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P4. Assistive technologies

Detailed programme, abstracts and presentations

P4.1. “INDEPENDENT – The Alzheimer Society telecare experience” 

Connolly Mary

The Alzheimer Society of Ireland (ASI) has among its strategic priorities 2009-2013:

  • Expand the range and number of dementia services for existing service users/those awaiting services
  • Promote new service models based on innovative practice and comprehensive evaluation.

ASI collaborated with Tunstall Emergency Response (TER) and the Work Research Centre (WRC) in 2007 and have delivered a telecare service in their Mid-west and Mid-Leinster areas since. This service is in the form of packages of telecare including items such as pressure mats, property exit sensors, fall detectors, enuresis sensors, bed occupancy sensors. These items are installed in the houses of ASI clients with dementia to assist them in living in their own homes.  WRC and ASI evaluated how these packages of telecare assisted carers in the homes of people with dementia. Carers of persons with dementia interviewed reported the following benefits:

  • “Peace of mind – You can now sleep at night, you now know if anything happens you know about it.”
  • “On one occasion he fell asleep whilst cooking. Telecare woke him up – it would have been fatal only for telecare.”
  • “It gives me great peace of mind at night and I know she is safe regarding the cooker and/or water being left on.  It has been a great benefit to me.” 

In 2010 a partnership was formed between ASI, WRC and TER and the collaboration became part of the INDEPENDENT project. “INDEPENDENT is a European pilot project that brings together twenty partner organisations across six European Member States which aims at better capitalising on information and communications technology (ICT) when it comes to supporting older people in their communities. The ultimate goal is to empower older people to maintain their independence.”

This funding has been used to enhance the communication between the telecare alerts received by TER from the homes of people with dementia and ASI. This was done via a web based portal, through which ASI staff can now log in and see how their clients are using the telecare.  

The new web based portal allows the Home Care Co-ordinators at ASI see exactly when the alert happened in their client’s home and the response to it. They can then adjust the care delivery to match their clients changing needs. The portal also allows ASI to recycle packages, directing them to new service users in need of telecare thus making the service more efficient.

P4.2. Electronic assistance services for people with dementia

Schneider Cornelia, Willner Viktoria, Turcu Ileana, Spiru Luiza

Background: People with mild to moderate dementia have to deal with a lot of challenges in their daily life. Generally, they have problems with time-space relationships and orientation even at familiar places. They suffer from moderate memory loss and have troubles in handling complex problems. Common routes and various tasks (shopping, housekeeping or simply taking a walk) become a daily challenge. As a result they get fearful, unsure in their daily routine, and consequently they gradually lose their mobility, independence and social insertion. Recently, it became more and more clear that various information and communication technology (ICT) based applications might significantly support the elderlies in dealing with their dementia caused deficiencies. A great challenge in assisting people with dementia is the extreme individual variability of their disabilities.

The Confidence project: Confidence aims at providing assistance services for people with mild-to-moderate dementia, adaptable to their individual needs. Its main goal is to offer a mobile phone application that combines “assistive technologies” with “personal help”. The mobile Confidence application is planned as a “virtual companion”, able to provide different levels of assistance that can be adapted depending on the situational needs of the patient and the degree of orientation loss. Conceptually five assistive modules are planned: (1) assistance and training at home, (2) virtual voice service, (3) virtual video service, (4) location tracking service and (5) mobile community service. For example if people lose their orientation the service will be activated either manually or automatically and the necessary help will be provided. A special aim of the project is to build up a community consisting of family members, employees of home care agencies and trusted volunteers (neighbours, friends or social volunteers). The community members will use the Confidence application for collaborating in providing integrated services for people with mild-to-moderate dementia. Estimated impact

Assistive applications initially envisaged physical and sensory disabilities of the elderly. The current multidisciplinary research equally envisages the cognitive ones. Such applications may significantly improve the quality of life of the elderly and may reduce the burden of formal and informal carers. Additionally, they represent one of the golden answers that science and technology may provide to global aging and ‘dementia crisis’ challenges, by improving the long-term assistance of people with special needs and by reducing their institutionalisation and care costs.

