Academic Chronicle/Synopsis
Intergenerational Tele-Mentoring®
Socio-Sanitary Benefits
Marie-Madeleine Bernard, Mathias Fruhwirth
Dedications
Ghislaine Alajouanine,
This Academic Notebook is dedicated to Ghislaine Alajouanine, President
and Founder of the Academy of Telemedicine and e-Health, President of
the French High Council for Tele-health.
Indeed, thanks to the visionary inspiration of Ghislaine Alajouanine,
"Madame Telemedicine", who invites us to create this Academic Notebook
on the Intergenerational Tele-mentoring, we can now illustrate the stages
of our journey and struggled, which, for thirty years has joined and
complete his. To the slogan "The carer-patient relationship can be done
remotely" we add "the young-elder relationship can be enriched remotely". It is the keystone of the
health of our populations and of Aging Well.
Anne Stora,
We express our deepest gratitude to Anne Stora, Honorary President of,
PACE2000.FR, who, through her donation, enabled us to develop the basis
of a new version of the Intergenerational Tele-Mentoring® on online
browser.
Martin Buysschaert
Our praise and deep gratitude go to Martin Buysschaert, Professor
(Emeritus) of Internal Medicine and Endocrino-diabetology at the Catholic
University of Louvain (UCL) Brusselsand President of the journal Louvain
Médical. Thanks to his expertise, his assiduous participation in our many
discussions and his writing, we have produced this Cahier Académique.
To our beloved grandchildren, Maxime, Coline, Alexandre and Pearl.
May you carry and transmit the intergenerational flame wherever you feel it is needed.
Table of Contents
Summary ...............................................................................................................................................4
Introduction : Médecine Conventionnelle et Apports de la Télémédecine........................................10
Intergenerational, common thread of Tele-Mentoring......................................................................13
Mandat et objectifs de la Fondation Internationale PACE 2000.........................................................15
4.1. Inspiration ................................................................................................................................15
4.2. First PACE 2000 intergenerational tele-sessions from 1994-1995 ..........................................20
4.3. Basis of technological co-design ..............................................................................................22
Synopsis of the technological journey 1996-2020 ..............................................................................23
connected by ISDN (Integrated Services Digital Network) telephone lines........................................24
Goniometer patent ®...........................................................................................................................26
Canada and INPI-France patents)........................................................................................................28
6.1. PART 1 : INTERGENERATIONAL TELE-MENTORING ™ “2D”.................................................31
Videoconference Goniometer.............................................................................................................43
6.3. THIRD PART: The Intergenerational Tele-Mentoring® “4D” ....................................................56
General Conclusions............................................................................................................................70
Awards and recognition awarded to the PACE2000.org Foundation .................................................72
Main peer reviewed publications........................................................................................................74
Contributions and Acknowledgments.................................................................................................75
Members of the Executive Board of the PACE 2000 International Foundation .................................75
A meeting of the PACE 2000 Foundation, July 30, 2021......................................................76
The PACE 2000 Team and Collaborators..............................................................................77
Main Sponsors and Partners:...............................................................................................78
Special events PACE 2000 1998 ..........................................................................................79
AUTHORS' BIOGRAPHIES.....................................................................................................................82
Preface
Pr (ém.) M. Buysschaert
Faculté de Médecine et des Sciences de la Santé, Université catholique de Louvain (UCL), Brussels
As a doctor I cannot but be impressed by the journey described by M.M. Bernard and M. Fruhwirth in this
Cahier Académique. Their primary objective, from the outset, was the development of an "intergenerational
Tele-mentoring" program. Initially the trigger for their project was the observation by M.M. Bernard, in a
residential retirement “village” in the United States, of the societal benefit of “encounters” in the field,
between youth and the elderly.
The authors of the Cahier, as pioneers, will revisit this concept by developing a program in Canada that will
gradually lead them to set up a virtual structure (versus face-to-face) adapted to this “youth-senior”
interrelation. It is based on the pair model – bringing two partners from different generations into contact –
with the aim of not only reducing geographic isolation but, on the contrary, actively bringing people together.
At a time of loneliness and the fragility of certain strata of our society, this Tele-Mentoring project is
appealing due to its human dimension. How to be in phase, in particular in the context of "aging well", with
this meeting between of "two generations" (trainer-trained) which brings together and enriches each of the
partners, and go beyond the video screen which separates them... ? That said, the intentions of this work is
also to favour empathy, which should not be erased by technology and the remarkable advances of
technologies in recent years. In this context, it seems to me that the human proximity approach proposed by
the authors meets the requirement of this prerequisite. Thus, a form of personalized communication - of
connections forged - between young and old, able-bodied and less able-bodied, immigrants and native
Canadians, ultimately results in getting to know each other better, sharing ideas and projects with them and,
last but not least, stimulating learning, beyond social economic differences. With dividends for everyone.
And then, in parallel, there is this evolution towards tele-medicine and medical tele-consultation which, in
2022, concerns us all, caregivers and patients.
This Cahier describes in an exhaustive and concise manner, based on a range of results, the various
achievements of M.M. Bernard MD and Mr. Fruhwirth BS-Eng in the vast field of Tele-Mentoring that they
have developed and adapted throughout their journey. We wholeheartedly wish good luck to this opus
combining technological progress and altruism.
Pr (ém.) M. Buysschaert
Faculté de Médecine et des Sciences de la Santé,
Université catholique de Louvain (UCL), 1200 Bruxelles
1. Summary
Guided by the global importance of intergenerational;
• human interactions,
• mutual support ,
• by the aging of populations and
• by the need to push the limits of local
intergenerational exchanges, already weakened in our
segmented urban societies and often confined to
Le Petit Prince se sent isolé
geographical isolation, we have made our way from 1994 to use
Information and Communication Technologies and…
produce innovations with societal impact that promote
links between generations and “Aging Well”.
It was therefore important to reduce the deleterious and
costly consequences of isolation on the health of our
populations, that they be confined in socio-professional,
cultural and generational silos, particularly in nursing
homes, and to contribute to the construction of a
intergenerational structure beyond borders, for societal peace.
Certainly the benefits of the
Inter-generational Residential Village, Mari de Villa, St Louis, USA,
founded by Mr. J and Mrs. G Linneman,
had convinced us very early of the impact of these face-to-face, fortuitous
or regular intergenerational contacts. However, where traditional means
of communication and exchange were no longer sufficient, we had to
resort to innovative means that were likely
to generate empathy for the benefit of
each generation, beyond ethnocultural
and geographical limits. First of all, it was a
question of convincing people of the
necessity and the value of relations
between seniors and youth, and this
before the era of the internet and social
networks.
We needed to resort to innovative means that could generate empathy for the
benefit of each generation, beyond ethnocultural and geographical limits.
So, at that time it was via radio (U. of Ottawa) and TV (Rogers) which,
through the weekly talk-show broadcasts of the " Inter-generational Salon
PACE2000", that we prepared the minds of the Ottawa-
Carleton Region, Ontario, Canada citizens and their
mayors (Marion Dewar, Jacquelin Holzman and Jim
Watson).
Thus, little by little, the questions common posed by senior sceptics of
"How could I be useful to a young person?" and youthful sceptics of “What
can I to do with an Elder…?” have gradually given way, throughout our
“technological journey”, to radically different testimonies in the follow-up
surveys on the use of the Tele-Mentoring™ including the following:
Bill Cleghorn (Senior):
“I made a friend in exactly eight hours!
But it didn't happen in a day, but an hour at a time, over
eight weeks...”
Léah Gunnell (Student):
“What I discovered is wonderful, an elder who is even more
active than me, with whom I learned a lot and who became
my friend”
Nathalie Mesnic (Student):
“I love this program. It’s rewarding and it seems to me that
many young people and seniors could benefit from this
experience.
It was a wonderful experience that made my summer ten
times more attractive!
...Never give up on this program!”.
Among our participants, it was these very persons who, had initially
doubted the value of these connections, who then supported the
Intergenerational programs and contributed to the co-design of the
Intergenerational Tele-Mentoring® software applications, group and
personal mode videoconferencing PACE-2-Face, including the option of the
VideoConference Based Goniometer, VCBG, [a human limb, post-surgery,
range of motion measurement tool] useful for encouraging motivation for
physical exercise and “Aging Well”.
To achieve our objectives, we have gradually deployed and then
evaluated four stages of technological innovation:
1. The development of the "2D" [image & voice] Intergenerational Tele-
Mentoring™ made the sessions accessible at home to isolated
people, or in groups in long-term care centres (retirement centres),
in schools and colleges, preschool day-care
centres and at the Catholic accommodation
Centre for immigrants. The first was to
ensure the feasibility of various cultural
exchange programs, learning and youth-
elder partnerships through tele-presence
and intergenerational coordination.
2. Then came the promotion of “Aging Well” through tele-monitoring
at home, tele-physiotherapy and telemetry of joint play, thanks to the
“2D” Intergenerational Tele-Mentoring equipped with the VCBG.
Once the chair-exercise programs were adapted to the needs of
patients and codified by the physiotherapy department of the Perley
and Rideau Centre, (long-term care retirement centre). the
enthusiasm for these tele-sessions was
such that participation increased year
after year. year and that it was
sometimes necessary to move to larger
premises (this was particularly the case of
the Champlain reception Centre (long-
term care retirement centre).
3. From 2002, the Internet had become more generally available and
allowed for videoconferencing connections to be made using Internet
protocol, IP as opposed to the digital telephone, ISDN lines. This
facilitated the deployment of connections at low costs, replacing the
expensive lines, which were provided free of charge by Bell Canada
as a goodwill gesture, which PACE 2000 gratefully acknowledged.
4. With the transition from "2D" to our development of the "4D";
Intergenerational Tele-Mentoring app [image, voice, shared reading,
and writing] the inter-relational horizon had widened: we had
proposed this "4D" technology to which we added as an addition to
the "face to face" 2D, the possibility of sharing
a document on the screen that the two
members of the pair could each modify as they
wished. These results enriched the bilateral
learning with the inclusion trainer-trained pair
generated empathy and as an enhancement of
the conditions of practice in a medical office.
Nevertheless, it was important to identify the human resources required
and to develop the know-how for the organization and coordination of
programs necessary for the success of the sharing between volunteer
candidates, with "professional profiles".
different", without geographic or socio-medical
limits, with the ultimate objective of taming
partners - able-bodied and less able-bodied,
young and old, immigrants and native,
"I can't play with you, I'm
overcoming "loneliness" and promoting changes
not tamed,” said the fox
in behaviours, with its advantages in terms of human relations.
It was these tele-exchanges of "trainer-trained pairs", where, in a
context that everyone controls, that empathy appears, active listening,
understanding, appreciation of the participants and self-confidence,
which when applied to tele-medicine/consultation programs expanded
the limits of traditional medical consultation and therapeutic education,
by defining quality criteria for a technological interface, qualities that
can be responsible for our observations of transformations in human
relations.
In total, it is an extensive panorama of innovative and rewarding
programs, including financially rewarding, that came into being thanks
to the use of the Intergenerational Tele-mentoring in the educational,
professional, linguistic and, not least, medical fields, including
teleconsultation, therapeutic tele-education and tele-monitoring of the
care pathway.
In the recent context of increased needs for human intergenerational
relationships, these needs are multiple: these are the phenomenon of
aging populations and the limits of the placement of the elderly in nursing
homes (reference Frances TV2 Emission Cash Investigation program, aired 01/03/2022),
pandemics of Covid 19, global warming and wars which present themselves
as dangers of migration and
societal divisions. In particular,
many
reception
and
integration problems are to be
expected in countries that are
poorly prepared for these waves of immigrants in the loss of cultural and
psycho-socio-sanitary integration. To the young person who has the dream
of an easy migration to an Eldorado, why not offer him the “4D”
Intergenerational Tele-Mentoring® with a senior as a sponsor, who has
become his “tele-mentor”?
The latter will become aware of the needs
of "his protege" for a priority loco-
regional solution and could thus avoid the
reckless risks of a long migration.
Fortunately, the baby boom of the years
1946-1948 provided a fine reservoir of
senior candidates and volunteers!
It is therefore necessary to provide for these young and elder candidates
appropriate coordination and planning, which our governments must
encourage, because the testimonies are significant, such as that of Donald
Lavergne, volunteer elder and assiduous telementor: "Do not say that the
Tele-Mentoring ™ is only for seniors who are isolated. What interested me,
I who am very active, is to be able to help young people. This program is
remarkable”.
“Don't say Tele-Mentoring™ is only for seniors who are isolated. What interested
me, I who am very active, is to be able to help young people. This program is
remarkable”.
In this multifactorial context of promoting listening and empathy, and
guided by the transformational successes of the Intergenerational Tele-
MentoringTM, we continue to ask national and international authorities to
build and manage intergenerational tele-presence structures across the
different ethnocultural environments.
2. Introduction : Conventional Medicine and the Contributions of Tele-
medicine
The unique "doctor-patient" relationship occupies an
essential place in our medical practice. This means, in its
first acceptance, a bilateral and protected relationship, of
trust, between the practitioner and “his” patient. It is the
meeting of “a confidence and a conscience”, or, better, of a
“competence, a confidence and a conscience”. In other
words, this humanistic approach, as opposed to a
hierarchical and paternalistic medical approach, leads the
clinician and his patient to become allies – partners – in the
treatment and monitoring of the disease.
of medicine, going beyond its remarkable progress, in particular technological, and
beyond societal mutations and evolutions. It also implies, as already mentioned in Kos
Greece by Hippocrates in 420 BC, that the patient is not a passive subject but that he
must be an active actor, who cooperates, in his own right, with the doctor to combat
the (his) disease. This was also the point of view in France of masters like L. Portes (1891-
1950).
Such
a
personalized
–
individualized
–
approach to the patient is now part of the
treatment algorithms for many pathologies,
particularly chronic ones. Thus, by way of
example, the American and European Diabetes
This implies that…the patient is not a
passive subject but that he must be an
active actor, who cooperates, in his own
right, with the doctor to fight the (his)
disease.
Societies
strongly
indicate
in
their
recommendations that a prerequisite for
lifestyle and dietary and/or medicinal
treatments is a close "partnership" between
the doctor and his patient. diabetic. It is
together that they will discuss the most
suitable therapeutic approach for the patient,
in a context of health education, integrating a
range of shared information. This type of
Hippocrates of Kos
“contract” is also an effective weapon in terms of long-term adherence and compliance – and therefore
treatment success (reference).
