Tag: aged care

Why is there interest in Internet-assisted in-home healthcare

There is a strong interest in using Internet-based connectivity as a tool for facilitating in-home healthcare.

Bluetooth-connected pulse oximeter

A Bluetooth-connected pulse oximeter in action

This involves the use of a mix of sensor types that are typically used to observe a patient along with the use of regular, mobile and other computing devices to process and present this information to the carers and to the medical professionals. It also includes implementing voice and video telephony to allow medical professionals to communicate with the patient without the need to frequently travel to where they live.

Why the interest?

Ageing at home

This is where a senior citizen is able to live independently at their home as much as possible but have supporting care from relatives, friends and professional carers.

tablet computer used as part of in-home telemedicine setup

A tablet used as part of an in-home telemedicine setup

One of the reasons driving “ageing at home” is the fact that the generation of people born through World War II and the post-war Baby Boomers will be entering their senior years which will place strong demands on health care and welfare facilities that cater to this group of people.

Another is that an increasing number of aged-care facilities have been associated with substandard quality of care“I don’t want to end up in the nursing home”.  This is brought about with more of us being aware of this level of care either through observing how those we have known in our life’s journey that were looked after in those facilities were being treated, or hearing about instances of substandard care in the media such as the infamous “kerosene bath” incident that hit the news in Australia in the early 2000s.

This has also been driven by the trend towards health-care deinstitutionalisation affecting geriatric and palliative care where there isn’t a desire to rely on large facilities for this kind of care.

Other healthcare needs

Increasingly hospitals are looking towards “hospital in the home” or similar programs as a way to provide ongoing care for convalescent patients and those with illnesses that require long-term attention. Here, the care associated with what would typically be provided in a hospital, typically nursing-focused procedures, would be offered at the patient’s home but with visiting nurses, doctors and allied staff.

Even obstetric care is also affected by this trend, with an increased preference for minimal hands-on professional care for low-risk mothers when they go in to labour. Similarly, low-risk psychiatric care is being delivered at home thanks to telecommunications-based technologies.

The advantages that are being put forward for this kind of care is that the patient can stay in the familiar surroundings of their home and, again, has been underscored by the concept of deinstitutionalisation in healthcare. Governments and others also see it as a cost-saving because they can focus a hospital’s beds towards those needing acute care.

The rural community are seeing an application for this kind of technology so as to avoid the need for frequent long-distance travel which would be of importance when it comes to specialised or advanced healthcare.

How is the kind of healthcare delivered?

Here, the focus is on observational healthcare where medical professionals can assess the situation based on either the data that is collected or through communications with the patient. In some cases, it may be based on an event-driven principle where the professional is alerted if the situation goes beyond certain limits.

This is facilitated through the concept of “telemedicine” where the data is conveyed through an Internet connection and has been facilitated through various technologies.

One of these is “machine vision” where one or more cost-effective high-resolution cameras feeds images in to a platform-based computer which runs software that recognises and interprets these images for medical use. One application that was put forward was to observe a patient’s pulse using a camera that observed the brightness of one’s face as the heart beats. Another application is to use a smartphone’s or tablet’s camera to read fluid-analysis strips as part of assessing urine or blood while an app in that device interprets this information rather than a person comparing what is seen on the strip against a chart.

Another of these is the implementation of common communications technologies like Bluetooth, Zigbee or Wi-Fi in sensor devices. This can lead towards the existence of cost-effective sensor devices that can work with existing computer devices with a minimal need for extra hardware, while these devices can use cost-effective software to interpret and present this information. This has led to startup companies and tech innovators developing devices like “wandering-alert” socks that work with Bluetooth and apps.

What needs to be done?

An issue that will affect in-home telehealth is where device manufacturers and health providers legally stand when it comes to providing these services.

One of the questions that is being raised is the use of non-medical sensor devices for medical applications. One of the scenarios is the use of a general wellness device like a fitness band or a wellness-focused thermometer as a medical sensor for clinical purposes. Another scenario would be the use of a “non-wellness” sensor like a security system’s PIR and door sensors, a home-automation sensor, or a smartphone’s camera for medical-observation purposes with these devices feeding their data to software running on a platform-based computing device.

These questions are being examined by the US’s Food and Drug Administration with respect to wellness-focused devices serving as medical devices in this context. But implementing home automation and security in this context may require a case-by-case assessment based on the actual installation and would only work with geriatric, psychiatric or allied situations where observational healthcare is the order of the day.

Similarly, software that uses devices like cameras for medical reasons like “machine vision” may have to be certified by medical-device authorities to be sure that the software provides accurate results no matter the input device. In the case of software that uses cameras, there would be a requirement for a minimum resolution for the camera to turn out consistently accurate results.

Conclusion

Once the issues that affect the provision of Internet-assisted in-home health care are identified and worked out, then it could be feasible for the home to be a place to deliver continual health care.