P4.3. MedRAM: An autonomous medication management framework to schedule, remind and monitor adherence

Hartin Phillip, Nugent Chris, Chen Luke, Hoey Jesse

With non-adherence of prescribed medications estimated to directly contribute €125 billion in annual healthcare costs and in addition to being attributed to approximately 194,500 deaths a year in the European Union, the need for improved adherence is increasing rapidly. There are many factors that contribute to non-adherence, however, the most prevalent is forgetfulness. Alzheimer’s disease, and other forms of dementia, exacerbate forgetfulness due to a decline in performance of executive functions, such as working memory, attention, planning and task switching, all of which are required to accurately manage a medication schedule independently. The aim of this work is to develop an autonomous medication management system, to adaptably schedule medication times in accordance with the activities of the user, deliver reminders when necessary and to reliably monitor adherence to the medications with minimal human intervention.

The proposed MedRAM (Medication Reminders and Adherence Monitoring) system makes use of smart environment technologies to provide a technological approach to medication management to relieve an element of the burden for carers and to provide an accurate measure of adherence. Each user will have their own medication profile describing their prescribed medication times, dosages, special instructions in addition to any drug interactions. Sensors embedded in household objects are used to detect the location and current activity of the user, such as eating, sleeping or watching television. Based on their activity an intelligent reminder service will determine the best time to deliver a reminder, in the best suitable format. For example, if the user was watching television, using Smart TV functionality, the television will pause and prompt the user that they are due to take their medications. Another example is if a certain medication should be taken with food, and the user is currently eating, they would be reminded that they should take their medication at the same time. The system will be capable of monitoring and recording medication adherence times via sensors located in the medicine cabinet. The medicine cabinet will also be weight sensitive, measuring the quantity of the dose taken to ensure the prescribed dose was administered.

The MedRAM system has the potential to address the aforementioned barriers relating to forgetfulness for persons with Alzheimer’s disease, by unobtrusively assisting the user with one aspect of their daily lives that demands high performance of executive functions. The developed system will be evaluated in an assisted living facility to establish its impact on adherence levels.

P4.4. DEM-DISC: an ICT tool for customised advice on care and welfare services

van Mierlo Lisa, Meiland Franka, van Hout Hein, Dröes Rose-Marie

Objectives: Though a wide variety of care and support services are available for the growing number of community-dwelling people with dementia and their informal carers, the available care and support is not effectively used by them. Reasons for this are: they are not aware of the offer, are not referred to it or do not use it because they expect the available care not to be attuned to their needs. The DEMentia Digital Interactive Social Chart (DEM-DISC) was developed to provide carers of persons with dementia with demand-orientated, web-based, tailored information on the social chart for dementia care. A pilot version was tested in a controlled trial and the results were positive: persons with dementia and informal carers had more met, and less unmet, needs, while informal carers reported higher levels of sense of competence compared to the controls. The aim of the present study was 1) to further improve the pilot version of the DEM-DISC so that care and support advice can be provided in a more tailored way, and 2) to evaluate the user-friendliness, usefulness and effects of the improved DEM-DISC among (in)formal caregivers and people with dementia, and to study barriers and facilitators of the implementation of DEM-DISC.

Methods: To evaluate the effect of DEM-DISC on (in)formal caregivers and people with dementia a randomised controlled trial was conducted as part of a larger study into casemanagement. People in the experimental group received DEM-DISC in addition to casemanagement for at least half a year up to one year, while people in the control group received casemanagement, but did not have access to DEM-DISC, they gathered information regarding available services as usual (via the general practitioner, newspaper, internet). Primary outcome measures were (un)met needs of persons with dementia and informal caregivers, sense of competence of informal caregivers, and experienced added value of DEM-DISC in professional caregivers. The user-friendliness and usefulness of  DEM-DISC is measured by the USE-questionnaire among informal and professional caregivers. A process evaluation was done using semi-structured interviews with stakeholders, to get insight into barriers and facilitators of implementation of DEM-DISC. The study is performed in four regions of the Netherlands.