In this spirit, the basic medical act remains the face-to-face consultation. This
meeting is based on a rigorous clinical approach that allows progress towards an
accurate diagnosis and appropriate treatment. The space of privileged
"caregiver-care receiver" time, remarkably described by G. Alajouanine in the
first Cahier de l'Académie Francophone de Télémédecine et e-Santé (ref) first
includes a patients detailed anamnesis report during which, after having has the
personal history (and possibly family) specified, the practitioner collects and
compiles all the symptoms of his patient. It
is a time of listening - and of exchange -
essential because it makes it possible to
Listening and exchanging words are
delimit the perimeter of the medical
problem in all its details to identify,
gradually, the essential aspects.
therefore a first step which, in many cases,
already makes it possible to evoke the
diagnosis.
Listening and exchanging words are
therefore a first step which, in many cases,
already makes it possible to evoke the
diagnosis. The richness of this "dialogue" is underpinned by the caregiver's empathy, as Alajouanine
mentions. This empathy of the caregiver is essential to anchor the relationship that is created between the
caregiver and the one who becomes "his"
patient.
After the interview, the practitioner
performs a complete clinical examination,
guided by data from the anamnesis. Then
come, on the basis of medical reasoning, the
This empathy of the caregiver is essential
to anchor the relationship that is created
diagnostic hypotheses which will lead,
between the caregiver and the one who
becomes "his" patient.
rationally,
to
targeted
additional
examinations, based on the most efficient
technologies. This ultimately leads to the
correct diagnosis and the initiation of treatment. All of this consultation, face-to-face, is therefore done
within the framework of a personalized dialogue, leading, at the end of the "meeting", to a sharing of words
explaining to the patient the diagnosis and the "why and how" of the treatment and possible follow-up, as
remarkably mentioned in 2010 by G. Reach in his book “Une Théorie du Soin. Concern and Love in the face of
illness”.
This sequential approach remains the common thread of any consultation, whatever the type.
However, it was not until the COVID-19 pandemic that this "ideal"
model, which was already coming up against certain limits
including remoteness, medical desertification, deficiencies in the
supply of care, financial constraints and the lack of time…, can be
modified… in innovative technological aspects, by following
quality criteria which also guarantee this privileged relationship
“carer-patient”. This was the result of our work since 1994.
Telemedicine, as a whole, and its various applications such as Tele-
Mentoring™, have become an alternative that has gradually established itself
in the medical care landscape. However, it does not aim to erase the
traditional approach, but to complement it. Telemedicine is defined by the
World Health Organizatoion, WHO as "the part of medicine which uses the
transmission by telecommunication of medical information, with a view to
obtaining a diagnosis, a specialized opinion, continuous monitoring of a
patient, a decision therapy”. Snoswell et al, in 2021, demonstrated, on the
basis of 38 meta-analyses, in ten medical specialties, that the effectiveness of
telemedicine was equivalent to a traditional medical approach . This was also Tchero's finding in a cohort of
diabetic subjects, including elderly patients . Tilden et al, in June 2021, in the journal Diabetes Care, also
reported in type 1 diabetics (insulin-dependent) that the transition from a face-to-face consultation to a
teleconsultation was not, in a majority of case, a brake on the quality of monitoring.
Recently, the COVID-19 crisis, which has shaken the world, has confirmed the interest of this new medical-
technological approach. The number of teleconsultations in France (CNAM figures) was in February 2020
before the pandemic 40,000. It exploded to more than 4 million acts in April 2020, with 56,000 teleconsultant
practitioners (vs 3,000 in February…)! We are therefore facing a growing success of this original telemedicine
concept and its applications, as Bokelo pointed out in 2020.
The Hippocratic spirit must be fully integrated into this new form of medicine...if medical excellence is to
be aimed for. Telemedicine, whatever its
application, without this empathy which makes
the richness of traditional medicine, does not
meet its primary objective. Personalized care
therefore retains a dominant place. This is what
It is the soul of telemedicine which
involves empathy through questioning,
listening, and exchange
Alajouanine strongly emphasizes in her Cahier:
“to be equivalent to face-to-face consultation, it
goes without saying that teleconsultation
requires the same prerequisites of excellence.
Getting into familiar the pathology of the other person is what makes telemedicine human. Each practitioner,
behind his computer screen, must do as he or she usually does in classic consultation. It is the soul of
telemedicine which includes empathy through questioning, listening, and exchange: these occupy a place of
choice – inseparable from the success of each telemedicine application. This is also the point of view of Lalau
and Klopp-Delaunay, in 2018 in their article entitled “Empathy and telemedicine”. Technological progress
also allows in 2021 a remote “clinical examination”, as reported in neurology by Al Hussona (ref) or in tele-
echography by Alajouanine. In short, there is an inexorable evolution underway, success of which today will
amplify tomorrow. Certainly, there are potentially obstacles to success. The lines of force obstacles and the
pitfalls of telemedicine have been described by Alajouanine in her Cahier "The caregiver-patient relationship
(RSS) and telemedicine".
The "Tele-Mentorin" in its various forms is part
of this vast landscape of telemedicine
"Tele-Mentoring" in its various forms is part of this vast landscape of
telemedicine of which it is an important variant. It is clearly a fundamental societal and socially oriented
application. The “doctor-patient” pair can be substituted in by a singular intergenerational approach, “a
“trainer – trained” pair. The trainer, whether he or she is in good health or has a disability/frailty, is the
expert: he or she sometimes has an educational role, like the doctor, sometimes a role of an Elder, the bearer
of collective memory ; the person trained has more of a “student” (patient) role. It is the trainees who will
benefit in their environment, from a
distance, from the skills of hi or her elder
"mentor", in different fields, always with
the same common denominator of singular
maintenance - and empathy. .
Thus our innovative technological journey
was dominated by the search for an
optimization of the human relationship and
In this context, the purpose of our
notebook is to describe in an exhaustive
better intergenerational accessibility.
way our experience in these applications of
Tele-Mentoring™ that we have developed,
as pioneers, since 1996.
The result of this original “intergenerational” approach by Tele-Mentoring has led to our PACE-2-Face™ tool
developed in Canada, in collaboration with hundreds of users.
We propose to first review the concept of intergenerational, common thread
of Tele-Mentoring™, then to define the mandates and objectives of PACE 2000.
We will then describe the historical evolution of PACE 2000 with its innovations
and technological progress which lead to an increasingly efficient
"intergenerational" model, and finally, we will analyse its various "clinical-
social" applications, as well as the evaluations of the participants. Whether in
face-to-face medicine or telemedicine in the broadest sense, empathy, as
already said, is a prerequisite, and will be a common thread throughout this journey.
Empathy will contribute to the richness of this Tele-mentoring and to its objectives of socio-sanitary benefits
in the service of older and/or vulnerable people.
3. Intergenerational, common thread of Tele-Mentoring
Whether in face-to-face medicine or
telemedicine in the broadest sense,
empathy, as already said, is a
prerequisite, and will be a common
thread throughout this journey.
Our era is experiencing a demographic revolution where the coexistence
of four generations will become the norm. It is likely that we have to go
back more than 30,000 years to see such a significant change in longevity,
which led to the appearance of the first grandparents. Palaeolithic
societies with crude technologies transformed into an era of
sophistication in the arts and weapons of combat during the Upper
Palaeolithic (Caspari et Lee, 2004).
Currently we may have the
opportunity to promote and amplify
intergenerational exchanges, within
the framework of this coexistence of
this isolation is now considered a risk factor for
mortality, equal to or greater than the risks
represented by a sedentary lifestyle and obesity
four
generations.
We
must
nevertheless note that in many cases
in our urban and even rural regions,
this intergenerational fabric is
weakened, which inevitably means a risk of isolation, of which the elderly in particular at risk.
Our modern society does not always take into account a “young-old”
social bond. For example, many spaces are built where people meet
without interacting (shopping Centres, large hotel chains, etc.). This is
also the case of the “placements” of seniors in Retirement centres (long-
term care centres), in which isolation and separation from the younger
generations contribute to aggravating their dependence.
However, non-isolation is the essential foundation for the harmonious
societal development of populations. The rich social bond is thus an essential component of “aging well”.
Long relegated outside the conventional borders of medicine, this isolation is now considered a risk factor
for mortality, equal to or greater than the risks represented by a sedentary lifestyle and obesity. On the other
hand, being integrated into a social network, participating in a project and contributing significantly to it
on a human level, are precious factors of longevity.
This observation of isolation with its consequences arises is also seen with chronic diseases (CD), which
moreover affect up to 60% of seniors aged 75 and over (General health insurance plan 2010). They are the
major concern of managers of health insurance agencies. The isolation of these patients, added to the
consequences of the chronic disease, can contribute to increasing their discomfort and their morbidity and
mortality. In this context, it will be necessary to control all these factors of isolation and anxiety experienced
by these people at risk is a priori a new approach that can limit isolation and lead to better self-management
of the chronic disease by the patient.
This was the first objective of our intergenerational
projects. The use of these Information and
Communication Technologies, ICTs, is an approach
that also allows remote coordination of the care plan
in which both the patient and the caregivers are
Promote, even “prescribe” human
relations through tele-twinning and
appropriate programs, thanks to
Information and Communication
Technologies (ICT),
directly involved. It is then a grouped approach
which is a test of a multifactorial solution by a
technological standard in the face of the potential
difficulties of communication between young people
and seniors, between patients and caregivers.
4. Mandate and Objectives of PACE 2000 International Foundation
Created in Canada in 1991, the PACE 2000 International Foundation has been a non-profit
organization since July 7, 1992 and a registered Canadian charity since January 1, 1993 (Reg.
#892857962 RR 0001). It gave rise to the creation in France of the PACE2000.FR association on
February 1, 2017 (W751238024).
Considering that the isolation of individuals is a source of increased morbidity and mortality rates,
the PACE 2000 International Foundation [PACE2000.org and PACE2000.fr]
Programs for
Autonomy and
Communication for the
Elderly,
has had the mandate since its creation in 1991, to promote new relationship-oriented solutions, including
social and physical activities, between youth and seniors, thus promoting their physical and mental health. It
has therefore developed innovative tools for urbanization and virtual communities’ thanks in particular to
new communication technologies.
The promotion of regular interactions between these two social, strata, in particular young and old, able-
bodied and less able-bodied, aims to transform their lives and enrich the heritage, including the cultural
heritage, of each generation.
They also promote the integration youth in their community of, and allow seniors, even if they are confined
to their homes, to live more independently and be useful to the younger populations.
PACE 2000 has developed a know-how and a friendly network of Intergenerational Telecommunications
at home, adapted to the handicap, in the recreational, cultural, linguistic, educational fields as well as in
telemedicine and health promotion.
As part of a pilot project, these are:
• Promote communication and links between young and old.
• Offer the choice of shared projects
• Discover the other and establish a different relationship
• Continue to learn about various topics
• Feeding on differences
4.1.
Inspiration
PACE 2000 has developed know-how and a friendly network of
Intergenerational telecommunications at home, adapted to the handicap, in
the recreational, cultural, linguistic, educational fields as well as in
4.1.1.
Le Dr M-M Bernard, à Saint Louis, MO, USA
Dr. M-M Bernard, winner of an NCWC (National
Catholic Welfare Conference) scholarship, lived,
as an "exchange-student" (1965-1966 program) in
the Residential Village Mari de Villa, St Louis, MO,
founded by Joseph and Georgina Linnemann.
G. Linneman
J. Linneman
She was impressed and inspired by the intergenerational meeting
programs already in place between the young people who were
housed there and the senior residents, she observed, among other things, that through the practice of a few
daily tasks for the senior, through time and exchanges of words, in particular during the daily distribution of
meals by the young person, and also by singing and dancing at gala events... that the students gradually
became an "ally" of the seniors, and gradually form a supportive pair with the senior.
The PACE 2000 logo was inspired by the Gateway
Arch of the city of Saint Louis, Missouri USA
Programs of intergenerational meetings already set up between the young
people who were housed there and the senior residents, she observes,
among other things, that by practicing a few daily tasks for the elder, by
listening and exchanging words,
4.1.2.
First intergenerational plan by neighbourhood residential structure
Dr M-M Bernard took the initiative, in view of this original program and its success in St Louis, USA, to better
standardize intergenerational mutual aid and to found a residential structure in Canada, the
Intergenerational Residential Village.
To achieve these objectives, PACE 2000 had set-up seven executive committees:
1. Intergenerational,
2. Integrated services
3. Marketing
5. Design,
6. Development,
7. Evaluation,
4. 4. Board Committees,
PACE 2000 had prepared the design of this Inter-generational Residential Village with architect B. Hobin on
the land to be granted for this project by the Daughters of Wisdom religious community, and which had been
selected for funding by the Ontario Government.
Appartements pour les jeunes et espaces de
rassemblement communautaires
Logements individuels pour aînés
4.1.3.
Thus on January 5, 1995, Pierre Jury, of the newspaper Le Droit, published:
“This dream, today has a name "PACE2000", which evokes by its Latin root, the word "peace". A non-profit
company, PACE 2000 proposes the construction of a housing project qualified as “intergenerational”.
The development brings together three buildings or groups of buildings: a hundred townhouses…which will
be sold to seniors, a building with 140 units at low rent, and a community Centre including day-care, medical
clinic, restaurant, etc…
Young adults benefiting from subsidized housing in this complex will be people in training and will have to
cooperate in various tasks, such as helping the seniors…
Young helping hands can help keep seniors home much longer.
Doing so results in huge savings in health care costs… Dr. Bernard argues that the real problem for seniors is
the “three I's”.
Isolation, Insecurity and Uselessness”.
"At full maturity”, writes Pierre Jury, “the dream that has become a project will have cost $33M and will cover
an area of 15 acres...".
However, this dream, conceived with Jean Nouvel and Barry Hobin, will not take place, at least not in 1995,
because the change of Ontario Government, from socio-democrat "New Democratic Party" to Conservative
party, will lead to the cancellation of this intergenerational housing project.”
The seven PACE2000 executive committees voted unanimously for the
continuation of the intergenerational dream which would then be mediated
by Information and Communication Technologies (ICT).
4.1.4.
It was an intergenerational challenge launched in the hope of a major change:
The seven PACE 2000 executive committees voted unanimously for the continuity of the intergenerational
dream which would then be mediated by Information and Communication Technologies (ICT):
It was a question of replacing the initial project of Intergenerational Residential Village with an
Intergenerational Tele-presence Village, de novo, which generates these links by another approach. In fact,
it was a two-fold challenge:
1. on the one hand, to convince the authorities and young and old populations of the benefits of
restoring intergenerational relations where they had been impoverished in generational silos,
2. and on the other hand explore and develop technologies that are ergonomic, user-friendly, intuitive
to use, adapted to handicaps, and at low cost.
