Unpaid carers’ access to and use of primary care services

GPs and members of the primary care team have a pivotal role in supporting unpaid carers in their caring role and helping them to maintain their own health and well-being. This paper investigates the difference that caregiving makes to individuals’ access to and use of GP and primary care services. It is based on longitudinal analysis of carers’ contacts with GPs, and a review of the literature including evaluations of measures to improve primary care-based support for carers. Men increase their consultation rates with GPs when taking on a caring role. In contrast, women who look after someone in the same household and carry heavy caring responsibilities have relatively less contact with GPs than expected. According to the literature, carers report a range of difficulties accessing primary health care. A fivefold typology is described covering barriers arising from: professional responses to the carers’ role, the way services are organised and delivered, language or culturally held beliefs and practices, carer or care recipient characteristics, and unmet information needs. Various measures to improve carers’ access to primary care have been introduced to overcome these barriers, but robust evidence of cost and utility is required to judge their acceptability and effectiveness for both carers and GPs. Although good practice guides, quality standards and evaluation tools are available to help improve primary care support for carers, further investigation of carers’ help-seeking for health care, and the factors involved, is required to underpin the prospects for developing a genuine partnership between unpaid carers and health professionals

On the Integration of Adaptive and Interactive Robotic Smart Spaces

© 2015 Mauro Dragone et al.. This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License. (CC BY-NC-ND 3.0)Enabling robots to seamlessly operate as part of smart spaces is an important and extended challenge for robotics R&D and a key enabler for a range of advanced robotic applications, such as AmbientAssisted Living (AAL) and home automation. The integration of these technologies is currently being pursued from two largely distinct view-points: On the one hand, people-centred initiatives focus on improving the user’s acceptance by tackling human-robot interaction (HRI) issues, often adopting a social robotic approach, and by giving to the designer and - in a limited degree – to the final user(s), control on personalization and product customisation features. On the other hand, technologically-driven initiatives are building impersonal but intelligent systems that are able to pro-actively and autonomously adapt their operations to fit changing requirements and evolving users’ needs,but which largely ignore and do not leverage human-robot interaction and may thus lead to poor user experience and user acceptance. In order to inform the development of a new generation of smart robotic spaces, this paper analyses and compares different research strands with a view to proposing possible integrated solutions with both advanced HRI and online adaptation capabilities.Peer reviewe

Aging in Place - Solutions to a Crisis in Housing and Care - An Issues Update

The issue of how people can age in place in a safe, healthy and dignified manner is a front-burner issue, especially for the poor, frail elderly who live in communities served by the NeighborWorks network and by other community-based housing and health-care entities. The Southern District office of Neighborhood Reinvestment convened practitioners in the fields of housing, healthcare and supportive services to address this issue

Utilising semantic technologies for decision support in dementia care

The main objective of this work is to discuss our experience in utilising semantic technologies for building decision support in Dementia care systems that are based on the non-intrusive on the non-intrusive monitoring of the patient’s behaviour. Our approach adopts context-aware modelling of the patient’s condition to facilitate the analysis of the patient’s behaviour within the inhabited environment (movement and room occupancy patterns, use of equipment, etc.) with reference to the semantic knowledge about the patient’s condition (history of present of illness, dependable behaviour patterns, etc.). The reported work especially focuses on the critical role of the semantic reasoning engine in inferring medical advice, and by means of practical experimentation and critical analysis suggests important findings related to the methodology of deploying the appropriate semantic rules systems, and the dynamics of the efficient utilisation of complex event processing technology in order to the meet the requirements of decision support for remote healthcare systems

Towards a practical framework for managing the risks of selecting technology to support independent living

Information and communication technology applications can help increase the independence and quality of life of older people, or people with disabilities who live in their own homes. A risk management framework is proposed to assist in selecting applications that match the needs and wishes of particular individuals. Risk comprises two components: the likelihood of the occurrence of harm and the consequences of that harm. In the home, the social and psychological harms are as important as the physical ones. The importance of the harm (e.g., injury) is conditioned by its consequences (e.g., distress, costly medical treatment). We identify six generic types of harm (including dependency, loneliness, fear and debt) and four generic consequences (including distress and loss of confidence in ability to live independently). The resultant client-centred framework offers a systematic basis for selecting and evaluating technology for independent living

User-centered design of a dynamic-autonomy remote interaction concept for manipulation-capable robots to assist elderly people in the home

In this article, we describe the development of a human-robot interaction concept for service robots to assist elderly people in the home with physical tasks. Our approach is based on the insight that robots are not yet able to handle all tasks autonomously with sufficient reliability in the complex and heterogeneous environments of private homes. We therefore employ remote human operators to assist on tasks a robot cannot handle completely autonomously. Our development methodology was user-centric and iterative, with six user studies carried out at various stages involving a total of 241 participants. The concept is under implementation on the Care-O-bot 3 robotic platform. The main contributions of this article are (1) the results of a survey in form of a ranking of the demands of elderly people and informal caregivers for a range of 25 robot services, (2) the results of an ethnography investigating the suitability of emergency teleassistance and telemedical centers for incorporating robotic teleassistance, and (3) a user-validated human-robot interaction concept with three user roles and corresponding three user interfaces designed as a solution to the problem of engineering reliable service robots for home environments

Older adults, falls and technologies for independent living: a life space approach

This paper draws attention to the need for further understanding of the fine details of routine and taken-for-granted daily activities and mobility. It argues that such understanding is critical if technologies designed to mitigate the negative impacts of falls and fear-of-falling are to provide unobtrusive support for independent living. The reported research was part of a large, multidisciplinary, multi-site research programme into responses to population ageing in Ireland, Technologies for Independent Living (TRIL). A small, exploratory, qualitative life-space diary study was conducted. Working with eight community-dwelling older adults with different experiences of falls or of fear-of-falls, data were collected through weekly life-space diaries, daily-activity logs, two-dimensional house plans and a pedometer. For some participants, self-recording of their daily activities and movements revealed routine, potentially risky behaviour about which they had been unaware, which may have implications for falls-prevention advice. The findings are presented and discussed around four key themes: ‘being pragmatic’, ‘not just a faller’, ‘heightened awareness and blind spots’ and ‘working with technology’. The findings suggest a need to think creatively about how technological and other solutions best fit with people's everyday challenges and needs and of critical importance, that their installation does not reduce an older adult to ‘just a faller’ or a person with a fear-of-falls