A Sensing Platform to Monitor Sleep Efficiency

Sleep plays a fundamental role in the human life. Sleep research is mainly focused on the understanding of the sleep patterns, stages and duration. An accurate sleep monitoring can detect early signs of sleep deprivation and insomnia consequentially implementing mechanisms for preventing and overcoming these problems. Recently, sleep monitoring has been achieved using wearable technologies, able to analyse also the body movements, but old people can encounter some difficulties in using and maintaining these devices. In this paper, we propose an unobtrusive sensing platform able to analyze body movements, infer sleep duration and awakenings occurred along the night, and evaluating the sleep efficiency index. To prove the feasibility of the suggested method we did a pilot trial in which several healthy users have been involved. The sensors were installed within the bed and, on each day, each user was administered with the Groningen Sleep Quality Scale questionnaire to evaluate the user’s perceived sleep quality. Finally, we show potential correlation between a perceived evaluation with an objective index as the sleep efficiency.</p

Technology and dementia: the future is now

Background: Technology has multiple potential applications to dementia from diagnosis and assessment to care delivery and supporting ageing in place. Objectives: To summarise key areas of technology development in dementia and identify future directions and implications. Method: Members of the US Alzheimer’s Association Technology Professional Interest Area involved in delivering the annual pre-conference summarised existing knowledge on current and future technology developments in dementia. Results: The main domains of technology development are as follows: (i) diagnosis, assessment and monitoring, (ii) maintenance of functioning, (iii) leisure and activity, (iv) caregiving and management. Conclusions: The pace of technology development requires urgent policy, funding and practice change, away from a narrow medical approach, to a holistic model that facilitates future risk reduction and pre- vention strategies, enables earlier detection and supports implementation at scale for a meaningful and fulfilling life with dementia

A Nurse-Led Delirium Prevention Program for Hospitalized Older Adults

Background: Delirium, an acute decline in cognition and attention, is a common and severe problem for hospitalized older adults, with incidence rates ranging from 11% to 56%, and 1.5 to 4.0-fold increased risk of death. Despite its multifaceted nature, delirium is preventable in 30% to 40% cases. A California academic community hospital experienced a higher incidence of delirium (30% to 40%) in adult non-critical care units as compared to delirium rates (11% to 29%) in similar hospital settings. The higher rates of delirium were believed to be due to fragmented, inconsistent, and non-individualized delirium care. Purpose/Objectives: The purpose of this evidence-based, quality improvement project was to determine whether a nurse-led Delirium Prevention Bundle (DPB) when compared to usual care, reduces delirium incidence in hospitalized geriatric patients. Method: The project was a two-group, pre-post design using the nurse-led DPB educational intervention for nurses. The project was implemented in two stages: 1) an educational session for nurses on completing the DPB including the Delirium Risk Factor Identification (DRFI) tool, targeted delirium prevention strategies (based on the Hospital Elder Life Program), and nursing documentation; and 2) the DPB implementation on a 26-bed geriatric unit at a 250-bed academic community medical center. Baseline data on delirium incidence rates were collected on eligible patients on the geriatric unit for one month before the intervention and prospectively on patients who were eligible following the educational intervention. Demographic data on eligible patients and unit nursing staff as well as nurse knowledge of delirium and adherence to the DPB were collected. Statistical analyses included descriptive statistics, t-tests, and chi-square test. Results: implementation of nursing education of the DPB, the addition of the DRFI tool, and documentation template in the hospital Electronic Health Record, was effective in reducing delirium incidence rate from 16% to 14% (p =&lt;.001) and improving documentation compliance from &lt;1% to 17%. Nurse delirium knowledge was also improved significantly (pre-test mean 80.0, post-test mean 94.3, p=.029). Conclusion: Nursing education utilizing the DPB is an effective approach in increasing nurse awareness of preventive care for delirium and decreasing incident delirium in this population

Engaging ‘hard to reach’ groups in health promotion: the views of older people and professionals from a qualitative study in England

