collaboration on smart textiles

Communication in Dementia Care Friday 23rd March 2007 Dublin

Technology and Dementia;A Health and Social Care

perspective from Northern Ireland

Suzanne MartinLecturer Occupational Therapy

University of Ulster at Jordanstown


Overview

• Northern Ireland Context

• Technology within health and social care

• Current University activity

• Aspirations


But First…

• University of Ulster– Lecturer– Researcher– Consultancy

• Clinical Practice– Acute Sector– Community

• Adults/childrensDisability• Environmental Design• Assistive Devices


Northern Ireland Context

• Review of public administration

• Bamford review of mental health and learning disability

• Establishment of Dementia Centre

• Statutory and non-statutory agencies


Review of Public Administration

• One Health and Social Services authority (April 2008)

– 7 Local Commissioning Groups• Mapped to district councils• Demand led by patients• Driven by GP’s and primary care professionals

• One patient and client council • 5 Trusts (ambulance service remains as single trust)


Bamford review of mental health and learning disability

• Concluded – Making it happen conference 31.10.06

• ‘Leader fuller lives’ consultation

• Outcomes for dementia


Northern Ireland Dementia Centre

• Funded by Atlantic philanthropies

• Dementia Services Development Centre at Stirling

• Based at a business park within the University of Ulster at Jordanstown

• Assistant Director


Strategic ContextRegional, National and Europeandirectives to exploit ICT with Health andSocial care

• People First 1990,• ICT Strategy 2001,2002, 2004,• Community Care Review 2002• Information for Health 1998, • NHS Plan 2000,• Building the Information Core 2001• eEurope 2002


Innovative practice driving bottom up approach to change

• HPSS Commissioners of Services• Housing Associations• Charitable Organisations

Statutory provision of technology via CSA in line with PASA Telecare contract

Operational Context


Agencies

• Statutory– Health– Housing– Department of social

development

• Non-statutory– Alzheimer’s society– Help the aged– Age concern– Housing

• John of God

Interagency collaborations and partnerships


Emerging Service Models:– Health and Social Care Provision in

Partnership across Statutory and Non-Statutory Agencies

– Exploitation of Mixed Economy of Funding Streams

– Tenants as Commissioners

Sociocultural and political Context


• Service User Expectations

• ICT Development– Decreased Cost

• Communications, Peripherals and Hardware

– Increased Capability• Data Gathering and Analysis to Inform Health Care

– Increased Device Stability– Enhanced Standardisation and Compatibility across

Devices

Other factors influencing change


Technology within Health and Social Care


What is technology?

Assistive technology‘ … a broad range of devices, services,

strategies and practices that are conceived and applied to ameliorate the problems faced by individuals who have disabilities.’ Cook 2002


What is a Smart Home ?

Definition:

“A dwelling incorporating a communications network that connects the key electrical appliances and services, and allows them to be remotely controlled, monitored or accessed.”

Remotely in this context can mean both within the dwelling and from outside the dwelling.

Source: DTI – DTI Smart Homes Project – September 2003


Smart Home Hierarchy

1. Homes with intelligent objects

2. Homes with intelligent objects that communicate

3. Connected homes

4. Learning homes

5. Attentive homes(Aldrich 2003)


Why?Continuum of service

• Who ?

Just Inside ?

Or Inside & Out ?

• Where ?

• What?


Movement

Smoke

Pull Cord

wirelessPhone line

Fall Detector

Hi-Low Temperature

Bed Occupancy

Wandering Person

Flood

Pendant

Risk Management Technologies


Environmental Control Systems

SENIOR Pilot

SRS 100 SRS Lite

SICARE Light


Environmental Control Systems

Buddy Buttons Leaf Switch

Suck/Blow Switch Thumb Switch Cap Switch


A Whole Systems Approach

• Unique individuals• Diverse care scenarios• Diverse environmental contexts• Intra-agency • Inter-agency

Complex service provision with interaction / connectivity of component parts essential for

service delivery


A Whole Systemscontributes to

• Clarity of activity sequence facilitates a streamlined process

• Clear roles and responsibilities• Identifies agency links • Traceable information flows• Enables service controls • Facilitates user centred focus to service

delivery• Supports evolving Health and Social Care


Societal Level - Virtuous Feedback Loops

Increasing Deployment To Technology To

Support Community Care

Increasing Visibility At Local Level Anecdotal Evidence Of Impact

Increasing Demand To Continue To

Exploit Technology To Support

Community Care


Service Provider Vicious Feedback Loops

Increasing Use Of

Technology

Increasing VisibilityIncreasing Demand On

Budgets To Fund Technology


University activity in this context

• Research

• Teaching

• Consultancy


Research

MATCH


Advent xt

ALTec Smart Personal SensorsNeck & Wrist Personal Triggers

Fall DetectorEnuresis Sensor

Advent xt Intercom

Client Wander Keypad

PIR Movement

Detector

Bed Occupancy Detector


COLLABORATION ON SMART TEXTILES


Hillmount Close Cedar Foundation & Habinteg Housing Association

– There are seven apartments all of which are fully adapted

– The tenant group includes people with physical disability, brain injury and sensory impairment