Where the daily meetings between young people and seniors of the Residential Village, ad hoc or
programmed, lavished their benefits, the role fell to technologies to be able to convey these links...
This figure illustrates an example of geographic separation in Ottawa between seniors who live in the centre
of the city and young people on the outskirts.
To "convince" influencers of the socio-sanitary benefits of intergenerational ties, it was first the weekly
programs of the "PACE 2000 Intergenerational Salon " broadcast on radio (U. of Ottawa) and on television
(TV Rogers) that prepared minds of the Region of Ottawa-Carleton, ON, Canada, as well as the policies of the
mayors (Marion Dewar, Jacquelin Holzman and Jim Watson). Here are some of the topics covered by the
Salon PACE 2000 televised broadcasts:
•
•
•
•
Assembly of First Nations
Links between students and veterans
Back to school at any age
•
•
•
•
Medicines for Seniors
Sexuality
Space Exploration by Seniors and Youth
Wildlife sightings
Intergenerational housing
Images from
Salon PACE 2000
Television programs
4.2.
First PACE 2000 intergenerational tele-sessions from 1994-1995
4.2.1.
First approach: commercial videoconferencing digital phone lines and services ISDN
First, there was the use of existing videoconferencing (VC) services hosted and sponsored by Bell Canada,
which also required the presence of technical staff and often a dedicated location. The VC connection
between two groups of participants was at the time based on the digital telephone system, and known as
ISDN [Integrated Services Digital Network].
This system allowed point-to-point communication using telephone lines. Increased image quality was
achieved by increasing the number of telephone lines used. This expensive technology was provided free of
charge by Bell Canada to PACE 2000 for all the centres involved:
•
•
•
including the cost of installation,
telephone lines and digital adapters
as well as long distance charges for each line used.
These fees, however did not allow wide dissemination of low-cost videoconferencing sessions.
In addition, users were forced to use cumbersome hardware and
standard interfaces designed by carriers or VC terminal
manufacturers. These interfaces were not suitable for the use of
the elderly and often required the assistance of technical staff to
guarantee the launch of the videoconference sessions.
Photo by Christina Morillo from Pexels
These interfaces were not suitable for the use of the elderly and often
required the assistance of technical staff to guarantee the launch of the
videoconference sessions.
4.2.2.
First PACE 2000 Forum at Ottawa City Hall - August 1996
To persevere our intergenerational
approach, we organized at Ottawa-
Canada City Hall in August 1996, the
First PACE 2000 Forum on advanced
technologies for young people and
seniors at Ottawa City Hall. The 360
older and younger participants,
The First PACE2000 Advanced Technology
Forum for Youth and Seniors at Ottawa City Hall
formed into intergenerational pairs upon their arrival, had thus, through their answers to the questionnaires,
guided our development of simple applications adapted to the handicaps, and made it possible to define a
design of innovative PACE 2000 interfaces so that they better meet the needs of young and older users.
Guest speakers and experts
attendees
at the forum
Seniors and Youth Forum
Thanks to the results obtained, we were able to define quality criteria for particular relationships in Tele-
Mentoring™. These exceeded our expectations and resulted in some successes that a conventional face-
to-face relationship, in some cases, could not achieve.
4.3.
Development Based on Technological Co-design
The challenge was therefore to develop with the input the elderly and young people, and to make available
to
them,
means
of
by
telecommunication
videoconference accessible
to all, able-bodied or less
able-bodied people, by
PACE 2000 has decided to adapt existing
videoconferencing to enable individual Telementorin
for elderly people in institutions and at home.
offering
them
simple,
standardized and low-cost
tools, which at the time did not yet exist.
PACE 2000 had decided to adapt existing videoconferencing to enable individual Tele-Mentoring™ for seniors
in institutions and at home.
Following previous research and experiments, two PACE 2000 projects were selected and funded by the
Ontario Ministry of Energy, Science & Technology in 1998: The Intergenerational Virtual Village (IVV)
“The Intergenerational Virtual Village
for social well-being” titled “IGTN#1*”,
and
"The Intergenerational
Telecommunications Network for home
medical support", titled “IGTN#2”.
The launch of these two projects formed the basis of the Intergenerational Virtual Village (IVV) and
required the following innovation stages:
*IGTN = Intergenerational Telecommunications Network
5. Synopsis of the technological journey 1996-2020
Mathias Fruhwirth, Xuemei Wang, Karim Guillaume Ouechni and Elisabeth Baumelou
We offer the reader a summary in four steps of technological innovations of PACE 2000 (Tele-
Mentoring Intergenerational® "2D, Visio-Conference Based Goniometer® - VCBG®, 4D"), which
follow the birth of the PACE 2000 International Foundation in 1992 in Ottawa, Canada .
•
•
•
•
INNOVATION 1: Intergenerational-2D Tele-Mentoring on H/W equipment adapted and
connected by ISDN telephone lines (Integrated Services Digital Network)
INNOVATION 2: The Intergenerational-2D Tele-Mentoring with the Visioconference®
Goniometer patent (OPIC-Canada and INPI-France patents)
INNOVATION 3: the Intergenerational-2D Tele-Mentoring accessible by Internet protocol
(IP)
INNOVATION 4: The Patent of Tele-Mentoring Intergenerational®-4D, PACE-2-Face™, (OPIC-
Canada and INPI-France patents)
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4 4 4
Chronological evolution of PACE 2000’s Intergenerational Tele-Mentoring®
5.1.
INNOVATION 1 : The Intergenerational-2D Tele-Mentoring on hardware
adapted and connected by ISDN (Integrated Services Digital Network) telephone
lines
The first objective was to offer a visual and auditory connection (i.e. "2D"),
accessible to all, able-bodied and less able-bodied people, alone or in
groups. (There was not yet the addition of bilateral reading and editing
capabilities of shared documents, resulting in "4D"). From the observations
collected during the PACE 2000 Forum on advanced technologies of August
1996, PACE 2000 was able to adapt existing videoconferencing technologies
(a VCON videoconferencing H/W module based in Israel)
The first objective was to offer a visual and auditory
connection (i.e. "2D"), accessible to all, able-bodied
and less able-bodied people, alone or in groups.
and realize a simplified equipment of Tele-Mentoring-2D which included:
•
An innovative mini-device on a personal computer (Desktop
PC) that accepted both ISDN and Ethernet signal input
•
A single simplified display screen, from the domestic television,
thus avoiding the purchase of a screen
•
•
•
Sound routed to TV speakers
A webcam with integrated microphone,
A pointing device, large format half-globe, which adapts to
arthritic hands and can be placed on the knees.
The development of the user-friendly display interface adapted
to the needs of seniors was carried out using the Software
Development Kit SDK -VCON. We've removed all
unnecessary user options, in favour of simplified, user-friendly
communication options in a [large text] format. Access to a few
commands is projected in large characters on the user's
television screen.
This ISDN technology does not use a data logging server.
Users are only connected to the international telephone network by a telephone number.
Thus, thanks to its simple and user-friendly access, the Intergenerational-2D Tele-Mentoring was used in
residences for the elderly, long-term care Centres and schools.
The intrusion of technologies became minimal and no longer required technical assistance in situ, the
largest component being the television, already used in places of residence…
5.2.
INNOVATION 2 : The Tele-Mentoring Intergenerational-2D with the
VideoConference Based Goniometer, VCBG, patented ®
At the end of 1998, following the customization of videoconferencing for the elderly and young, PACE 2000
equipped the Tele-Mentoring-2D with a means of telemetry of joint play, the Automated Videoconference
Based Goniometer® (VCBG).
It facilitates tele-monitoring and rehabilitation at home from the hospital or the place of exercise of the
health professional, after surgery or simply to motivate seniors to practice regular physical exercises. These
goniometric telemetries also avoid trips to the hospital or clinic, so that the measurements are carried out
manually using the Universal Goniometer.
5.2.1.
4.2.1.1 The equipment includes two modes:
1 Hospital mode for healthcare professionals, who use the PACE 2000
developed software on their PCs:
•
•
•
It automatically telemeters the joint angle once the patient's recognition
points have been identified on the screen by the healthcare professional.
It provides local storage of data, tabulation of measurement history and
production of joint articulation evolution graphs.
These operations are all performed in secure local mode.
2 The Personal mode Tele-Mentoring-2D,
Tele-goniometry, VCBG®, associated with a user-friendly intergenerational telecommunications tool, Tele-
Mentoring-2D, was also an opportunity for young trainees to carry out telemetry in complete safety from
images already captured or stored in a data, followed by subsequent checks by medical personnel. The links
between young trainees and seniors thus developed could sometimes be extended into sessions of
intercultural intergenerational teaching with the same patients.
The links between young trainees and elders thus developed could sometimes
be extended into intercultural intergenerational Tele-mentoring sessions with
the same patients.
This equipment was regularly used by the members of the Intergenerational Virtual Village, in particular the
elderly with no computer experience, or those with a loss of autonomy, or even those with arthritis or other
disabilities. Le Goniomètre automatisé de visioconférence®, VCBG, obtained a patent in France and in
Canada.
5.3.
INNOVATION 3: the Intergenerational-2D Tele-Mentoring by Internet-IP
Protocol
From 2002, the Internet had become more and more accessible and allowed the realization of connections
by Internet protocol (IP).
All the stations in the Centres and residences
of the Intergenerational Virtual Village were
gradually adapted to receive Telementoring-
It is then through a digital network that the data now passes, without requiring dedicated and expensive
telephone lines from the ISDN network.
Thus, any connection number using
the IP protocol can be made at no
additional cost and henceforth
without resorting to a sponsor.
The speed of the IP protocol connection, called bandwidth, was initially a factor limiting
the quality of calls from Tele-Mentoring-2D. For example, a desired connection with the
First Nations of the Canadian North from the Ottawa General Hospital was not achievable
in those times.
However after 2003, primarily in large cities, high-speed Internet connections became
more common, guaranteeing better stability of tele-sessions.
5.4.
INNOVATION 4: The Intergenerational Tele-Mentoring ®4D PACE-2-Face™
Patents (OPIC-Canada and INPI-France patents)
Until 2003, intergenerational connections and exchanges were practiced in two "2D" dimensions, which
included the verbal and the visual (non-verbal). The partners are “face to face”.
It is thanks to the technological progress guided by the opinions of hundreds of young and old users, who
tested the design of the new software, that we developed the new concept of 4D communication (patented):
The Intergenerational Tele-Mentoring ® “4D” allows simultaneously:
1. to see and see each other, as in 2D,
2. in front of the same document,
3. to share it and to be able to modify it,
4. while observing the signals verbal and non-verbal of their partner,
This innovation laid the foundations for tele-consultation and therapeutic tele-
education, as an alternative to add to the benefits of a face-to-face consultation.
The PACE-2-Face™ Tele-mentoring logo
It has the following main features:
•
A point-to-point connection strategy by personalized design for the intergenerational pair
It ensures the simplicity and security of videoconferencing and promotes one-on-one dialogue, as
opposed to "multi-point" open to multiple users.
•
Large buttons to launch features:
Always visible without hidden menu items, with simplified
presentation according to the activated phase, accessible to the
visually impaired and limited to simple commands
•
•
[Local and remote] images of participants placed side by
side, of identical size, sometimes occupying more than 50% of
the screen, sometimes the size of two icons to leave the
remaining field to the sharing document [symmetry], by simple
"toggle" in one click on the field of the two images
Either participant can alternately select, share and edit
documents from their computer, including websites
o To do this, on their reciprocal station, they have the
same document search process (identical screen,
images and buttons) and the same operating
choices.
o
Shared documents are renewed in an identical way
in their form, size, characters, content and mode of
renewal for each partner [synchronization]
•
The participants appearing simultaneously on the two
respective icons, these can guide the exploration and
editing of the document by their verbal and non-verbal
language
• In addition, PACE 2000 has developed software tools for
session authentication and scheduling calendars to administer
its programs.
Essentially the PACE-2-Face™ “4D” software allows the local user and the
remote user to share the same experience and observe each other at the
same time, as if they were sitting beside each other sharing a single PC
display monitor.
Each can annotate and edit the same document while observing verbal,
non-verbal, or written cues from their partner.
This program optimizes the establishment of a bilateral and protected relationship, in trust. It is intended for
the trainer-trained pair, for a time of listening - and exchange - essential to any learning, whether in an
educational environment where pedagogy takes precedence, or for a privileged time "carer-treated", where
the empathy becomes a priority thanks to the use of this innovative four-dimensional “4D” communication
process.
These specificities give the IntergenerationalTelementoring-4D a “bio-medico-psycho-social” dimension.
During this long process of co-design/co-construction, PACE 2000 had to adapt Microsoft's legacy
"NetMeeting" SDK, and adapt the interface to allow use by the elderly, in institutions or at home, and by
those who are not fully computer literate. PACE 2000 called this new application PACE-2-Face ™ which
allowed in 2004 the launch of the programs of Tele-Mentoring Intergenerational collaborative, entirely in 4
PACE 2000 called this new application PACE-2-Face which allowed in 2004
the launch of the collaborative, Intergenerational Telementoring programs
entirely in 4 dimensions [4D: joint video, audio, reading, and writing].
dimensions. During this long process of co-design/co-construction, PACE 2000 had to adapt Microsoft's
"NetMeeting" SDK, and adapt the interface to allow use by the elderly, in institutions or at home, and by
those who are not fully computer literate. PACE 2000 called this new application PACE-2-Face ™ which
allowed in 2004 the launch of the collaborative Intergenerational TeleMentoring programs, entirely in 4
dimensions, [4D: 1-video, 2-audio, 3-reading, and 4-writing].
The Intergenerational-4D Tele-Mentoring® with shared exploration of documents for people with disabilities
has become a patent in France and Canada. Since 2020, Anne Stora's donation in 2021 has made it possible
to create a new "base" of the Intergenerational Tele-Mentoring® PACE-2-Face™
PACE 2000 Since 2020, Anne Stora's donation has made it possible to create a
new "base" of the Intergenerational Telementoring PACE-2-Fac
“Proof of Concept, POC” for a
lightweight browser-based version,
which does not require any
downloading to user devices.
Partners on an equal footing
Secure screen and
Co-editing of text
6. IMPLEMENTATIONS OF THESE INNOVATIONS AND EVALUATIONS (see
synopsis §5)
Initiated in 1994-1996 from Ottawa, Canada, the PACE 2000 Intergenerational Tele-Mentoring® project has
gradually made it possible to offer intergenerational approaches according to methods that have evolved as
technological innovations have been made, ensuring bilateral connections, trusted and protected, as
indicated in this synopsis of the technology journey.
