ICT solutions and new welfare technology facilitating integration

Why was this example implemented?

It is expected that the number of older people living at home with poor functional ability as well as cognitive impairment is increasing. Appropriate services with technological solutions supplied at the right time will help these people to manage their activities of daily living and therefore support their independence at home. This also requires good cooperation between older people, informal and formal carers as well as integration of services. There have been problems in integrating services, in creating a safe and manageable solution in the home setting, and in cooperation between different actors.

There was a need to develop more productive and functional processes that help in supporting  older people to sustain a good quality of life and to be able continue living at home longer. With this ISISEMD  project, Eksote has been able to address different interfaces between health care professionals and other actors. The care processes can be made more functional for example with a partnership where a local authority, health and nursing entrepreneurs as well as technology and communication companies are taking part.

Description

ISISEMD is a European project aiming to improve the quality of life of older people with pre- and mild dementia living in their own homes, as well as improving the quality of life of their caregivers, by offering innovative intelligent customised services. The service aims to support the needs of older people from this target group to live safely at home, to self-care by supporting their basic daily activities and to facilitate daily interaction with relatives, friends and caregivers, giving them the feeling of safety and preventing social isolation.

The project is piloting a set of innovative and intelligent scalable services that will support the independent living of older people in general, and older people with cognitive problems or mild dementia in particular, and at the same time supporting  formal and informal carers in their daily interaction with older people.

The objective of ISISEMD is to offer a platform that differentiates it from existing solutions instead of offering one single tele-care system. It is not competing with existing solutions but aims to work in conjunction with them and integrate them in a novel manner.  For example, take an older person with mild dementia who lives by herself and may fall in the bathroom during the night. The ISISEMD system has a bedsensor which is set to alarm informal or formal carers if she doesn’t return to her bed after 30 minutes. The carer will go and check the situation. If the older person goes out shopping,  she will take the tracking device (Lommy) with her. This tracker also includes a falling sensor and if she falls the device sends an alarm to  informal/formal carers. A voice connection can be made via Lommy to the older person to assess the situation. Also available to carers is a tracking device showing location and coordinates on a map to see where she is.  To demonstrate applicability in Europe, the operation will be validated, evaluated and tested in realistic conditions for a 12 month period in four Member State regions which have extensive experience in innovative tele-homecare services for older people. Eksote is representing Finland and is one of the four end-user organisations testing the solutions. ISISEMD is being carried out from 2009 to 2011. Implementation ended at the end of June 2011, and the final evaluation data is being collected.

ISISEMD system was developed during the project and before the pilot started, ten end users, ten informal and two formal carers were trained to use the system. Training was offered by project staff and project staff installed the equipment.

The system works automatically in the background at older peoples’ homes, so extensive training is not needed for the end users. How older people were able to use the system and in what capacity depended upon the type of service they had installed and the extent of the training they had. This variability also extended to how reminders were shown on the touch screen.

Informal caregivers have been trained to use an internet portal where they can control the ISISEMD system, edit sensor settings and see what kind of events home safety sensors have detected at older people’s home. Training took approximately 2 hours and available at a later time if the informal carer needed it.

Formal carers were given the same training as informal carers. Training costs were covered from project staff costs.

ISISEMD system has been developed during the project with all participants:

• Aalborg University
• North Denmark EU office
• Belfast, UK
• Frederikshavn, Denmark
• Eksote (Lappeenranta), Finland
• Trikala, Greece
• Alcatel-Lucent, Italy
• Converge ICT Solutions & Services, Greece
• Eltronic, Denmark
• Hewlett Packard, Italy
• Socrate Medical, Italy
• Institute of communication and computer systems, Greece

The equipment cost was €2000-€3000 depending on what equipment had been installed. Equipment costs cover touch screen computer, sensors and wires. Installing costs varied between €200-€400 depending on the size of the older person’s  home.

What are/were the effects?

The quality of life of older people, formal and informal carers was studied in the beginning, during and at the end of the project using questionnaires and interviews. Various tools for measuring the quality of life were used such as AD, ADL, IADL, MMSE and MoCA. The informal and formal carers also replied to a Zarit Burden Interview (ZBI) which measures their level of burden. Their user satisfaction and acceptance were also studied with structured interviews.

Furthermore, the use of health services of older people was monitored during the project. Evaluations on effects of utilizing technological solutions as well as cost analysis are being made.

The sample size in the Finnish pilot was 21 people, which was divided between the pilot (10) and control groups (11). The other three pilot countries were Greece, Denmark and UK where sample sizes ranged between 10 to 20 older people.

First results:

• The system supports older people with dementia and their relatives in their daily activities and the older people were able to  manage at home longer.
• The system makes older people feel safer at home.
• Informal carers are able to see whether an older person is at home and whether everything is fine and reduces informal carers' stress.
• Reminders and date and time information helps older people control their lives, because they do not need so much support from caregivers.
• Home care is able to take care of more older people with the same resources.

What are the strengths and limitations?

Strengths

• Cooperation between different actors together with technological solutions support older people to live at home longer.
• Informal carers' stress concerning older peoples’ survival at home can be reduced.

Weaknesses

• Some ICT solution problems.
• Learning to use new technology solutions takes time.

Opportunities

• Using telemedicine solutions increases the productivity of work.
•  New solutions can facilitate the integration of services.

Threats

• Slow diffusion rate, the acceptance of using the new technology may take time, especially among older people.
• There is not enough money to develop practice.

Credits

Author: Merja Tepponen, the South Karelia Social and Health Services (Eksote), Teija Hammar, National Institute for Health and Welfare (THL)
Reviewer 1:
Reviewer 2:
Verified by:

External Links and References

• www.isiemd.eu
• Jani Taalikka:ISISEMD-projektin teknologian käyttöönoton arviointi. Evaluatioin of implementation of ISISEMD project technology. Saimaa University of Applied Sciences, Lappeenranta, Degree Programme in information Technology.Final Year Thesis, 2010 (in finnish with English abstract)
• Heikki Hilvonen:  Usability in Assistive Technology for Elder. Lappeenranta University of Technology. Final Thesis will be available end of 2011