Koen Milisen

Use of physical restraint in nursing homes: clinical-ethical considerations

This article gives a brief overview of the state of the art concerning physical restraint use among older persons in nursing homes. Within this context we identify some essential values and norms that must be observed in an ethical evaluation of physical restraint. These values and norms provide the ethical foundation for a number of concrete recommendations that could give clinical and ethical support to caregivers when they make decisions about physical restraint. Respect for the autonomy and overall wellbeing of older persons, a proportional assessment of the advantages and disadvantages, a priority focus on the alternatives to physical restraint, individualised care, interdisciplinary decision making, and an institutional policy are the central points that make it possible to deal responsibly with the use of physical restraint for older persons in nursing homes.

Camera Based Fall Detection Using Multiple Features Validated with Real Life Video

More than thirty percent of persons over 65 years fall at least once a year and are often not able to get up again unaided. The lack of timely aid can lead to severe complications such as dehydration, pressure ulcers and death. A camera based fall detection system can provide a solution. In this paper we compare four different fall features extracted from the dominant foreground object, as well as various combinations thereof. All tests are executed using real life data, which has been recorded at the home of 4 elderly, containing 24 falls. Experiments indicate that a fall detector based on a combination of aspect ratio, head speed and fall angle is preferred. The preliminary detector, which still has a substantial false alarm rate with a precision of 0.257(±0.073) and a promising recall of 0.896(±0.194), gives insights for further improvement as is discussed.

Mealtime care on a geriatric-psychiatric ward from the perspective of the caregivers: a qualitative case study design

This study aims to obtain insight into the care process surrounding mealtimes within a geriatric-psychiatric ward from the perspective of the caregivers. A qualitative study was carried out in accordance with the case study method. Data was generated by participant observation, semi-structured interviews, and focus groups. A mealtime turned out to be a much more complex event than it appears to be, looking at it superficially. The caregivers recognize the valuable therapeutic meaning of the mealtime. Nevertheless, they experience internal conflict when it comes to certain significant problem areas in their search for a balance between the functional-organizational approach and the patient-oriented approach.

Semi-automated Video-based In-home Fall Risk Assessment

The development of an in-home fall risk assessment tool is under in- vestigation. Several fall risk screening tests such as the Timed-Get-Up-and-Go-test (TGUG) only provide a snapshot taken at a given time and place, where automated in-home fall risk assessment tools can assess the fall risk of a person on a contin- uous basis. During this study we monitored four older people in their own home for a period of three months and automatically assessed fall risk parameters. We selected a subset of fixed walking sequences from the resulting real-life video for analysis of the time needed to perform these sequences. The results show a sig- nificant diurnal and health-related variance in the time needed to cross the same distance. These results also suggest that trends in the transfer time can be detected with the presented system.