Supporting the Health and Wellbeing of our Ageing Population

Capitalizing on our experience and science-based insights to replicate a successful approach to a public health challenge and take it a step further!

1. The Best Frailty Care Program

The world's population is ageing rapidly. Between 2015 and 2050, the proportion of the world's population over 60 will double from about 12% to 22%, according to the WHO (1).

In order to make sure our societies and #healthcare systems are prepared for this tremendous shift and to support the health and wellbeing of our fast-ageing population, national and local health policies are starting to focus on effective strategies to promote healthy aging and independent living.

In 2017, Danone Ecosystem 🌍 , in coalition with VeiligheidNL , Nutricia , ONVZ , and Purpose, co-created the Best Frailty Care program (called TOM in the Netherlands) to promote healthy aging and independent living.

The Best Frailty Care program is a holistic, 4-month long community group-based program that integrates 3 pillars: nutrition, physical activities, and social interactions.

Nutritionists use group lunches as an opportunity to educate participants on #healthy eating and drinking habits, and touch on the other pillars as well.  In addition, participants have access to individual sessions with a dietician, and physical activity sessions in groups supervised by physiotherapists.

At first, the Best Frailty Care project did not consider the #social element to be integral to the project itself.  However, it quickly became evident that including social interactions was crucial to the success of the program. Project organizers observed  that socially isolated individuals often found it challenging to prioritize and fully appreciate a nourishing meal. Thus, incorporating social connections emerged as a significant driver in breaking the cycle of isolation.

This innovative and holistic program has been recognized as an effective and sustainable approach to prevent falls among seniors and thus accompany them as they agein  healthy and independent ways. It is listed as an approved intervention by the Dutch Ministry of Health as a “best practice intervention” in the National Elderly Pact. To date, the program has supported over 8000 beneficiaries, trained over 800 professionals, and has been rolled out in more than seven municipalities in the Netherlands. (2)

Program Insights

• A comprehensive approach combining nutrition, physical and social activities is needed, and the public and private sectors can collaborate to achieve this.
• Healthcare budgets need to evolve and focus on assisting and enabling patients to stay in their own homes.
• A unique program to promote healthy aging by preventing falls needs to be put in place at the national level.

Best Frailty Care Positive Impacts

• 6 months after the program’s conclusion, total falls were cut in half.
• The annual cost to society to maintain one senior in optimal health is 50K€ in the Netherlands; with TOM, the annual cost for society to maintain a senior in optimal health is 16K€.
• The program has positively impacted 8000+ seniors and also helped 800+ healthcare professionals and healthcare system stakeholders understand the importance of preventing falls.

2. Capitalizing on our Experience and Science-based Insights to Design a New Public health program in France

Based on the success of TOM's multi-model approach - including nutrition, physical activities, and social interactions - Danone Ecosystem is capitalizing on the experience and its science-based insights to design a new program in France. The project is being co-built with the NGO Association Siel Bleu and Nutricia France.

The forthcoming program’s goal is to make ageing synonymous with living well, and its eventual success will rely on an adapted approach that responds to local French challenges and contexts:

• By 2030, 2.2 million additional people will be over 75 years old.
• Estimates project that the number of dependent individuals will more than double by 2070, in line with the overall aging of the population.
• Healthcare budgets need to evolve and focus more on prevention, which currently represents less than 3% of the French national health budget.

Putting Older People at the Center

The aim of this new project is to create and make accessible a multimodal prevention pathway – as deployed in the Netherlands - to help preserve autonomy and quality of life for French seniors.

The project aims to innovate by co-developing a program with the beneficiaries, thereby putting older people’s own vision of their health and wellbeing at the center of the project design.

As a first step in codesigning a human-centric project, the coalition did a deep dive into several different studies: the OSSEBO study, Siel Bleu knowledge, Rapport Libault…

Amélie Aubert Plard , a socio-anthropological researcher along with Titouan Bénégui conducted a literature review with the goal of understanding the context of #aging in #France, and to begin to identify the right levers for preserving autonomy and quality of life for French seniors. Plard’s study provided insights to ensure that people remain at the core of a system or program - most importantly thinking for them and with them. The  future program will not built on a priori assumptions, but will be derived from the point of view of the beneficiaries, so as to remain  consistent with their goals, desires and daily practices. 

A major takeaway for initial program design is to  focus on assisting people in making ongoing informed decisions.  A multimodal prevention pathway to help preserve  autonomy and quality of life for French seniors must take an individual approach and not generalize people’s experiences or desires.

Key learnings

Diving deeper into the context surrounding aging in France through a sociological and anthropological lens, we find:

Aging is not a status. Aging is often associated with retirement or poor health, whereas the elderly consider aging to be a process.

1. There area diversity of perceptions and experiences associated with the aging process.
2. It is key to avoid  negative generalizations and to adopt an evolutionary and localized approach.
3. The primary concern for aging individuals is their quality of life. What is important to understand:

(a) The connections individuals nurture, the environments they inhabit, and the activities they participate in. (b) The constraints and resources at their disposal. (c) The decisions they either make or abstain from making.

4. Consider ageing people as full-fledged citizens with rights and duties. Acknowledging their role as active and useful members of society remains a major social challenge.[ML1] 

The global literature review has also shown that “autonomy” is not only limited to living independently at home, as commonly thought. It involves the ability to make one’s own choices and live one’s preferred life. This realization led us to develop a program that is selected by and for the beneficiaries.

A 3-Phase Approach

Drawing from valuable insights gathered through various studies and investigations, our project partners have crafted a comprehensive approach divided into three distinct phases.

Each phase is designed to ensure that the future project is collaboratively developed, professionally supported, and widely disseminated to make a lasting impact on preventive healthcare.

PHASE 1: The first phase, sets the stage for this transformative journey. To begin, we have launched an initial study  to evaluate the future program’s feasibility  by actively involving and considering the contributions of the individuals who are the key focus of the program. With this phase, we aim to achieve the following objectives:

• Gain a deeper understanding of our target audience(s).
• Explore the expectations and motivations related to preventive healthcare.
• Identify the priority groups  and lay the foundation for the project's pilot approach.

PHASE 2: Building upon the foundations laid in the first phase, the second phase – as it is imagined to date – will serve as a bridge, connecting the insights gained from the initial study to actionable plans and implementation of two pilots. The two pilot formats involve over 100 beneficiaries.

• One format includes a 5-day group-based program, followed by individual monthly follow-ups for 6 months
• The other format involves a 6-month support program with 2 hours of in-person sessions per week. This format can be attended through collective or individual sessions to be able to reach isolated individuals.

After the completion of the two pilot programs, an #impact assessment will be conducted to determine the success factors and effectiveness of the program. This assessment will evaluate the social usefulness and behavioral changes experienced by the program beneficiaries.. Based on the findings, the programs may be adjusted as necessary before moving on to Phase 3, which involves a large-scale deployment.

PHASE 3: Finally, the third phase – as it is imagined to date – should focus on scaling up the approach and disseminating the knowledge gained to a wider audience.

As we embark on this journey, we recognize the significance of actively involving the very individuals who will benefit , from  inception to  implementation.

The project coalition will share new insights and updates when possible, so stay tuned!

Sources:

1. World Health Organization (2021) - Step safely: strategies for preventing and managing falls across the life-course
2. Ministère chargé de l’autonomie (2022) -  https://sante.gouv.fr/IMG/pdf/dp_plan-antichute-accessible28-02-2022.pdf