Results: Preliminary results indicate that informal caregivers find DEM-DISC relatively easy to learn and user-friendly. First impressions of professional caregivers are that, though they value DEM-DISC as an important tool, they expect new (and less experienced) employees to benefit most from using DEM-DISC. Professional carers think DEM-DISC can be particularly useful when referring clients to care services outside the region they work in. Further results on the user-friendliness, usefulness, and effectiveness of DEM-DISC will be presented at the conference.

Conclusion: The DEM-DISC is a promising tool to support carers of persons with dementia with tailored information on care and welfare services in dementia care.

P4.5. Assistive Technology (Welfare Technology) and Dementia – Experiences from Alma´s House

Aketun Sigrid, Stigen Linda

Background for project: In Norway more than 70 000 persons have dementia and the number will probably double by 2040. Research and experience show that people with dementia and their family carers do not have sufficient information and access to assistive aids and technology that could support them and make their situation better and safer.

Aim of project: Establish a centre for welfare technology with a demonstration flat that contains dementia friendly physical environment, assistive aids and technology. The target groups of the centre are health personnel, decision makers and the public, as well as persons with dementia and their carers with individual visits.

Method: Develop and describe the process of the different visits by different target groups. The flat was designed in co-operation with an architect with competence in universal design and a lighting designer. In addition there was carried out a service design process, describing the needs of and designing the service for the different target groups and the content in different demonstrations. Emphasis is put on designing the service as a dynamic link in the process of improving and supporting the home situation of people with dementia. Also the process of obtaining or applying for different aids technology was discussed and planned.

Results and conclusions: The target of designing a demonstration flat with dementia friendly environment and welfare technology is reached.  From 9th of October 2012 the flat is in operation as a new service for knowledge and competence at the Oslo Geriatric Resource Centre. The service and demonstrations include a dynamic co-operation with different actors and institutions, including local occupational therapists and other health personnel, dementia teams, nursing homes and the national insurance agency for funding of technology. It is also an arena for dialogue with researchers, developers and distributors of technology, as well as users.

Alma´s House is run and serviced by occupational therapists with specific competence in dementia, and knowledge of welfare technology for activity, wellbeing, participation and safety. This is crucial for the quality and content of the service.

P4.6. Using gaming technology to benefit people with dementia

Hicks Ben, Cutler Clare, Innes Anthea

There is little research exploring the experiences of people with dementia and their engagement with technologies such as the Nintendo Wii, Nintendo DS and the Apple I Pad. Engaging people with dementia and their carers in the use of these technologies can promote social engagement, mental stimulation, and physical activity. This presentation will report on a pilot project, conducted in the South of England involving people with dementia in a ‘Technology Club’, which aimed to encourage engagement in social and leisure activities through the use of the above technologies. It will also explore the behaviours adopted by the researchers to ensure people with dementia were able to participate and engage with the activities.

This pilot study identified that the Technology Club provided opportunities for social interaction, stimulation and access to learning. There was huge significance around the desire to learn and the importance of support. The Nintendo Wii and Apple I Pad were found to be the most enjoyed and beneficial technologies used. In particular participants reported that bowling and balance games were the most fun of all the Wii games.  Google Earth, was the most popular app used on the I Pad. The Nintendo DS proved to be less popular due to its small screen and difficult navigation routes. Researcher’s behaviours were key in removing the ‘fear factor’ associated with technology and encouraging people with dementia to participate and engage with the gaming activities.

Technology can aid people with dementia in developing and acquiring new skills and knowledge. Games and apps such as bowling, balance games and Google Earth are exciting ways to encourage people with dementia to exercise, challenge their physical abilities and to have fun. However, the facilitating behaviours of those leading the activity sessions are vitally important in ensuring its success. A larger research study is required to test the initial findings on a larger scale.

 

 
 

Last Updated: Monday 25 November 2013

 

 
  • Acknowledgements

    The 23rd Alzheimer Europe Conference in St. Julian's, Malta received funding from the European Union, in the framework of the Health Programme. Alzheimer Europe and the Malta Dementia Society gratefully acknowledge the additional support provided by foundations and companies.
  • European Union
 
 

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