An Assisted-Living Home Architecture with Integrated - ICMCC

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An Assisted-Living Home Architecture with Integrated - ICMCC

An Assisted-Living Home Architecture with Integrated

Healthcare Services for Elderly People

as perceived by INHOME IST-45061, R&D Project

VMW Solutions Ltd

INHOME Project IST-045061

An Intelligent Interactive Services Environment for Assisted Living at Home

ICMCC Conference

London, 9-11 June 2008


Overview

Issues Addressed:

Medical Scene, Needs & Challenges

Medical Scene, Technology Update

Medical Scene, Way to the Future

INHOME, A Solution on Assisted Living

INHOME, Needs Addressed & Objectives

INHOME, Architectural View

INHOME, User & Medical Requirements

INHOME, Medical Scenario

INHOME, Benefits to Elderly Population

Conclusions & Future

Questions & Answers

INHOME Project, IST-045061 Slide 2


Medical Scene, Needs & Challenges

Worldwide the population of elderly people grows absolutely and

relatively to the overall population.

More and more consumers will be over 60 years of age. Several

studies and surveys identified a lack of products and services

designed for the special needs of elderly people.

The health condition is getting worst with increasing age; it

depends on personal limitations and becomes more difficult to

carry out the daily tasks. Even simple services supporting the daily

life and giving back a little autonomy are currently missing.

Elderly is a high risk group, the statistical figures are alarming:

The median age of the persons found helpless or dead is 73 years.

Total mortality was 28%; 23% was found dead, an additional 5% died in

the hospital.

Out of 62% of the alive patients, a further 62% were unable to return to

living independently.

Total mortality was 67% for patients estimated to have been helpless

for >72h, as compared with 12% for those who had been helpless for


Medical Scene, Needs & Challenges

(cont’d)

For elderly people who live alone, becoming incapacitated and unable to get

help is a common event. Unfortunately, this usually marks the end of their

ability to live independently.

Among people with Activity of Daily Living limitations, independent reports with

multivariate models showed that use of equipment and assistive technology

was associated with fewer hours of personal assistance.

Assisted living is not a panacea, negative effects may exist if not adopted

appropriately:

Risk of over-reduction of informal caregivers services to the elderly

Psychological negative consequences for the elderly

Health status deterioration because of lower degree of attention

Greater demand for services / Rise in services use

Program costs higher than predicted/expected

INHOME Project, IST-045061 Slide 4


Medical Scene, Technology Update

Mostly new products are developed with high sophisticated and innovative

features. However the user behaviour of a huge number of these devices is too

complex.

Technology is a key enabler for elderly-friendly homes. Specifically the

innovations and cost reductions in the following areas:

Sensors e.g. body network, bed sensors, indoor sensors

Low cost of wireless communication e.g. 802.11 and Bluetooth

Large availability and cost reduction of broadband

Gateway and set-top box availability and cost reduction

Tele-surveillance, remote video technology and new p&p user-friendly health

care services at home were:

Effective

Well received by patients

Capable of maintaining quality of care

Potential for cost savings

Caregivers' psychological burden decreased substantially

Total cost of health and social public services used per client dropped

by 17% after the first 3 months and by 39% in the second 3 months

INHOME Project, IST-045061 Slide 5


Medical Scene, Way to the Future

Houses should be adaptable to allow elderly occupants to remain at home and

minimize the cost of service care.

Most companies do not design their houses to be adaptable, as demand for

adaptable housing is currently low.

But this will change, especially due to governmental and European legislation.

For example, UK is amending its home construction rules to build houses that

would suit the needs of senior Britons.

By altering national standards on home constructions, the U.K. seeks to reduce

by 60 percent the number of falls suffered by the elderly, which reach 1.25

million incidents a year and costs the National Health System 750 million

pounds (1 billion of Euros) in health bills.

Both public organisations and private health should be appropriately equipped,

trained and deployed for providing efficient, user-friendly and personalised

home care.

INHOME Project, IST-045061 Slide 6


INHOME, A Solution on Assisted Living

It is the aim of the INHOME project to deal with the special needs of

elderly people.

The development of a service aware architecture is one of the main

goals for INHOME.

INHOME partners are developing a framework and relevant enabling

technologies for that will assist the elderly on a daily basis.

