is a general inequality in health among seniors, and that the seniors’ health condition has not improved since 2010”, among other things regarding the research.The reason the year 2010 is mentioned, is because it refers to a scientific result stating that:On average females aged 65 still have 23,7 years left to live. Out of these 23,7 years, 7,4 years will be with functional limitations on average. On average approximately 31% of their remaining lifetime will be with functional limitations.Similar research from 1987 (23 years earlier) showed that females aged 65 had 21,7 years left on average. Out of these 21,7 year, 8,4 years were with functional limitations. On average approximately 39% of their remaining lifetime were with functional limitations.On average males age 65 still have 17,4 years to live. Out of these 17,4 years, 5,2 years will on average be with functional limitations. On average approximately 30% of their remaining lifetime will be with functional limitations.The similar research from 1987 showed that average males age 65 would have 20,6 years left to live. Out of these 20,6 years, 4,3 years were with functional limitations. On average approximately 30% of their remaining lifetime were with functional limitations.The report calls for reflections, perhaps not only in Denmark.If a central part of the overall political purpose of the launching and investment in the Active Ageing Concept is to reduce the need for care later in life, then the BEPRESEL partnership think it is time to ask;Has the understanding of "being active in senior life"as a prevention measure been launched inadequately and therefore, been misunderstood by the seniors?And to ask if the understanding and approach among senior citizens and relevant stakeholders still is;Being active as senior citizen has a health-sustaining effect&contributing to maintaining the mental and physical competences among senior citizens&The active ageing lifestylecontributes to reduce, postponed or evencompletely eliminatethe need for home care services or institutional care later in life.If that is still the basic approach and understanding, then this Danish report is sad reading. The effect from the way the Active Ageing Concept has been implemented, at least in Denmark, is not overwhelming.Let’s make it clear to avoid misunderstandings. Being an active senior citizen and taking part in many different activities undoubtedly contributes to a better senior life and a higher life quality. It maintains and strengthens social and mental health. But it is also a fact that many of the activities the senior citizens participate in doesn’t contribute to minimizing their need for help and support later in life. Many of the activities such as lectures, sewing, ceramics etc. are performed while sitting. These activities don’t strengthen the 8 physical parameters (physical fitness, muscles strength in arms and legs, balance, blood pressure and more) pointed out by the Danish Health Authorities as essential competences to maintain to postpone or avoid ending up in need of care. Many of the senior learners participating in the BEPRESEL test courses expressed that they could recognize and identify themselves with larger parts of this fictive week program presented to them.Weekly activity scheduleMondayTuesdayWednesdayThursdayFridayChoirPotteryVisiting a friend suffering from dementiaEnglish lectureKnitting clubVolunteering at a Red Cross second hand shopBadmintonEgypt history lectureVolunteering at a Red Cross second hand shopPlaying musicEvening walkEvening walkEvening walkEvening walkEvening walkThis fictive senior presented in this schedule will see themselves as a very active senior. Their surroundings will also view them as very active. The learners we presented this plan had no doubt about why they were active in senior life. They wanted to maintain their health and stay fit and independent for longer. However, the fact is that none of these activities keep practical assistance or personal care at distance later in life, if the need of personal support and care are due to physical causes.Some readers will probably object, pointing out that this fictive weekly schedule shows that this particularly person plays badminton once a week and go for evening walks. Both activities may potentially contribute to the preservation of some physical skills and competences. The answer to this objection depends on how this person plays badminton and by what speed this person walks in the evening.Visits to sports centers have shown that many senior citizens playing badminton don’t sweat or become exhausted. They still benefit from playing badminton. They have a good time, socialize and it is beneficial to different physical parameters. The case is the same for the evening walk. It is good for many things but whether it contributes to maintaining their physical fitness depends on their pulse. Most people just walk which doesn’t raise their pulse enough to benefit them later in life.These 2 examples represent some of the many small discussions and clarifications that are necessary during the 16 lessons. Seniors are active because they know they need to be, and they want to stay healthy and keep their strength later in life. Many seniors believe that they are staying active and healthy, but most of them aren’t. To avoid misunderstandings. It is better to play badminton and go for evening walks than doing nothing.However, over years of doing these good activities, many will slowly adapt to a lower level of intensity because they become weaker and lose their physical competences, despite playing badminton and walking every evening. They will lose physical competences because they don’t know:About reserve capacityWhat reserve capacity isWhat the level of reserve capacity means for future physical tasks How to preserve a high reserve capacity and what it takesMost seniors don’t know why they need to reach, in this case, a level of approximately 80% of their max pulse twice or even three times a week, if they want to maintain their present level of condition and stamina, or what it takes to strengthen their condition because they don’t know Their age-related max pulse and what it tellsHow to measure it and for what purposeHow to plan and act according to this physical parameter, to maintain their present level or even do a little better in the future.Losing our condition/stamina is only 1 of the 8 key factors, published by the Danish health authorities, determining why too many become dependent and in need of practical and personal support and care to early.There is a lot of knowledge about the aging process to share with and educate seniors about. We believe that there is a big need to upgrade seniors’ knowledge since 95% of the senior participants taking part in the BEPRESEL test courses responded in their evaluation of the course;That they are surprised and very surprised that there is so much knowledge about the physical parameters of the aging process. That they are surprised and very surprised that there is so much concrete knowledge about how tiny the difference is;whether a senior slowly slides into independency andhow little it takes to avoid sliding into dependency and maintaining a sufficient level of e.g. their physical fitness/stamina.The general approach to the ageing periodAnother finding from the BEPRESEL text course was that the seniors need to be challenged on their fundamental preunderstanding of the ageing process, and that many seniors have negative expectations of what the years to come will bring. right67983700302387067691000Many seniors have a preunderstanding based on cultural experiences and narrative of aging, supplemented by a number of misguided myths and personal assumptions. Most of it is wrong but conceived to be indisputable truths by many seniors and an indisputable truth to most people in general.It is necessary to change this preunderstanding as otherwise, all the materials and research communicated to seniors in newspapers, magazines etc. will be interpreted and understood by the seniors based on their wrong preunderstanding. 31099269458700It was confirmed that this culturally based preunderstanding exists, when the senior learners were presented with these illustrations. 299535110723200384048014922500The majority of the senior learners at the test courses expressed that these old pictures and this new figure, were very illustrative for how they “looked” at the years to come and what they expect the last part of their life will bring. Even though the illustrations are old, they still illustrate how most seniors and people in general believe the years ahead of a senior citizen will be.The BEPRESEL partnership believe that it is of great importance to talk and reflect with seniors and future seniors about why we look at life the way we do. Particularly why we look and understand the last part of life the way we do (illustrated at the graphic to the right).If we want the majority of seniors to do better and for more seniors to implement the active ageing concept as a part of their daily life to ensure they are active and stay independent for longer, We need to educate them in why and howWe need to educate them in what determines their physical fitness 3, 5 or 10 years from now and about the choices they can make and their consequences.As long as it is still a biological physical truth that ageing is characterized as a life period of losing skills to many people, we will continue to hear variations of these explanations and reasons as to why a person at age 75 or 85 is no longer able to do what he or she was able to do 5 years earlier.“I can’t, and the reason why is that I am older”“Grandmother/grandfather can’t, but that is understandable and normal, as they have become older”As long as it is a biological physical fact will the 85 year or 90-year-old lady who is independent and rides her bike to the grocery store, be perceived as the abnormal one despite the fact that she represents the majority of ladies at age 85 or 90. 2580640146050025882606985[Fang l?serens opm?rksomhed med et citat fra dokumentet, eller brug denne plads til at fremh?ve nogle n?glepunkter. Du kan tr?kke dette tekstfelt til andre steder p? siden.]00[Fang l?serens opm?rksomhed med et citat fra dokumentet, eller brug denne plads til at fremh?ve nogle n?glepunkter. Du kan tr?kke dette tekstfelt til andre steder p? siden.]We can illustrate the challenge we need to overcome if we want to reduce the requirement for care later in life.To most learners participating in the BEPRESEL test courses it was a revelation, when the learners were presented with this slide.The first slide (to the right) shows plan A (the second yellow line). The senior learners were asked to consider if they would like the educator to make them an activity schedule that would speed up their loss of physical competences and skills. A plan that would lead to a quicker loss of physical competences and probably an earlier death as an alternative to their present schedules which were probably identical and took them to the end of life by Plan B.Everyone agreed that it is an option. Mostly because almost all learners knew someone who they believed were more inactive than they were themselves and already on the road of Plan A.Having the option of choosing a life activity circle opens a discussion about the possibility and option to design and implement e.g. Plan C or perhaps Plan D.right-508000You can choose Plan C as a senior learner (the blue straight line). The plan will ensure2322195-486410[Fang l?serens opm?rksomhed med et citat fra dokumentet, eller brug denne plads til at fremh?ve nogle n?glepunkter. Du kan tr?kke dette tekstfelt til andre steder p? siden.]00[Fang l?serens opm?rksomhed med et citat fra dokumentet, eller brug denne plads til at fremh?ve nogle n?glepunkter. Du kan tr?kke dette