We propose to describe in more detail the main clinical--social applications, first from the “2D” protocol,
then in “4D”
6.1.
PART 1 : INTERGENERATIONAL TELE-MENTORING ™ “2D”
TECHNOLOGIES: refer to chapter #5.1.1
Method The module runs automatically as soon as the computer is turned on. The
local image then appears, and the hardware is ready for connection. The image of
the remote speaker appears on the screen as soon as one or other of the speakers
has established the connection by clicking on the recipient's identifier. The pointing
device used is not a conventional mouse but a half-globe that adapts to arthritic
hands and can be placed on the knees.
Access to a few commands is projected in large characters onto the user's television screen.
Since 1998 it has been used in the various
Centres of the PACE 2000
Intergenerational Virtual Village in the
Ottawa-Carleton Region, in family
Access to a few commands is projected in
large characters onto the user's television
screen.
lounges
playrooms
and
in
long-term care
centres, in particular at the Centre d'accueil Champlain (160 senior residents) and
the Perley & Rideau Veterans' Health Centre (450 senior residents), the Catholic
Centre Reception House for Immigrants, Fisher Park Summit/Alt School and
Almonte High School. This module is also installed in the private living rooms of the
elderly. The server used for this application was used to only establish connections and did not store any
personal data.
6.1.1.
PROGRAM ORGANIZATION
The Intergenerational Tele-Mentoring™ "2D" programs require the following prerequisites:
Each program requires prior planning and meetings with the directors of each Centre, then the installation
of the Inter-PACE 2000 equipment and the Integrated Services Digital Network (ISDN) or Internet Protocol
(IP) line connection.
•
Each program requires prior planning and meetings with the directors of each Centre, then the installation
of the Inter-PACE 2000 equipment and the ISDN or IP line connection.
In agreement with the respective
centres, PACE 2000 collaborates with the
centres/partners to choose the profile of
the participants, their recruitment, the
planning and choice of activity themes,
the calendar and the conduct of the tele-
sessions.
•
Training of Intergenerational Coordinators
Each group session requires one to two “intergenerational coordinators” IC.
Their role is in particular to prepare/invite the seniors and young
people/immigrants to the sessions and to facilitate the exchanges during
these. These are recruited among university
and college students (Engineering, Art and
communication, psychology, journalism,
social sciences, gerontology, legal studies,
leisure
sciences,
physiotherapy,
occupational therapy, etc.). Their status is
that of trainee in validation for their respective institution. At the end of their
internship, they can be recruited for new projects.
In contrast to conventional social projects, we often observe a preponderance of male
candidates, probably due to their attraction to the adventure of our technology-human relations.
A training session is given to them by tele-
presence with Seniors who are already
experienced in the practice of IG Tele-
Mentoring. They then receive a “kit” to help
with the conduct of these tele-sessions and
the choice of content (games, stories, songs,
culture in their country of origin and in
Canada).
Other seniors do not need an IG coordinator
and organize Intergenerational tele-sessions
themselves from their homes, with young
people who have already taken part in group
tele-sessions.
When PACE 2000 had the budget, evaluations
are carried out at the start and end of the
program as well as session reports. In our
experience, the best exchanges by
videoconference are obtained with
a
maximum of twelve participants per session
(one to six on each side).
•
Each exchange by videoconference is
therefore intergenerational and
simultaneously connects two Centres or
places of residence of young people and
seniors. Bringing generations together
involves cultures exchanges in a playful
atmosphere (games, wheel of fortune,
mimes, hanged man, folk songs, drawings,
riddles, etc.). Thanks to this powerful tool,
community centres that had little or no
opportunity to meet can now be connected.
- I'm looking for friends, said the little
prince, what does "taming" mean?
- it's a thing too forgotten, said the fox
"it means
create links… "
6.1.2.
The “Intergenerational istrot” model and its activities
The popular art of living in bistros and cafes constitutes an
intangible cultural heritage in France and elsewhere. It is also
through its missions one of the solutions to isolation and
loneliness. However, access to these places is very often
unrealistic for seniors, particularly those with reduced
mobility, who are confined to their homes. Thus isolated,
deprived of these
contacts, whether they
take place in the bistro,
cafe or in other spaces, these seniors cannot share their life
experiences with the younger generations.
This involves including the most fragile categories of society (subject
to motor deficits, school failures or socio-cultural ruptures) who are at
risk of "desocialization", and inviting them to communicate with a
different generation (Example : Young immigrants or pupils of a school
and residents of retirement centres
We have found that youth (like the fox) are tamed by the eldest (Little Prince) over time, at
best when the tele-sessions are scheduled to take place on the same day of the week, at the
same time, according to the taming process described by A. de Saint-Exup ry….
Youth (like the fox) are tamed by seniors (Little Prince) over time, at best when the tele-
sessions are scheduled to take place on the same day of the week, at the same time,
according to the taming process described by the author A. de Saint-Exupéry
"I can't play with you," said the fox.
"I haven’t been tamed "
“what does being tamed
mean?”
“If you come, for example, at four o'clock
in the afternoon, at three o'clock every
day I will begin to prepare my heart"
The main programs of PACE 2000’s Intergenerational Bistrot indicated in the table below have been
evaluated by the participants and the coordinators. Here we summarize the most outstanding
programs:
•
•
•
Tele-sessions between a preschool day care centre and
seniors in institutions and veterans (Tales, games and
puppets)
Linguistic immersion in French or English for young
immigrants or Canadian students (high school classes).
(1999)
Intercultural exchanges between immigrants and
seniors
•
•
Support for school projects
Cultural exchanges between immigrants and residents
of long-term care centres (folk songs, stories and
games)
•
•
Wheel of Fortune, between Centre d’Accueil Champlain
and Catholique immigration Centre
ocal news and memories of times past (“The League
of the Good Old Pot Bellied Stove”) between a seniors’
club and residents of a long-term care Centre
Thus, thanks to this "Intergenerational Bistrot" model with
innovative technologies developed since 1996, we have been able to
observe the following benefits of the "Intergenerational
Telementoring “ D”:
Thus, thanks to this "Intergenerational Bistrot" model with innovative technologies developed since
1996, we have been able to observe the following benefits of the "Intergenerational Telementoring ® “2D”:
•
It breaks isolation and encourages improvisation and
sharing of experience between two communities of
different generations and origins, and a priori totally
dissociated and distant.
•
It promotes the development of intergenerational
relationships in
a
safe and easily accessible
environment, erasing the constraints of disabilities,
distances and bad weather.
•
It offers the opportunity for free debate, abolishing the
restraints and inhibitions of an intergenerational face-
to-face meeting and allowing the two generations to
listen to each other
•
•
Spontaneous expression of interests and greater open-
mindedness are observed with rapid disappearance of
stereotyped attitudes on both sides
The result is often enriching experiences in the fields of
culture, leisure and health, which are important for
these two generations, and the discovery of differences
between Anglo-Saxon and French-speaking cultures…
•
In the long term, it is a contribution to social autonomy and to the improvement of the vital prognosis
of the patient confined to his accommodation, insofar as isolation is a source of increased morbidity.
These are solid contributions to the prosperity and health of our community
networks.
These are therefore solid contributions to the prosperity and health of our community networks.
6.1.3.
EVA UATI “ D” P AM
6.1.3.1.
Evaluations of Elder-immigrant cultural programs
Evaluations 10/1998 – 5/1999, and2001
Evaluations 10/1998 – 5/1999
Participants of the Intergenerational Bistrot
19 seniors from the Centre d’Accueil Champlain and 35
Immigrants from the Catholic Centre for Immigrants, Ottawa,
Canada.
Results
The majority of immigrants, who were between the ages of
16 and 30, felt they knew nothing of Canadian customs and
culture, and had neither English nor French as their mother
tongue.
They all considered that:
the tele-sessions of the Intergenerational Bistrot helped to
facilitate their adaptation to living in Canada
They kept very good memories (63% of them), and good memories (37% of them). Most immigrants (80%)
felt that a good or very good relationship had developed with Canadian seniors.
For 72% of seniors, most aged 80 to 88, the relationships developed by the screen with immigrants were
good or very good and they want to continue them. Almost all seniors (93%) have good or even very
favourable memories of the program.
Evaluations 2001
The 2001 evaluations of cultural programs for seniors-
migrants corroborate those of previous years: they are the
assessment of Immigrants from the Congo, Sudan,
Afghanistan, Iraq and Rwanda: The majority (55%) had
arrived less than a month and had no contact with
Canadians. Many of them were initially rather suspicious of
the objectives of the PACE 2000 program, despite invitations
from the director of the Catholic Centre for Immigrants to
join
this
program.
Admittedly, these migrants had experienced considerable
difficulties during their previous journeys before
succeeding in immigrating to Canada, which could explain
their initial reluctance. Others, on the contrary, already
felt secure, were grateful for the welcome, and wanted to
get involved as best they could in these tele-exchanges.
The sessions of Tele-Mentoring™ Inter-generations
“ D”
sessions represented for them a first
opportunity of contact with Canadians.
In this context of difficult arrivals for immigrants, nevertheless of
interpretation to be differentiated, the successes of the
Intergenerational Bistrot continue year after year, for
both young and old.
Seniors were immediately interested in the opportunity to contact
young people from their homes.
Evelyn Shore reported :
“Thanks to these weekly exchanges with immigrants,
I travel around the world and discover their
culture”
To these evaluations of the participants, young people and seniors,
were added the appreciations of the intergenerational coordinators
themselves, who made a point of expressing their experiences and
opinions on these intergenerational activities within the framework of
a Declaration published on August 31, 1999 (§ 6.1 .3.3).
6.1.3.2.
School language immersion program
Project Educational Pilot, the PACE 2000 Inter-Generational Telecommunications Network
Liane Meunier, Ovidiu Nastai, Marie-Madeleine Bernard MD Le Journal of IMMERSION Vol 22 N°1
Evaluations in 1999 by middle school students from Almonte District
High School (Teacher: Kelly Stuart) and Seniors from the Centre
Pauline Charron (President Huguette Poulin)
Protocol :
Seventeen students from the same class, aged 14-15, initially
reluctant to interact with Seniors, all responded to the evaluation
questionnaire at the end of the intergenerational tele-mentoring
program.
Results :
Their weekly telementoring sessions with the Seniors were highly appreciated (72 ±12%). They considered
that it was a beneficial form of learning for their practice of French as a second
language (70 ±13%), were able to familiarize themselves with the use of new technologies, and discovered
the advantages of exchanges with people with more experience. The vast majority (14/17) asked to renew
this program, and visited the Seniors of the Centre Pauline Charron for a day of celebrations.
The Seniors did not receive a questionnaire, but reported their evaluations to the teacher after each tele-
session of the Intergenerational "2D" Telementoring they appreciated this unique opportunity to exchange
with young people, while most lived alone and had little relationships with younger generations. They liked
to develop a "comradeship" which also allowed them to “joke around” with them.
The elder-telementors appreciate this opportunity for enriching exchanges, which has changed their
perception of the younger generations whom they do not have the opportunity to meet, because the
majority of them live in isolation.
Following these observations, the seniors proposed to animate several sub-groups of 3 to 4 students, which
replaced the more formal “masterful” tele-session, which previously included the whole class and the
teacher. The students were thus less intimidated to practice French in the absence of their teacher...
The elder-telementors appreciate this opportunity for enriching
exchanges, which has changed their perception of the younger
generations whom they do not have the opportunity to meet,
In total, the benefits were reciprocal for each generation: regression of generational stereotypes, freedom
of debate and discovery of cultural differences between the English-speaking and French-speaking worlds on
topical issues (eg violence of all forms, genetic manipulation, victims' rights, etc.) ), and language learning!
6.1.3.3.
Declaration of PACE 2000 Intergenerational Coordinators
“We, intergenerational coordinators, iane Meunier-Norman, Line Beauséjour, Rebecca Shore, Léon Albert
and Jennifer Campbell, declare that we have lived this beautiful dream:
“ ringing seniors, young people and people from other
countries together in telepresence, with the impression of
being in the same room, and seeing them;
talk, laugh and share their life experiences
in an atmosphere of mutual respect, each listening with an open
heart, a dream come true through the productive efforts of the
PACE 2000 International Foundation”.
Then, mutually “tamed” by their weekly tele-sessions, “the seniors
of the Centre d'accueil Champlain impatiently awaited the arrival
of the immigrants at their Centre at 1:30 p.m. on Friday, May 23,
1999.
Thus prepared by the tele- sessions at
the Intergenerational Bistrot, the
intergenerational dynamic on site was
incredible.
Tony, who arrived in Canada last November from Zaire, considered
contact with seniors a privilege. “In my country, when an elder speaks,
we are silent and we listen carefully because they have great wisdom and
they can guide us through their experience. For my part, I have access to
the precious riches of Canadian seniors and I can learn important things
that only they can teach me.».
Tony from Zaire...
"For my part, I have access to the precious riches of Canadian seniors and I
can learn important things that only they can teach me."
The immigrants, who felt privileged by participation in the tele-sessions,
recognized the seniors as a treasure trove of advice on how to conduct
themselves appropriately in their new country. Also, as Tony said (He has
been on the videoconference sessions since November 1998) “Even
among us immigrants we are learning something from each other
about countries other than anada”.
From the perspective of seniors, they are curious about life in newcomers'
countries of origin and they want to know if the stories they see on television are true. Through their weekly
video conferencing sessions, the seniors felt connected to the community and were offered a window to
other lands and countries that they never imagined possible. Moreover, the immigrants' vague memories of
their country became clearer as they shared stories of their homeland.
Tony, a Zairian youth:
"I have access to the precious wealth of Canadian seniors and I can
learn important things that only they can teach me."
Evelyn Shore :
“We seniors feel connected to our community and can open a
window to other lands and countries that we never imagined
possible.”
As soon as they arrived at the Centre d’accueil Champlain, the immigrants were warmly welcomed by the
seniors. It was then up to the intergenerational coordinators to initiate a discussion on the
different religions...a subject considered "taboo", especially among seniors. The group was made up
of Protestants, Catholics, Muslims and even voodoo followers. For a few seconds, the silence was complete…
Line (an intergenerational coordinator) broke the silence and presented an article found in a newspaper
announcing the “Pilgrimage 2000”, a march through Quebec to bring together people of different religions.
The participants were then invited to share the different aspects of their religious beliefs and practices as
well as their history.
Canadian seniors spoke of the power wielded by priests in the 20th century and the strictness of their laws.
