Mann

Slide1: 

University of Florida Rehabilitation Engineering Research Center on Technology for Successful Aging Funded by National Institute on Disability and Rehabilitation Research

The University at Buffalo RERC-Aging (91 – 01): 

The University at Buffalo RERC-Aging (91 – 01) Supported by the National Institute on Disability and Rehabilitation Research of the USDE

Slide3: 

Consumer Assessments Study How do frail elders cope in face of impairment / disability / pain?

In-Home Interviews of Frail Elderly: 

In-Home Interviews of Frail Elderly 2849 interviews over 10 years in Western New York and North Florida

R1: Consumer Assessments Study: 

R1: Consumer Assessments Study Explored functional needs of frail elders - over time (10 years) with focus on AT and Home Modifications Provided direction for other RERC-Aging Research, Development, and Dissemination Projects Participants serve as “sample pool” for other studies and projects – Continues today with Concept testing, usability testing, prototype testing for industry Focused research studies with additional grant funding Led to present study: Needs and Barriers to Home Monitoring and Communications Technology

Consumer Assessments Study: Data Collected: 

Consumer Assessments Study: Data Collected Demographics Health status Functional status Psychosocial status Services received Quality of life Caregiver survey (if person has family caregiver) Ownership, use, satisfaction, problems with AT Home / neighborhood environment & modifications

Who does the CAS Sample Represent?: 

Who does the CAS Sample Represent?

Device Ownership, Use, and Satisfaction: 

Device Ownership, Use, and Satisfaction Summary

Consumer Assessments Study: Findings : 

Consumer Assessments Study: Findings Of all impairment groups, elders with cognitive impairments use the fewest number of assistive devices, with a mean of 5.8 devices per person (Mann et al., 1992).

Assistive Technology Use by Elders with Dementia: 

Assistive Technology Use by Elders with Dementia

Slide12: 

Subject Attrition and Reasons

Slide13: 

Subjects with Alzheimer's: Chronic Diseases at Year 1

Slide14: 

Changes in Functional Status, Physical Disability and Pain (n=7)

Slide15: 

Use of Assistive Devices (n=7)

The Caregivers (n=7): 

The Caregivers (n=7) Mean age: 69.4 years (SD=6.2) None employed

Slide17: 

The Caregivers

Case 1 - Mrs. Grella (slide 1) : 

Case 1 - Mrs. Grella (slide 1) MMSE Years 1, 2, 3 - -19, 0, 0 FIM Years 1, 2, 3 - - 81, 18, 18 SIP Years 1, 2, 3 - - 13.6, 42.1, 44.2

Case 2 - Mrs Grella (slide 2): 

Case 2 - Mrs Grella (slide 2) Devices Year 1, All used, satisfied with 1. Lock system - key required to exit 3. Watch with date 4. Hand written schedules 2. Towel bar and soap dish used as grab bars 5. Locking thermostat cover

Case 2 - Mrs. Grella (slide 3): 

Case 2 - Mrs. Grella (slide 3) Devices Year 2, Changes in Year 1 Devices uses none of the year one devices, now non-ambulatory Devices Year 2, Additions Incontinent briefs and pads, urinal Over bed table Hospital bed with double side rails Hoyer Lift

Case 2 - Mrs. Nichols (slide 1): 

Case 2 - Mrs. Nichols (slide 1) MMSE Years 1, 2, 4 - -17, 21, 9 FIM Years 1, 2, 4 - - 88, 73,29

Case 3 - Mrs. Nichols (slide 2): 

Case 3 - Mrs. Nichols (slide 2) Magnifiers Calendar for orientation to date Notes around home for reminders Year 1 Devices

Case 3 - Mrs. Nichols (slide 3): 

Case 3 - Mrs. Nichols (slide 3) No changes in Year 1 devices Grab bar added in tub Year 2 Devices

Case 3 - Mrs. Nichols (slide 4): 

Case 3 - Mrs. Nichols (slide 4) Not using Year 1 Devices Spouse added: wheelchair, wheelchair restraint, walker, bath chair, hospital bed, incontinence pads Year 4 Devices

Summary - Alzheimers Subjects: 

Summary - Alzheimers Subjects High attrition, most to Nursing Homes Those followed for two years (3 interviews) Decline in mental and functional status Increase in physical disability Increase in #s of ADs owned Little change in #s of ADs used Major change in types of devices used

Summary - Caregivers: 

Summary - Caregivers Increase in hours spent caregiving Increase in assistance and other resources More depression Burden dropped Year 2, increased Year 3

Slide27: 

How are we addressing these problems?

Technology for Successful Aging: 

Technology for Successful Aging University of Florida Rehabilitation Engineering Research Center on Technology for Successful Aging Funded by National Institute on Disability and Rehabilitation Research

Smart Phone – Carry Anywhere Assistant: 

Smart Phone – Carry Anywhere Assistant Smart Home At Home

Why Cell Phones?: 

Why Cell Phones? Elders are accustomed to using phones – it is one of their most important technology devices Most portable and mobile device Better chances for acceptability as compared to other computing devices Smart Phone evolution: Voice Computer and IP data network on board Platform standardization  enabling third party application developers

Smart Phones: 

Smart Phones

Smart Phone – Carry Anywhere Assistant: 

Smart Phone – Carry Anywhere Assistant … and Away Grocery Stores On the road Restaurants Doctor Office Parking Lots . . . . . . Other Smart Spaces

Emerging Mobile & Wearable: 

Emerging Mobile & Wearable Subscriber Identification Module (SIM)

Wireless Networks: 

Wireless Networks

Slide35: 

Check locks on doors and windows Other Services Automatically refill prescription Check if laundry is done Call in a nurse Call in for help and Assistance Monitor of kitchen: oven and stove on/off; temp. Turn on/off lights (and visually inspect) other rooms. Sense and see visitors/strangers at front door Order groceries with dietary restrictions

Honeywell Partnership: 

Honeywell Partnership Leverage of Smart Home technology: The Independent LifeStyle Assistant (ILSA) Program Plans for future collaboration on joint applications that uses Smart Phones and ILSA Testing in the homes of elders beginning October, 2002 (next month).

Cognitive Assistance: 

Cognitive Assistance U. of Wisconsin – focus on mild impairment U. of Florida – focus on moderate impairment Addressing interface questions

Partnership with Veterans Health Administration: 

Partnership with Veterans Health Administration Tele-homecare demonstration Low ADL Monitoring Project (LAMP) Spinning off applications from RERC to Veterans in VISN-8

Issues Relating to Older Drivers: 

Issues Relating to Older Drivers Testing Remediation Florida ‘leading the nation’ in older drivers

Policy: 

Policy Promoting home based services versus institutional Reimbursement for independence tools and services Models that promote independence

International Conference on Aging, Disability, and Independence: 

International Conference on Aging, Disability, and Independence December 4-6, 2003 Washington, DC

Slide42: 

rerc.ufl.edu