INHOME developments will not add additional complexity to administer

or manage; on the contrary the technology will be p&p and pragmatic.

INHOME Project, IST-045061 Slide 7


INHOME, Needs Addressed & Objectives

The goal of the INHOME project is to provide the means and improve the quality

of life of elderly people at home by:

developing generic technologies

managing elderly users’ domestic ambient environment

integrating white goods, entertainment equipment and home automation systems

increasing elderly users’ autonomy and safety

For assisted living, there is the need for establishing implicit and explicit

methods for appliance self-configuration and management, improving

appliance usability.

The exploitation of such methods in the context of multimodal human-machine

interfaces (e.g. phonetic, one-button interfaces, etc.) would allow invoking

appliances’ intelligent functions for the benefit of home users, resulting in

considerable simplification of daily tasks at home.

Contrary to the practises followed up to now, the INHOME project focuses on

the problem of appliances flexible usage by making the separation between

experienced and inexperienced rather than enabled or disabled users.

With this viewpoint, the project is posed to set out a generic set of appliance

design guidelines targeting the intensification of home appliances usage and

user dependency.

INHOME Project, IST-045061 Slide 8


INHOME, Architectural Details

INHOME Project, IST-045061 Slide 9


INHOME, Requirements Case

A health elderly-oriented questionnaire has been created and

distributed in a randomized sample of people living in the Athens

metropolitan area.

The questionnaire consisted of two distinct parts: an open questions

part followed by a closed questions part.

The open questions regarded things or conditions that made life of elderly

people difficult in the home environment as well as actions or services that

would change such difficult conditions.

The closed questions regarded specific targeted services which participants

were asked to rate, based on importance and effectiveness according to

their personal perceived needs and opinions.

INHOME Project, IST-045061 Slide 10


INHOME, Medical Scenario

Medical

Devices

Nonin-4100 Pulse

Oximeter

Bluetooth

Bluetooth

TV

Weight Measurement

Scales

WLAN

Siemens DECT

Phone

Blood Pressure

Monitor

Multi-Service Terminal

HTC P3600

Residential

Gateway

Public Internet

INHOME Project, IST-045061 Slide 11


INHOME, Information Flow – Example Scenario

Medical

device

INHOME

terminal

Residential

Gateway

TV

DECT

phone

The data are

transmitted

over Bluetooth

to the

INHOME

terminal

The INHOME

terminal

forwards the

data to the

Gateway

The service at

the Gateway

pushes the data

to the TV

The service at

the Gateway

checks the

values and if an

alarm is raised

it pushes the

physician’s

phone number

to the phone

INHOME Project, IST-045061 Slide 12


INHOME, Benefits to Elderly Population

Independent living is something that most people take for granted,

during most of their life.

Far from reality for the elderly population, the status of independent

living changes as people’s age changes.

INHOME addresses needs and assists in taking steps to ensure an

independent living. Also, the type of services that should be available

for helping someone to meet personal goals.

It is achieved by offering a broad category of services, based on the

INHOME platform. Regarding the health and medical assistance

services, these are incorporated within the INHOME architecture.

Early detection & intervention

Analysis & interpretation

Efficiency

Independence from caregivers

Independence from physician visits

Affordability

INHOME Project, IST-045061 Slide 13


Conclusions & Future

Current adoption of technology and integrated solutions for elderly home care

will be slow due to restrictions and limitations.

The use of medical monitoring systems with wireless technology and sensors

will enable real-time, remote monitoring while the user can move freely.

Patient information will be stored in a secure database allowing access by

clinicians or carers.

Current consumers’ demand for electronic communication with physicians will

facilitate deployment for home care.

INHOME Project, IST-045061 Slide 14


Thank You, Questions & Answers Session

INHOME Project, IST-045061 Slide 15


Additional Information

INHOME Project, IST-045061 Slide 16


INHOME, Benefits to Elderly Population

In more detail, we mean:

Early detection & intervention: Events such as heart arrhythmias, falls and stumbles can

be detected, alarmed and recorded as they occur, allowing clinicians, nursing staff or carers

to intervene quickly and effectively.

Analysis & interpretation: Clinicians can draw upon more accurate data for analysis and

interpretation and increase compliance to treatment, without increasing costly and

unnecessary patient visits.

