Kevin Doughty

A smart fall and activity monitor for telecare applications

The design of a smart sensor to detect falls and monitor activity is discussed in terms of its integration within an intelligent telecare system. The proposed device measures the impacts associated with a fall and monitors the status of the faller to identify whether assistance is required. The device thus distinguishes between a fall-event (faller gets up of their own accord) and a fall-alarm (faller remains down) and transmits an appropriate message to a local intelligence unit (LIU) which is connected to a response network. Fall-event codes provide essential input data for algorithms to determine fall prediction indices (FPI), whilst fall-alarm codes instruct the LIU to automatically notify an appropriate care provider. The device also provides a measure of activity which may be utilised in the automatic calculation of the activities of daily living (ADL), for use by social workers and occupational therapists for continuously determining a persons ability to live independently in the community. It is hoped that such a device will promote an integrated approach to the management of falls by the elderly in the community.

Socially dependable design: The challenge of ageing populations for HCI

This paper considers the needs of an ageing population and the implications for Human Computer Interaction (HCI) research. The discussion is structured around findings from interviews with medical and care professionals and older people. Various technologies are being successfully used to monitor for falls and other emergencies, and also to assess and manage risk. The design of this technology is currently driven by a medical model of client needs and takes little account of the social context of the home. The design challenges for HCI are to make this technology attractive, provide privacy, allow informed choice and reduce rather than increase the isolation currently felt by many older people. It is argued that the ageing population presents a fundamental challenge to HCI in the need for socially dependable systems. Socially dependable systems take account of social context, the need for sociability and are accessible to all who need them.

A systems approach to achieving CarerNet-an integrated and intelligent telecare system

The system requirements for an integrated telecare system are presented by using a modification of the CORE methodology. The resulting system model uses viewpoint analysis to establish the needs and requirements of both the client and the care providers within a system context and discusses the implications for a user-centered, technology-based solution referred to as CarerNet. The implementation of CarerNet is considered in terms of the enabling technologies required within the local environment of the client and identifies the monitoring, networking requirements, and system intelligence necessary to the provision of a comprehensive telecare service. A hypothetical case study based on patient aftercare following discharge from the hospital is presented to illustrate the points discussed.

SPAs (smart phone applications) – a new form of assistive technology

Purpose – This paper seeks to describe how the special built‐in features of modern smart phones can be used to open up the potential of these devices for use as assistive technologies in supporting the independence and quality of life of vulnerable people.Design/methodology/approach – The paper describes, through a number of relevant examples, how low‐cost, downloadable applications enable the camera, the microphone, the accelerometer, the GPS receiver and the touch‐screen, to be used for specific assistive purposes.Findings – Smart phones and their applications are capable of providing useful support to a range of vulnerable groups including people with sensory disabilities, diabetics and people suffering from mental health problems, epilepsy or communication issues. It is likely that mobile care services using smart phones will be offered in tandem with home telecare services to extend the independence of the service user from the home to the outside environment.Originality/value – The paper demonstrate...

Safety and risk issues in using telecare

The increasing adoption of technology to support independent living at home through the extended use of community alarms and, ultimately, second-generation telecare systems poses some safety problems. The implications of any failure of the technology must be addressed in order to provide a safe and reliable care service. The risks of using home-based technology can be assessed by standard techniques under three categories: environmental factors; human factors; and technological factors. A safety classification system for telecare devices is proposed leading to a range of design guidelines which represent good practice. An example of the use of these design principles is a prototype second-generation telecare system, MIDAS, which is currently undergoing trials. In order to reduce the risks associated with device failure, the system incorporates distributed intelligence, built-in self-testing and redundancy. Potentially hazardous situations can therefore be controlled.

Telecare, telehealth and assistive technologies — do we know what we're talking about?

The development of telecare services across the UK has been supported by grants from the respective governments of Scotland and Wales, and by the DH in England. New services are being established to sometimes operate alongside existing community equipment services and community alarm services. Elsewhere they are embracing a wider range of services including rehabilitation, intermediate care and health services designed to reduce the use of unscheduled care services. This paper discusses the difficulties in understanding the scope of telecare services, and the definitions of services that will need to be confirmed so that service users can choose appropriately if offered direct payments. Two different service models are offered, one of which uses telehealth as an umbrella term to cover all telecare, e‐care and m‐care, and telemedicine where the former includes all such services offered in the service users home, including those of a medical nature. The second model views telecare alongside assistive technologies and telemedicine as one of three different technology groups designed to make people more independent or to bring care closer to home. There is significant overlap between the three groups, which justifies the introduction of a new term ‐ ARTS (assistive and remote technology services) ‐ to describe this area of support.

Continuous assessment of the risk of falling using telecare

The prevention of falls in the elderly could be based on risk assessment and the prediction of when an individual is likely to sustain an injury. A telecare system should allow the dynamic assessment of risk to be produced by a control centre computer, based on data transmitted from local sensors in the elderly persons home. A fall risk index could be calculated from mobility, activities of daily living and medication. However, substantial data-sets will be required before such fall risk indices attain statistical significance. As they are developed, fall prediction algorithms could be constantly reviewed and modified in order to reach the point where an acceptable level of accuracy is reached.

Continuous automated telecare assessment of the elderly

An automated scheme is proposed to assess the ability of elderly people to live alone in the community. It employs an Enhanced Activities of Daily Living index based on a computerized questionnaire form. In addition, a number of low-cost sensors have been developed which provide electronic measures of certain activities; these can provide additional inputs to the assessment form using telemetry. The sensors are capable of measuring a wide range of functional performance, thus providing the means of continuously and objectively assessing a patients condition following hospitalization.

DIANA-a telecare system for supporting dementia sufferers in the community

This paper describes the design of an integrated second generation telecare system which provides monitoring and support of demented patients living alone in their own homes. It employs a number of non-invasive sensors to measure the patients everyday activities and habits as a function of time in order to determine an on-going dementia lifestyle index (DLI). Slow increases in this index can be tracked as an indicator of decline in cognitive function. Environmental factors are also recorded electronically. Local intelligence is employed to compensate for confusion or forgetfulness while a telephone response centre provides further information and reminders which can be displayed within the home environment. Wandering is countered using a paging device which emits a locatable low-power radio beacon. The DIANA system reduces the risks associated with community living for older people suffering from dementia.

The role of telecare in the protection of individuals from domestic violence

Domestic violence is a threat to the well‐being of many families in the UK, and a great burden on health, social care and police resources. Its management requires swift action either to protect the victims in their own homes, or to move them to more appropriate accommodation where the perpetrators will be unable to find and harm them. However, the risk of violence often remains and requires some immediate action and access to support services on a 24‐hour basis. Special call lines have been created both at national and at local level, but these are not always suitable when there is a risk of the perpetrator being aware of such communications. Telecare offers a more sophisticated and responsive way of managing the risks, and is becoming popular with local authorities across the country. While basic systems using alarm pendants to raise an alert are popular with most authorities, the addition of smart sensors and the use of video monitoring can both be used to good effect. In the future, it may be assumed that a much wider range of telecare devices will be deployed to provide automatic detection of problems, and to ensure that victims of abuse are protected appropriately both in their homes and in other locations. Most local authorities use at least some elements of telecare, but there may be considerable potential for improving support by including a greater level of technology, some of which could be provided through Supporting People programmes or through the police.