Designing a gamified social platform for people living with dementia and their live-in family caregivers

In the current paper, a social gamified platform for people living with dementia and their live-in family caregivers, integrating a broader diagnostic approach and interactive interventions is presented. The CAREGIVERSPRO-MMD (C-MMD) platform constitutes a support tool for the patient and the informal caregiver - also referred to as the dyad - that strengthens self-care, and builds community capacity and engagement at the point of care. The platform is implemented to improve social collaboration, adherence to treatment guidelines through gamification, recognition of progress indicators and measures to guide management of patients with dementia, and strategies and tools to improve treatment interventions and medication adherence. Moreover, particular attention was provided on guidelines, considerations and user requirements for the design of a User-Centered Design (UCD) platform. The design of the platform has been based on a deep understanding of users, tasks and contexts in order to improve platform usability, and provide adaptive and intuitive User Interfaces with high accessibility. In this paper, the architecture and services of the C-MMD platform are presented, and specifically the gamification aspects. © 2018 Association for Computing Machinery.Peer ReviewedPostprint (author's final draft

Collaborating to Create Elder Friendly Communities in New Hampshire: A Scan of the Current Landscape

The fact that the population of the United States is aging is no surprise; the demographic projections are well documented. There have never been as many older adults living as there are today, and this number will only increase. Northern New England is aging more rapidly than the rest of the country, with Vermont, Maine, and New Hampshire having the oldest populations in term of median age (U.S. Census, 2014). New Hampshire is expected to be the fastest aging state in New England through 2030, with nearly one-third of its population being over the age of 65 (Norton, 2011). This phenomenon is anticipated to place substantial pressure on publicly-funded health programs and long-term services and supports in the Granite State. But the story of the aging of the population is not only about increased numbers. As longevity increases, the average age of the older population will see a dramatic increase. The number of persons over the age of 85 in the United States is expected to increase five-fold by 2040. As the possibility for functional limitations and disability increases with age, the need for long-term, formal, and informal supports is expected to increase as the number of older adults, particularly those over the age of 85 increases. In addition, women continue to live longer than men; on average, life expectancy for women is three years longer than for men. These factors create a complex picture of aging, which includes a growing population of older adults, a majority of whom will be women; and a growing number of those over the age of 85, who are more likely to require some type of assistance as they age. It is a mistake to look at our aging population in a singular way. Although we tend to make generalizations about older adults, as a group, they are more physiologically and socially diverse than any other age group (Brummel-Smith & Mosqueda, 2003). As we age, we become more and more diverse, as there are no two people who have had the same life experiences, shaping who we are over our lifetimes. The baby boomers (those born between 1946 and 1964) are likely to be the most diverse cohort of older adults we have seen to date, and it is likely that they will redefine our conception of age and aging. Older adults bring a diverse set of skills, talents, and knowledge that should be tapped as a significant natural resource to support a new and exciting vision of aging

Doctor of Philosophy

dissertationCare transitions for elderly family members enrolled in hospice care to and between home, Assisted Living Facilities (ALF), and Nursing Homes (NH) are fraught with distressing emotions and suffering for both the elderly persons and their families. The purpose of this study was to explore how bereaved families, after the death of their loved one, experienced and perceived these care transitions. Hospice nurses also participated in the study, to provide their perceptions of the end-of-life transition. Glaserian grounded theory (GT) was used to systematically generate theory from the data. Thirty-nine unstructured interviews were conducted with family members (n=14), hospice nurses (n=13), an ALF nurse (n=1), and social workers (n=2). Additional interviews were conducted with family and hospice nurses (n=5) and theoretical group interviews were also conducted (n=4). Data were coded using interpretive, axial, and selective coding. Analysis commenced concurrently utilizing GT principles of constant comparative method as well as memoing. A theoretical model was developed of the stages of the basic social psychological process of Living Through Care Transitions of the Dying Elderly: The Changing Nature of Guilt in Family Caregivers. Findings indicated that guilt escalated during the initial stages of the transfer, and was mitigated by achieving what family members deemed as a "good" death. The experiences and perceptions of the hospice nurses were identified during each phase of the care transition. Results revealed the hospice nurses role in alleviating guilt iv for the family caregivers was by supporting the transition through advocating, navigating the complexities of both facility systems and families, and especially coaching during the dying process, which was seen as the critical support for families during that stage. The findings provided new insight into the nature of guilt and its resolution in bereavement through the attributes of a "good" death. If a "good" death was not achieved, guilt appeared to linger; however, this needs further study. Furthermore, findings also provided educational stage-specific implications for hospice nurses supporting family caregiving through difficult care transitions. Implications of this research also highlight significant issues that affect families caring for older adults that can influence public policy

A Living Lab Facility on Safety in Homes among the Elderly and Elderly Disabled: A Literature Review