Efficiency: Personal monitoring reduces the burden placed on already over-extended

clinical staff and carers.

Independence from caregivers: Patients receiving in-home care are able to maintain a

higher degree of independence and especially in the surroundings of their home

environment that are familiar to them.

Independence from physician visits: Patients who require medical monitoring without the

need for hospitalization can be effectively monitored reducing both costs and patient

discomfort.

Affordability: The cost of providing continuous personal monitoring is lower than the costs

of transporting and accommodating the elderly patients.

INHOME Project, IST-045061 Slide 17


INHOME, User Requirements

List of Difficult Conditions (opened questionnaire):

Difficulty with stairs/ painful movement in the house environment

Sense of loneliness/ need of company/home visits

Respiratory problems connected with pollution/dust

Visual acuity problems/ need of larger symbols/images/buttons

Dishwashing/ need of assistance with household/ with cleaning the house

Difficulty in preparing food

Difficulty in bathing/personal hygiene

Difficulties in taking prescribed drugs/ comply with treatment regimen

Central Heating/ Air-conditioning related problems

Air purification from smoke and dust

Too many and complicated household appliances/ electronic devices

Need of somebody to assist in /perform shopping/grocery

Hearing problems with telephone/bell

Difficulty in operating TV set with complicated remote control

Problems with environmental noise

INHOME Project, IST-045061 Slide 18


INHOME, User Requirements

List of Services Considered Helpful (opened questionnaire):

Easier and more frequent communication with friends, relatives and family

members

Elevators or ramps and house entrance preferably at ground floor in order to

reduce the number of stairs

Automatic turning of TV set and lights off when falling asleep in the living room

Direct and easy communication with hospital/physician in case of

need/emergency

Medication reminder apparatus

Loudspeakers for telephone/door bell

Security alarms and services of home environment/notification in case of

emergency

Automatic or assisted repair of household appliances in case of malfunction

Design of one single remote control device for all electronic devices and

household appliances

INHOME Project, IST-045061 Slide 19


List of Desired Services (closed questionnaire):

When leaving the house, with one keystroke all appliances switched off.

Usage of cordless phone when someone rings at door to ask who it is/ open the door.

On holiday lights are automatically switched on/ off to simulate that I am at home.

Remote diagnosis on appliances by after-sales service.

Individual "home-coming" scenario: when entering the house, desired light setting, music/ TV

program is switched on/On way home (e.g. from work) switching on of heating/ air-conditioning

so that rooms are warm/ cool upon arrival at home (especially lights on).

In case of fire, water leakage, burglary, alarm is automatically transferred to mobile phone/

neighbour/ police/ security firm.

When answering phone volume of TV/ stereo is automatically turned down.

Medication reminders.

INHOME, User Requirements

Retrieval on TV screen of operating instructions for electronic devices.

Roller blinds automatically open/ close depending on time of day/ day of the week.

Automatic failure report of household appliances.

On way home switching on of heating/cooling so that rooms are warm/cool upon arrival.

Usage of TV/ remote control to see who rings at the door/ to open the door.

Individual "getting-up" scenario: by setting alarm clock, lights and TV are automatically

switched on and bathroom gets pre-heated.

INHOME Project, IST-045061 Slide 20


INHOME, Medical View on Requirements

Difficulties and Conditions as observed by HCV during elderly home visits:

Difficulty in using the common home appliances (washing machine, telephone, TV)

Difficulty in understanding buttons and programmable devices

Forget to turn off appliances

Difficulty in changing burnt light bulbs

Difficulty in preparing food

Difficulty in getting up from bed/couch/sofa especially when low

Difficulty in washing/drying clothing

Difficulty in reaching objects placed in very high/very low places

Difficulty in lifting weights/moving objects with both hands

Difficulty in climbing stairs

Difficulty on using the bathroom/ performing personal hygiene

Difficulty in cleaning the apartment

Difficulty in opening and closing the windows/roller blinds

Difficulty in keeping the air clean and fresh in the house/apartment

Difficulty in putting on shoes, stockings

Difficulty with slippery floors and carpets

INHOME Project, IST-045061 Slide 21


End of Presentation

INHOME Project, IST-045061 Slide 22

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