**4. Participation of the elderly**

From the outset of the programme, the ZonMw committee worked to ensure that elderly people were not only the object of inquiry and research in the programme but were also included as subjects and participants. The elderly people were encouraged to participate in the geriatric networks and in working groups. As a result, the focus of empirical research on medical care innovation shifted over time, based partly on what elderly people themselves considered being important. This in turn led to an increasing emphasis on welfare and support of the elderly in the continuum of well-being and care.

Initially, elderly people had to become accustomed to participating in a professional setting. Collaboration between volunteers (the elderly people) and professionals cannot be taken for granted and requires commitment from everyone involved. Elderly people were trained to discuss project proposals, procedures and outcomes with professionals. Frail elderly people were not involved in these procedures. However, as the active elderly people had regular contact with the frail elderly people, the voices of the frail elderly people could be included in the working groups. Embedding elderly people in the organisation of the networks and involving them in projects and research meant that all networks had a strong core group of active elderly people. The project outputs were better suited to elderly people's needs because elderly participants were included in target group panels and advisory boards. For example, participants proposed improved integration of medical care and welfare and more preventive activities.

A new phenomenon is the involvement of elderly people in education, not just occasionally but as a structural part of the curriculum. This occurs especially where colleges and universities train students to work as professionals—nurses, doctors, physiotherapists, and psychologists, for example—with elderly people. Elderly people participate as teachers in various roles, for example, as patient, guest lecturer, mentor or co-supervisor of theses. They also participate in research, in focus groups and in training groups. The combination of elderly and young people has proved to be valuable to everyone concerned. Elderly people have also been asked to participate in technical and vocational training programmes. The Organization of Elderly (*DenkTank 60+ Noord* in Dutch) has five research and development education groups. The demand for elderly is now greater than the offer.