Raphael, originally from Haiti, explained the basics of voodoo, while Tony told the group about his Protestant
faith. Kathy, from a Muslim background, was surprised when one of the seniors announced that she had had
17 children. "By the same man?" Kathy exclaimed. This question made the eldest laugh because she had been
married to the same man all her life. In Kathy's native country, polygamy is accepted and men can have up
to 4 wives.
During this intergenerational and intercultural
exchange, Mr. Bordeleau, a senior storyteller over 80
years old, recited two excellent poems so full of
humour that they triggered laughter in the room.
This unique meeting was a discovery, because it turned out to be
enriching and entertaining.
Nixon from Haiti also recited two interesting poems. The group thanked the two speakers.
These festivities revealed that intergenerational bonds had already been forged
during the group sessions of the Intergenerational Tele-Mentoring®, even before
the participants met face-to-face.
In short, everyone was satisfied with the intergenerational contact established thanks to the weekly tele-
sessions sponsored by PACE 2000 and the intergenerational coordinators”
The table below shows the increase in the number of Tele-Mentoring® sessions over time indirectly reflecting
the success of this model.
6.2.
E D PA T: “ D” Intergenerational Tele-Mentoring equipped with the
Automated Videoconference Goniometer
6.2.1.
ontext for “Ageing Well”
Colloquium “Aging after sixty years”
Professors Emile Etienne Baulieu and Maurice Tubiana, Presidents
Symposium of the Academies of Sciences and Medicine, Institut de France (December 4, 2007)
Prof E.E Baulieu, during this symposium
dedicated to aging, concluded:
“Aging is associated with an
increased risk of isolation, physical
inactivity and disability, factors of
dependence. »
The current demographic explosion of the elderly should encourage
health authorities to:
•
•
•
meet preferences for services and follow-up at home rather than in an institution;
to promote mobility, social activities
volunteering by seniors
In line with these proposals, the use of innovative and user-friendly technology solutions (whose design by
the PACE 2000 Foundation allows their application to telehealth, education, physical exercise, culture and
recreation initiatives), deserve the evaluation of their feasibility and reliability for use away from the elderly
person's home.
Indeed “Aging Well in ealth” is based on a tripod:
1. Mobility,
2. Human relations and
3. Diet education.
It is largely physical exercise that leads to multiple significant positive effects that oppose the aging
phenomena observed in particular on the cardiovascular, respiratory, musculoskeletal systems, with the
prevention of sarcopenia and musculoskeletal aging. , as well as on metabolisms (minerals and carbohydrate-
lipid-protein) and on emotional, social and cognitive quality of life (José Sahel and Yves Agid).
One solution for “aging well” is therefore to practice adapted physical exercises (aerobic exercises, use of
weights, impact exercises, etc.).
Interestingly, most of the physical exercise programs whose benefits have been demonstrated can be
practiced at home, in a secure environment, which lends itself to the use of videoconferencing adapted to
the disability, in connection with another Centre. (§ 6.2.4.2.C).
However, one of the difficulties of "Aging Well" is the need for sustained
motivation for the practice of physical exercise over the long term.
These exercises, in one session weekly (or even three per week), often have a greater impact than drug
treatments against osteopenia and sarcopenia of aging, frequent causes of falls and fractures. Training on
weights weighing 65 to 85% of the maximum that the individual can lift, results in an increase in muscle
strength of 8 to 174% depending on the types of duration and intensity of the programs. The decrease in
falls, secondary to these programs to
increase muscle strength, can reach
50% (Taylor, Cable, Faulkner, Hillsdon,
Narici, Van Der Bij, 2004).
Aerobic exercise sessions have
multiple significant effects on
cardiovascular and respiratory
health. The Fitness, Arthritis, and
Seniors Trial (FAST) study showed that
only a 2-4% improvement in lower
extremity muscle strength and joint
range of motion resulted in an 8-10%
recovery in capacity older adults, such
as walking speed and activities of daily
living.
However, one of the difficulties of "Aging Well" is the need for sustained
motivation for the practice of physical exercise over the long term.
What wonder drug could claim a range of benefits to our organs similar to that of regular physical exercise?
However, one of the difficulties of "Aging Well" is the need for sustained motivation for the practice of
physical exercise over the long term.
Moreover, despite knowledge of the main factors of "Aging Well", currently the health professional in terms
of prevention, cannot have a direct impact on the essential factors of mobility and socialization. It can only
issue recommendations.
The objectives of PACE 2000 are therefore
that the same time, simple and accessible
to people with disabilities or the
uninitiated, makes it possible to practice at
home both Tele-mobility, the relational
link, as well as Tele-consultation, Tele-
Therapeutic education.
The objectives of PACE2000 are therefore that the same device,
simple and accessible to people with disabilities or the uninitiated,
makes it possible to practice at home at the same time:
• Tele-Mobility,
• the relationships link,
• as well as Tele-Consultation, Tele-Therapeutic Education.
6.2.2.
Development plan to achieve the “Ageing Well” objectives
To achieve the objectives of "Aging Well", the PACE 2000
Foundation has drawn up a development plan which integrates
intergenerational participation facilitated by the design of devices
particularly adapted to the elderly and/or those with a disability.
The use of new technologies has thus
made it possible to consider a more
direct impact of health professionals
on "Ageing Well",
in particular for better intergenerational participation and for
monitoring compliance with telesessions thanks to automated
recordings of their beginning and end.
As already mentioned in the chapter on technological development § 5.2.2, this innovative development
plan for the purpose of promoting “Ageing Well” includes the following stages:
•
Offer participation in tele-physiotherapy for each elderly
person from their place of residence:
o
After medical evaluation of their aptitude for the practice
and tele-monitoring of mobility exercises, the participants
connect directly via the "2D" Tele-Mentoring, either to a
group located remotely, or to an individual coach, a young
apprentice initiated previously by the a physiotherapist.
o
o
Enhance these tele-sessions with the participation of a
few young people initiated into the exercises in each
Centre.
Develop means of remote assessment of the beneficial
effects of these activities on joint play, autonomy and
quality of life; test their reliability and reproducibility, and
use them as a means of monitoring and motivating
participants.
Equipped with these innovative measurement methods, we have
described the system (§6.2.3) and the evaluations (6.2.4) of long-
term tele-monitoring programs with tele-evaluations of tele-
physiotherapy sessions.
6.2.3.
Description of the "2D" Intergenerational Tele-Mentoring equipped with the
VideoConference Based Goniometer® “VCBG”
Since 1999, to promote diagnosis, motivation and long-term
mobility follow-up, PACE 2000 has provided a link to a
personalized real-time videoconference (VC) service to
seniors with loss of mobility and confined to their homes, to
offer them the tele-monitoring of their mobility by
rehabilitation Centres, and tele-activities with various
community organizations.
PACE 2000 thus associates the telemetry of joint movement by the VideoConference Based Goniometer®
(VCBG®) with the IntergenerationalTele-Mentoring-2D.
The technology is described in chapter 5.2.2. The telemetry is
automated and listed from the screen prints of the remote
patient who is connected by the Tele-Mentoring-2D. These
data are recorded locally by the professional in a hospital
database, without an internet transfer, which ensures their
security.
Physiotherapists perform telemetry of joint
articulation from their office and provide remote
monitoring of rehabilitation exercises for patients at
home, in particular for those with reduced mobility
secondary to variable conditions (osteoarthritis,
osteoarthritis, trauma, joint prostheses …). The
opportunity of telemetry serves both the professional
who can thus adjust rehabilitation remotely according
to the results and evolution curves of mobility, but
also the patient who finds in it a source of motivation
for the regular practice of exercises. physical.
6.2.4.
Evaluations of Tele-Mentoring programs “ D +VCBG®”
The VCBG® has been the subject of several publications and thesis that we summarize here in healthy
subjects and in the elderly.
6.2.4.1.
In healthy volunteers
A- Study of the reliability of remote measurement of joint mobility in healthy subjects using the
Videoconference Goniometer®
Charlebois R., C t N., O’Rourke M., erville D., McComas ., Fruhwirth M., Bernard M-M., Brosseau L.
Journal of Rehabilitation Outcomes Measurement, 2000, 4(3), 23-33
The aim of this study was to measure the reliability of the Videoconferencing Goniometer® inter and
intra tester, and to examine the convergent validity with the universal goniometer, UG.
Protocol :
The reliability and validity of the VCBG® were tested against the UG. The study was carried out in the
Department of Rehabilitation Sciences, University of Ottawa (Pr. Joan McComas), during active knee
flexion and extension measurements with volunteers in a seated position.
Results :
The study made it possible to determine a highly significant reproducibility for all the telemetry carried
out by each operator (r = 0.988). The intra- and inter-rater reproducibility of the VCBG® is also
significant, particularly for the flexion positions (r = 0.987–0.995), as well as the convergent validity of
the device compared to the UG for these same measurements.
Conclusions :
The study made it possible to determine a highly significant reproducibility for all the telemetry carried
out by each operator (r = 0.988). The intra- and inter-rater reproducibility of the VCBG® is also significant,
particularly for the flexion positions (r = 0.987–0.995), as well as the convergent validity of the device
compared to the UG for these same measurements.
B- Similar conclusions were observed in the evaluation of the range of active
movements of the shoulder
“ Study of inter- and intra-tester Reliability and Convergent Validity of the Tele-Mentoring equipped
with the VisioConferencing Based Goniometer® (VCBG) for telemetry of active shoulder flexions,
extensions and abductions in 49 healthy volunteers. » Thèse 2001.
Liane Meunier-Norman, Ereny Bassilious, Ruth Letourneau, Kim Bellini
Département Re-Education Sciences of, Universit d’Ottawa
Overall, based on these studies, several benefits emerge from the data comparing Tele-
Mentoring “ D+ VCBG ” with the Universal oniometer in healthy subjects Table # 3 :
•
•
•
• Reliable assessments can be done remotely, the person being assessed does not
have to go to the assessor's premises
Remote monitoring becomes more flexible on both sides; it does not require the
presence of a technician
The therapist assesses the risks of complications earlier; he better manages the
priorities and the action to be taken, given the importance of monitoring in the
patient's environment
•
•
It promotes the relationship between the physiotherapist and the patient in his
home
The automation and saving of measurements and snapshots objectifying the
benchmarks used, are secure and allow better standardization of data
•
•
It limits sources of error and manual transcription oversights
A qualitative and quantitative history is automatically produced for each patient
The use of measurements taken in the past by the same or by another observer are all useful
specificities in therapy and clinical research.
6.2.4.2.
In elderly patients
A-
Tele-Monitoring of the Mobility of Senior Citizens at Home after Orthopedic Surgery by the
Tele-Mentoring™ equipped with the VisioConference Based Goniometer VCGB®.
Bernard M-M 1, Fruhwirth M. 1, Meunier-Norman L. 1, McComas J. 2, Grabowski J. 2
Vie et Vieillissement, Volume 4 (3), Automne 2005 p 25-32
1-PACE 2000 International Foundation, Ottawa, Ontario, Canada
2-The Ottawa Hospital, General Campus, Division of Orthopaedic Surgery
Objectives :
The objective of the study was to evaluate the feasibility of telemetry at home and the user-
friendliness of the Tele-Mentoring "2D + VCBG®" device with elderly patients, after orthopaedic
surgery for total knee prosthesis.
The objective of the study was to evaluate the feasibility of telemetry at
home and the user-friendliness of the Tele-mentoring "2D + VCBG" device
with elderly patients, after orthopaedic surgery for total knee prosthesis.
Protocol :
Each tele-rehabilitation session at home begins with the VCBG® with three tele-measurements,
maximum, passive and active flexion, and active extension of the knee. The test being a
performance, the maximum value of three telemetry made by the same experimenter is retained.
Telemetry is followed by a standardized exercise program. Each home tele-session lasts about
twenty minutes per patient, three times a week, and evolves according to the progress of the
patients.
Connection times and dates are automatically recorded by the VCBG® and will be used to assess
compliance.
Results :
Ten seniors were included (70.3 ± 4.4 years). None of them had computer experience. They all
had degenerative osteoarthritis and had pathological WOMAC values (lower limb arthritis
symptomatic severity index) on inclusion.
•
Compliance with the twelve tele-sessions was 95.4% (103/108 scheduled for the month),
with no dropout from the study; in addition, the automated recording of the dates and
durations of the tele-sessions identifies 17 additional tele-sessions carried out at the
request of 4 patients.
•
•
The satisfaction index was 8.30 ± 1.62 for the “2D” Tele-Mentoring device equipped with
the VCBG®. The assessment of the quality of tele-sessions was 8.9 ± 0.77, The frequency of
telerehabilitation (three per week) is estimated at 9.0 ± 0.82.
The quality of the relationship by the “2D” element equipped with the VCBG® with youth
assisted physiotherapy was highly appreciated (9.38 ± 0.52).
The table below shows the average improvement in active flexion during home telerehabilitation
sessions.
The observation of individual curves (table below) by the physiotherapist improves post-operative joint
monitoring and quickly alerts the orthopaedic surgeon if necessary.
For example, the graph of patient 03 shows a plateau during the last telesessions, which required an
early face-to-face consultation and allowed the diagnosis of edema to be made.
Conclusions of the study:
Thanks to its simplicity and user-friendliness, the "2D" Tele-Mentoring associated with VC's
Automated Goniometer is well accepted by the elderly and improves attendance at physical
exercises and medical tele-monitoring.
The user-friendliness and ergonomic approach of the “ D
+ VCBG®” Tele-Mentoring have won over even seniors
who are reluctant to use new technologies at home.
The VCBG® allows the evaluation of the amplitude of
the articular movement of the knee in a precise and
reproducible way. It stands out as a very reliable tool
whether it is used by the same or by several
therapists.
These results open or can open the way to a standardization of tele-rehabilitation in the home of
elderly patients.
The VideoConferencing Based Goniometer® “ CBG®” can be used either pragmatically and be part
of the therapist's daily diagnostic arsenal (especially in the office of orthopaedists, rheumatologists,
physiotherapists, occupational therapists, general practitioners and nurses) to guide the therapist's
decisions, or as an instrument evaluation of clinical research protocols.
B- Tele-monitoring at home and intergenerational support: Feasibility and reliability of the
evaluation of autonomy, mobility and nutrition by videoconference with seniors over 70;
randomized cross-over study, remote evaluations vs in situ measurements
Bernard M-M, Kenny R, Fruhwirth M., Brown S, Meunier L, Janson F, Burzillo L; Société Canadienne
de Télésanté, Tele-Health ; Halifax, Nova Scotia, 5-7 Oct. 2003.
Centre d’accueil Champlain; Centre Perley & Rideau ; Centennial College ; Centre de Physiothérapie
Familiale, Universit d’Ottawa, Fondation Internationale PACE 2000.
