Electronic tracking system and wandering in Alzheimer's disease: a case study.

INTRODUCTION: Wandering is a behavioural disorder, which occurs in Alzheimer's disease or other dementia. People who wander are at risk of physical harm and untimely death. Moreover, wandering behaviour causes a lot of stress to the caregivers. In the last few years, different geolocation devices have been developed in order to minimise risk and manage unsafe wandering. These detection systems rarely meet patients and caregivers' needs because they are not involved in the devices building process. AIM: The aim is to explore the needs and perceptions of wandering persons and their caregivers towards existing tracking devices as well as their acceptability and usability. This paper reports a dyad case. MATERIALS: The tracking system tested is presented as a mobile Global Positioning System (GPS) receiver-shaped, including function of telephony and data transfer via GSM/GPRS. METHOD: Dyad patient/caregiver expressed their needs and perceptions towards tracking devices and gave their impressions about the functioning of the tested device at the end of the test. RESULTS: The patient focused on the device's shape which he found too voluminous and unaesthetic, and was unable to give an opinion about the device's functioning. The spouse highlighted malfunctions and usage difficulties, which made the device not appropriate to her needs. CONCLUSION: Involving end-users in the co-design of new technologies is necessary for building tailored devices. Moreover, in this area of dementia care, the person-centred approach is essential to a tailored wandering management.

What do family caregivers of Alzheimer's disease patients desire in smart home technologies? Contrasted results of a wide survey.

OBJECTIVES: The authors' aim was to investigate the representations, wishes, and fears of family caregivers (FCs) regarding 14 innovative technologies (IT) for care aiding and burden alleviation, given the severe physical and psychological stress induced by dementia care, and the very slow uptake of these technologies in our society. METHODS: A cluster sample survey based on a self-administered questionnaire was carried out on data collected from 270 families of patients with Alzheimer's disease or related disorders, located in the greater Paris area. Multiple Correspondence Analysis was used in addition to usual statistical tests to identify homogenous FCs clusters concerning the appreciation or rejection of the considered technologies. RESULTS: Two opposite clusters were clearly defined: FCs in favor of a substantial use of technology, and those rather or totally hostile. Furthermore the distributions of almost all the answers of appreciations were U-shaped. Significant relations were demonstrated between IT appreciation and FC's family or gender statuses (e.g., female FCs appreciated a tracking device for quick recovering of wandering patients more than male FCs: p = 0.0025, N = 195). CONCLUSIONS: The study provides further evidence of the contrasted perception of technology in dementia care at home, and suggests the development of public debates based on rigorous assessment of practices and a strict ethical aim to protect against misuse.

Level of activity, night and day alternation, and well being measured in a smart hospital suite.

The present paper reports a study on the daily activity of elderly people in a hospital suite, with presence infrared sensors. It is an attempt to produce parameters and indicators for the predictive analysis of the daily activity of fragile persons. A relationship is proposed between well being of the patient and the night and day activities alternation.

Fall detection--principles and methods.

Fall detection of the elderly is a major public health problem. Thus it has generated a wide range of applied research and prompted the development of telemonitoring systems to enable the early diagnosis of fall conditions. This article is a survey of systems, algorithms and sensors, for the automatic early detection of the fall of elderly persons. It points out the difficulty to compare the performances of the different systems due to the lack of a common framework. It then proposes a procedure for this evaluation.

An experimental health smart home and its distributed internet-based information and communication system: first steps of a research project.

We present a study and whole experimental tele-monitoring and medical tele-surveillance system for maintaining patients at home. The project features networked sensors, in a fully equipped apartment, operated by an advanced information and communication system based on Internet, Java, and object oriented modeling. The sensors are connected, mainly wirelessly, with a in-home software module devoted to signals analysis and detection of critical situation such as falls, sickness, sudden palsy, stroke, hypothermia, etc. This module communicates, either via modem or ethernet network, with a remote medical control station in charge of appropriate response to received information and alarms. The system is designed to be a powerful information and communication tools for medical and social workers. It offers a series of functions such as medical file management, user profiles and rights management, drafting and management of ordinances and visit notes, confidentiality of medical information, and management of scenarios of detectable events. The access to the system is allowed to authorized users only (physicians, emergentists, social workers, etc.), and is available on as much authorized computers as needed, by means of a Java applet invoked from any traditional web browsers.

A smart room for hospitalised elderly people: essay of modelling and first steps of an experiment.

We present a study of modelling and the first steps of an experiment of a smart room for hospitalised elderly people. The system aims at detecting falls and sicknesses, and implements four main functions: perception of patient and environment through sensors, reasoning from perceived events and patient clinical findings, action by way of alarm triggering and message passing to medical staff, and adaptation to various patient profiles, sensor layouts, house fixtures and architecture. It includes a physical multisensory device located in the patient's room, and a multi-agent system for fall detection and alarm triggering. This system encompasses a perception agent, and a reasoning agent. The latter has two complementary capacities implemented by sub-agents: deduction of type of alarm from incoming events, and knowledge induction from recorded events. The system has been tested with a few patients in real clinical situation, and the first experiment provides encouraging results which are described in a precise manner.