tekstfelt til andre steder p? siden.] that you, (senior learner at e.g. age 75), at a minimum will be as physically competent as you were at age 70. However, it requires an active choice by the senior learner to have a Plan C development. You can choose Plan D as senior learner (the straight green line). Plan D will ensure you (the senior learner at age 75) to be more physically competent than you were at age 70.However, it requires an active choice by the senior learner to have a Plan C development.What face to face education can do that information cannot:Education allows seniors to ask questions.Senior learners do not just accept the claim based on a scientific result presented on a power point, showing that it is An option to become physical stronger later in life, if you as the senior make the choice.Especially if what is told or shown is contrary to their personal beliefs about old age development. To many seniors it is very difficult to accept these kinds of facts that turn their previous assumptions upside down. These kinds of statements are almost seen as a provocation to some seniors. Many refuses to accept statements like; it is possible for a person to reach the highest condition figure in his or her life after passing age 80. Some even react a little hostile. Some learners think that is means that other elderly, for example family members, are to blame if they ended in need of support or people they know right now are in a position in need of personal and practical support. There is a lot of resistance to overcome. A resistance we in the BEPRESEL believe is not possible to overcome only by informing people but can be overcome by having seniors face to face during a short educational program. The scientific results need to be documented multiple times, illustrated from different angels and discussed. Seniors changing their mindset and understanding of the ageing process will only happen during an educational process.For example, by presenting slides 2618105421005[Fang l?serens opm?rksomhed med et citat fra dokumentet, eller brug denne plads til at fremh?ve nogle n?glepunkter. Du kan tr?kke dette tekstfelt til andre steder p? siden.]00[Fang l?serens opm?rksomhed med et citat fra dokumentet, eller brug denne plads til at fremh?ve nogle n?glepunkter. Du kan tr?kke dette tekstfelt til andre steder p? siden.]264104944005500like the one to the right, showing the results of a research showing the diversity among a group of people age 70, who had a number of physical competences and abilities measured. 5 years later the survivors were measured again. 10% did better60% had the same results 30% were weaker. Part of the educational materialFollowed by questions like: How come 10% became stronger efter5 years? What does it tell us?Why did only 30% become weaker after 5 years if we believe that you are supposed to become weaker when you age? Is it caused by age or a reduction in activity level and intensity?In which groups do you think we will find the first receivers of care?Which group will you like to be a part of 5 years from now?And slides like this one;Presenting the result of 2 groups of 85-year-old females. All measured to have a condition of 15. Having a condition figure of;15 - it is a huge effort to walk up the stairs to the first floor.11 - people are not able to take care of their own basic needs anymore.The slide shows what can be achieved in 8 months, by a very small weekly effort of 1 hour and only working 15 minutes at a level of 60% of their maximum. The green ladies had on average improved to a condition figure of 18, 8 months later2491740917575[Fang l?serens opm?rksomhed med et citat fra dokumentet, eller brug denne plads til at fremh?ve nogle n?glepunkter. Du kan tr?kke dette tekstfelt til andre steder p? siden.]00[Fang l?serens opm?rksomhed med et citat fra dokumentet, eller brug denne plads til at fremh?ve nogle n?glepunkter. Du kan tr?kke dette tekstfelt til andre steder p? siden.]The yellow ladies continuing their normal way of life during these 8 months reached a level of 13 on average. After another 8 month they will reach the red line and need personal and practical support.250675921498900Showing this experiment made a lot of seniors understand the message and become more active. Over the years, many will still slowly become physically weaker. Thus, the entire active approach will easily end up confirming seniors’ pre-assumption that age equals loss and decline.It is good to inform senior citizens about exercise. But if the they exercise without having the basic knowledge and understanding of the intensity to reach, to maintain or increase their physical conditions, many will exercise without gaining benefits. It is good to play badminton and do the evening walks, but without getting the pulse close to 80% of one's age-related max pulse, the benefit will be very limited. The person’s fitness will still slowly reduce. When a person’s level of fitness continues to reduce, even though they play badminton, we risk that being physical active is going to support the pre-perception of physics in old age. it pays of 3.1 EDUCATINg SENIORS PAYS OFFIt is natural to us all, that our children and adolescents should spend at least 9, 10, 12 and some up to 15 or 18 years in education to become knowledgeable and competent adults able to cope with the challenges and tasks they will face during adult life.The adult period of life can be set to approximately 35 to 40 years starting from age 20 or 25. Then senior life begins.We invest a lot of money in the education of our children and youth because it is necessary and because we know that it pays off.Retirement either before age 60 in some countries and late 60s in other countries, means that most people still have a minimum of 20 years ahead. Which is about the same number of years many people spend working.The fact is that most people base their approach, understanding and expectation to their senior lives on myths, misguiding public truths and personal assumptions handed over from generation to generation.That is a challenge and a problem for multiple reasons.It is a challenge because many seniors do not react immediately on symptoms of diseases.Many elderlies do not react immediately to a number of losses and challenges they meet, which might be the first symptoms of diseases. They do not react because they believe that the problems they face are a normal part of getting older.The do not react on physical reductions and limitations.Elderlies assume that the slow loss of physical abilities are due to their age. They believe that it is inevitable and not something they can change. It means that a lot of seniors won’t react to the reduction in their physical abilities and slowly become more dependent on outside help. Offering even a short educational program (12 to 16 lessons) to all senior citizens, which might be up to 20% of the population in some EU countries, could be considered a huge ambition. However, it is not as big of an ambition as when our ancestors decided that all children should be educated 6 to 8 lessons every day for 10 to 12 years and some even for 16 to 18 years. They did it because they believed it was necessary and that it would pay off. If we really want to change the understanding and mindset of people, attitudinal changing education is the answer. It is not enough to only provide information. We believe, after having this opportunity to educate almost 100 senior citizens in four countries, that it is time to make sure that people entering this lifespan have an updated scientifically based knowledge and understanding of what really determines whether we remain independent Too many seniors slowly slide into dependency to early Back to the question on the frontpage: “Is it not the time to start educating our senior citizensand citizens becoming seniorsto become more knowledgeable and competent about the aging process?”.Our answer is: ?Yes, we believe it is time to educate our senior citizens. Partly for the sake of the individual seniorand partly because it is a good investment which will pay off.”3.1 It pays of 1When we in the previous chapter emphasized describing the approach to educate our children, it was based on our ancestors’ belief that it was a good investment. We believe the situation is the same when it comes to senior citizens. The immediate benefit of becoming a more knowledgeable and competent senior citizen is a higher life quality. There will also be a significant financial benefit from educating seniors and future seniors to be better prepared for senior life. We believe that the authorities who have the budgetary responsibility to finance and deliver the practical and personal support to elderly people can benefit from investing in educating senior citizens.The first, and very direct, cost-benefit calculation.Some years ago, it was announced that fractur collum femoris (hip fracture) in Europe as a whole, was at a cost level of approximately 40 billion euro and caused approximately 43.000 deaths on an annual basis.To bring it down to a more operational level, we will use Denmark as an example.The number of seniors aged 65+ is set to be 1.2 million in Denmark. Many preventive measures to avoid osteoporosis and falls, such as screenings, education and training of people in risk groups, for genetic reasons, as well as general information, have been taken in Denmark.Never the less, Denmark faces, on an annual average basis:10.500 fractura colli femoris (55%) and fractura pertrochanterica femoris (45%) And an additional 17% will face a second time fractura, which is around 1.785 people.Altogether on average 12.285 cases per birth year. The risk is increased as you age, culminating after age 80, and only a few will face the challenge before age 65. Still, many will be diagnosed with e.g. osteoporosis after having the fracture.If we look at e.g. the birth year 1953 in Denmark, (appendix x) we know that 66.599 people will enter the senior life period +65 in 2018.This means, that on average 10.500 out of the 66.599 will face a fractura colli femoris or a fractura pertrochanterica femoris and 1.795 of them will face a second fractura, which is close to 18,5% of the 66.599 people.Due to many things, and very different life condition, the number of seniors who will face a fractura colli femoris or fractura pertrochanterica femoris, varies in different countries. In Romania, as an example, only 1 in 3 will face this challenge, compared to Denmark. In total, it means that out of 66.599 Romanian senior citizens only 4.071 will have to face this challenge. The following table show the risk per birthyear, ranging down from the Danish level, to the Romanian level.Table 1Country/level DenmarkLevel atLevel atLevel atRomaniaNumber per year12.28510.0008.0006.0004.071% of people entering the age group 65+ in 2018, with their birth year being 195318,5%15,02%12,01%9,01%6,15%353631520383503448685120015[Fang l?serens opm?rksomhed med et citat fra dokumentet, eller brug denne plads til at fremh?ve nogle n?glepunkter. Du kan tr?kke dette tekstfelt til andre steder p? siden.]400000[Fang l?serens opm?rksomhed med et citat fra dokumentet, eller brug denne plads til at fremh?ve nogle n?glepunkter. Du kan tr?kke dette tekstfelt til andre steder p? siden.]393255595885420052595885449770589535476567588265482981069913500342011069278500408685927368500553021533020055302155397505528945727710554291596647055429151186180361886511468103637915922020363664571374036442655219703632835335280530415581915506666586995These figures mean, that in every class of e.g. 16 senior learners in Denmark, 18,5% or 2,96 people will statistically face a fractura colli femoris or a fractura pertrochanterica femoris later in life, and a minor group will face it twice.The cost of 1 fracture in Denmark was, some years ago, estimated to cost 23.000 euros.It