The Ethical Implications of Personal Health Monitoring

Personal Health Monitoring (PHM) uses electronic devices which monitor and record health-related data outside a hospital, usually within the home. This paper examines the ethical issues raised by PHM. Eight themes describing the ethical implications of PHM are identified through a review of 68 academic articles concerning PHM. The identified themes include privacy, autonomy, obtrusiveness and visibility, stigma and identity, medicalisation, social isolation, delivery of care, and safety and technological need. The issues around each of these are discussed. The system / lifeworld perspective of Habermas is applied to develop an understanding of the role of PHMs as mediators of communication between the institutional and the domestic environment. Furthermore, links are established between the ethical issues to demonstrate that the ethics of PHM involves a complex network of ethical interactions. The paper extends the discussion of the critical effect PHMs have on the patient’s identity and concludes that a holistic understanding of the ethical issues surrounding PHMs will help both researchers and practitioners in developing effective PHM implementations

Intelligent sensing technologies for the diagnosis, monitoring and therapy of alzheimer’s disease:A systematic review

Alzheimer’s disease is a lifelong progressive neurological disorder. It is associated with high disease management and caregiver costs. Intelligent sensing systems have the capability to provide context-aware adaptive feedback. These can assist Alzheimer’s patients with, continuous monitoring, functional support and timely therapeutic interventions for whom these are of paramount importance. This review aims to present a summary of such systems reported in the extant literature for the management of Alzheimer’s disease. Four databases were searched, and 253 English language articles were identified published between the years 2015 to 2020. Through a series of filtering mechanisms, 20 articles were found suitable to be included in this review. This study gives an overview of the depth and breadth of the efficacy as well as the limitations of these intelligent systems proposed for Alzheimer’s. Results indicate two broad categories of intelligent technologies, distributed systems and self-contained devices. Distributed systems base their outcomes mostly on long-term monitoring activity patterns of individuals whereas handheld devices give quick assessments through touch, vision and voice. The review concludes by discussing the potential of these intelligent technologies for clinical practice while highlighting future considerations for improvements in the design of these solutions for Alzheimer’s disease

When technology cares for people with dementia:A critical review using neuropsychological rehabilitation as a conceptual framework

Clinicians and researchers have become increasingly interested in the potential of technology in assisting persons with dementia (PwD). However, several issues have emerged in relation to how studies have conceptualized who the main technology user is (PwD/carer), how technology is used (as compensatory, environment modification, monitoring or retraining tool), why it is used (i.e., what impairments and/or disabilities are supported) and what variables have been considered as relevant to support engagement with technology. In this review we adopted a Neuropsychological Rehabilitation perspective to analyse 253 studies reporting on technological solutions for PwD. We analysed purposes/uses, supported impairments and disabilities and how engagement was considered. Findings showed that the most frequent purposes of technology use were compensation and monitoring, supporting orientation, sequencing complex actions and memory impairments in a wide range of activities. The few studies that addressed the issue of engagement with technology considered how the ease of use, social appropriateness, level of personalization, dynamic adaptation and carers' mediation allowed technology to adapt to PWD's and carers' preferences and performance. Conceptual and methodological tools emerged as outcomes of the analytical process, representing an important contribution to understanding the role of technologies to increase PwD's wellbeing and orient future research.University of Huddersfield, under grants URF301-01 and URF506-01

Ethical issues in the use of surveillance cameras to support ageing in place

Background and Objective: Surveillance technology allows family members to monitor older adults’ daily activities and their interaction with the home environment. In particular, video surveillance cameras and surveillance technology’s implementation raises critical ethical concerns due to their invasive and obtrusive nature. Thus, this paper aims to address the ethical issues regarding the use of video surveillance for older adults to age in place. Methods: A literature review is conducted using Springerlink, Sciencedirect, and PubMed Publications related to older adults’ care, ageing in place, and the use of surveillance technologies were included in this project. Results: A total of 19 publications met the inclusion criteria. Nine ethical issues emerged from the data: informed consent, privacy, conflict of interest, stigmatization and obtrusiveness, homogeneity among older adults, and imbalance relationship. These nine themes were further explored in respect to ethical principles, including autonomy, beneficence, non-maleficence, justice and fidelity) Conclusion: Although surveillance cameras can be invasive, well-grounded ethical thinking and proactive response help reduce the risk and ethical challenges associated with it. By examining the ethical issue in video surveillance, it helps to reflect and enhance the current legislation

