Case studies in SenseCam use for cognitive stimulation therapy in early-stage dementia.

Estimates suggest that Ireland will have 50,000 people with dementia by 2016 and over 100,000 by 2036. Combined with European total costs are estimated in 2005 at €130 billion. As dementia is incurable there is a real need to support the existing dementia health care practices and carers by innovative technology use. Using technology to improve mental health of the people with dementia is one way of such support. This research explores intervention which uses Microsoft SenseCam images within the principles of Cognitive Stimulation Therapy (CST) to engage people with early stage dementia in meaningful discussion. This SenseCam intervention, like the CST approach, aims at general enhancement of quality of life and global cognitive and social functioning

SenseCam intervention based on cognitive ctimulation therapy framework for early-stage dementia.

Estimates suggest that Ireland will have 50,000 people with dementia by 2016 and over 100,000 by 2036. Combined with European total costs estimated in 2005 at €130 billion. In the absence of a cure for dementia there is a real need to develop pervasive, user-centered technologies to enhance the well-being and quality of life of people with dementia. This study explores the use of Microsoft SenseCam images within the principles of Cognitive Stimulation Therapy (CST) to engage people with early stage dementia in meaningful discussion. The SenseCam intervention, like the CST approach, is aimed at general enhancement of quality of life and global cognitive and social functioning

Case study in SenseCam use as an intervention technology for early-stage dementia

Dementia is a growing concern with an estimated 41,740 in Ireland and 35.6 million people living with dementia worldwide. In the absence of a medical cure for dementia, pervasive technologies are emerging to support people with dementia. Among such applications is lifelogging, which involves continuously wearing technology to capture a large part of the wearer’s life emerging. The recorded data allows clinicians and others to detect behaviour changes or help in memory recall. This study explores the use of SenseCam lifelogging technology as a therapeutic intervention for people with early stage dementia. Based on the principles of Cognitive Stimulation Therapy (CST) it aims to engage them in meaningful discussions about their recent past as captured in the SenseCam images. These discussions offer potential to help maintain the person’s identity. The preliminary findings from the first case study highlight some functional issues of SenseCam use within CST principles

Dementia ambient care: multi-sensor support to enable independent home-based living for people with dementia

The quality of life of the person with dementia is often impacted by the loss of autonomy and independence that can arise during dementia progression. Ambient assistive technologies represent a way of enabling independence and facilitating “ageing in place”, by supporting the health, lifestyle, and safety of the person with dementia in an unobtrusive manner. Dem@Care is a European FP7 funded project, which is using ambient and wearable sensors to maintain independent home-based living for as long as possible. We have identified five frequently problematic areas for the person with dementia that can be supported by technology: Sleep, Activities of Daily Living, Physical Activity, Social Interaction, and Mood. In Dem@Care, a clinical assessment is carried out with the person with dementia and their family to identify their unique needs in each of the 5 areas. An individualised sensor “toolbox” is tailored and discussed with the individual and their family, and an acceptable and useful system is configured and deployed. Over time, information gathered by sensors is used to provide feedback to identify changes in patterns of behaviour that may indicate deterioration, improvement, stasis, or the risk of future deterioration, and to increase awareness of behaviours that are detrimental to health and well-being. We report relevant guiding principles from the literature, and findings from the first Dem@Care pilot evaluation, regarding user-centred design, individualization, ethics, and the acceptability and usability of current Dem@Care sensors. We present results from the monitoring of sleep, physical activity, and daily-living activities and following promising initial results, we are expanding data collection to incorporate additional sensors and new participants with the expectation that we can demonstrate the ability of the Dem@Care system to enable persons with dementia to remain independent and living in their own homes for longer

Designing for and with vulnerable people: The Dem@Care "toolbox" approach

We describe the challenge set to us within the Dem@Care project, of designing a multi-component system to support safety, enablement, and diagnosis for older adults with dementia. Specifically we discuss the system as it relates to home-based enablement. Person-centred care is the gold standard in dementia care, which we incorporate into technology design by engaging in a user-led, participatory approach. The result of our considerations is the Dem@Care “toolbox”, a solution which addresses the challenge of providing home-based, person-centred care and enablement for older adults with dementia, utilising sensor technologies. The current text describes the toolbox and the terms of its future deployment

Dementia ambient care: ethical issues arising from the use of a home-based multi-sensor support system

Background: With the worldwide increase in dementia prevalence acceptable cost-effective home-based solutions are needed to support people with dementia (PwD) living in the community and to delay institutionalisation. Ambient assistive technologies represent a way of enabling independence and facilitating “ageing in place”, by supporting the health, lifestyle, and safety of PwD in an unobtrusive manner. However, ethical issues associated with their use remain under-reported. Methods: Dem@Care is an FP7 project that uses ambient and wearable sensors to support physical activity, sleep, activities of daily living, social interaction, and mood in PwD. It uses a multiple case study design with purposive sampling of people with early stage dementia. An individualised sensor “toolbox” and intervention strategy is developed for participants based on a clinical assessment of their needs. Sensor data is aggregated over time to identify changes in patterns of behaviour that could signify improvement, stasis, or deterioration of function. Results: Our first two case studies raised important ethical issues associated with sensor use. Difficulties using the technologies resulted in heightened anxiety for the PwD and their carer. Sensor ‘privacy’ buttons were often forgotten resulting in image capture that might not have been intended and was potentially embarrassing to the PwD, and ambient video recording could not be deployed given the lack of an acceptable solution to obtaining third party consent. Conclusions: Although potentially beneficial to PwD, the ethical issues associated with the use of ambient assistive technologies require further discussion given the vulnerability of this population

Dem@Care: a proposed system for the home-based ambient monitoring and enablement of older adults with dementia.

With an ageing population comes an anticipated leap in the numbers of individuals with dementia, and it is advisable both from an economic and community perspective to maintain home-based care for individuals with dementia for as long as possible. Ambient assistive and sensor technologies comprise a key contribution towards helping the person with dementia maintain independence in their community, by supporting their health, lifestyle, and safety, in an unobtrusive manner. Ambient technologies can be used to assess the status of the individual with dementia, and also to enable their independent home-based living for as long as possible. Methodology Dem@Care is an FP7 funded initiative, which aims to provide multi-parametric remote monitoring and enablement for persons with dementia living in the community. We here describe the goals of Dem@Care, as well as the principles behind its design, and early identified issues with deployment. Results We report relevant guiding principles from the literature, as well as principles arising from the team’s own clinical expertise. These principles include user-centred design, individualisation, involving the caregiver, and the prioritising of unobtrusive monitoring. Our goals include the successful enhancement of the quality of life of individuals with dementia, and the efficient and unobtrusive design of technological sensor-based systems in the home. We outline our plans to date to deploy the complete Dem@Care in the homes of community-dwelling older adults with dementia. An emphasis throughout is maintained on the individualised, ‘toolbox’ nature of the system, since we are aware that one size does not fit all for dementia. Conclusions The current proposal introduces the Dem@Care project, as a system for remote management and enablement of persons with dementia. We anticipate valuable insights pertaining to dementia care arising from this multidisciplinary initiative