means that a class of 16 learners contain a future cost of minimum 66.700 euro for the end-payer of the hospital treatment and aftercare, provided either as home care or as an institutional care nursery in Denmark. If we calculate the cost based on the low Romanian level, it is still a future cost of 22.540 euro.Table 2Country/levelDenmarkLevel atLevel atLevel atRomaniaNumber of senior learners in a class1616161616% of people entering age group 65+ in 2018 with their birth year being 195318,5%15,02%12,01%9,01%6,15%Number in a class of 16 learners, statistically estimated to face a fracture at different risk level.2,962,401,921,440,98Lowest estimated cost of one fracture23.00023.00023.00023.00023.000Total expected cost caused by 16 learners age 65 in the year to come66.70055.20044.16033.12022.540If we estimated (table 3), on behalf of a total cost per course of 1.400 euro, it means that the effect of 1 course should be a reduction of 0,12 people, from 2,96 person per 16 learners having a fracture to 2,84 people having a fracture in Denmark, as well as a reduction from 0,98 to 0,92 out of 16 learners at the Romanian level.Table 3Country/level DenmarkLevel atLevel atLevel atRomaniaTotal expected cost caused by 16 learners age 6566.70055.20044.16033.12022.540Estimated cost of one course1.4001.4001.4001.4001.400Reduced cost to deal with fractures65.30053.80042.76031.72021.140New % number in class of 16 learners, statistically estimated to face a fracture at a different risk level.2,842,331,861,380,9223.00023.00023.00033.00022.540 At a set course price of 1.400 for a similar course as the BEPRESEL project means that the course only needs to reduce the numbers from 2,96 to 2,84 people having a fracture during the years to come. All beyond 2,84 people will be a good business.Country/levelDenmarkNumber of senior learners in class16% of people entering age-group 65+ 2018 birth year 195318,5%Number in class of 16 learners statistical estimated to face a fracture at different risk level.2,96Low estimated cost of one fracture23.000Total expected cost caused by 16 learners age 65 in the year to come66.700Estimated cost of one course1.400Reduced cost to deal with fractures65.300New % number in class of 16 learners statistical estimated to face a fracture at different risk level.2,84Cost per fracture23.000The question for the end-payer of later treatment and aftercare of people having a fracture is:Do we/you believe, that if we educate 8,25 classes of 16 senior learners aged 65, to have a better understanding of Why 2,96 of them will fall and have a fracture later in life,Their balance and how to stimulate, train and maintain their balance,Their muscles power and how to stimulate, train and maintain their muscle power,Their competences to react quickly, and how to stimulate, train and maintain their ability to react quickly,are tested to show them their present status, so that one person out of the 24 senior learners, in these 8,5 classes of 16 learners, statistically expected to have a fracture later in life, will be aware of the risk and what it takes to minimize the risks of having a fracture later in life.Offering all 66.599 people from the birth year 1953, passing age 65, a course of 16 lessons, having 16 senior learners per group, will require 4.162 courses at a set price of 1.400 euro (see appendix x), which equates to 5.830.000 euro. This amount is similar to the cost of 253 incidents out of 12.285 annual cases.Due to many things and very different life condition, the number of seniors to face a fractura colli femoris or fractura pertrochanterica femoris varies in different countries. In Romania only 1:3 will face this challenge compared to Denmark. For comparison it means that out of 66.599 Romanian senior citizen only 4.071 will have to face this challenge. The following table 4 show the risk per birthyear rating down from the Danish to Romanian level.Table 4Country/levelDenmarkLevel atLevel atLevel atRomaniaNumber of fractures per year12.28510.0008.0006.0004.071% of people entering agegrup 65+ 2018 with the birth year 195318,5%15,02%12,01%9,01%6,15%If we calculate Denmark on behalf of the low Romanian level.Table 5Country/levelDenmarkLevel atLevel atLevel atRomaniaNumber of senior learners in class1616161616% of people entering age-group 65+ 2018 with the birth year 195318,5%15,02%12,01%9,01%6,15%Number in class of 16 learners, statistical estimated to face a fracture 2,962,401,921,440,98Low estimated cost of one fracture23.00023.00023.00023.00023.000Total expected cost caused by 16 learners age 65 in the year to come66.70055.20044.16033.12022.540Estimated cost of one course1.4001.4001.4001.4001.400Reduced cost to deal with fractures65.30053.80042.76031.72021.140New risk % in class of 16 learners statistical estimated to face a fracture 2,842,331,861,380,92Cost per fracture23.00023.00023.00023.00023.000Reduction of number of people having a fracture0,120,70,60,60,6right15494000407606523114000If we estimate Denmark as Romanian (table 2) it means that the effect of 1 course should be a reduction of 0,12 people having a fracture later in life, from 2,96 people per 16 learners to 2,84 people, or a reduction from 0,98 people to 0,92 people out of 16 learners.Even at a Romanian level (dividing the Danish-Danish figures by 3) it is still a very good business to educate seniors on avoiding fracturing column femoras.Therefore, the question is to an End-payer of later treatment and aftercare of people having a fracture based on the Romanian level of registered fractures isDo we/you believe?That educating 17 classes x 16 senior learners = 272 seniors, who statistical are expected to produce approximately 16,66 fractures, will be informed and aware of the risk and what it takes to minimize and eliminated the risks of having a fracture later in life, that 1 person less or only 15,64 people will have a fracture later in life and few a second fracture. People can be, and are in most countries, informed about this big risk in brochures and articles. But telling a class of 16 people that 2,96 out of you or 0,98 at Romanian level will face this challenge later in life if they don`t act, simply has a stronger impact. To avoid column fractures later in life requires both seniors to have:a better understanding of the process and causes, that through many years, lead to a fractura colli femoris the understanding, that it is not random who will face the challenge. It is not a nature given result of being older. It is a result of what we didn?t do in due time.32848551016000It makes the senior citizens reflect when they are told that “2,98 of you will statistically face a collum femora’s fracture if your lifestyle stays the same. It also makes the seniors reflect when they are asked about why seniors fall more often, and it is right22606000pointed out that in a classroom of 16 learners right146734004 out of you will pass age 80 and become older, but 2 out of the 4, will have lost your independence and need care.It becomes clear to the seniors that the situation can be changed. The claims and scientific facts cannot be properly explained in articles and brochures but requires face to face education. If people have a preconceived idea about the aging process without a basis of factual and scientific knowledge about the body, the information they read will not be understood correctly. Seniors need face to face education if they have a view of the aging process like;Age means decline and that we continuously lose skills andit is luck that determineswhether we remain independent or need help.3.2 IT pays of 2The perspective of starting to educate seniors based on the need of care later in life shows that the potential for savings might be bigger. We base these cost benefit calculations on Danish figures. The care of elderly has been free in Denmark and been financed by the tax system for many years. It is to be believed that the number of seniors requesting and receiving some form of help or support reflect the total number of senior citizens in need of support. There are no dark figures as everyone in need of care are assumed to apply because it is free.We will only calculate the cost benefit ratio based on care and help delivered either as Home care or Institutional careWe are aware that there are significant differences between the EU member states when it comes to senior health status. One example already mentioned is the difference between Denmark and Romania when it comes to fractures collum femoris. Differences in the average life time is another example which has an impact on the overall requirements for senior care.However, we think that it makes sense to use the Danish figures as a basis to illustrate the potential of savings if seniors become better prepared for senior life. The country differences are believed to be +/- 3 to 5%.Table 7 Number of seniors receiving homecare service in Denmark 2018Age group 65 - 79Age group80+TotalTotal number in age groups845.451249.7211.095.172Number of receivers of homecare service58.59087.402145.992% of age group receiving some form of home service6,9%35%13,33 %% Independent living93,10 %65 %86,67 %The table show that there are 845.451 people in age group 65 to 79 there are 58.590 people and 6,9% will end up in need of some form of practical or personal support from the homecare service before the end of age 79. 29,54% or 4,7 people out of 16 senior learners will still be alive at age 80+. 35% of these seniors will end up in need of homecare services.35% or 1,6 people out of these 4,7 people will already have or will develop a need for home care service after age 80.In total 13,33% will end up in need of homecare service later in life, like the 2,1 people out of the 16 learners who are still alive after age 80 and ends up in need of homecare service, It means that 13,33% of 16 learners or 2,13 people will require and receive home care services before they reach age 80.If we set 1 hour of homecare service (inclusive salary, time of transport, administration, management and help equipment) to cost 34 euros.The cost of 1 educational course is set to be 1.400 euros.2,13 people receive 1 hour of homecare service 3 days a week.Then the effect of participating in a course for Better Preparation for Senior Life only needs to postpone the date that these 2,13 people will ask for care by 6,4 weeks.2,13 people x 3 hours a week x 34 euros = weekly cost of 217 euros.Cost of course 1.400 euro/ 217 euros = 6,4 weeks later.There are of course a myriad of care situations and requirements.If one of these 2,13 people ends up in a situation where they need 2 hours of help a day, the effect of participating in a senior health course only needs to postpone the day this particularly person applies for care with 2,9 weeks.1 person x 7 days x 2 hours a day x 34 euros = a weekly cost of 476 euro.Cost of course 1.400 euro/ 476 euros = 2,94 weeks. Table 8 Number of seniors becoming resident at a Care homeAge group 65 - 79Age group80+TotalTotal number in age groups845.451249.7211.095.172Number receiving homecare service16.63335.07651.7091,97%14,05%4,72%93,106586,67Table 2 shows that 1,97 % of age group 65 to 79 and 14,05% of age group +80 will become residents at a care home and that on average 4,72% of all age 65+ will become residents at a care home.It means that in a classroom of 16 learners including the 4,7 of the 16 learners who will still be alive after age 80, there will be 4,72% or 0,76 people who will become a care resident.On average a care home placement can be set to 1.000 euros per week.The cost of 1 educational course is still set to be 1.400 euro.It means that the 0,75 people shall ask for a placement at a care home approximately 1,9 week later 1.000 euro x 0,75 x 1,9 week = 1.425 euro.A course is set to cost 1.400 euro meaning that the effect of the 16 learners has to be, that the o,75 