BMC Med Inform Decis Mak - Deployment of assistive living technology in a nursing home environment: methods and lessons learned.

Tópicos

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Resumo

CKGROUND: With an ever-growing ageing population, dementia is fast becoming the chronic disease of the 21st century. Elderly people affected with dementia progressively lose their autonomy as they encounter problems in their Activities of Daily Living (ADLs). Hence, they need supervision and assistance from their family members or professional caregivers, which can often lead to underestimated psychological and financial stress for all parties. The use of Ambient Assistive Living (AAL) technologies aims to empower people with dementia and relieve the burden of their caregivers.The aim of this paper is to present the approach we have adopted to develop and deploy a system for ambient assistive living in an operating nursing home, and evaluate its performance and usability in real conditions. Based on this approach, we emphasise on the importance of deployments in real world settings as opposed to prototype testing in laboratories.METHODS: We chose to conduct this work in close partnership with end-users (dementia patients) and specialists in dementia care (professional caregivers). Our trial was conducted during a period of 14 months within three rooms in a nursing home in Singapore, and with the participation of eight dementia patients and two caregivers. A technical ambient assistive living solution, consisting of a set of sensors and devices controlled by a software platform, was deployed in the collaborating nursing home. The trial was preceded by a pre-deployment period to organise several observation sessions with dementia patients and focus group discussions with professional caregivers. A process of ground truth and system's log data gathering was also planned prior to the trial and a system performance evaluation was realised during the deployment period with the help of caregivers. An ethical approval was obtained prior to real life deployment of our solution.RESULTS: Patients' observations and discussions allowed us to gather a set of requirements that a system for elders with mild-dementia should fulfil. In fact, our deployment has exposed more concrete requirements and problems that need to be addressed, and which cannot be identified in laboratory testing. Issues that were neither forecasted during the design phase nor during the laboratory testing surfaced during deployment, thus affecting the effectiveness of the proposed solution. Results of the system performance evaluation show the evolution of system precision and uptime over the deployment phases, while data analysis demonstrates the ability to provide early detection of the degradation of patients' conditions. A qualitative feedback was collected from caregivers and doctors and a set of lessons learned emerged from this deployment experience.CONCLUSION: Lessons learned from this study were very useful for our research work and can serve as inspiration for developers and providers of assistive living services. They confirmed the importance of real deployment to evaluate assistive solutions especially with the involvement of professional caregivers. They also asserted the need for larger deployments. Larger deployments will allow to conduct surveys on assistive solutions social and health impact, even though they are time and manpower consuming during their first phases.

Resumo Limpo

ckground evergrow age popul dementia fast becom chronic diseas st centuri elder peopl affect dementia progress lose autonomi encount problem activ daili live adl henc need supervis assist famili member profession caregiv can often lead underestim psycholog financi stress parti use ambient assist live aal technolog aim empow peopl dementia reliev burden caregiversth aim paper present approach adopt develop deploy system ambient assist live oper nurs home evalu perform usabl real condit base approach emphasis import deploy real world set oppos prototyp test laboratoriesmethod chose conduct work close partnership endus dementia patient specialist dementia care profession caregiv trial conduct period month within three room nurs home singapor particip eight dementia patient two caregiv technic ambient assist live solut consist set sensor devic control softwar platform deploy collabor nurs home trial preced predeploy period organis sever observ session dementia patient focus group discuss profession caregiv process ground truth system log data gather also plan prior trial system perform evalu realis deploy period help caregiv ethic approv obtain prior real life deploy solutionresult patient observ discuss allow us gather set requir system elder milddementia fulfil fact deploy expos concret requir problem need address identifi laboratori test issu neither forecast design phase laboratori test surfac deploy thus affect effect propos solut result system perform evalu show evolut system precis uptim deploy phase data analysi demonstr abil provid earli detect degrad patient condit qualit feedback collect caregiv doctor set lesson learn emerg deploy experienceconclus lesson learn studi use research work can serv inspir develop provid assist live servic confirm import real deploy evalu assist solut especi involv profession caregiv also assert need larger deploy larger deploy will allow conduct survey assist solut social health impact even though time manpow consum first phase

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