Information and communication technology solutions for outdoor navigation in dementia

INTRODUCTION: Information and communication technology (ICT) is potentially mature enough to empower outdoor and social activities in dementia. However, actual ICT-based devices have limited functionality and impact, mainly limited to safety. What is an ideal operational framework to enhance this field to support outdoor and social activities? METHODS: Review of literature and cross-disciplinary expert discussion. RESULTS: A situation-aware ICT requires a flexible fine-tuning by stakeholders of system usability and complexity of function, and of user safety and autonomy. It should operate by artificial intelligence/machine learning and should reflect harmonized stakeholder values, social context, and user residual cognitive functions. ICT services should be proposed at the prodromal stage of dementia and should be carefully validated within the life space of users in terms of quality of life, social activities, and costs. DISCUSSION: The operational framework has the potential to produce ICT and services with high clinical impact but requires substantial investment

Adult missing persons:a concept analysis

Missing persons incidents incur considerable societal costs but research has overwhelmingly concentrated on missing children. Understanding the phenomenon among adults is underdeveloped as a result. We conducted an evolutionary concept analysis of the ‘missing person’ in relation to adults. Evolutionary concept analysis provides a structured narrative review methodology which aims to clarify how poorly defined phenomena have been discussed in the professional/academic literature in order to promote conceptual clarity and provide building blocks for future theoretical development. A systematic literature search identified k = 73 relevant papers from which surrogate terms for, and antecedents, consequences, and attributes of the occurrence of adult missing persons were extracted and analysed. The core attributes of the adult missing person are (i) actual or perceived unexpected or unwanted absence accompanied by an absence of information and (ii) a potential adverse risk outcome as perceived by those left behind. The centrality of mental ill-health in actual adult missing persons cases is not reflected in theoretical development which largely comprises descriptive typologies of variable quality and questionable utility. There is a clear need to shift research emphasis towards clinical and psychological domains of inquiry in order to further advance the field of adult missing persons research

Behavioral Management Related to Dementia in the Elderly in a Long Term Care Facility

Alzheimer’s disease (AD) is the most common cause of dementia in adult life and recognized as the most common cause of late life dementia world wide. Care of an elderly individual with dementia requires a systematic approached to the management of behavioral disturbances. The purpose of this project was to provide education regarding management of an elderly individual with behavioral disturbance related to dementia to health care providers in long term care facilities. The project was conducted in three rural long term care facilities. Healthcare providers who receive education can become more competent in intervening with an individual who is exhibiting behavioral difficulties

Constructing dementia and dementia care: daily practices in a day care setting

Abstract • Summary:This article explores the ways in which dementia can be constructed and maintained by the actions, and received ideas concerning dementia, of social care staff practising in a local authority day care setting in the UK.The article is set within the context of ‘daily practice’, the things that we do forming the basis of how things may be (re)defined. • Findings:The study suggests that the physical environment of the day care setting, the routines and activities provided and the practices of care staff indicate three particular ways in which dementia was constructed. These comprised ‘holding and homogenizing’, ‘demarcating and distancing’ and ‘caring and controlling’. Each depended on individual approach, training and experience and was influenced by ‘received’ traditional approaches. • Applications:This is important to our understanding of dementia care as we seek to recognize diverse experiences and to consider pluralistic approaches to best practice in dementia care.The study indicates the need for training at a deep and reflective level in which the new culture of person-centred dementia care becomes part of daily practice rather than a distant ideal

Ambient assisted living deployment aims to empower people living with dementia (AnAbEL)

Ambient Assisted Living aims to support the wellbeing of people with special needs by offering assistive solutions. Those systems focused on dementia claim to increase the autonomy of people living with dementia by monitoring their activities. Thus, topics such as Activity Recognition related to dementia and specific solutions such as reminders and tracking users by Global Positioning System offer great advances that seek users' safety and to preserve their healthier lifestyle. However, these solutions address secondary parties by providing useful activities logs or alerts but excluding the main interested user: the person living with dementia. Although primary users are taken into consideration at some design stages by using user-centred design frameworks, final products tend not to fully address the user's needs. This paper presents an Ambient Intelligent system aimed to reduce this limitation by developing a final solution more strongly focused on enhancing a healthy lifestyle by empowering the user's autonomy. Through continued activities monitoring in real-time, the system can provide reminders to the users by coaching them to keep healthy routines. Continuous monitoring also provides a complete user's behaviour tracking and the context-awareness logic used involves the caregivers through alerts when necessary to ensure the user's safety. This article describes the process followed to develop the system aimed to cover the previous concerns and the practical feedback from health professionals over the system deployment working in a real environment

Wandering as a sociomaterial practice : extending the theorization of GPS tracking in cognitive impairment

Electronic tracking through global positioning systems (GPSs) is used to monitor people with cognitive impairment who “wander” outside the home. This ethnographic study explored how GPS-monitored wandering was experienced by individuals, lay carers, and professional staff. Seven in-depth case studies revealed that wandering was often an enjoyable and worthwhile activity and helped deal with uncertainty and threats to identity. In what were typically very complex care contexts, GPS devices were useful to the extent that they aligned with a wider sociomaterial care network that included lay carers, call centers, and health and social care professionals. In this context, “safe” wandering was a collaborative accomplishment that depended on the technology’s materiality, affordances, and aesthetic properties; a distributed knowledge of the individual and the places they wandered through, and a collective and dynamic interpretation of risk. Implications for design and delivery of GPS devices and services for cognitive impairment are discussed

Design and technical evaluation of an enhanced location-awareness service enabler for spatial disorientation management of elderly with mild cognitive impairment

The progressive ageing of population has turned the mild cognitive impairment (MCI) into a prevalent disease suffered by elderly. Consequently, the spatial disorientation has become a significant problem for older people and their caregivers. The ambient-assisted living applications are offering location-based services for empowering elderly to go outside and encouraging a greater independence. Therefore, this paper describes the design and technical evaluation of a location-awareness service enabler aimed at supporting and managing probable wandering situations of a person with MCI. Through the presence capabilities of the IP multimedia subsystem (IMS) architecture, the service will alert patient's contacts if a hazardous situation is detected depending on his location. Furthermore, information about the older person's security areas has been included in the user profile managed by IMS. In doing so, the service enabler introduced contribute to “context-awareness” paradigm allowing the adaptation and personalization of services depending on user's context and specific conditions or preferences

Location tracking: views from the older adult population

Background: there has been a rise in the use of social media applications that allow people to see where friends, family and nearby services are located. Yet while uptake has been high for younger people, adoption by older adults is relatively slow, despite the potential health and social benefits. In this paper, we explore the barriers to acceptance of location-based services (LBS) in a community of older adults. Objective: to understand attitudes to LBS technologies in older adults. Methods: eighty-six older adults used LBS for 1-week and completed pre- and post-use questionnaires. Twenty available volunteers from the first study also completed in-depth interviews after their experience using the LBS technology. Results: the pre-use questionnaire identified perceptions of usefulness, individual privacy and visibility as predictive of intentions to use a location-tracking service. Post-use, perceived risk was the only factor to predict intention to use LBS. Interviews with participants revealed that LBS was primarily seen as an assistive technology and that issues of trust and privacy were important. Conclusion: the findings from this study suggest older adults struggle to see the benefits of LBS and have a number of privacy concerns likely to inhibit future uptake of location-tracking services and devices