Dementia Care Research and Psychosocial Factors

Area of Science:

• Gerontology and Aging in Place Technologies
• Health Informatics and Remote Patient Monitoring
• Human-Computer Interaction in Assistive Technologies

Background:

• Falls are a significant injury risk for individuals with cognitive impairments, requiring advanced detection and response systems.
• Ambient sensing technology offers continuous monitoring and customizable alerts to reduce unnecessary emergency service calls.
• This study investigated the practical application of tiered response protocols for fall management in home care environments.

Purpose of the Study:

• To explore the feasibility and acceptability of implementing ambient sensing technology for fall detection in home care.
• To assess the effectiveness of customizable escalation protocols involving a 'circle of friends' versus direct emergency dispatch.
• To gather qualitative feedback on user preferences and implementation barriers for remote fall monitoring systems.

Main Methods:

• A feasibility study involving 25 participants across 23 homes utilizing two ambient sensing systems (fall detection and broader monitoring).
• An alert center processed notifications, verifying fall details, occupant status, and escalating through a 'circle of friends' or to emergency services based on preference.
• Qualitative feedback was collected from 8 client care managers and families to evaluate the system's usability and identify challenges.

Main Results:

• A strong preference (24/25 families) for escalating alerts to a 'circle of friends' over automatic 911 calls was observed.
• The system demonstrated flexibility and customization in its escalation pathways, meeting diverse family needs.
• Inactivity alerts, learning daily routines, effectively minimized false alarms by enabling pre-escalation confirmation checks.

Conclusions:

• Ambient sensing technology, coupled with personalized escalation protocols, presents a viable and well-received solution for fall detection in home settings.
• The 'circle of friends' model enhances personalized care, reducing reliance on emergency services and mitigating concerns about inappropriate interventions.
• Further research is recommended to refine protocols and confirm efficacy across varied care environments.