The study aimed to improve safety in the home environment for the elderly to live independently. The focus was discussing the measures of safe environment that promoted health, safety and security of the elderly. The study described the constituents of a safe home environment and approaches that safe environment promoted health of the aging. The objective was to utilize the results to advance safety in homes and assist the development of a living laboratory in the Ostrobothnia region. There is evident urgency for preventive health care measures that reduce injuries. The major hindrance in reducing falls was the inadequacy of facilities in homes for safety. Housing designs were inconsiderate of the elderly population. As a result, majority of this population were enrolled into rehabilitation institutions prematurely. A literature review with content analysis was established. The databases included Ebrary, CINAHL, Ovid, SAGE Premier and Science Direct as well as reliable electronic publications. These included WHO and Statistics Finland. The elderly safety was improved through modification of simple measures (grab bars, adequate light and non-slippery floor) and introduction of emerging advanced technology. Emerging care technologies were designed to enhance and maintain the well-being and independence of the aged. Technologists were to acknowledge pre-existing practices by enhancing them rather than replacing them. The recommendations include data on statistics that evaluated the safeness of the technologies and their direct correlation to the nursing profession

PROVIDING CONTEXT-AWARE SERVICES TO DEMENTIA PATIENTS AND CAREGIVERS

As a result of increased human lifespan, dementia becomes a national public health and social care priority worldwide. Although, there is no cure for dementia, the wandering behavior of dementia patients can be managed by an ambient assisted living system. In this paper, Wandering Behavior Ontology (WBO) used for dealing with wandering behavior seen in early stage dementia patients is proposed. WBO is used in iCarus, which is an intelligent ambient assisted living system, for providing context-aware services to dementia patients and their caregivers. Knowledge sharing, knowledge reuse and logical reasoning are provided by using ontologies. iCarus aims to reduce the problems and financial burden associated with a wandering episode for the patients and their caregivers. It provides longer independent living for the elderly people and a cost-effective way of remotely monitoring them. The actions that are to be taken are determined by rule-based reasoning. These actions are sequential and they are defined in the developed ontology. These actions include warning the patient and informing the caregiver and the emergency service

Ohio Long-Term Services and Supports Factbook

This factbook provides a broad overview of Ohio's system of long-term Services and supports. Numerous charts provide descriptions of those who use services, kinds of services, payment systems and other topics. It is designed to be a reference and resource guide

An Ambient Assisted Living Approach in Designing Domiciliary Services Combined With Innovative Technologies for Patients With Alzheimer’s Disease: A Case Study

Background: Alzheimer’s disease (AD) is one of the most disabling diseases to affect large numbers of elderly people worldwide. Because of the characteristics of this disease, patients with AD require daily assistance from service providers both in nursing homes and at home. Domiciliary assistance has been demonstrated to be cost effective and efficient in the first phase of the disease, helping to slow down the course of the illness, improve the quality of life and care, and extend independence for patients and caregivers. In this context, the aim of this work is to demonstrate the technical effectiveness and acceptability of an innovative domiciliary smart sensor system for providing domiciliary assistance to patients with AD which has been developed with an Ambient Assisted Living (AAL) approach. Methods: The design, development, testing, and evaluation of the innovative technological solution were performed by a multidisciplinary team. In all, 15 sociomedical operators and 14 patients with AD were directly involved in defining the endusers’ needs and requirements, identifying design principles with acceptability and usability features and evaluating the technological solutions before and after the real experimentation. Results: A modular technological system was produced to help caregivers continuously monitor the health status, safety, and daily activities of patients with AD. During the experimentation, the acceptability, utility, usability, and efficacy of this system were evaluated as quite positive. Conclusion: The experience described in this article demonstrated that AAL technologies are feasible and effective nowadays and can be actively used in assisting patients with AD in their homes. The extensive involvement of caregivers in the experimentation allowed to assess that there is, through the use of the technological system, a proven improvement in care performance and efficiency of care provision by both formal and informal caregivers and consequently an increase in the quality of life of patients, their relatives, and their caregivers

Intelligent assisted living framework for monitoring elders

Recently, Ambient Intelligence Systems (AmI) in particular Ambient Assisted Living (AAL) are attracting intensive research due to a large variety of application scenarios and an urgent need for elderly in-home assistance. AAL is an emerging multi-disciplinary paradigm aiming at exploiting information and communication technologies in personal healthcare and telehealth systems for countering the effects of growing elderly population. AAL systems are developed to help elderly people living independently by monitoring their health status and providing caregivers with useful information. However, strong contributions are yet to be made on context binding of newly discovered sensors for providing dynamic or/and adaptive UI for caregivers, as the existing solutions (including framework, systems and platforms) are mainly focused on checking user operation history, browser history and applications that are most used by a user for prediction and display of the applications to an individual user. The aim of this paper is to propose a framework for making the adaptive UI from context information (real-time and historical data) that is collected from caregivers (primary user) and elderly people (secondary user). The collected data is processed to produce the contextual information in order to provide assistive services to each individual caregiver. To achieve this, the proposed framework collects the data and it uses a set of techniques (including system learning, decision making) and approaches (including ontology, user profiling) to integrate assistive services at runtime and enable their bindings to specific caregivers, in so doing improving the adaptability parameter of UI for the AAL. © 2017 IEEE