Technical Development and Clinical Evaluation of Intelligent Continence Management System at Nursing Home

International audienceUrinary incontinence and diaper use is common among elderly people with dementia staying at nursing homes. Delays in timely diaper change will cause personal, social and economic ramifications to those elderly as well as to the carers who provide nursing care. In order to alleviate these daily care issues, an intelligent continence management system leveraging on sensors, pervasive sensor network, ambient intelligence and reminders is designed and developed. Clinical trial is conducted with multiple elderly people with dementia at a nursing home to evaluate the applicability and usefulness of the developed system. The analysis of trial outcomes and usability studies proves that this will be a feasible and effective approach to tackle the problems faced in managing incontinence effectively at nursing home

Future bathroom: A study of user-centred design principles affecting usability, safety and satisfaction in bathrooms for people living with disabilities

Research and development work relating to assistive technology 2010-11 (Department of Health) Presented to Parliament pursuant to Section 22 of the Chronically Sick and Disabled Persons Act 197

The clinical utility of the electronic toilet-top bidet for Australian nursing home residents and staff

Inability to self-toilet has negative outcomes for older people, including risk of admission to residential care. In residential care, toileting is the most frequent task undertaken by staff and may provoke distress, particularly for people with dementia. This work comprises an iterative, mixed methods investigation of the feasibility and clinical utility of the wash-and-dry toilet-top bidet for older dependent people, staff and family carers. A literature review and three exploratory studies were conducted. First, interviews with five family carers found the bidet acceptable if it met physical and symbolic needs. Ongoing use was mediated by environmental constraints, cleaning ability, reactions of the older person, and quality of interactions with health professionals. Carers reported it cleaned reliably, reduced incontinence and helped ‘normalise’ familial relationships. Second, a single-arm study in a dementia aged care home (ACH) found bidets were feasible and acceptable for residents and staff, were reliable, and cleaned effectively. Staff workload and facility expenditure on incontinence products decreased. Third, a non-randomised, controlled pilot study in two ACHs (n= 49 residents, 73 staff) found bidets were acceptable, reduced staff workload, improved resident behaviour during toileting and lowered rates of constipation. No changes were found in incontinence associated dermatitis or odour. Residents in the bidet condition were more likely to have a clear case of bacteriurea or a probable urinary tract infection, however higher rates of faecal incontinence at baseline may have mediated this result. The studies have ecological validity and bidet technology shows promise for improving dignity and ease of toileting. These studies have contributed to a more nuanced understanding of factors that influence uptake and ongoing use of assistive technologies in aged care settings, and development of measures also provides a basis for future confirmatory studies

AN EXPLORATORY SECONDARY DATA ANALYSIS OF THE IMPACT OF HETEROGENEITY ON ASSISTIVE TECHNOLOGY TO REDUCE SAFETY AND WANDERING RISKS FOR PEOPLE WITH DEMENTIA LIVING AT HOME

Introduction: There is an acknowledged gap between the potential and achieved benefit of assistive technology in the care of people with dementia. In order to make better use of this resource, this research aimed to investigate the heterogeneity of population characteristics of people with dementia living at home who have safety and wandering risks and how this is related to assistive technology recommended and installed to meet their needs. Methods: This research consisted of two studies; a systematic review and secondary data analysis. Initially, published quantitative data describing the needs of people with dementia living at home was subjected to meta-analysis in order to explore the prevalence of needs reported by people with dementia and their caregivers and associated heterogeneity. Following univariate analyses, ordinal models were developed using secondary data which described the needs of people with dementia, and their level of wandering and safety risk, to explore the relationship between needs and risks in this population. The possibility of grouping participants according to data describing multiple needs, predisposing characteristics and enabling resources was investigated using cluster analysis. Associations between these groups and recommended and installed Assistive Technology were investigated. Results: Prevalence estimates for twenty-four needs reported by people with dementia and their caregivers were provided for the first time. Heterogeneity was associated with the person reporting the needs and age of onset. Level of need was often not recorded in the dataset indicating limited assessment. Wandering risks were shown to be associated with posture and mobility, routine and cognition needs, whilst safety risks were associated with posture and mobility, and problem-solving needs. Partitioning Around Medoids cluster analysis demonstrated that robust clustering solutions could be created from data describing participants. Clustering solutions were then validated through exploring their association with recommended and installed Assistive Technology data and the published literature. Caregiver support and living situation impact Assistive Technology installed for people with dementia. Discussion: This research advances understanding of the impact that needs, safety and wandering risks, caregiver support and the living situation of the person with dementia have on variation in the assistive technology interventions recommended and installed for people with dementia. Results have implications for needs assessment and for the tailoring of Assistive Technology for this population. Keywords: dementia, assistive technology, community dwelling, meta-analysis, cluster analysis, ordinal regression, wandering, safety, risk, needs