assistive technology workshop 2013

with Lifestyle Choices

Assisted Living Technology Workshop

Tahir Idris & Steve Bonner

Assistive Technology Consultants


Today’s Workshop

What you go away with is dependent on how many

questions you ask, so please choose to share your own

personal experiences!


INTRODUCTIONS BACKGROUNDASPIRATIONS


Assistive Technology:

Any device or technical means by which a person is able to live more independently and safely and perhaps be able to regain

lost skills and abilities. These devices may or may not be something the user is aware exists or is in place, nor does it necessarily

require them to have any technical knowledge to make use of the equipment.

Assistive Technology and other enabling Technologies...


An AT device can be as simple as:

Or as high-tech as:


AT is an umbrella description of a number of technologies including:

Aids to daily living.Physical adaptations.Telecare and social alarms.Safety equipment.Lifestyle Monitoring.Safe Walking.Telehealth / Telemedicine.Communication aids and environmental controls.Relaxation and therapy devices.


Active Assistive Technology

A piece of equipment that the user is aware of, knows its function, and which requires the direct participation of that user to operate, e.g. pressing a button to

unlock and open a door.

A piece of equipment that the user is either unaware of, and/or which requires no direct participation of that user to operate. The device

operates automatically in response to some outside influence, e.g. a triggered smoke alarm may switch off the electricity to a stove or other

appliance.

Passive Assistive Technology

Assistive Technologies fall into two broad categories based on how their use is implemented and to what purpose they are put. In general terms AT equipment can be classed as:


Telecare

An electronic device that acts as a safety net to maintain the health, safety and well-being of an individual without impeding their normal daily

activities and does not usually require them to have any awareness or technical knowledge of that device.


TeleMedicine and/ or Telehealth

Equipment which is used to monitor a users vital medical readings, generally when they are within their own home environment. - Those readings can be stored, accessed and acted upon remotely by a GP or other health professional. This approach allows the user to remain at home whilst they may otherwise be retained 'under observation' in hospital.


The tip of the Iceberg.....

.

Next: Aids to Daily Living and Physical Adaptations


Aids to Daily Living:

Any device or technical means by which a person is able to live more independently and safely and perhaps be able to regain lost skills and abilities.

Invariably they are simple low-tech, low cost items, which can be readily bought from most high street

shops. Usually no technical knowledge or specialist installation is required.

Aids to Daily Living and Physical Adaptations


Aids to Daily Living


Physical Adaptations


Good building design and layout may reduce or remove

the need for assistive or enabling technologies!


Next:Social Alarms and Telecare


Social Alarms

Social Alarms and Telecare


Telecare

An electronic device that acts as a safety net to maintain the health, safety and well-being of

an individual without impeding their normal daily activities and does not usually require them to have any awareness or technical

knowledge of that device.


Active Assistive Technology

A piece of equipment that the user is aware of, knows its function, and

which requires the direct participation of that user to operate, e.g. pressing a button to unlock and

open a door.

'Active' Assistive Devices


Passive Assistive Technology

A piece of equipment that the user is either unaware of, and/or which requires no direct

participation of that user to operate. The device operates automatically in response to

some outside influence, e.g. a triggered smoke alarm may switch off the electricity to

a stove or other appliance.

'Passive' Assistive Devices


Next: Telehealth and Telemedicine


Telehealth and TelemedicineEquipment which is used to monitor a users vital medical readings, generally when they are within their own home environment. Those readings can be stored, accessed and acted upon remotely by a GP or other health professional. This approach allows the user to remain at home whilst they may otherwise be retained 'under observation' in hospital. If appropriate it may also allow for remote consultation with a GP or health professional.


Telehealth


Telemedicine


Next: Lifestyle Monitoring


Equipment which discreetly monitors a persons normal daily activity e.g. cooking,

using appliances, moving around the home. If they deviate from a typical daily

pattern or no activity is detected, an alarm can be raised with a carer or a relative.

Unusual activity can also be used to flag up potential health or well-being issues.