people who is likely to become resident at a care home waits 12 days before moving into a care home.Is it trustful? Can we believe in it?A mix of factors interacting with each other determines whether a senior citizen is independent or dependent on care later in life. We are sure that it is possible to reach the presented effects by educating seniors to be better prepared for senior life. Seniors need to become more aware of what happens to their physical conditions during senior life and become more knowledgeable about how little it takes to avoid or at least postpone them becoming dependent on help and support.If we only look on one factor that we know plays a central role in losing independence: Our stamina – our condition expressed in physical fitness.We know that:Having a condition figure of 15 makes it a maximum amount of work to walk the stairs to the first floor.Having a condition figure of 11 means that people haven’t got the stamina and physical strength to take care of themselves anymore and become dependent on help.Females in Denmark at age 60 are measured to have a condition figure of 22 on average.In this case a Danish female has a condition at the average level of 22, and a daily life activity circle at a level where she doesn’t maintain her condition but lose 3% of her condition. Loosing 3% a year is such a small reduction that it probably won’t be registered by the person.Year 2019Age 60Year 2037Age 78Year 2047Age 88Condition figure 22 14,81 10,92But 3% a year will bring the person to a level of 14,81 at age 78 and a level of 10,92 at 88.If the average condition figure of these females age 60 was raised to 25, which can be easily done in a few months (remember the yellow and green ladies of age 85 page 17), and they have a daily life activity level that will reduce the condition with 3% per year, it will look like the following:Year 2019Age 60 Year 2041Age 82Year 2051Age 92Condition figure 25 14,81 10,98This person starting at level 25 will reach 14,81 at age 82 and 10,98 at age 92 or 4 years later than the person starting at condition level of 22.All seniors can raise their condition figure – some to a high level with a very small weekly effort. However, they need to know that it is possible and how to do it. cost and payment4.1 cost of coursesIt is important how the business model looks before starting offering senior health promotion courses. It is important to know what the costs to build and offer such courses are and how much seniors are ready to pay. It is also important to know what the costs to an End-payer for the required care later in life is, if seniors are offered free health promotion courses. With the presented cost benefit calculations of the courses and the potential positive impact on the demand for care, we hope that we have inspired potential End-payers to consider offering the courses for free. Offering the courses for free will be better business, if the provider manages to design and use the right launching methods and recruitment tools. Tools that ensure great contact and participation from the social economic senior groupings who constitute about 30-35% of the total senior group, but who later in life accounts for up to 70% of the total care of seniors.We are aware that there are huge differences when it comes to the financial position of senior citizens in different countries and that these financial differences have an impact on their willingness and ability to pay for the senior health courses.However, if we assume that there is a coherence between the cost index of offering senior health courses and the income index for seniors in different countries, we believe the presentation can provide guidance as to whether to start developing and offering senior health courses on a commercial basis or not.The following calculations are based on Danish figures and needs to be adapted to national contexts.The teachers’ salaries are the main costs of the senior health courses. Table 9 shows 3 different levels of salary according to years of experience. A newly educated person – a medium and a senior educator.A teacher in Denmark will normally be obliged to teach between 700 and 800 lessons a year. In this case we set the expected number of annual lessons to 750.Table 9Cost level 1Cost level 2Cost level 3Teacher salary 1 hour25 euros35 euros45 eurosAnnual workhours1.6801.6801.680Annual salary42.00058.80075.600Number of annual lessons750750750Cost per lesson56 euros79 euros101 eurosThere is a huge difference in the cost of having a young or a senior educator. We suggest that a potential provider uses the senior professional for multiple reasons, but mostly because of the value of the peer to peer effect. Table 10 shows the costs based on a 16-lesson course according to the 3 different salary levels and a set overhead of 30% Table 10Cost level 1Cost level 2Cost level 3Teacher salary per lesson 25 euros35 euros45 eurosTotal salary cost for 16 lesson400 euros560 euros720 euros30% overhead120168216520 euros728 euros936 eurosFee12 learners43 euros61 euros78 euros16 learners33 euros46 euros59 eurosTable 11 shows the costs based on a 16-lesson course according to the 3 different salary levels and a set overhead of 40%Table 11Cost level 1Cost level 2Cost level 3Teacher salary per lesson 25 euros35 euros45 eurosTotal salary cost of 16 lesson400 euros560 euros720 euros40% overhead160224288560 euros784 euros1008 eurosFee12 learners47 euros65 euros84 euros16 learners35 euros49 euros63 eurosIt would be relevant to raise the number of senior learners to e.g. 24 learners per course to reduce the fee. In the application for the BEPRESEL project it was stated that the courses were to have 12 senior learners. Some of the courses were implemented with up to 24 senior learners without any problems.There are still several goods reasons to minimize the number of learners. Many seniors are not trained to sit in a theoretical learning situation, and it is to be expected that many will find it difficult to ask the questions if they are a lot of people in the class.Having 12 learners requires a minimum of 3 lessons for testing x 2 tests = 6 lesson, leaving 10 lessons for the theoretical part.Having 24 learners requires a minimum of 6 lessons for testing x 2 tests = 12 lesson, leaving only 4 lessons for the theoretical part. We suggest having a minimum of 20 lesson when working with 24 learners. If a provider goes for 24 learners per course having 20 lessons and estimate 40% overhead, the result will be quite similar to having 16 learners at a 16-lesson course.Table 12 shows the fee of having 24 learners have a 20-lesson course and an overhead of 40%Table 12Cost level 1Cost level 2Cost level 3Teacher salary per lesson 25 euros35 euros45 eurosTotal salary cost for 20 lesson500 euros700 euros 900 euros40% overhead200280360700 euros980 euros1260 eurosFee24 learners30 euros41 euros53 eurosThe overhead is set to cover costs related to offering a course such as advertising, administration and rent. A provider must pay attention to the costs of equipment for the tests. It is not a huge investment if more courses are planned and offered regularly. It can be a cost of 800 euros to 1500 euros or a little more. It is important not to buy a cheap a bicycle to measure the seniors condition figures.EquipmentcheapSuggestion1Bicycle to measure condition5009002Blood pressure monitor40603Height measure40604Weight50705Fat percentage measures10606Tape measure227Balance tester10708Hand ergometer501009Measure strength in thigh muscles50100752 euros1.422 eurosAs a part of the evaluation of the courses the senior learners were asked:This course was free. What do you think it is worth, now that you know what it contains? How much would you pay for the knowledge you have today? You may try to relate your answer to what you would normally be willing to pay for courses with other content.Table 13In Denmark 38 seniors participated and 35 filled out the evaluation.Row no.1234567Willing to pay15 euros25 euros40 euros50 euros70 euros80 eurosNo AnswerNo. of person52510517Percentage14,3%5,7%14,3%28,6%14,3%2,9%Table 13 shows that the seniors’ willingness to pay varies a lot.The lowest fees calculated in the previous tables were 30, 33 and 35 euros, based on the lowest teacher salary cost and having 16 learners at a 16-lesson course. Table 5 shows that almost 80% of the seniors expressed that they were willing to pay a fee higher than that.The calculated fee based on the highest teacher salary cost show a fee level of:78 and 84 euro having 12 learners for a 16-lesson course.Only 2,9% - 1 person out of 35 expressed a willingness to pay a fee at this level.59 and 63 euro having 16 or 12 learners17,2% of the seniors express a willingness to pay a fee at this level.The fee based on the highest teacher salary cost and 24 learners at a 20-lesson course show a fee level of:53 euro which almost half of the seniors express a willingness to pay1 out of 35 is a lot of people when it comes to senior citizen.2,7% as a potential target group willing to pay the high rate at 80 euros might not sound like much. However, it is important to remember that the overall target group we focus on count 18 to 20 percent of the total population in different countries.1% of the target group in Denmark represent 12.000 potential senior customers or 500 courses. The 1 person who expressed a willingness to pay 80 euros represents more than 32.400 senior citizens or 1.350 courses on a national scale.From a strict business point of view, we think that there is a marked to develop and go for, even if it requires that the educational performance and the testing needs to move around regionally or nationally.A more operational levelBringing these figures to a more operative level, such as a municipality of e.g. 50.000 inhabitants. On average 9.000 to 10.000 out of 50.000 inhabitants will be senior citizens. 2,7% will be willing to pay the high fee of 80 euros. Out of 10.000 senior citizens there are approximately 300 potential senior customers and there will be 100 new customers for every 1% the provider manages to go higher than the 3%.If the provider can go by a fee of 53 to 57 euros, it opens a potential costumer group of up to 46% or 4.600 seniors in a municipality of 50.000 people. They will probably not show up from day one. The interest and motivation to sign up for the senior health courses must be built by delivering high quality courses and later highlighting improved results achieved by the seniors being tested according to the 8 parameters. Another figure that is important to pay attention to, is the number of annual ?new? 65-year-old people. If the operator is a municipality or another authority, they will have access to the exact number of people turning 65. A private operator can estimate that out of every birth year 65 years earlier, approximately 85% will turn 65. On average 1,10 to 1,20% will turn 65 every year. In a municipality of 50.000 people it means that between 550 and 600 people will celebrate their 65th birthday every year. Having the same % of willingness to pay means that 15 seniors will be ready to pay 80 euros, but around 250 new seniors can be motivated to sign up for a course every year if the provider is able to offer the courses at a fee of around 50 euros.We believe that there is a marked of interest to a commercial provider. To social and health authorities, insurance companies and the End Payers of the care services that approximately 50% of senior citizens will require after age 65, the seniors who are willing to pay might not be the most interesting senior groups to educate about senior life. The most interesting groups for the End-payer stakeholders are the socio-economic groups who are overrepresented when it comes to the need for treatment, homecare and institutional care.The socio-economic groups are characterized