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The CSIRO considers the Internet Of Things a viable alternative to the alarm pendant

Article

Why the CSIRO is building smart homes for elderly Australians | IT News

My Comments

The typical situation to assure the welfare of an  elderly, disabled or chronically-ill person who is living alone at home is to have them wear a pendant or wristband panic-button that signals carers or loved ones if they need help.

But issues have been raised about these devices being, for example, left somewhere in the home because the person forgets to wear it after they have finished an activity which may not play well with these devices. As well, these wearable devices are only of value if they trigger the device in response to an emergency situation like a fall.

The CSIRO are looking towards the use of the “Internet Of Everything” as a way of monitoring the welfare of these people, a use case which I do frequently refer to in the context of this technology.

Here, they would use commonly-available sensor technology like the motion sensors that are part of every intruder-alarm system, or flow meters and power meters on appliances; or door-contact sensors on wardrobes or kitchen cupboards to observe for normal activity.

Along with this, the CSIRO effort also wants to use health sensors like blood-pressure monitors or scales to register a person’s health statistics and it has been valued because the patients will be wanting to know how they are doing along with the ability to provide more knowledgeable information to their doctor about their symptoms.

They want to use knowledge of past health incidents affecting elderly, disabled or chronically-ill people to train the machine-learning algorithm to identify the abnormalities at an earlier stage rather than when a serious incident occurs. Of course, any machine-learning setup needs to be able to adjust to newer legitimate changes so as to avoid any “false positives”.

A question that will always be raised is the cost to set up this kind of observation with it costing less than AUD$3000 because of the use of common technologies and components rather than specialised hardware.

The topic of privacy has also been raised because the CSIRO monitoring system is based on cloud technology and Internet-based data access, and is of importance to reduce the risk of elder abuse. Here, the goal is to allow the patients to control their data so that it is exposed to whoever they trust in a granular manner. This is more so with relatives because they may be trusting of certain people within their family.

As well, the features that have been raised as being of importance to the elderly community for this personal-health monitoring setup include the ability to know who is at the door, the ability to engage in videocalls with family and friends along with the ability to know if one has forgotten to turn off a tap or appliance. This can easily affect older people who may become increasing forgetful about these things such as a burner on the newer gas cooker being left on but turned really down or not being able to hear clearly that the washbasin tap is still running.

The effort that CSIRO is undertaking is to be able to allow an elderly or other vulnerable person to live independently yet be able to know that help is at hand while their loved ones are sure that they are well.

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Microsoft implements Internet of Things to support ageing at home

Article – From the horse’s mouth

Lab Of Things Helping Seniors Who Live Alone | Microsoft Research

My Comments

I have provided a lot of coverage regarding the concept of technology assisting the “ageing at home” principle where older and infirm people can stay at home and live in dignity knowing that the people close to them and their carers can act as a safety net for them.

Here, I had covered technology being used to guide seniors with shopping and food-preparation along with use of existing technology like cameras for medical observation. I have also covered in an article about CSIRO doing research in this field with a view of using the “Internet Of Everything” technology like energy sensors, movement sensors and smart locks to assess whether someone is keeping well such as knowing if they are going in to the kitchen to keep themselves nourished or if they are surfacing and going outside to collect the paper or mail.

Microsoft is working with their research laboratories in China to address the issue of ageing at home in the Asian communities. This is because these communities are becoming increasingly older like most of the world thanks to the good healthcare that is being made available to them.

Here, they are identifying how older people who are living independently at home coping, including factoring in cultural issues. They are also implementing robotics to build a medical-supplies trolley to serve the medicines that these people will need at the proper times as well as shoehorning the Kinect movement sensor as a fall sensor to detect if one is falling or convulsing.

The medicine trolley doesn’t just work with medicines that require regular doses but also can work with medicines that are taken in response to symptoms like asthma attacks and is based around knowing what the symptoms will look like. The Kinect sensor as a fall sensor has to work in a manner to assure personal privacy which is important because of the fact that some of these falls or convulsions can occur when one is using the bathroom or toilet and these devices could be located there.

What I see of this is various technologies that make use of the computer, the home network and the Internet Of Everything are being used to create a safety net for older people or people with chronic illnesses who want to preserve independence and dignity.

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Bluetooth Smart technology to detect if Grandpa has the wanders

Article

16 Year Old Develops Bluetooth Smart Solution to Keep Alzheimer’s Patients from Wandering | Bluetooth Blog

From the horse’s mouth

SafeWander (SensaRx)

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Video

Overview (Click / Tap to play in YouTube)

NBC 4 New York News report (Click / Tap to play in YouTube)

My Comments

A 16-year-old had developed a device which alerts someone else if a person like an Alzheimer’s patient wanders out of bed. This boy, Kenneth Shinozuka, was inspired to develop this device because of an incident where he was out with his grandfather at age 4 and Grandpa wandered off and was lost. Here, this brought to his family’s attention that Grandpa had Alzheimer’s disease.