Lifestyle Monitoring


Lifestyle Monitoring and Assessment

Assess a persons ability to manage their own care without external support.

Identify underlying health issues.

Provide hands-off monitoring/support after discharge from hospital or nursing care and during recuperation.


Provide a care safety net without excessive intrusion.

Monitor a person with a deteriorating physical or cognitive condition e.g. Parkinsons, MS, dementia, and decide on an intervention at an appropriate time.

Manage risk situations e.g. falls or fire, without constant supervision.


Next: Prompts & Reminders


Prompts and Reminders

Just a few of the areas of risk are:

Forgetting to switch off domestic appliances, e.g. cooker, or failing to switch off taps.Not securing the home or not taking adequate security precautions when answering the door to callers.Forgetting to take medication at appropriate times or taking excessive doses of medication.


Prompts and Reminders


Talking Handbooks


'I'm OK', an alternative to morning calls.

Alerting by exception.Can be used to remind user

of appointments, medication times, etc.Paging / messaging to provide information or

warnings (e.g. arrival of community transport, bogus

callers alerts, etc).


Hearing and Visual Impairment


Next:Communication and Social Interaction


Communication and Social Interaction


Talking Handbooks


Video Communication

Television-based 'Skype' communication.No computer or computer skills needed.Uses existing TV remote control or wireless keyboard.Looks like a Wii/Kinect.


Software also allows users to communicate with a standard PC, Laptop or

Netbook.

Communication software configured to work with the

Apple iPad and iPhone platform using high quality

speech engines.

Tablets, Apps and Smartphones


Environmental Controls


Mobile Telephones

•Simplified keypad functions.•Large buttons.•Easy to read display.•SOS/Emergency call options.•Pay as You Go.•Low cost: loss or damage less of an issue.


Next: Safe Walking


Safety on the Move ('Safe Walking')

The emergence of GSM (Mobile Telephone) and GPS (Global Positioning) better network coverage,

and the dramatic reduction in cost, has made the use of GSM and GPS a viable option for supporting

people to live a more independent lifestyle.

The ability for vulnerable people or those with a learning disability to get out and about on their own

has come to be know as 'Safe Walking'.

Safe Walking


•GPS embedded technology.•SOS buttons.•Man Down / fall alerts.•Connection to social alarm call facilities.•Text messaging / Google-maps etc.•Useful for Lone Workers or those in vulnerable situations.


•Geo-Fencing•Real time tracking•'Ping' to get location•Accurate to within 5 metres


A taste of the Future?


Next: Dementia


Dementia


'Nana' Technology


'grouple'

'ode'


'buddi band'

'Trading Times'

'DementiaDog'


'Giraffe'


Next: Ethics


Ethics of Technology Use?


Thousands of old people 'drugged'

More than 22,000 elderly people in nursing homes are being given powerful sedatives for no medical reason, it has been claimed.

A report by the Liberal Democrats suggests residents who do not need these drugs are being kept sedated to make life easier for staff.

Its health spokesman Paul Burstow said the situation may be even worse in residential homes.

"Quite simply the over medication of older people is abuse," he said.

The report's figures are based on a review of British and international studies in this area and information released to parliament.

BBC News November 2003


Comments?

Next: Case Studies


Case Studies


CASE STUDY A

Mr and Mrs Smith

Mr and Mrs Smith have been married for 55 years. Mr Smith has dementia, and due to his restless sleep patterns, Mr and Mrs Smith sleep in separate beds, but in the same room.

Mrs Smith is her husbands main carer, and will assist him whilst going to the toilet at night and coax him back to bed if he becomes agitated.

Being on call 24 hours a day has taken its toll on her health, energy and sleep patterns, and a recent incident particularly upset Mrs Smith.

One evening Mrs Smith was physically exhausted and did not wake up when her husband get out of bed and left the room. She was awakened to the sound of her husbands cries coming from the bathroom. He had found his way into the shower cubicle in the bathroom, closed the door behind him, and due to the clear glazed screen, was unable to work out how to get back out of the shower unit.