by; Seniors with a low or no education.Seniors who have a low income and less money than average in senior life.Senior males and particularly males of a higher age.Seniors belonging to different immigrant groups.Seniors who aren’t convinced about their own ability to change their life conditions in later lifeWe believe that these groups overlap those who are less willing to pay for senior health courses for several reasons;They have less financial capacityThey have very little or no experience signing up for “teaching” and have very little confidence that they can learn anything at allThey are less convinced about their own ability to affect the life conditions in later lifeA fee will easily become an excuse as to why they won’t sign up for the courses, even though they might be the ones who will benefit the most. This group of seniors is the main reason why we suggest End-payers seriously consider making senior health courses free.Using the Danish seniors’ evaluation, we might be able to figure out how big the challenge to reach the seniors who might benefit the most for the courses will be. It is important to keep in mind that the Danish seniors on a European scale probably are in the top 5 in terms of economic and social security. From that, one can assume that it is not surprising that the Danish seniors respond that they are willing to pay for the course they have completed in table 5.Particularly when we look at how the seniors responded to 3 other questions in the same evaluation:Question: You have completed a course of 16 lessons including time for testing.Have you learned anything new about the aging process?Please only mark one.NoYes, a littleYes, someYes, a lot I am surprised about the amount of knowledge there is about what makes a difference in senior life.No answer019141842,9%25,7%40,0%51,4%Question: Do you think the course will make you train and maintain your various physical skills?Only one XNoYes, a little Yes, someYes, a lotYes. Right now, I believe I will start to work out to maintain my physical strength and competences.Yes. Right now, I believe that I will start to work out to improve my physical strength and competences.12,8%38,5%1440,0%925,7%1337,2%720,0%Question: Do you think the course had a content and a quality that will make you recommend it to your acquaintances if it is re-launched?Only one XYesNoI don’t know3497,14%012,86%Where would you place yourself according to these categories?Only one XNot wealthyIn the middle-income group among senior citizensSomewhere in betweenI think I have a better economy than most senior citizens.No Answer411,43%1851,43%38,57%925,71%12,86%Although 88% of the Danish seniors believe that they have a good private economy:20 % answer they are not ready to pay more than 25 euros for a 16-hour course in senior health including testing.Despite that95% indicate great satisfaction with the course and 90% indicate that they are surprised that so much documented knowledge about ageing exists. 98% respond that they think the content of the course had such a high quality that they will recommend their closest to enroll in a course.It is thought-provoking that Danish seniors who like to use? 500 or 800 euros for a one-week holiday and ? Who happily pays 40 and 50 euros for a 40 hours course in ceramics, flower binding etc. are hesitant to pay, for example 70 and 80 euros, to get the knowledge and the tests that may help them stay independent for longer and give them more years to participate in activities or go on holidays.The fact that the seniors in Denmark responded as they did, calls for reflection and consideration.One could formulate a thesis that reads: “If you asked people directly whether they would pay 80 euros, or 200 euros for that matter, to get 1 or 2 years more as an independent citizen with good health”, everyone would answer yes and will probably be willing to pay more.The resistance against paying for example about 80 euros among the current participants is probably because they don’t believe, that their physical reductions are caused by age and don’t think that it can be changed. They do not believe that they have seen the final "proof" of the effect from the courses. They are not aware that they can see the evidence in the examples presented to them. In the oral part of the feedback from the participating seniors in Denmark, there was a central message worthy of being aware of for future providers of senior courses;Focus on what seniors get out of participating in the courses in the advertisementrather than the content.It is a challenge to formulate the advertisement for the courses, since you cannot guarantee that the senior learners have a longer life with more independent years. Reaching out for senior learnersSenior citizens are as diverse as all other age groups and therefore you do not reach all senior citizens the same launch methods.One should therefore be prepared as a potential future provider of senior health promotion courses.that the larger part of the overall target group you want to reach, must be invested in many different forms of communication and narratives.That it is a market where interest must slowly "wake up", which is why it will take time to build the market.That the limit for how large a proportion of the total senior group when using traditional advertising initiatives may only constitute between 5 and 20% for a start.That a hand-held advertising effort is almost needed to reach those who, in a prevention perspective, have the greatest interest – the approx. 30% who will later demand the vast majority (70-75%) of health and care services later in life. One must work as providers and work continuously to change the preconception many have regarding the aging process.5.1 build up a strong informative web-pageWEB PAGEWe suggest that future operators establish a link on their webpage containing information regarding the issue of staying fit and independent longer before doing anything else.We believe that it is important that this webpage is established on at a local and municipal level, and that the content reflects and communicates to local seniors. “We write to you in the Ptuj area from the Ptuj area”“We will like to support you who live in the Ptuj area”It becomes more relevant and familiar to many seniors if the communicator is someone they connect to and perhaps even know in advance. Build up a person, a face or two people and faces (put the faces on the homepage), who becomes familiar to the local people when it comes to senior health issues. It could be in cooperation with a local doctor and a person representing the educational provider. It will give credit to the link if a medical person is involved. Ensure that the external person has a modern and updated understanding of the ageing process.We don’t believe that a link to the BEPRESEL homepage is useful, because it will confuse many seniors entering an international webpage. The long-term purpose of the BEPRESEL homepage could and should be a forum to exchange new scientific knowledge across borders and between related partners.The overall purpose of the homepage is to stand by with further information, so the operators/providers of senior health courses have a source to refer to, in all later announcing initiatives.It is important that the text on this page is very short, concrete and written in a none medical language. Many seniors don’t read long “professional” articles and if they meet words, they don’t understand they will stop reading.In the same way we will suggest that one or 2 small videos are made presenting the same information, which will provide visitors with different options.The focus in the material and videos should be;That it is not normal or determined, to lose physical competences in such a manner that we lose our independence when ageing.That too many elderlies unnecessarily lose their physical competences in such a manner that they lose their independency and self-determination.We believe it is important that all text use the word “we” and not “you”. It means that the operator and provider should ensure that the people and faces launched at the homepage, to become known to senior citizens, have the “right age”. Most of the information to be presented on the homepage, can be identified and picked out from the educational material developed by the BEPRESEL project. If identical scientific results and figures exist in the home country of the provider, it is of course best to exchange the figures/statistics or to support the presented knowledge with national scientific results. It makes the results stronger if similar results from different sources are presented.Keep it short. Consider using the opportunity to build up a text that opens part by part if the reader wants more information after reading the first part.However, as stated in the beginning, we don’t believe that the main purpose of this link/forum for knowledge of ageing at an existing homepage, is to motivate and recruit senior learners directly. The level of seniors’ access to the internet and competences, experiences and willingness to search and gather information varies in different countries. The intention is to be able to refer to the content and to provide an address, as a part of the other materials and announcements. We believe that in many cases it will be younger family members who will be the visitors. Hopefully after visiting the homepage they will start to talk and motivate elderly family members to sign up for a course and a test. 5.2 Influence public understandingAs a potential provider of health-promoting senior courses, one must work continuously in trying to change the cultural and myth-based preconception of the aging process many of us have, regardless of our age, to stimulate the interest in such courses on the long run.Trying to change it from;Being older and getting old is a period of losing mental and physical skills.That it is normal to lose physical competences and become weaker.To;How my physical skills are in 1, 3 or 5 years is the result of what I have done to preserve them in the previous 1.3 and 5 years.That it is not an inevitable part of "normal aging" to become weaker.We therefore propose that a potential operator and provider of senior health courses, consider allocating the resources to write small articles on this topic on an ongoing basis. With small articles, we mean small articles. There can be 2 sections and a total of 20 to 30 lines in the local newspaper. Many seniors, perhaps especially those who are most interesting in a prevention perspective, do not start reading long articles at all. It will probably require 1 or 2 weekly hours to make these articles.On the short term, the articles shall be published on the webpage and saved as a part of the content regarding senior health issues.We will suggest that a potential future provider consider.To contact the editors of the local weekly or monthly published newspapers, to point out to the editors that this is a topic that not only interests the senior group (potential 20% of their readers), but an issue of interest to family members of all ages. They all want to keep their parents and grandparents healthy for as long as possible.To investigate the possibilities of creating a joint venture with local companies that regularly distribute advertising sheets in the local area. It could be supermarkets. The collaboration could include their advertising sheets, as part of their CSR efforts; and small notes on what A better preparation for senior life contains.To establish contact to local radios and broadcasts, to point out that this is an issue that contains enough knowledge to make a weekly or monthly magazine.5.3 1 day eventsIn a start-up phase and as a recurring annual event, it may bring more motivation to enroll and participate in Senior Health Promotion Courses, to establish and invite seniors to an annual one-day event. A day with a program containing elements many seniors are familiar with and will find attractive will create a bigger motivation. An initiative like this will probably reach skeptical seniors, the senior profiles hard to reach and the seniors who don’t become motivated or convinced by watching or reading an announcement in a newspaper or a brochure. A program like this establishes an opportunity to the provider of senior health courses to have a direct face to face contact with many seniors during the day. Going for all seniors in an area is a big task and cannot be done with a one-day event. 