– It combines housing with care and technology to increase independence and enhance quality of life. The tenants can utilise the latest in assistive technology to manage the tasks of daily living

– Evaluation carried out on:• Service Model• Experience of tenants and care staff


Emerging Technologies


DGHome – Telecare Platform

STB

Control Center

DGHome platform

remote management of user’s alarms

tele-monitoring of clinical parameters

Control medical compliance

tele-support and remote management of user’s agenda

e-government services

Alarm

communication with social and health Services Centre

Communication

STB receive siganls from environmental

sensor (radio communication) and

send alarm to DGHome platform

M3 PlatformMEDICATION MANAGEMENT on MOBILE


Consultancy-KTP

Non- Complex:– Pressure Mats with Alarms– Electric Bells with Lights– Audible Door Alarms– Medication Management Systems– Emergency Call Pendants


Consultancy-KTP

Complex:– Networked Home

Environments– Data Gathering and

Analysis– Interface Design for

Tenants and Carers– Multi-agency

Provision

Ulster institute for eHealth

KTP dedicated staff

UUTECH consultancy


Teaching

• MSc in Dementia care

• CPD Occupational Therapists– Post grad. Module– Awareness sessions– EAT forum

• BSc Hons Occupational Therapy


Technology within healthcare….

Complex Interagency Collaborative Working

Person Centred Service Provision• Context in which People Live• Geographical Location• Environmental Design of Home• Technology Specification• Functional Limitations of Disability


NetWell Project

• Area– Exploitation of emerging ICT Technologies for Ageing in Place

• Funder– INTERREG IIIA

• Description– The NETWELL project is a pilot component part of the larger Nestling

Technology Initiative programme aimed at developing an all-island centre of excellence for ‘models for ageing-in-place’ based on the appropriate exploitation of emerging ICT technologies. Initally focussed in the East-Border Region, the project envisages growth throughout the eligible area in future stages, and ultimately into pan-european networks.


CPVS

• Area– Providing Video support via mobile phones to ageing people

with dementia

• Funder– ETAC (US Alzeimer’s Association, Intel Corp and Agilent)

• Role– Technical development, Prompting, Home-based,back end

analysis


Mobile Phone-based Video Streaming

• Area– Providing Video support via mobile phones to ageing people

with dementia

• Funder– HPSS R&D RRG

• Role– Back end analysis


COGKNOW: Helping People With Dementia Navigate Their Day

• Area– Decision support and decision reinforcement for people

with dementia

• Funder– EU FP6 eInclusion STREP

• Role– Technical coordinator

• Description– The challenging aim of our proposal is to breakthrough with

research that addresses these needs, for the percentage of those with mild dementia in Europe. At about 2% of the elderly population, this equates to around 1,900,000 people. In order to achieve our aim, practically this means helping people navigate through their day. This entails cognitive reinforcement, and may be expressed as the social objectives of our research for the needs of people with dementia, helping people to remember, maintain social contact, perform daily life activities and enhance their feelings of safety.


i-Living labs

Kitchen Area(Sink, cooker, fridge etc.)

Living Area(Sofa, TV, light etc.)

Benches(Scope, soldering, PCBs etc.)

Workspace for 4 people

Workspace for 4 people


Communication is important


Challenges

• Recurrent Funding for Mainstreaming

• Prioritising Service Developments in Line with HPSS and Corporate Targets

• Managing Changed Mode of Service Delivery– Staff Expectations– Service User Expectations


Challenges

• Understanding Available Evidence– Telemedicine, Telecare, Teleconsultation,

Smart Home, EAT, ICT, Ambient Home Environment, Ubiquitous Intelligence.

– Development of Health and Social Care or Move of Acute Sector Provision into Community Setting ?

• Health Promotion with Fit Healthy ?– Risk Management Devices & Services


• World Health Organisation (2002) International Classification of Functioning Disability and Health

• Evolving Social Model of Disability- biopsychosocial model

• Challenges of delivering Health and Social Care to future populations with a changing demographic profile

Opportunities


Opportunities

• Service Process Re-engineering

• Target Priority Areas

• Learn from Available Examples

• Lead Innovative Service Developments


What is a Smart Home ?

“TECHNOLOGY”

IT IS NOT JUST SIMPLY


Electronic Assistive Technology in Health and Social Care

Supported Independent Living Via Tailored Integrated

Services & Technologies


Concluding aspirations

• Strategic policy to support innovative aspirations

• Robust research methodologies applied to emerging applications to provide evidence to support further development

• Funding– Provision and clarity


Thank You

[email protected]


Websites

• Review of public administrationhttp://www.rpani.gov.uk/

• Bamford reviewhttp://www.rmhldni.gov.uk/

• Living fuller liveshttp://www.rmhldni.gov.uk/dementia-consultation-july06.pdf


• Dementia service development centre

http://www.dementia.stir.ac.uk/

• PASA

http://www.pasa.nhs.uk/PASAWeb/Productsandservices/Telecare/LandingPage.htm

collaboration on smart textiles

Health & Medicine

social care provision

social care perspective

social care people

community care review

evolving health

assistive technology

service delivery

use of technology