Mrs Smith has now resorted to 'tethering' her wrist to her husbands with a piece of ribbon, but still finds it difficult to get a good nights sleep.


CASE STUDY B

Billy W

Billy is 10 years old and is autistic. From an early age he has had a tendency to 'escape' from the house through open doors, so his parents ensured that the garden was enclosed with a fence Billy could not get over.

Now he is older and taller he can scale this fence in seconds if he is outside and unsupervised. The external doors have standard Yale type locks so cannot be secured from inside, and now Billy can easily open the doors to make his getaway.

Unfortunately there have been a number of incidents when he has left home in the middle of the night in his pyjamas as his parents slept, and been picked up by the Police.

It is a Housing Association property and Billy's parents asked them to fit a secure lock on his bedroom door, but they refused due to the risk to his safety in the event of a house fire.


CASE STUDY C

Miss W

Miss W moved into an Extra Care scheme with her sister. Both had a diagnosis of early onset dementia. Unfortunately within the first 2 months of them moving in, her sister died.Which left Miss W both bereft and becoming increasingly confused.

The flats in the housing scheme had secure wings for residents to stop visitors from entering private dwellings from the communal areas. These secure areas were accessed by the use of a 'fob' swipe door system.

Miss W would leave her flat to visit the communal areas and socialise with staff and other tenants, but started to forget to take her keys and fob with her. As a result she would be unable to get back to her flat and walk around the communal area becoming more upset and confused.


CASE STUDY D

Mr Y

Mr Y has mental health issues with a diagnosis of schizophrenia. He has no concept of danger. He lives alone within a housing scheme where there is a care support presence and all supported tenants are connected to care staff via a call alarm system.

Mr Y has been re-homed into this supported dwelling because he has managed to set fire to his previous 6 tenancies due to his actions.

Examples of what has been witnessed is him trying to fry an egg in 1” of cooking oil in a pan, and wanting to pour a cup of water into his electric toaster because he had burnt the toast and it was smoking.

As a result it has been decided that he should not be allowed to prepare any meals requiring the use of cooking appliances without care staff supervision.


CASE STUDY E

Mrs W

Mrs W is recently widowed and is frail, but has no cognitive impairment issues. At her daughters insistence she has recently moved from her 3-bedroomed semi-detached property into a 2-bedroomed flat within an 'Extra Care' supported housing development. She has taken much of her furniture and possessions with her.

Mrs W has settled into her new property, and enjoys the companionship of other tenants and the activities which get her out of the flat to socialise. The only problem is that she has started having falls, mainly within her own property. Whilst as yet she hasn't injured herself badly, it has shaken her confidence, and is becoming more and more reluctant to leave her flat, or even out of her favourite armchair.


CASE STUDY F

Mr T

Mr T has had one leg amputated and requires a (self-propelled) wheelchair to get around.He lives in a sheltered housing development in a 1-bedroomed flat. He likes to socialise with other tenants in the communal lounge and activity rooms, but due to his being unable to get out of his wheelchair, requires one of the care staff to come and collect him from his flat so he can be involved in the schemes activities.


CASE STUDY G

Miss N

Miss N is a young woman who has been paralysed due to a road traffic incident. She is in her mid-30's, and has two children. Her paralysis limits her to a small degree of arm movement, but it allows her to perform basic tasks, and operate the joystick on her powered wheelchair.

Miss N has a PA (Personal Assistant) who helps her with bathing, toileting and dressing. She has a good family support network as her mother and father live locally.

She is fiercely independent and wants to look at options to allow her to regain lost skills since her accident. - She has received a substantial insurance settlement to cater for her current and future care needs.


CASE STUDY H

Edward

Edward is a young man in his early-20's. He is confined to a (powered) wheelchair but he has good manual dexterity, so he can mobilise himself using the chairs joystick control.

He lives in a shared property with 3 other physically and/or learning disabled tenants. The tenants are provided with 24 hour sleepover care.