18% to 22% of a total population is +65. In a local population of 50.000 (a municipality) there is between 9.000 and 11.000 seniors. It will require an event that will probably last a week.As inspiration it can be mentioned that several Danish municipalities already invite seniors to such events. The municipalities focus vary. A big municipality with 337.000 inhabitants invites all who already have or will turn 75 that particularly year. All receive an invitation to participate in a full day event at the town hall.The program for such a day could look like this:10:00 The mayor welcomes and offers conversation with the target group (alternatively the responsible person).11:00 Presentation of knowledge about senior health promotion/introduction to the course12:00 light dinner and ???12:30 visit "booths" that represents different opportunities to be active in senior life such as creative opportunities, volunteering, advice and guidance.13:00 A "well-known lecturer" or musical feature14:00 Coffee and last visits to "stalls" 15:00 End of the dayIt will be a good idea if the municipalities play a central role in planning and conducting such a day(s). Either by taking the initiative themselves or because a commercial partner involves the municipality. There is no doubt that it means something for many, to be invited by, for example, the mayor.The only body and operator who can handle personal invitations is the municipality, because it is the only body who has relevant birth data, the addresses of the elderly and know the exact numbers of elderly in different age groups.For a commercial operator the number of seniors in different age groups in a local area of 50.000 people, can be estimated like this1,15% will be 65 years = 574 seniors.0,91% will be 75 years = 404 seniors.0,33% will be 85 years = 166 seniors.0,17% will be 90 years = 83 seniors.0,05% will be 95 years = 26 seniors.It will vary in the local areas. It can function as a reliable guideline to a private provider who wishes to know what it will require in terms of facilities and cost.The 3 groups need can be described as;65 years: Provide a good start to their senior life period.75 years: Many (up to 30%) will have realized that they have become weaker85 years: We know the number of seniors in need of care raises quite dramatically from now and the years to come.It is important not to have to many guests to ensure that everyone feels comfortable and feel that the people they would like to talk to have time for them.The key point for the provider of senior health courses setting up such a day, is to have the opportunity to present the importance of seniors becoming more aware of what determines why too many elderlies become dependent on help too early.To kill some of the culturally based and wrong myths and assumptions regarding aging It is best if both 1 and 2 are done in a professional way but also with a little humor and presented by a person of age similar to the audience. It is good if the speaker is able to talk about ?we? and not have to use the word ?you?.To tell and ?sell? the message the provider will have; The time on stage to tell and present some of the basic scientific facts. The opportunity to set up posters in the room showing some of the key figures we know and good phrases. The training provider can also have a sales bit on equal terms with everyone else presenting themselves and their goods and servicesIf the group behind the organization is a commercial company and doesn't have the financial capacity to offer it for free, it can be justified to have people pay a fee, to pay for the amusement and catering. Sponsors can also be used, such as; banksshops having relevant articles for the target grouporganizations presenting themselves, perhaps looking for volunteering people for their tasks. The municipality or insurance/pension companiesIn return for the sponsorship, these partners can set up sales and presentations stalls.The reason to hide the informational part regarding senior health issues in a bigger and more diverse program is, that we believe our experiences (from the Danish municipalities) are that it is attractive to a large group of seniors to come. Some will like to listen and say hello to the mayor. Some come for the amusement and some for the food. There is a bigger chance of getting in touch with the seniors who are normally difficult to reach if you only invite them to a shorter introduction speech about the importance of senior health promotion as a sales introduction of the courses. The overall profile and numbers of seniors, who will only attend an introduction event to the senior health aspect, will be those, who already know much and have understood the message when it comes to senior health promotion.5.4 public advertising - brochuresAdvertising in public newspapers and in distributed brochures introducing specific courses are normal ways of launching senior courses and an option to create public awareness and invitations to A Better Preparation for senior life.The effect will probably be limited and might not create interest among a huge number of seniors.We did it in the BEPRESEL project – in Aarhus, Denmark. We made an advertisement in 1 side full scale (a2) in a weekly distributed newspaper. The newspaper is free and are distributed to all addresses in the northern part of Aarhus, unless people actively have made the choice not to receive it.This northern part of Aarhus has a number of senior citizens of approximately 95.000 people and the overall seniors count 14,3% of all 330.000 inhabitants in the municipality of Aarhus = approximately 6.300 seniors 65+ in the northern area. The advertise was published for 3 weeks from the first course day on the 13th of marts 2019 and the following 3 Wednesdays.There was an immediately response shortly after the newspaper were handed out. During day one, we received 24 requests from seniors for participation and during the following days we reached a total of 35 registrations.It is less than 0,5% of 6.300 potential customers and participants.To prepare and motivate senior citizens in the town and municipality of Skanderborg, we wrote an article to the local weekly newspaper distributed to all addresses for free. The day after the article was published 3 weeks from the start of the courses, and the day after the article was published:we placed 50 A4 folded brochures at the House of Culture in Skanderborg. It is a central place and many seniors come to the House of Culture for different activities. The course was presented at the homepage of the local evening schools, AOF Skanderborg-Odder The article had some basic information about ageing and the course was described. In the article there was a reference to the homepage of AOF Skanderborg – Odder, where visitors could find more information and sign up.The reaction was the same. During the first hours after people had received the newspaper the first 18 registrations arrived and at the end 22.Skanderborg has approximately 11.125 senior citizen. Meaning that 0,2 % of potential 10.000 reached seniors reacted to an article public in a household distributed free newspaper and the placement of 50 brochures.CONCLUSION:Even though the launching of this free educational offer regarding Senior Health Promotion, took place in the very middle of the traditional spring season of annual senior activities. It means that many seniors had applied and signed for the different activities they would like to participate back in Nov/Dec.Many seniors are very active and “occupied”. Many are involved in volunteering work.Even paying attention to these 2 excuses the response result of 0,5% in Aarhus North and 0,2% in Skanderborg of all potential senior customers, can`t be characterized as overwhelming.We believe that the very limited numbers of reaction by public advertisement, fit the outcome of the pilot survey based on questionaries’ and interviews of 4 x 21 people in the four partner countries, at the beginning of the project. The meeting with these seniors also allowed us to tell these seniors, that a course in Senior Health promotion of 12 to 16 lessons would be developed and offered to seniors. Asking them very directly if it was an offer they would consider signing up for and take part in, the overwhelming answers was “No”“I don`t think so”.This negative response was very similar to what other seniors answered when the partners occasionally described the course to come and asked other senior citizens about their motivation to join a course like this. Asking why they did not want to sign up and participate, the reasons were variations of the same;“No I don`t need to – I know what I need to know about ageing”“I am in the middle of the ageing process – so I know what it is about”“what would the purpose be – nothing can change – it will turn out the way it will”We think it is important statements, containing important messages and lessons to learn from, for potential operators and future providers of senior health courses. There is a need of increasing the basic knowledge and understanding of the ageing process among people in general and particularly among senior citizens, but there is also a barrier to overcome.It is difficult to sell something to a target group, when the target group doesn’t think it needs or will benefit from it.It will require a long-term effort to build up this awareness among seniors. To a commercial provider it is enough to reach and motivate a small percentage of this huge target group, to make a sustainable business. In that sense it is of course of interest, that 95% of the participants who took part in the test courses expressed, now knowing what they gained from the course themselves, that they would recommend the course to others. A little math shows, that if they recommend the courses to 3 others on average, the 35 participants will quickly raise to a number of interests for a commercial provider. 