Background Older people living in deprived areas, from black and minority ethnic groups (BME) or aged over 85 years (oldest old) are recognised as ‘hard to reach’. Engaging these groups in health promotion is of particular importance when seeking to target those who may benefit the most and to reduce health inequalities. This study aimed to explore what influences them practicing health promotion and elicit the views of cross-sector professionals with experiences of working with ‘hard to reach’ older people, to help inform best practice on engagement. Methods ‘Hard to reach’ older people were recruited through primary care by approaching those not attending for preventative healthcare, and via day centres. Nineteen participated in an interview (n = 15) or focus group (n = 4); including some overlaps: 17 were from a deprived area, 12 from BME groups, and five were oldest old. Cross-sector health promotion professionals across England with experience of health promotion with older people were identified through online searches and snowball sampling. A total of 31 of these 44 professionals completed an online survey including open questions on barriers and facilitators to uptake in these groups. Thematic analysis was used to develop a framework of higher and lower level themes. Interpretations were discussed and agreed within the team. Results Older people’s motivation to stay healthy and independent reflected their everyday behaviour including practicing activities to feel or stay well, level of social engagement, and enthusiasm for and belief in health promotion. All of the oldest old reported trying to live healthily, often facilitated by others, yet sometimes being restricted due to poor health. Most older people from BME groups reported a strong wish to remain independent which was often positively influenced by their social network. Older people living in deprived areas reported reluctance to undertake health promotion activities, conveyed apathy and reported little social interaction. Cross-sector health professionals consistently reported similar themes as the older people, reinforcing the views of the older people through examples. Conclusions The study shows some shared themes across the three ‘hard-to-reach’ groups but also some distinct differences, suggesting that a carefully outlined strategy should be considered to reach successfully the group targeted.Peer reviewedFinal Published versio

Designing P4 healthcare interventions for managing cognitive decline and dementia : where are we at?

This paper presents a systematic literature review aimed at assessing how well current technology-based interventions that focus on dementia and other cognitive impairments align with the principles of the P4 vision for healthcare: Predictive, Preventive, Personalised and Participative. A search of the SCOPUS database yielded 887 articles, of which 48 were ultimately selected for analysis. Looking at whether and how each intervention implements each ‘P’-principle, our results suggest a partial and non-systemic embrace of the P4 vision. Reasoning on possible explanations for this state-of-the-art, we propose that our findings represent an opportunity for the engineering design community to engage with P4-based healthcare delivery models through the development of design frameworks, new indicators for assessing the success of such healthcare delivery models, as well as tools and methods

Adulthood: New terrain

The article reviews the book Adulthood: New Terrain, edited by Mary Alice Wolf

The experiences, needs and outcomes for carers of people with dementia: Literature Review

This literature review was conducted as part of my role at the Association of Dementia Studies, University of Worcester.RSAS is developing new and innovative ways of supporting carers, people living with dementia and their families. The charity aims to enhance the health and well-being of carers through providing services that increase their knowledge and understanding of dementia, further enhances their caring skills and provides supportive and therapeutic services to them. This literature review provides an up-to-date review concerning the evidence in relation to the following questions: 1 What is the experience of caregiving for a person living with dementia, and in what context does caregiving take place? 2 What implications does caregiving have for the person/family member involved in caregiving and the person with dementia? 3 What is currently known about the factors that protect or increase the risk of poor outcomes in caregiving? 4 What evidence is there for interventions to support family caregiving and reduce the risk of poor outcomes and how is this delivered in relation to: a Information and Education b Multi-component, psycho-educational interventions c Psychological Interventions d Peer support and other social interventions e Assistive technology and new media 5 What form of service provision is required to support family caregivers? This will include consideration of such issues as: a How might a service be delivered? b What factors will influence delivery including location, design, accessibility and flexibility? 6 Who will the service be for and how can family caregivers be supported to engage with the service