A situation that was very common for him and his family was that his aunt who was his Grandpa’s primary carer wasn’t sleeping properly because she worried that if she slept, he would climb out of bed and wander absent-mindedly.

Here, he designed the device to be attached to the patient’s sock, slipper or foot to sense foot pressure associated when they climb out of bed to start wandering. This device uses a Bluetooth Smart (Bluetooth Low Energy) link to a suitable smartphone that is equipped with an “alarm” app that audibly alerts the carer and shows up a timer to show how long they have been off the bed. There is the ability to set up a threshold and a “hold time” so as to allow for situations like the patient going to the bathroom at night to do what he has to do.

He developed this device through a few science fairs including the Google Science Fair where he got the respect and was given the Google Science Fair Global Finalist prize amongst a few other awards. Scientific American and Popular Mechanics, both respected science and technology magazines even gave him awards for this device. He was able to use the prototype with his Grandpa and his aunt in this situation and she was able to claim a lot more sleep each night because of not worrying if he was about to get the wanders overnight.

Kenneth saw this as being important for the “ageing at home” phenomenon where older people are staying at home in the care of family members and friends rather than going in to care at nursing homes or similar facilities. He is evolving the technology towards other aspects of this phenomenon like a bathroom floor that senses if someone is falling and a medicine box which alerts the older person to take their pills at the right time.

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CSIRO to use mobile-platform app as part of system to support ageing at home

Article

CSIRO app to help older people live at home safely | Aged And Community Services Australia

My Comments

Increasingly, the home network is becoming a key feature to support the “ageing at home” concept where an older person can live in their home yet is monitored for signs of ill-health or is assisted as they complete regular tasks using the technology supported by these networks.

One of the main goals is to support the concept of deinstitutionalisation in aged care and allied health care, which is becoming more relevant as we see an increasingly-ageing population accelerated by the baby boomers reaching the old age. This concept also reduces the need to build many aged-care facilities which also reduces the costs associated with building them.

There have been efforts in the UK to provide for dignified independent living for older people including the use of projected text to remind Alzheimer’s patients of stages in a cooking procedure and a GPS system to help with shopping. Similarly, IRIS who is a company in the US is distributing through an American chain of  hardware stores products and services that also are about keeping tabs on one’s elderly relatives. This is being augmented by Fujitsu refining technology that makes a digital-camera image sensor measure one’s pulse which comes in handy with in-home aged care.

In the latest effort, the CSIRO have established a system to help with this concept. This is based around a mobile-platform tablet that works along with a system of sensors to observe the health and well-being of the senior citizen.

Energy sensors aren’t just to “be green” in this case, but to monitor use of appliances as part of a healthy daily lifestyle. For example, knowing if they have used the kettle to make a cup of coffee or tea at all or the use of a “cooking device” such as the stove, the microwave oven or toaster oven indicates if the person is well and looking after themselves. Similarly, knowing if they have left the oven or stove hob on for too long can indicate a dangerous situation.

Similarly, those motion detectors that are part of a security system can also identify whether the person has entered particular rooms like the kitchen as part of their regular activities. These work alongside various health sensors like blood glucose monitors or pulse monitors to observe the health of the older person.

This information is presented on a mobile-platform tablet to allow the person to see how they are keeping with life and a carer or the person’s loved ones can know what is going on if there are abnormalities. There are options in this system to help with assuring data privacy so that people only have access to this data only if they need it as part of the health-care plan for the elderly person.

Some other devices can work as part of this same equation such as the new breed of residential “smart locks” that effectively work as a business-grade access-control system for our homes. Here, they could be able to identify whether the door was locked or not and, preferably, identify whether it was locked or unlocked from inside or outside. This could, for example identify whether they got up and went outside to get the paper or mail for example thus knowing if they are well.

There can be questions raised about the use of technology as part of “ageing at home” in the context of over-monitoring the elderly population or stripping out the personal aspect of the care that is to be provided to this population. What needs to happen is that relatives and friends, along with professional carers need to engage with the older person for their health and welfare and not just have these systems monitor them for abnormalities.

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IRIS now integrates home automation to the ageing population

Article

Iris Care Lets You Know When Your Parents Have Fallen and Can’t Get Up | Gizmodo

My Comments

As part of a new trend for the home automation and security industries, there is strong interest in technology to facilitate “independent ageing”. Here this allows older people or those of us with chronic illnesses to be able to live independently yet there is the gentle eye for illnesses or accidents.

Iris, which is sold through the US Lowes hardware-store chain, have set up an option for their home-automation and security offering which does this. Here, you have the standard medical-alert fob that hangs around the person’s neck but there is the ability to notify if certain things are out of order as you determine. For example, you could know if there is continual normal movement or, for example, know if the front door had been left open or the stove was left on at an odd time.

What I see of this is that the industry is answering to the ageing baby-boomer population which is becoming older; and a desire for “ageing with dignity” where an older person can live independently yet their relatives and friends are safe in the knowledge that they are OK.

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