35 x 3 = 105 seniors = 4 courses105 x 3 = 315 seniors = 12 courses315 x 3 = 945 seniors = 36 coursesWe believe the mouth-to-mouth method and the peer-to-peer contact and recommendation will be essential and important to spread awareness. However, we also believe that recruitment by this method will have a limit of maximum 10 – 15% of all potential senior customers and participants.10 % is of course of interest to a commercial operator and provider of courses. In an area of 60.000 people and approximately 11.000 seniors, it is 1.100 potential senior learners. In an area of approximately 60.000 people it can be expected that every year another 1,15% or 700 people will turn 65.10% of 700 newly retired people = 70 potential learners or 2 to 3 courses.A potential future provider should pay attention to the challenge that occur advertising in public. The cost of advertising must be calculated in the total cost of a course(s). Looking back on the part of this document focusing on senior’s willingness to pay and knowing the cost of advertising, the extra cost for advertising can easily be the cost that raise the fee to the level few seniors are willing to pay. The impact of public advertising can of course be limited by launching more course periods at the same time. That courses are launched at the same time as most other offers targeting senior citizens.The participants in Denmark were asked to comment and evaluate the advertisement that had caught their interest and they made an important comment. “We should pay less attention to what we offer in this course and put more attention on explaining the benefits of the course. We believe it is an important feedback for reflection on how to formulate a text in advertising material. The challenge is that a provider of senior health course, can’t promise a long and healthy life.The 10% will probably mostly be the seniors who already have interest in senior health conditions, who have already understood the message of active ageing. To a commercial provider the profile of learners is of course of minor importance. But to an End Payer of later required care of seniors, these 10% or more might not be the group of most interest. The most interesting group is the 30% of seniors, who will trigger the overwhelming need of care later. Perhaps up to 60 or 70% of the care provided. This group will probably not react on public advertised courses. It requires other and more innovative and direct contacts to build up their trust and motivation to take part in senior health courses.5.5 placing brochures.To motivate senior citizens in the town and municipality of Skanderborg, we wrote an article to the local weekly newspaper and afterward we placed 50 A4 folded brochures at the House of Culture in Skanderborg. It is a central place where many seniors come for different activities.The placement of the brochures took place the day after the article was published in the household weekly distributed newspaper. The article had some basic information about ageing and the course was described. In the article there was a reference to the homepage of AOF Skanderborg – Odder, were visitors could find more information and sign up for the course.The reaction was more or less the same. During the first hours after people had received the newspaper the first 18 registrations arrived and at the end a total of 20.Skanderborg has approximately 60.000 and approximately 10.000 to 12.000 senior citizen. It means that 0,2 % of the potential 10.000 seniors reacted to an article public in a household distributed free newspaper and the placement of 50 brochures.CONCLUSION:This negative response was very similar to what other seniors answered when the partners occasionally described the course to come and asked other senior citizens about their motivation to join a course like this. Asking why they did not want to sign up and participate, the reasons were variations of the same;“No I don`t need to – I know what I need to know about ageing”“I am in the middle of the ageing process – so I know what it is about”“what would the purpose be – nothing can change – it will turn out the way it will”We think it is important statements, containing important messages and lessons to learn from, for potential operators and future providers of senior health courses. There is a need of increasing the basic knowledge and understanding of the ageing process among people in general and particularly among senior citizens, but there is also a barrier to overcome.It is difficult to sell something to a target group, when the target group doesn’t think it needs or will benefit from it.It will require a long-term effort to build up this awareness among seniors. 5.6 Go for relatives We know from socio economic studies that there is inequality in health. This inequality also applies when it comes to senior citizens requirement of home care and institutional care. Seniors of low education and income are overrepresented in the group of seniors, who ends up in a life situation where they lose their independent living and become dependent on care.From a cost benefit point of view the most important group of seniors might also be the group who are the most difficult to reach and motivate to participate in senior health courses.This group might be characterized by;Low willingness to pay for senior health courses.Very limited interest and motivation for “education”.Probably no experience of taking part in education. Low self-expectations to their learning ability.Low positive expectations regarding change of their life situation and their own influence to change.The higher the age – the stronger 1,2, 3 & 4 becomesMales are in general more difficult to reach.Elder immigrants are overrepresented, when it comes to health risk and losing their physical competences.This group are expectedly the biggest group, but also the most interesting group to End Payers such as municipalities and insurance companies.If End Payers of care want to reach out for this group, the fee of courses has to be limited to an absolute minimum. As we have verified earlier it will from a cost benefit point of view be a good investment to offer the courses for free.It is very difficult to bring in new information to this group and to convince them that it matters. GO FOR THE RELATIVESChildren and grandchildren will like to keep their parents or grandparents for as long as possible and keep them in the best physical and mental state as possible.Having this in mind, We could go for both the child(ren) and the parent(s) to the child as a relevant target group, at the same time. Children age 60 to 70 and parent(s) at age 80+Children at age 55 to 60 and parent 75+In other cases, it will probably be A child age 25-40 and parents age 60+orA grandchild age 20 to 35 and grandparents of 75+ By innovating and implementing this approach, we believe it is possible to the operator/provider of senior health courses to establish and create partners inside the families, when it comes to motivating the seniors difficult to reach.Many seniors will normally like to do something with their children, grandchildren or great-grandchildren.Potential strong positive effects of reaching out for the relatives and create a joint venture between 2 family members and have 2 close related learners could be:A better benefit and learning outcome to the final beneficiaries.The presented perspectives and practical suggestions for maintaining the physical and mentally competences later in life, could be a subject for conversations and discussions in the families.That the young and the old ones starts to do something physical together. It is often a challenge to many seniors in families to find wishes for Christmas and birthday presents. Launch A Better Preparation for the Years to Come as the perfect l birthday/Christmas present for the elderly of the families, as a gift card.It could be a relevant gift for both the family members to hand over and to the receiver of a present. A present, which hopefully will secure more birthdays and Christmas as an active and independent family member.We believe there is potential in launching this gift as “the present above all presents” to senior family members in local areas. Beyond the 3 positive effect already mentioned It will provide an option for a better price for the courses.Level of costs for gifts are probably very different from country to country and from family to family. In Denmark as an example, we expect a fee at a level of 100 euro to 150 euro per course of 16 lessons and 16 to 24 seniors per class. It will provide a turnover at a level of 1.600/2.400 euro having 16 learners and 2.400 euro to 3.600 euros per course having 24 learners per class.Even the highest calculated fee in the previous calculation of 150 euros is not unusual for a present in Denmark.It could be a gift card with a special text to be handed over from spouse to spouse.It could be a gift cared with a special text to be handed over from children to parents.2 children paying 75 euro each = 150 euroA gift card with a special text to be handed over from grandchildren to grandparents.10 family members (grandchildren paying 15 euros each is a low contribution to most when it comes to presents for family members.)A gift card to be handed over from friends to friends.5 friends paying 30 euros = 150 euro and a normal limit to many for a present in DenmarkIt can be launched as an opportunity for only the receiver of the present.We suggest that an operator/provider let the gift card cover 2 people.It will motivate many seniors to do a course activity together with a younger family member. The most important part of this special present will probably be the pleasure of doing it with a grandchild.Having co family learners will reduce the number of senior learners per class. The reduced income by this effect must be adjusted in the final cost. Going for a joint venture, involving younger family will require some reflections about time. When are younger family members free to follow the senior family member? It could be: Late evening (after normal school time) 16.00 – 20.00 x 4 days, including joint dinners (part of cost)Week course 8+8 hours inclusive joint lunch & opportunity to speak about nutrition. We think it will make it easier to many families if different younger family members can follow the senior family member at split coursesAn initiative like this could also be a joint venture between a private commercial operator and the End payer of the required care later in life. The model could be supported economically by the End Payer to limit the cost of a gift card. Look up 1 or 2 sponsors, who can brand themselves by supporting courses like this, is also an opportunity to consider. How to launch the idea.Make a press announcement.Write a small article for the local newspaper presenting the idea.Make an advertisement presenting the ideaPlace brochures at relevant places such asPharmacies, GPs, gift shops (including a fee to the shop owner).Posters at youth educational institutions.5.7 Go for the companiesThis model of making the course into “a present” could also be introduced to companies as a part of the companies last presents to employees retiring.We will suggest potential operators/providers to make a survey as either a small questionnaire or even better to invite yourself for a talk with the key people at local and regional companies. Before setting up these meetings high quality material presenting the challenges occur in senior life and the potential outcome for the individual senior (employee) has to be produced.Basic content of this material can easily be found in the BEPRESEL educational materials.The level of presents to resigning employees are of course different from company to company and from country to country. Most companies in Denmark will not consider a present at a cost level of 150 euros as much too much as a supplementary present to a long time employed and loyal staff member.It is important to point out to the companies the CSR perspective of offering this kind of present to their staff member at the end of a long working life.Step 1: Make the material to be presented.Step 2: Identify the 5 to 10 biggest companies in the local area. If you go for individual meetings start with the one you believe the most in. That way you can use it as a reference in future meetings. Step 3: Make an invitation for an introduction meeting.Step 4: Inform about the perspective.5.8 Go for the children and youthIf others change their view of us,we slowly change our view of ourselvesOn a longer term we suggest that public authorities establish“A new common understanding and storytelling about the ageing period.”We have to ask our self why the majority of children and young people, when they are ask to describe “the ageing process”.