Edward and his fellow tenants enjoy lots of outings and activities, and Edward likes to record these events with his camera, and loves to share his photographs with anyone he meets.

The main frustration for Edward is that his vocalisation skills are very poor and he finds it very difficult to describe his photographs to those he is sharing them with. Also, because of his poor speech he can quite often withdraw within himself and become angry at not being able to communicate his wishes easily.


CASE STUDY I

Mrs B

Mrs B has severe arthritis. During the day she is confined to a wheelchair (which she cannot propel herself) or sits in an armchair, and at night has to be helped to get into bed. She does have a limited degree of mobility in her right hand, which allows her to answer the telephone and operate her television.

She has regular visitors (family and carers), but cannot open the door to them herself. She has made the decision to permanently leave her door on the 'latch' during the day, and when her carer leaves after helping Mrs B to bed, the carer takes the latch off, and closes the door behind her so it is locked.

Her family and carers have concerns that her property is insecure during the day and that Mrs B may be vulnerable to theft or attack.


CASE STUDY J

Mr C

Mr C is a heavy smoker and has a history of alcohol abuse. He lives alone with minimal care support. He has no family to assist him.

He is physically active, but his smoking and drinking have lead to some issues around 'near misses' with fires and cooking accidents.As he lives in a small block of flats, his neighbours are particularly worried about his lifestyle!


CASE STUDY K

Miss W

Miss W is in her early 20's and is profoundly deaf. She is single but she has just given birth to a baby, and moved into her first ever tenancy, which is in a block of flats.

She gets good levels of support from her parents, and whilst they are keen for Miss W to gain her independence, they are concerned about both their daughters ability to cope, and the welfare of their new grandchild.


CASE STUDY L

Mr Y

Mr Y has had a severe degeneration in his vision. This is an inoperable/incurable condition, which makes it increasing difficult to read text unless it is in large print or with a good contrast between paper and text. He has always been an avid reader.

Mr Y finds it very frustrating that he can no longer read letters he is sent, that he cannot read newspapers, and that whilst his local library has large print books, they limit his choice of reading topics.

His daughter has bought him a large 'widescreen' television in the hope that he can at least make out some of the images and keep some connection to the outside world.


CASE STUDY M

Mr G

Mr G has dementia, but he is still fit and healthy, walking his dog every day. Unfortunately one day he took his dog for a walk and got disorientated.

He didn't return home and his absence was reported by his daughter. After an extensive search by emergency services and relatives, Mr G was eventually found 25 miles away... Both he and his collie dog were exhausted and dehydrated.

Since that incident Mr G has lost all confidence about going outside and he has become very depressed.


CASE STUDY N

Miss A

Miss A has a learning disability and lives in a shared supported tenancy. She is obsessive about knowing what she is doing each day almost on a minute by minute basis.

Her carers spend a lot of time describing her day to her, and if they are unavailable, even for a short time, she gets very distressed.

Miss A's care staff are trying to encourage her to become more independent and be aware of her own timetable without constant prompting.


CASE STUDY O

Mr & Mrs F

Mr & Mrs F both have Downs Syndrome and have been living in their own home (with some external care support) for the past 12 months.

Unfortunately they are living in a high crime area and they are too trusting of visitors to their door. They have been victims of bogus callers and people talking their way into their home on numerous occasions, and robbing them of goods and money.

They do have a social worker and some relatives who live a short distance away, but despite their problems with bogus callers, they wish to remain living independently.


CASE STUDY P

Mr D

Mr D has short term memory problems. He is easily distracted and has on a number of occasions forgotten when he has left a tap running in the kitchen or the bathroom.

The result has only been minor floods, but as he lives in an upper flat in a block, his neighbours below have become concerned as it impacts on their own property.

As Mr P also has some health/frailty issues, he has been previously supplied with a 'social alarm' pendant call system.

assistive technology workshop 2013

Health & Medicine

assistive technologies

safety equipment

passive assistive technology

active assistive technology

piece of equipment

physical adaptations

technical knowledge

telehealth equipment