Objectives :
The aim of this study was to assess the feasibility and reliability of validated scales evaluating
autonomy, mobility and the risk of undernutrition, using the "2D" Tele-Mentoring equipped with the
VCBG®.
Protocol :
Subjects aged over 70 were recruited and randomized
into two groups according to a cross-over, the subject
being his own control. At the two stages, virtual and
conventional, the subject responded successively to
three tests lasting a total of 20 minutes: AGGIR
(Assessment of Gerontology Autonomy Group Iso Resources),
Tinetti mobility tests, and NSI (Nutrition Screening Initiative) questionnaire. Patients with
cognitive impairment, or bedridden or with hearing impairment, were excluded from the study.
The statistical analysis looked for any discrepancy between the results of the tele-assessment
system and the face-to-face assessment, including with the universal goniometer.
Results :
21 people aged 82 ±7.4 years completed the study.
Cross-over intra-evaluator convergence (ICC) was
excellent: 97.8% ± 2% (Myers and Blesh scale).
Conclusions of the study
The tele-assessment device by the “ D+VCBG®” Tele-
Mentoring™ can usefully replace a face-to-face consultation
for the practice of the Tinetti tests, balance and mobility, and
the AGGIR scale.
As early as 2003, these results hinted at a promising future for remote monitoring of mobility and
autonomy in patients' homes.
C- Physiotherapy program by VC and tele-assessments for seniors over 75, confined to their
homes. Pilot study over ten weeks.
Bernard M-M., Janson F., Flora P.K., Faulkner G. E. J., Meunier-Norman L., Fruhwirth M.
Activities, Adaptation & Aging, 33 :39–48, 2009
Université du Saskatchewan, Saskatoon, Saskatchewan, Canada
Facult d’Education Physique et Sant , Universit de Toronto,
Fondation Internationale PACE 2000, Ottawa, Ontario, Canada
Context
Tele-rehabilitation in the home of the elderly can be a solution to the increased needs of seniors,
because it offers quality tele-monitoring at home and the promotion of autonomy. In fact, only 40% of
people over the age of 65 are completely independent. Disabilities and even dependency are becoming
a major concern among seniors aged 75 to 85.
Protocol :
It is among this population that we recruited 17 seniors confined to their residence
(average age: 82.4, ±7.2 years) to measure the effectiveness of a ten-week program of tele-
physiotherapy intended to improve muscle strength and joint play, using the
VisioConference Based Goniometer®. These 17 candidates were recruited from among 22
seniors, because of their participation in the tele-evaluation sessions at the start and at the
end of the program.
Results :
Their participation in the physiotherapy program (and tele-physiotherapy for 5 patients) was
54%, while compliance was the best for those who participated remotely using Tele-
Mentoring "2D" to connect to the tele-sessions of the Physiotherapy Centre Family at the
Perley and Rideau Centre.
Under these conditions after 10 weeks, significant improvements were observed for tele-
measurements of muscle strength and joint range of motion following the tele-physiotherapy
program.
In addition, the program was rated very favourably by all participants (average 9.1 on a scale
of 0 to 10).
This study highlights the effectiveness of a medium-term (ten-week) home tele-
physiotherapy program for seniors over 75, and the possibility of telemetry of their
performance in their homes by the Tele-Mentoring equipped with of the VCBG®.
6.2.5.
Conclusions of the Evaluations of the Tele-Mentoring™ “ D + VCBG®”
The link to a simplified and personalized service of Tele-Mentoring-2D equipped with the Automated
Goniometer of VC® is therefore provided in real time to seniors with loss of mobility and confined to their
homes, and to those with no computer experience, offering them sometimes tele-monitoring with
rehabilitation centres, sometimes relational activities of the Intergenerational Telementoring or tele-mobility
exercises with various community organizations.
Thus, by its simplicity and user-
friendliness…
the Intergenerational Tele-
Mentoring®, coupled with an
automated telemetry capacity
of the amplitude of joint play,
facilitates post-operative
home rehabilitation, and is a
powerful means for the
elderly to improve medical
follow-ups and their
attendance at physical
exercises, to promote “Ageing
Well”.
6.3.
THIRD PART: The Intergenerational Tele-Mentoring® “4D”
6.3.1.
The role of Mentoring and of “4D" Intergenerational Tele-Mentoring
We would like to describe the innovative and specific contributions of the "4D" Intergenerational Tele-
Mentoring® to classical mentoring: some were anticipated, others were the subject of unexpected
discoveries by the examiners who expressed a keen interest in them for the benefit of their mentees.
A Definition of Mentoring
According to mentoratquebec.org, "mentoring is a means of development and learning, based on a
voluntary, free and confidential interpersonal relationship (the mentoring relationship), in which an
experienced person (the mentor) invests his acquired wisdom and their expertise to promote the
development of another person (the mentee) who has skills and abilities to acquire and professional and
personal goals to achieve.
Mentoring is often used to promote professional integration, facilitate the integration of immigrants,
stimulate the transfer of valuable knowledge or support career planning, while creating a mentoring culture
that favours sharing and cooperation (mentoratquebec.org, 2014).
“Mentoring is a practice that promotes e uity, diversity and inclusion”.
Some Mentoring prerequisites are sometimes obstacles to its achievement (ESPUM 2015; Guide
for mentors and mentees).
We note :
•
•
•
The importance of help with the anchoring phase concerning the state of mind, the
prejudices and the opinions of each one on their relationship,
Then the need for regular meetings for an average duration of six months to a year (ESPUM
2015; Guide for mentors and mentees).
The limits of recruiting seniors: the most common ages of mentors in 2015 were: 35 to 44
(25.7%); 45 to 54 years old (23.1%) then 25 to 34 (19.6%) Recruitment of 55+ is too low to
mention. (The Chronicle of evidence based mentoring 2022).
•
In this context, we will describe the contribution of Intergenerational® “4D” Tele-Mentoring,
and its role in resolving the obstacles encountered during Mentoring (§6.3.4).
6.3.2.
DESCRIPTION OF THE INTERGENERATION TELE-MENTORING® “4D”
Impact of the decade-long Technology Journey:
A revolution in communication !
We have described and evaluated the “2D” Tele-Mentoring™ programs, which ensure “Aging Well” through
intergenerational tele-presence (2D: verbal and non-verbal) and through the practice of remote mobility
monitoring with the VCBG®.
Continuing our journey of promoting an empathic relationship between a "trainer-trained" pair, one
located at a distance from the other (§ 6.1.3), we have highlighted the need for two other simultaneous
dimensions: bilateral sharing and editing of the same “4D” document. This is to allow the trainer in front of
his desk to share the same document with his "trainee" wherever he is.
THE TECHNOLOGIES have been described in chapter 5.2
Through an innovative process of four-
dimensional “4D” communication, the interface of the Tele-Mentoring™ “4D” software allows local and
remote users to share and edit the same document together while still seeing each other.
PACE-2-Face™ switched to sharing mode
PACE-2-Face™ 4D interactions
Like mentoring, this program is intended for the trainer-trainee pair, for a time of listening - and exchange
- essential to any learning, whether in an educational environment where pedagogy takes precedence, or
for a privileged time. “carer-cared for”, where empathy becomes a priority.
These specificities give the Intergenerational Tele-Mentoring®-4D a "bio-medico-psycho-social" dimension.
We will examine the contributions of the Intergenerational Tele-Mentoring®-4D to conventional mentoring
programs (§ 6.3.4)
It is a revolution in human communication that is taking place for the
promotion of Empathy, because this "4D" mode of communication provides an
additional means of collaboration in the face-to-face encounters
6.3.3.
PROGRAMS USING TELE-MENTORING INTERGENERATIONAL® “4D”
Our 4D application has allowed us to expand the possibilities of Intergenerational Tele-Mentoring®. A
publication illustrates this technological and human relationship advances.
6.3.3.1.
Telementoring®-4D in Educational Settings – publications
The use of technologies must go hand in hand with programmed and
appropriate human coordination.
It is therefore necessary to follow the following preparation:
•
Candidates are identified and contacted by the inter-generational coordinator who takes note of
their profile and expectations, through PACE-2-Face™.
•
An appropriate youth-elder pairing is proposed to the
candidates, for
An “ice breaking” first meeting first in "tele-
presence", while a face-to-face meeting will
be on their initiative at the end of the
program, according to the availability and
possibilities of each.
•
The candidates thus matched agree to carry out a
minimum of five tele-sessions according to a pre-established schedule.
"If you come, for example, at four
o'clock in the afternoon,
at three o'clock I will begin to be happy"
Inter-Generational Tele-Mentoring® for the Promotion of Social Relations and Health
Marie-Madeleine Bernard, MD, PhD, Kamel Ouacel, Mathias Fruhwirth P.Eng, Martin Brooks, PhD, Kate Oakley,
PhD, Xuemei Wang, PhD, Karim Guillaume Ouechni, B.A.Sc, Frederick Janson, MBA
The Journal of Gerontechnology, 10 (1), 2011
Protocol :
18 seniors residing in Ottawa, aged 70±7, guided 18 young people
(nine students from the Ottawa-Carleton Region and nine young
unemployed people from the Paris suburb Bobigny, in Ile de France)
in learning a second language, assistance from the Intergeneration
Tele-Mentoring® program accessible to people with disabilities.
We analyzed data (input and
output) generated by server
systems, as well as
questionnaires (beginning
and end of study) from
participants and intergenerational coordination staff.
Results :
The 18 telementors were aged between 55 and 82 years old, which
is considerably older than the usual recruitment of mentors allows (35-55 years old see § 6.3.1). 67% of
seniors had chronic illnesses and/or disabilities, which limited their movements.
The young people were between the ages of 14 and 23, enrolled in Sir Robert Borden or Hillcrest secondary
schools, or students of Carleton University or Ottawa.
All of them, young and old, expressed a high rate of
appreciation of their program by the Intergenerational Tele-
Mentoring®: averages above 80%, with a particular interest
in the human relationships they were able to develop, the
feeling of complicity and communication "on an equal
footing", and the opportunity for personal development and
intercultural exchange.
Young people (86%) also reported that they had benefited
from their immersion experience by videoconference in their
language of learning.
Senior Telementors showed higher motivation and adherence than unemployed youth (p < 0.025).
Positive changes in behaviour with these “mentees”
were quickly observed by the respective authorities
who observed them before and after the program.
They noted in particular the development of self-confidence, better verbal and non-verbal expression,
and new motivations with regard to projects or job search, after only two to four sessions. These changes
in behaviour were often reported with great emotion by the respective managers, because they had not
been able to obtain them previously in person.
For example, a teacher noting the sudden and cheerful participation of an immigrant pupil who
had hitherto been silent, reported it to his vice-principal, John Sainis (Fisher Park Summit Alt.
School) who later revealed to the teacher the participation of the student in the Tele-mentoring
Inter-generations® program.
J. Sainis, the Vice-Principal of Fisher Park School concludes:
“The results of the Intergenerational Tele-Mentoring® program have been
fantastic. We observe a better self-esteem, a better understanding of
homework, an increased level of general culture and a privileged friendly bond”.
The Tele-Mentoring program also allowed older participants to learn technologies who were not familiar
with them: 77% of them developed more confidence in their use, 80% felt more comfortable in front of
the camera, and 100% considered that the videoconference had been very useful for their discussions.
6.3.4.
Conclusions of the Study: Intergenerational TELE-MENTORING ® and MENTORING
In addition to the benefits of Mentoring reported in § 6.3.1, our observations of
Intergenerational Elementorat®“4D” over more than a decade, lead us to specify additional
benefits:
•
Intergenerational ® “4D” Tele-Mentoring provides a very positive experience that can
exceed and complement the scope of conventional mentoring and coaching programs.
En particulier on observe (Tableau ci-dessous) :
•
Greater ease of recruitment of target populations, particularly seniors over 55, including
octogenarians, and populations traditionally excluded from conventional mentoring
programs
•
Accessibility and simplicity of tele-meetings from participants' homes, regardless of
geographic location
•
•
•
•
•
•
The security and confidentiality of tele-meetings
The absence of stigma
From the outset, a connection on "an equal footing" thanks to the use of the "4D" interface
Quick results and behavioural changes in one to four tele-sessions
Improved self-esteem and self-confidence
Better motivation and understanding of tasks, resulting in an increased level of general
knowledge,
•
and a privileged friendly bond!
The “4D” Intergenerational Tele-Mentoring® represents a new educational method resulting
in the observation of rapid changes in behaviour, observed in 1 to 4 tele-sessions.
When geographical proximity and the absence of stigmas allow it, it is also likely to prepare
the “anchoring phase” of mentoring and to direct research towards the study of innovative means
of inducing motivation.
•
Marcel Nouvet, Assistant Deputy Minister, Health Canada, told Dr MM Bernard on the 6 May 2005:
“I am very pleased to announce that the Public ervice of anada has
endorsed your project proposal entitled ™ for the promotion of the second
language…
• Be proud of this result and rejoice yourself and your organization in your
determination to advance the official languages file at Health Canada.
Congratulations ! »
6.3.5.
Tele-Mentoring®- 4D in the Medical Environment - publications
In the medical field described below, the "4D" Tele-Mentoring therefore concerns therapeutic
education and the necessary motivation for self-care of chronic diseases, and the reduction of the
risk of morbidity and mortality linked to isolation.
Consultations using a Telemedicine-Tele-Mentoring® 4D interface
A- Impact evaluated by 30 patients with chronic diseases
a
M.M. Bernard , E. Dresco a, T. El Gharbi a, O. Gallon a, K.G. Ouechni b, L. Turner
European Research in Telemedicine (2015) Vol 4, 103-107 Doi : 10.1016/j.eurtel.2015.10.001
a Centre hospitalier Sud Essonne, site de Dourdan, 2, avenue du Potelet, 91410 Dourdan, France
b PACE 2000 International Foundation, 356, Woodroffe Avenue, , Ottawa, ON K2A 3V6, Canada
Protocol :
Thirty patients with chronic diseases, from 27 to 79 years old (58 ± 16 years old; 53% over 60 years old)
were recruited "in real life", according to the register of consultation appointments, to evaluate the
interface of the "4D" Tele-Mentoring in direct connection with their hospital doctor.
Results :
Context: during the two years preceding the study, the travel time of these patients to go for a
consultation at the hospital was 21 ± 17 min; these subjects had made 7 ± 5 visits to their hospital, for a
hospital waiting time of 23 ± 26 min.