“an old person”.in many cases still describe a person characterized by myths and wrong assumptions. Many children will use a cane if they pretend to be “an old person” even though it is hard to find a person younger than 80 using a cane. Many will imitate a person who can`t remember well, even though it is a minority who face this challenge and so on.We must ask what the impact of this mindset and understanding among the surroundings means to all of us and particularly to the senior group. Does it develop a negative or a positive expectation regarding the years to come? It could be considered by municipalities, primary schools and youth educations to develop a plan for a thematic course of perhaps one day or half day focusing on ageing.Children and young people are in general good ambassadors, when it comes to bringing in new knowledge and understandings into families. They will probably also be able to bring in a new understanding and approach to how families understand and encourages their elderly members.The purpose of thematic days could be to discuss with pupils and youth;How do we think about being old?What do we connect with the fact that we are going to become old?Why do we think the way we do about elderly people and the ageing process? Why does elderly think the way they do?Presenting and discussions of facts – adapted to the different age group.Presenting, discussion and mutual reflection on behalf of good physical health based on stories/examples.It could be a home task – To provide children with some of the scientific material and ask them to go home and explain the scientific results to their parents. To make a questionnaire with a certain number of right and wrong statements. Ask the pupils to go home and solve the questionnaire together with their parents and/or grandparentsBring back the family result and make a statistic on the class’ result, and hand over this result to their grandparents for a continuing conversation. Were we right or wrong and why?That the children should go home and make an interview with their grandparents, about their physical activity level in a week. Come back and make a statistic /result on the class/more classes at same grade. Bring the result to their parents and grandparents for further conversation. All these suggestions and subjects can easily be adapted to different age groups. To secure the quality of thematic days and to overcome the challenge that we can’t be sure that all teachers have an “updated” approach and understanding of ageing, it should be considered;to develop a general material and concept provided by an external educator coming to the school. 691089128881A person connected to the project has been told that a competition has been established with his children and grandchildren. Everyone must report on a minimum of 2 physical activities, that have made them exhausted every week. It must be physical activities that the person believes builds up or maintains physical strength and competences. 00A person connected to the project has been told that a competition has been established with his children and grandchildren. Everyone must report on a minimum of 2 physical activities, that have made them exhausted every week. It must be physical activities that the person believes builds up or maintains physical strength and competences. It is good for everyone in the family – as physical activities are missing in most families and it raise awareness and will slowly implement a new understanding of how to maintain and develop physical competences. It becomes a subject of conversation.5.9 Immigrant seniorsSenior immigrants are generally in a vulnerable socio-economic situation and their willingness to pay for this kind of educational is believed to be a challenge. The awareness and knowledge about the importance of preventive measures in senior life are in general not at the same level as seniors in general.The family bonds are very strong in many immigrant families and younger family members have a huge affection for the elderly in the families. We believe the reflections we have presented about “going for the relatives” may be the key to entering this senior citizen group.Another option to reach immigrant seniors is to join and cooperate with their local associations. Most immigrant groups have local associations and clubs. Many associations will have the ability and probably willingness to pay their senior members to enter a senior health course, if they are well informed about the perspectives. The Danish BEPRESEL partners made such a cooperation with the Turkish Cultural Association in Aarhus and planned and performed a 3 hours introduction program to the BEPRESEL course at the Turkish Cultural Centre. The experience was that there were an interest and people show up. 20 males and 7 females took part in this 3-hour introduction and responded that they found the information very interesting. After asking the group if they would want to participate in such informative sessions, more participants responded “yes, but it can`t be during the summer because we are not here, but during the winter we are bored”. But it was also made clear to the educator, that their willingness to pay for such kind of “unknown activity” was non-existent.Two things became clear during this test-presentation.The standard material made by the BEPRESEL project needs to be adapted to this target group. Some of these seniors have a very short educational background (some only a few years in primary school in their homeland – some are basically illiterate) which means thatPresenting statistics to them the normal way won’t work. The transfer of knowledge and information does not take place automatically, in the same way it does with most seniors. Many are not trained to look at power points and models. The illustrated stories work better.At the test program we used interpreters. It is an option, but it is not the best solution. Many of the immigrant seniors do not understand, in this case Danish, even after years in Denmark. They especially don’t understand Danish when the content is about unfamiliar issues. Using interpreters slows down the presentations. We believe the best solution is to identify an ethnical health educated person, who speaks the senior learners’ mother tongue.If we hope that the senior immigrants will participate in the courses, we have another reason to establish an initiative with a local cultural center or religious institution. Many immigrant seniors will never use established training facilities in the local area. If the ambition is to persuade these immigrants to take better care of themselves, it will have to take place in physical facilities well known to them, supported by people they know. 5.10 Tv programWe believe it could be central to some stakeholders and authorities to persuade a national or local television station to produce a senior program.A program targeting senior citizens will potentially have a target group of up to 20% of the population.A program containing Features showing what seniors are doing on daily basis – including interviews with seniors.Features interviewing well known people of interest.Features interviewing what unknown people do of special interest.Features visiting and showing different activity offers for seniors – interviewing participants.And particularly Features where facts about ageing in all aspects are presented, discussed and given perspective.Features where myths are presented, discussed and eliminated.Features where different physical aspects are explained and activities to maintain or develop physical competences are presented.Features where different mental aspects are explained and activities to maintain or develop mental competences are presented.Looking at different tv programs there are several programs targeting youth. Why are there not the same number of programs targeting seniors? Is it because those who make programs are younger people?The effect will be bigger if programs are made on exiting channels. However, it is easy and not that expensive to make online television. It is possible for stakeholders, regional authorities, municipalities and insurance companies to build up their own network. Alternatively, it could be a volunteer senior group activity in the local area.who is the teacher?6.1 Profile of educatorsThe most natural educator is a health educated person. A health educated teacher will make it possible to start offering senior health educational program including ongoing tests every 4 to 8 months immediately. Using a health educated person will guarantee that the competences to implement courses and tests. Choosing a health educated person can be more expensive which might impact the final fee to be paid by the seniors. We think it is important to pay attention to the well-documented Peer to Peer effect. It is more persuasive and creates a greater effect to the senior learners if the educator has an age, which allows the educator to talk about “we” when presenting, rather than a young teacher telling the old people what to do. The dilemma is that aa senior health-educated person probably will have a higher salary. If the price is the most important factor when aiming to reach as many as possible, it could also be an option to start a cooperation with local or regional health educational institutions. It could be organized either as an integrated part of their own education and development of competences (than it could be offered more or less for free), or it could be organized as a student job for health students. Student jobs are often on hourly-based payment and at a lower salary, than the salary of graduated health professionals. This model will provide cheaper courses and at the same time be good training for the students. It could be an option to identify and use retired health educated people. They will have the age required for the Peer to Peer effect and will often be on hourly-based payment. Hourly payment will reduce the costs of a course. To retired health educated people it could be an option to earn a little and many retired people like to use their competences. As a part of implementing the BEPRESEL course different models were used. Some of the BEPRESEL partners identified seniors of interest to become educators. Most of them were not educated in health. These seniors were trained to perform either one or more modules and the belonging tests. It has been successful establishing a group of seniors to perform the courses together as a team. It makes it possible and easier for more seniors to become educators, when they only need to focus on few modules.To prepare the educators and to secure the needed quality of the Senior Health courses, the BEPRESEL project have developed A Curricula for the Senior Health Course A Curricula for the Facilitators of the Senior health courses. -40320914138800 KA204-2017-012 Project partners:SOSUAARHUS AARHUS SOCIAL AND HEALTH CARE COLLEGE (AARHUS -DENAMARK)UNIWERSYTET JAGIELLONSKI (KRAKOW - POLAND)UNIVERSIT? DELLE LIBERET? DEL FVG (UDINE – ITALY)LJUDSKA UNIVERZA PTUJ (PTUJ – SLOVENIA)AOF SKANDERBORG AFTENSKOLE (SKANDERBORG – DENMARK)This project has been funded with support from the European Commission. This publication [communication] re?ects the views only of the author, and the Commission cannot be held responsible for any use which may be made of the information contained therein.Appendix The materials are distributed on 7 modules in the form of PowerPoints with related guides. 28054301524000Module 1: Intro 1 + teacher guidanceIntro 2 + teacher guidanceModule 2: Fitness and stamina + teacher guidance.3961459133600Module 3: Muscle strength in the grip and arms + teacher guidanceModule 4: Muscle strength in the back muscles of the thigh and the legs in general + teacher guidanceModule 5:Balance + teacher guidanceModule 6: Blood pressure + teacher guidanceModule 7: Diet, BMI, fat percentage and hip dimensions + teacher guidance43154601460500Interactive senior health profiles. The profile can be handed out to the seniors. A calorie counter. A protein counter. ................
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