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

Smart home applications for cognitive health of older adults

Capítulo 6The lifespan of older people is growing together with their proportion in the population Growth in the older population. This leads to an increasing need for support services for older adults who will inevitably experience a significant decrease in their cognitive capabilities and mental health conditions. Cognitive function, including memory, attention, sleeping, problem-solving activities, or speed processing, are playing a crucial role in everyone’s independent daily life. Technologies can help maintain their independence and improve quality of life, reducing the care costs. In this regards, smart home applications (SMAs) offer a solution to the complex needs of older adults and their families, monitoring physiological and functional issues, as well as aiding in emergency detection and response. This chapter provides an overview of current applications reported in the scientific literature, identifies the frameworks proposed for designing these types of applications, and defines evidence based recommendations for designing SMAs for cognitive health of older adults

Design of a Framework for Cognitive Support in Dementia Care for the Elderly

Dissertation presented as the partial requirement for obtaining a Master's degree in Information Management, specialization in Knowledge Management and Business IntelligenceThis section provides an overview of the magnitude of dementia care in communities and health care systems. It introduces the background and context for the utilization of technology and digital solutions to address mental health issues in the elderly, specifically focusing on dementia. The objective is to propose a design framework for the development of health technology that caters to caregivers of individuals living with dementia. A brief review of the latest studies related to the successful adoption of technology for dementia and cognitive impairment decline will serve as the foundation for the proposal of this thesis. The following paragraphs approach the background and context of the healthcare problems related to ageing and introduce dementia from a technological perspective. The research question is presented, along with the proposed objectives to address that question. Furthermore, the relevance of this study within the context of information management is summarized

Assistive Technologies in Dementia Care: An Updated Analysis of the Literature

none5noObjectives: Technology can assist and support both people with dementia (PWD) and caregivers. Recently, technology has begun to embed remote components. Timely with respect to the pandemic, the present work reviews the most recent literature on technology in dementia contexts together with the newest studies about technological support published until October 2020. The final aim is to provide a synthesis of the timeliest evidence upon which clinical and non-clinical decision-makers can rely to make choices about technology in the case of further pandemic waves. Methods: A review of reviews was performed alongside a review of the studies run during the first pandemic wave. PsycInfo, CINAHL, and PubMed-online were the databases inspected for relevant papers published from January 2010. Results: The search identified 420 articles, 30 of which were reviews and nine of which were new studies meeting the inclusion criteria. Studies were first sorted according to the target population, then summarized thematically in a narrative synthesis. The studies targeting technologies for PWD were categorized as follows: monitoring and security purposes, sustaining daily life, and therapeutic interventions. Each category showed potential benefits. Differently, the interventions for caregivers were classified as informative, psycho-education programs, psychosocial-supportive, therapeutic, and cognitive/physical training. Benefits to mental health, skills learning, and social aspects emerged. Conclusions: The evidence shows that technology is well-accepted and can support PWD and caregivers to bypass physical and environmental problems both during regular times and during future pandemic waves. Nevertheless, the lack of a common methodological background is revealed by this analysis. Further and more standardized research is necessary to improve the implementation of technologies in everyday life while respecting the necessary personalization.openPappada A.; Chattat R.; Chirico I.; Valente M.; Ottoboni G.Pappada A.; Chattat R.; Chirico I.; Valente M.; Ottoboni G

Attitudes to telecare among older people, professional care workers and informal carers: a preventative strategy or crisis management?

This paper reports findings from an attitudinal survey towards telecare that emerged from twenty-two focus groups comprising ninety-two older people, fifty-five professional stakeholders and thirty-nine carers. These were convened in three different regions of England as a precursor to telecare service development. The results from this study suggest that informants’ views were shaped by prior knowledge of conventional health and social care delivery in their locality and the implication is that expectations and requirements in respect of telecare services in general are likely to be informed by wider perceptions about the extent to which community care should operate as a preventative strategy or as a mechanism for crisis management

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