Interest of the Tele-Mentoring ® “4D”: There was less than 15 min allocated to the training initiation
to the Tele-Mentoring® “4D” interface. 24 individuals (80%) considered it satisfactory. The possibilities
of mutual understanding and perception of the exchanges during the teleconsultation were considered
satisfactory by 12 patients (43%) and excellent by 16 (57%). Two patients did not respond. Twenty
patients (72%) fully approved of using the interface to maintain a personal and confidential relationship
with their doctor; 5 (18%) simply approved of it; 1 considered it somewhat useful and 2 disagreed; 2
unanswered cases.
The answers are not related to age (r=0.127).
Conclusions of the study
• The majority of patients are very satisfied with the doctor-
patient relationship that is established with the “4D” Tele-
Mentoring® called PACE-2-Face™.
• They adhere to the practice of teleconsultation alternating
with a traditional course.
B- Tele-consultations for the promotion of empathy
MM Bernard, M Fruhwirth, L. Laloum, E Baumelou-Torck, S. Hanneton
PACE2000.FR. 61 rue Caulaincourt, 75018 Paris
Centre Médical Europe, 44 rue d’Amsterdam, 75009 Paris
Société Francophone du Diabète ; communication selected for the Nice congress, March 2022
Protocol :
40 patients with chronic diseases in endocrinology-diabetology are invited to a first teleconsultation
connection by Tele-Mentoring®4D (see § 5.2.4 Technologies and § 6.3.1), without prior training, while
they have already consulted face-to-face at the European Medical Centre. The prerequisite is to have
internet access and an email address. They then answer an evaluation questionnaire.
Results :
•
•
•
•
34 patients (85%) say they connected easily with their doctor.
95.1% said the software interface (video size, locations, etc.) suited them.
Patients (84.2%) were able to share and annotate the medical report with their doctor.
All patients (97.3%) consider that document sharing associated with “4D” eye contact is
beneficial.
•
92.7% of patients testified to a good mutual perception and understanding of the messages
exchanged with the doctor.
4D Tele-consultations and shared medical report - Patient testimonials
Here are some of the testimonials of patients from the first use of Intergenerational Tele-Mentoring:
"It was the first time and I thought it was great",
"Being able to stay in your room with your computer and
still bein front of your doctor, for me it's really personal and confidential"
“This technology is great, we have the doctor all to ourselves!”
“At first I wasn't interested, but now that I have it all figured out, it's
wonderful...I'll take my meds and go running with my daughter!”
Frequent comments:
"It's convenient because you don't have to travel, especially when you live far
from the medical Centre."
“We are quickly taken care of if there is a problem...”
Conclusions of these two studies:
The “4D” Intergenerational® Tele-Mentoring achieves its objectives of accessibility, safety, and
promotion of the doctor-patient relationship with Empathy and generates a very positive appreciation
and often playful enthusiasm.
The enthusiasm of patients for this means of teleconsultation by Tele-Mentoring "4D" is perhaps also
linked to their direct contribution to the joint drafting with their doctor of the medical report, both
continuing to exchange and see each other. There perhaps begins the anchoring of a partnership for the
joint management of the care pathway.
C- The place of “4D” Tele-Mentoring™ in the Tele-care treatments
We have described the impacts of the design of the interface of Tele-Mentoring™ "4D" (§ 6.3.2) on the
quality of communication and the relationship of the trainer-trainee pair.
Thus, in line with the recommendations of the Société Francophone du Diabète, SFD, and the Haute
Autorité de Santé, HAS, which are to promote the expression and understanding of the patient and to
allow shared decision making between the patient and the healthcare professional, our numerous
experiences and evaluations (§ 6.3.2 and 6.3.3) lead to the following observation:
•
the design of the interface of Tele-Mentoring® "4D" optimizes the learning factors which
are in particular, motivation, self-confidence, understanding, and other conditions of
success required in Therapeutic Education
•
The doctor develops an active partnership with his patient.
One of the innovative elements of the "4D" Tele-Mentoring which seems to us to be preponderant in
favouring motivation for self-care and the speed of results in Therapeutic Education, is the joint writing
of the medical report, by means of “4D” telecommunications (technologies § 5.4 and § 6.3.2; evaluations
§ 6.3.3).
These studies invite us to define and evaluate the quality criteria for the
use of a teleconsultation interface that generate satisfaction and a feeling
of empathy for patients.
Indeed, by referring to the evaluations of educational programs (see § 6.3.3.1), changes in behaviour
are observed in 2 to 4 tele-sessions, while mentoring programs require practice lasting 6 to 12 months.
(§ 6.3.1).
Through randomized studies, it would be appropriate to verify that the objectives of Therapeutic
Education, which in face-to-face “constitute a slow and difficult process to achieve” (G. R ach), are more
quickly achieved by the Intergenerational Tele-Mentoring® “4D” program.
D- What are the recommendations of the Health Authorities?
In parallel with our technological advances, we wanted to take stock of the official prerequisites:
The Haute Autorité de Santé, HAS, published a
press release on March 18, 2021 issuing its
recommendations concerning “telecare, an act
accessible to all, simple and secure”:
Whatever the device used, "the protection of
personal data, respect for medical secrecy,
obtaining the patient's consent, and support in the
event of material (computer science in particular) or
medical difficulties" are essential conditions for its
implementation.
The choice of the telecare device must first and foremost:
• Promote the expression and understanding of the patient or his companions,
• Allow a shared decision between patient and professional
• As well as the drafting of a report followed by its transmission to the patient
E- The Francophone Diabetes Society
In June 2021, the SFD published a description of the "specifications of the ideal technical solution",
which focuses on the methods of managing medical data:
•
Une déclaration de conformité par les autorités
compétentes
•
A description of the use of the data, their content, their
accessibility, the portability of secure data and an alarm
configuration
•
•
•
Maximum interoperability with different devices and
adaptation to international standards
Interfacing with the DMP and, to be expected, with the
digital health space (ENS)
Secure communication and the possibility of a dialogue
between the patient and the healthcare professionals involved in his care.
F- The Diabéo tool reported by Pr Alfred Penfornis
The DIABEO diabetes monitoring software (Vidal 2022)
•
•
It is a tool for adapting insulin doses in addition to patient follow-up through
consultations or telephone calls.
It manages and uses patient data, coupled with medical remote monitoring in
accordance with the recommendations of the SFD.
This software does not have the additional functionality of optimizing the caregiver-patient relationship
and promoting empathy, but it facilitates diabetic control.
G- Five steps to carry out a Teleconsultation. Pr Jérôme Salomon, DG of Health and Ghislaine
Alajouanine, President of the Francophone Academy of Telemedicine and e-health, March
17, 2020
Among the 5 steps described for the patient who is a candidate for a teleconsultation, we consider that
the digital divide is often revealed from the second step: finding and clicking on a secure link inviting
him to connect to a site or an application is a step difficult for the uninitiated who do not have a PC and
who try to access it on their smartphone. The fourth step of receiving encrypted prescriptions also
presents difficulties to the uninitiated.
However, access to the Digital Health platform is intended
to reduce this digital divide.
H- Are there indicators of the quality of teleconsultation technologies for an aging
population, at home or in an institution?
MM Bernard, E. Dresco, E. Baumelou-Torck, M. Fruhwirth, T. Moulin
Association PACE2000.FR, demi-finaliste du Prix Européen AAL-EU Smart-Ageing 2020
Communication 2021 Congress of the Francophone Diabetes Society
Objectives :
Search the scientific literature for the criteria for judging a teleconsultation that meets the expectations
of professionals and elderly patients, often suffering from chronic diseases, and compare them with our
assessments.
Protocol :
Repeated evaluations of the Tele-Mentoring®-4D interface, in a loop, with retro-feedback between
health professionals, patients and developers (Living Lab PACE2000; AGILE methods, are pragmatic and
involve the continuous collaboration of users in a closed loop) .
Bibliographic research of judgment criteria for teleconsultation interfaces (Virtual visits) on:
Medscape, Pubmed, Researchgate, Open Access.
Results :
We did not find in the literature any work evaluating the technological interfaces used for medical
teleconsultation.
Our evaluations (see § 6.3.3 and 6.3.5), highlighted the impact of the
specificities of the interface of Tele-Mentoring®-4D on the quality of the
human relationship, on the learning conditions and on the therapeutic
optimization.
In particular in the study § 6.3.2.2.D, 93% of the “all comers” of the patients, were satisfied very
satisfied with their perception/understanding of the exchanges with their doctor.
According to our experience, the interface of Inter-generational Tele-Mentoring ® -4D can exceed
certain quality criteria of a conventional consultation:
•
•
Confidentiality and simplicity Individual intuitive tool (does not require assistance)
Motivation Users seen side by side and face to face, “on an equal footing” (behavioural
sciences)
•
•
Accessibility The obstacles to remote consultation are lifted for all ages and motor disabilities
(in particular: app on a single screen, PC or mobile)
Shared decisions Symmetry and synchronicity of documents and images.
The medical report becomes a shared snapshot:
Everyone can annotate a shared document while observing head movements, verbal, non-verbal or
written signals from their partner: the patient becomes a conscious and motivated actor in the
management of his disease.
Discussion
The publications and recommendations concerning the act of medical teleconsultation focus mainly on
the management of medical data (content, protection, portability, transfers, etc.). The study of the
ergonomic and motivational impact of a teleconsultation interface does not seem to hold the interest
of researchers to date.
According to our experience, the motivation generated and the rapid changes in behaviour observed
during the use of the Tele-Mentoring®-4D interface deserve long-term randomized studies, particularly
in comparison with therapeutic education sessions.
Evaluation Findings
We hope that the impact of the teleconsultation interface
on the quality of the doctor-patient relationship and the
trainer-trained pair will become a specific subject of
evaluation and hold the attention of the competent
authorities.
7. General Conclusions
The challenge launched in 1994 by the seven committees of the unfinished
Intergenerational Residential Village project in Ottawa, a challenge which
consisted in developing innovative technological solutions adapted to the
handicaps, for the promotion of empathy between the generations and
of "Ageing Well", across geographic boundaries and human silos, was
successful with the participation of hundreds of youth and seniors,
partners and sponsors.
The results and evaluations of this technological and humanitarian
adventure, which developed in four technological stages, lead to the
conclusion that
The Intergenerational Tele-Mentoring® “ D”, e uipped with the
Videoconferencing Goniometer® and “4D” are likely to:
•
•
“Break down the walls of urban ghettos”,
To bring the human interactions in the retirement centres as well as
the "Aging Well",
•
•
And simultaneously to facilitate remedial education, the socio-
professional integration of young people, and in short,
to “cause a Sea Change” in the field
Our work illustrates:
•
•
What Intergenerational Telementoring® brings to conventional
mentoring
What the medical Telementoring™ brings to conventional consultations
and follow-up of the home care pathway.
Our initially very original approaches are essential at a time when isolation,
of all ages, is considered a quasi-comorbidity, where surveys, which
highlight the great loneliness of the elderly, even their vulnerability in their
residence or retirement centre(as described recently by V Castanet in his
book "Les Fossoyeurs"), are likely to multiply in the face of the rapid
increase in the elderly population.
Currently lost opportunities, these isolated seniors, even in their eighties,
constitute a reservoir of experience and prodigious expertise transmitted
voluntarily, but which will run out if they are not solicited.
Next steps: It is a question of entrusting our know-how and our tools to
organizations likely to benefit their target populations, with the only costs
being those of human and technical coordination of intergenerational
programs.
We see it as the guarantee of a necessary humanism, but also of reducing
the costs of unemployment, remedial education, immigration and
dependency.
The little prince managed to
tame the fox and they were able
to remain friends and help each
other no matter how far apart
they were.
8. Awards and recognition awarded to the PACE2000.org Foundation
•
1999 celebrations at the United Nations, New York:
Dr. A. Sidorenko, International Director of Social Programs, United Nations, commends PACE
2000 and its innovative programs with a speech produced at twelve Tele-Mentoring™2D Centres in
France (Veterans Centres, Les Invalides; sponsor France Telecom), and in Canada (Perley &
Rideau Veterans Centre and patients at home).
•
2000 Ministry of Health and Long-Term Care Telemedicine Award, ONTARIO,
Canada
• Gérontechnologies Prize 2003 awarded to Pr André Bonnin and Dr MM
Bernard,
It was awarded jointly by the Fédération Hospitalière de France (FHF), the French
Society of Gerontology-Geriatrics (SFGG) and the National Foundation of
Gerontology at "HIT 2003", Health Information Technologies, Gérontexpo, Paris,
France.
“André Bonnin, Member of
the National Academy of
Medicine, in collaboration
with
Marie
Madeleine
Bernard, of Ottawa,
has developed a project
based on the use of a
surveillance
and
telecommunications system allowing seniors living alone to remain in constant contact with
their care network and with their family, by using the Internet network, by inspired by a model
already operational in Ottawa and Montreal, Canada. In 2003, their project won the
Gérontechnologie prize awarded by the French Hospital Federation and the National
Gerontology Foundation”.
Historical and Scientifical works comity Institute attached to the National School of Charters
•
UNESCO (Paris, France): November 10, 2006, presentation of the Intergenerational
Telementoring® during the international conference AIFA – FIAPA.
•
International Prize of the FIAPA Intergenerational Competition, 2006:
Selection of the best Information and
Communication
Technologies,
"Knowledge Sites" category, presented
to the President of the PACE 2000
International Foundation, by the
President of FIAPA, (International
Federation of Associations for the
Elderly) with the contribution of 'AG2R.
EU-Ambient Assisted Living, AAL Award 2020: semi-finalist
Tele-Mentoring Intergenerational®-4D
9. Main peer reviewed publications
Charlebois R., Côté N., O'Rourke M., Verville D., McComas J., Fruhwirth M., Bernard M-M., Brosseau L.
Intra- and Interrater Reliability of the Video Conference-Based Goniometer for Active Knee Flexion and
Extension in Healthy Subjects Journal of Rehabilitation Measurement Outcomes, 2000, 4(3), 23-33
MM. Bernard, R. Kenny, M. Fruhwirth, S. Brown, L. Meunier, F. Janson and L. Burzillo.
Feasibility and Reliability of Videoconferencing Assessments of Autonomy, Mobility and Nutrition in 70+
seniors.
Canadian Society of Telehealth, 4th annual meeting, Halifax, Canada, 2003.
Bernard M-M, Fruhwirth M., Boivin D.
Télé-g rontologie: ix ans d’activit s du Village Virtuel Intergenerational
Vie et Vieillissement, Volume 4 (1,2) 2005, p 31-37
gerontologie.htm
Bernard M-M., Fruhwirth M., Fortin J-P.
Révolution de la longévité : défis et solutions innovantes
Vie et Vieillissement Vol 5 (1) 2006, 3-8
Bernard M-M., Fruhwirth M., Meunier-Norman L., Grabowski J.
Télé-suivi de la mobilité des aînés à domicile après chirurgie orthopédique. Application du goniomètre
de visioconférence
Vie et Vieillissement, Volume 4 (3), Automne 2005 p 25-32
M-M Bernard*, H. Buttar, A-M Leroux, Ivo Hynie, Therapeutic Products Directorate, Health Canada,
Well Defined “ ealthy ifestyle” eference roups Are eeded in the Design of
Clinical Evaluations of New Drugs In Type 2 Diabetes
Science Forum, Health Canada, November 9, 2007
Bernard M-M., Janson F., Flora P.K., Faulkner G. E. J., Meunier-Norman L., Fruhwirth M.
Videoconference-Based Physiotherapy and Tele-Assessment for Homebound Older Adults: A Pilot
Activities, Adaptation & Aging, 33:39–48, 2009
based%20physiotherapy%20-%20Bernard%20et%20al%20(2009).pdf
M-M. Bernard, M.Fruhwirth, M.Brooks, K.Oakley, X.Wang, K.Ouechni, F.Janson
Intergenerational Tele-Mentoring for the promotion of social relationships and health
J.of Gerontechnology, Volume 10 (1), 2011 publication pending
Bernard M-M., Fruhwirth M
Du transfert intergénérationnel à la télémédecine : quelles perspectives pour bien vieillir ?
Vie et Vieillissement Vol 9 (4) 20012, 36-41
Bernard M-M, Dresco E., El Gharbi T, Gallon O, Ouechni K-G
Evaluation by 30 chronically ill patients of a connection to their specialist physician, using a telemedicine-
Tele-Mentoring interface
European Research in Telemedicine / La Recherche Européenne en Télémédecine
Volume 4, Issue 4, December 2015, Pages 103-107
Bernard M-M., M.Fruhwirth, C de Mareuil Villette
Virtual Village: Innovation at work
European Research in Telemedicine (2015) 4, 9-12
Bernard M-M, Dresco E., El Gharbi T,
Big data and teleconsultations for homebound seniors
Gerontechnology (2016) Vol15_31s Supplement
Bernard M-M., Dresco E., Baumelou-Torck E., Fruhwirth M., Moulin T.
Y a-t-il des indicateurs de la qualité des technologies de téléconsultations pour une population
vieillissante, à domicile ou en institution ?
Société Francophone du Diabète 2020 : communication affichée
Bernard M-M., Fruhwirth M., Laloum L., Baumelou-Torck., Hanneton S.
Téléconsultations pour la promotion de l’Empathie
Société Francophone du Diabète 2022: communication affichée
10. Contributions and Acknowledgments
Over the years, mainly since 1995, the contributions of volunteer candidates have multiplied: we would like
to thank them warmly for their participation and for the success of the PACE 2000 intergenerational
programs.
Particular merit is attributed to those whose expertise and consistency in their commitments have made it
possible to meet the challenges of the technological shift leading to discoveries of the benefits of quality tele-
presence, complementary to the realities of the face-to-face.
11. Members of the Executive Board of the PACE 2000 International
Foundation
11.1.1.
In honour of their dedication and faithful contributions 1993 – 2008:
Jean Vautour (P.Eng), Agnes Fennell (Unitarian House), Evelyn Shore, Michael Sherwood (College Ashbury),
Pr Doug Angus (U. Ottawa), Yvan Morin (BLG)
Michael Sherwood
Agnes Fennell
Jean Vautour
Yvan Morain
We pay tribute to our late mentors: Pr. André BONNIN et Pr. Jean-Pierre LUTON (Hôpital
Cochin, Paris), who have sponsored us during this technological and human journey between
France and Canada.
11.1.2.
In thanks for their current active contributions:
Helen Ge, (Helen Ge CPA Professional Corp.), Trésorière, Liane Meunier-Norman (Physiothérapeute, Ottawa,) Louise Plouffe, PhD (Santé
Canada, retired), Karim Guillaume Ouechni (B.Sc.A, MBA, Sorbonne B.), Claudia Lahaie (PhD, U. New York), Mathias
Fruhwirth (Environnement Canada, retired), Dr Marie-Madeleine Bernard (Santé Canada, retired),
Helen Ge
Liane Meunier-
Norman
Louise Plouffe
Karim Ouechni
Claidia Lahaie
Dr Marie-Madeleine Bernard Mathias Fruhwirth
11.2. A meeting of the PACE 2000 Foundation, July 30, 2021
Members of the Board of Directors of the PACE2000.FR association
… Thanks and honours to our French Board Members
Dr Eric Dresco (CH Côte de Lumière), Anne Stora, PhD, Dr Elisabeth Baumelou (GHICL), Louise Plouffe, PhD
(Santé Canada), Dr Marie-Madeleine Bernard (Centre Médical Europe). Mathias Fruhwirth, P.Eng.
(Polycom),
Eric Dresco
Louise Plouffe
Anne Stora
Elizabeth
Baumelou-Torck
Marie-Madeleine Bernard
Mathias Fruhwirth
11.3. The PACE 2000 Team and Collaborators
11.3.1.
- Software development:
Alan Lair, Dr. Xuemei Wang, Richard Kowalski, Robin Chahal, Antoine Nguyen, Erwan Pelmoine
PACE 2000 Technologies:
Alan Lair
Xuemei Wang
Richard Kowalski
- Design Management, and Quality Controls:
Karim G. OUECHNI, Marie-Madeleine Bernard et Mathias Fruhwirth, Sylvain Hanneton
11.3.2.
Staff and intergenerational coordinators:
•
•
•
•
•
•
•
Léon Albert,
Line Beauséjour,
Liane Meunier,
Dylan Gunnell
Rébecca Shore,
Jennifer Campbell,
Frederic Janson,
Stéphanie Gueye-Lebasque,
Lucy Lu
•
Lisa Banister,
•
•
•
•
•
•
Gursevak Kasbia,
Jared Boughton,
Elisabeth Glen Bentley,
Asha Sitaram,
Arnaud Leviez,
Alissa Welsh
•
•
11.3.3.
Special Contributions from Researchers:
Joan McComas, PhD (U. Ottawa), Kate Oakley (U. Carleton), Pr Joann Blessing-Moore (Stanford U.),
Emile Etienne Baulieu, Professeur émérite au Collège de France et membre de l'Académie des
sciences, Pr.Thierry Moulin (Doyen, Faculté de Médecine, CHU de Besançon, past président, Société
Française de Santé Digitale), Martin Brooks, PhD (Centre National de Recherche Canada, Institut de
Technologie de l’Information), amie Rossiter (Agence de Sant Publique Canada), Mel Shipman (U.
York), Sylvain Hanneton (U René Descartes), Lionel Laloum (Centre Médical Europe).
11.3.4.
Special contributions from expert consultants and lawyers:
Dick KO (Research and Innovation), Caroline de Mareuil-Villette (ICOSA), Marie-Christine Halpern,
Daniel Boivin (FAJEF), Matthew Roy (Gowlings)
11.3.5.
Influencers :
Richard Patten (MPP), acques anson (Officier de la gion d’honneur, Conseiller à l'Assembl e des
Français de l'étranger pour le Canada), Pr Emile Etienne Baulieu , Caroline Laloum (Centre Médical
Europe, Paris), Rima Aristocrat (Willis College), Maitre Marie-Christine Halpern (Paris), Madeleine
Meilleur (ministre des Affaires Francophones), Brigitte Léger (Sciences et Technologies, ambassade
du Canada à Paris), Ethel Côté (présidente fondatrice de mécènESS), Max Keeping (CJOH TV),
Dominic Darcy et Lysia (Artistes).
11.4. Main Sponsors and Partners:
11.4.1.
Main Sponsors
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ondation Trillium de l’ ntario ; Lorraine Gandolfo, Jean-Paul Gagnon
Minist re ntarien de l’Energie, ciences et Technologies : Dick KO
Bell Canada
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Ottawa-Carleton District School Board
Programme d ral d’Innovation en angues fficielles (LO)
EU-Ambient Assisted Living, AAL
11.4.2.
Main Partners:
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Société Canadienne de Télésanté ; Penny Jennet
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SoQibs Quebec ; Jean-Paul Fortin
Institut Européen de Télémédecine ; Pr Louis Lareng, Chantal Bekhat
Société Française de Santé Digitale (Lydie Canipel, past-président Thierry Moulin)
Association La Mire, 93, France ; Kamel Ouacel, Khaled Nacel
Cabinet ICOSA ; Caroline de Mareuil-Villette
Santé Canada ;Marcel Nouvet, Harpal Buttar, André-Marie Leroux, Ivo Hynie
Centre National de Recherche Canada ; Martin Brooks
Centre de santé des Vétérans Perley et Rideau ; Greg Fougère, Sharon Trumaine
entre d’accueil hamplain ; Pierre Arsenault, Denyse Thériaut
Centre Pauline Charron, Vanier Ontario ; Huguette Poulin
Unitarian House, Ottawa, Ontario; Agnes Fennell
Centre Catholique pour Immigrants, Ottawa, Ontario ; Carl Nichols, Chamroun Lei
Fisher Park /Summit Alt. Public School, Ottawa, Ontario; John Sainis, Trudy Brand-Jacobsen
Ecoles secondaires Sir Robert Borden et Hillcrest, , Ottawa, Ontario
Ecole secondaire d’Almonte, Almonte, Ontario; Kelly Stuart, Norbert Boudreau
La Cité Collégiale, Ottawa, Ontario ; Andrée Lortie
acult d’Administration de la ant , U. Ottawa ; Pr Doug Angus
Centennial College, Toronto, Ontario; Renée Kenny
Centre de Physiothérapie Familiale, Université d’Ottawa
pital n ral d’ ttawa, chirurgie orthopédique; Jenny Grabowski, Dr Giachino
acult d’Education Physi ue, Université de Toronto
Club Richelieu International, Ottawa, Ontario ; Jean-Luc Malherbe
Institut de Santé Positive pour Ainés, Ottawa, Ontario ; Gabriel Blouin
11.5. Special events PACE 2000 1998
1998 Intergenerational Technology Forum at Ottawa City Hall
Testimonial from a senior
Max Keeping, présentateur de
CJOH TV News en tant que maître
Étudiant d'Almonte HS travaillant avec
des seniors
Le Dr MM Bernard s'entretient avec Dr
Joan Blessing-More de l'Université de
Stanford par visioconférence
11.6. Deux célébrations internationales ont marqué l'histoire de PACE 2000 :
Two international celebrations marked the history of PACE 2000 :
11.6.1.
December 24, 1998: Transatlantic Christmas celebration
Transatlantic Christmas Eve between children with cancer at the Red Cross long-term care Centre,
Margency, France, and seniors at the Centre d'accueil Champlain, long-term care Centre, Ottawa, Canada.
Lysia Ouechni actrice dans le
spectacle de marionnettes l'hôpital
de Margency Paris France
Dr Bernard avec les étudiants
bénévoles et aînés du Centre d'Accueil
Champlain
Affiche d'annonce
d'événement
11.6.2.
May 11, 2004 PACE 2000 at the "Eleventh thematic day of the French society of
Geriatrics and Gerontology" Paris
On behalf of PACE 2000, Mathias Fruhwirth, P. Eng. and Dr. Marie-Madeleine Bernard presented a poster at
the Eleventh thematic day of the French Society of Geriatrics and Gerontology
Pr Alain Franco
Notre regretté et pionnier de la Télémédecine, Pr. Louis
Lareng (Grand Officier de la Légion d’Honneur, Officier de
l’Ordre National du Mérite et Commandeur de l’Ordre des
Palmes académiques)
(Chef du Département De Médecine
Gériatrique et Communautaire, CHU de Grenoble) et
Dr Marie-Madeleine Bernard
11.6.3.
September 24, 2004: participant-developer exchanges
As part of the results of the PACE-
2-Face™ programs, PACE 2000
invited its volunteers who had
used and tested the new system to
share their experiences and
provide feedback to the program
developers. 2005 - 2008
11.6.4.
June 3, 2005, Intergenerational Tele-Mentoring Press Conference ®
Presentation of the results and benefits of the PACE-2-Face™ programs.
11.6.5.
March 2006 Women in Science Conference: in Paris, presentations to the Ministry
of Health and Solidarity, and in Nice, to the CUM (M.C: Brigitte Léger and Julie Paillette)
11.6.6.
November 23, 2007, Participants from La Mire (93) invited to the Senate, Paris
To celebrate his very successful Tele-Mentoring program involving young people at risk in the suburbs of
Paris France, the President of the National Centre for Distance Education invites us to the Senate
11.6.7.
September 19, 2008, Poitiers France, EADTU CNED Congress
At an invitation from Jean-Michel Lacroix, Rector of the Academy, Director General of the CNED.
To publicize their successes in
the PACE-2-Face Tele-Mentoring
Program, the La Mire team, Dr.
Bernard
software
and
programmer
PACE-2-Face
Dr.
Xuemei Wang presented a paper
at the EADTU Congress,
12. AUTHORS' BIOGRAPHIES
Dr Marie-Madeleine Bernard
A graduate of Medicine in France and the USA, then
a specialist in Endocrinology and Metabolic
Diseases, Dr Marie-Madeleine Bernard carried out
the clinical practice of her specialty at the same time
at the Hauts de Seine clinic, at the Saint Vincent de
Paul hospital, as well as that the evaluation of new
drugs as medical director of pharmaceutical
multinationals first in France until 1990, then at the
Canadian Ministry of Health, as an expert in the
evaluation of new drugs, general direction of
products Health and Food, Bureau of Metabolism,
Oncology and Reproductive Sciences, under the
direction of Dr. Paul Roufail and then Barbara Rotter,
until her return to France in 2009. She practiced her
specialty at the Centre Medical Europe in Paris. In
1991, she created the PACE 2000 International
Foundation (Programs for the Autonomy and
Communication of Elderly Elderly), a charitable
organization, and coordinates the development of the "Inter-generational Virtual Village"
(IVV) following the launch by PACE 2000 of the "First Advanced Technology Forum for
Youth and Seniors" in 1996 at Ottawa City Hall.
Mathias Fruhwirth
A Graduate engineer in electronics, University of
Waterloo, Canada, with 29 years of experience in
aerial remote sensing notably for the Government of
Canada, Ministry of the Environment [1980-2009],
and in high-end videoconferencing with Polycom
France [2009-2018] ; director of the PACE 2000
network, co-inventor of the Automated Goniometer
for Visioconferencing®, VCBG, and of the
videoconferencing application Inter-generational
Telementoring® specially adapted PACE-2-Face™.
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