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Technology and Dementia A Health and Social Care perspective from Northern Ireland

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Title: Technology and Dementia A Health and Social Care perspective from Northern Ireland


1
Technology and DementiaA Health and Social Care
perspective from Northern Ireland
  • Suzanne Martin
  • Lecturer Occupational Therapy
  • University of Ulster at Jordanstown

2
Overview
  • Northern Ireland Context
  • Technology within health and social care
  • Current University activity
  • Aspirations

3
But First
  • University of Ulster
  • Lecturer
  • Researcher
  • Consultancy
  • Clinical Practice
  • Acute Sector
  • Community
  • Adults/childrensDisability
  • Environmental Design
  • Assistive Devices

4
Northern Ireland Context
  • Review of public administration
  • Bamford review of mental health and learning
    disability
  • Establishment of Dementia Centre
  • Statutory and non-statutory agencies

5
Review of Public Administration
  • One Health and Social Services authority (April
    2008)
  • 7 Local Commissioning Groups
  • Mapped to district councils
  • Demand led by patients
  • Driven by GPs and primary care professionals
  • One patient and client council
  • 5 Trusts (ambulance service remains as single
    trust)

6
Bamford review of mental health and learning
disability
  • Concluded
  • Making it happen conference 31.10.06
  • Leader fuller lives consultation
  • Outcomes for dementia

7
Northern Ireland Dementia Centre
  • Funded by Atlantic philanthropies
  • Dementia Services Development Centre at Stirling
  • Based at a business park within the University of
    Ulster at Jordanstown
  • Assistant Director

8
Strategic Context
  • Regional, National and European
  • directives to exploit ICT with Health and
  • Social care
  • People First 1990,
  • ICT Strategy 2001,2002, 2004,
  • Community Care Review 2002
  • Information for Health 1998,
  • NHS Plan 2000,
  • Building the Information Core 2001
  • eEurope 2002

9
Operational Context
  • Innovative practice driving bottom up approach to
    change
  • HPSS Commissioners of Services
  • Housing Associations
  • Charitable Organisations
  • Statutory provision of technology via CSA in line
    with PASA Telecare contract

10
Agencies
  • Statutory
  • Health
  • Housing
  • Department of social development
  • Non-statutory
  • Alzheimers society
  • Help the aged
  • Age concern
  • Housing
  • John of God

Interagency collaborations and partnerships
11
Sociocultural and political Context
  • Emerging Service Models
  • Health and Social Care Provision in Partnership
    across Statutory and Non-Statutory Agencies
  • Exploitation of Mixed Economy of Funding Streams
  • Tenants as Commissioners

12
Other factors influencing change
  • Service User Expectations
  • ICT Development
  • Decreased Cost
  • Communications, Peripherals and Hardware
  • Increased Capability
  • Data Gathering and Analysis to Inform Health Care
  • Increased Device Stability
  • Enhanced Standardisation and Compatibility across
    Devices

13
Technology within Health and Social Care
14
What is technology?
  • Assistive technology
  • a broad range of devices, services,
    strategies and practices that are conceived and
    applied to ameliorate the problems faced by
    individuals who have disabilities. Cook 2002

15
What is a Smart Home ?
  • Definition
  • A dwelling incorporating a communications
    network that connects the key electrical
    appliances and services, and allows them to be
    remotely controlled, monitored or accessed.
  • Remotely in this context can mean both within the
    dwelling and from outside the dwelling.

Source DTI DTI Smart Homes Project September
2003
16
Smart Home Hierarchy
  • Homes with intelligent objects
  • Homes with intelligent objects that communicate
  • Connected homes
  • Learning homes
  • Attentive homes
  • (Aldrich 2003)

17
Why?Continuum of service
  • Who ?

Just Inside ?
  • What?

Or Inside Out ?
  • Where ?

18
Technology Continuum
Environmental Control Systems
Automated Home Environment
Social Alarms
Assistive Technologies
19
Smart HomesCare Continuum
Environmental Control Systems Automated Home
Environment
Risk Management Technologies
Assistive Technologies Telecare
Increasing Level of Dependency
20
Risk Management Technologies
Flood
Movement
Pendant
Smoke
Phone line
wireless
  • Fall Detector
  • Hi-Low Temperature
  • Bed Occupancy
  • Wandering Person

Pull Cord
21
Environmental Control Systems
SENIOR Pilot
SICARE Light
SRS 100
SRS Lite
22
Environmental Control Systems
Buddy Buttons
Leaf Switch
Suck/Blow Switch
Thumb Switch
Cap Switch
23
A Whole Systems Approach
  • Unique individuals
  • Diverse care scenarios
  • Diverse environmental contexts
  • Intra-agency
  • Inter-agency
  • Complex service provision with interaction /
    connectivity of component parts essential for
    service delivery

24
A Whole Systemscontributes to
  • Clarity of activity sequence facilitates a
    streamlined process
  • Clear roles and responsibilities
  • Identifies agency links
  • Traceable information flows
  • Enables service controls
  • Facilitates user centred focus to service
    delivery
  • Supports evolving Health and Social Care

25
Societal Level - Virtuous Feedback Loops
Increasing Deployment To Technology To Support
Community Care
Increasing Demand To Continue To Exploit
Technology To Support Community Care
Increasing Visibility At Local Level Anecdotal
Evidence Of Impact
26
Service Provider Vicious Feedback Loops
Increasing Use Of Technology
Increasing Demand On Budgets To Fund Technology
Increasing Visibility
27
University activity in this context
  • Research
  • Teaching
  • Consultancy

28
Research
MATCH
29
Advent xt
ALTec Smart Personal Sensors
Neck Wrist Personal Triggers
Client Wander Keypad
PIR Movement Detector
Advent xt Intercom
Enuresis Sensor
Fall Detector
Bed Occupancy Detector
30
(No Transcript)
31
COLLABORATION ON SMART TEXTILES
32
Hillmount Close
  • Cedar Foundation Habinteg Housing Association
  • There are seven apartments all of which are fully
    adapted
  • The tenant group includes people with physical
    disability, brain injury and sensory impairment
  • It combines housing with care and technology to
    increase independence and enhance quality of
    life. The tenants can utilise the latest in
    assistive technology to manage the tasks of daily
    living
  • Evaluation carried out on
  • Service Model
  • Experience of tenants and care staff

33
Emerging Technologies
34
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35
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36
DGHome Telecare Platform
37
Consultancy-KTP
  • Non- Complex
  • Pressure Mats with Alarms
  • Electric Bells with Lights
  • Audible Door Alarms
  • Medication Management Systems
  • Emergency Call Pendants

38
Consultancy-KTP
  • Complex
  • Networked Home Environments
  • Data Gathering and Analysis
  • Interface Design for Tenants and Carers
  • Multi-agency Provision

Ulster institute for eHealth KTP dedicated
staff UUTECH consultancy
39
Teaching
  • MSc in Dementia care
  • CPD Occupational Therapists
  • Post grad. Module
  • Awareness sessions
  • EAT forum
  • BSc Hons Occupational Therapy

40
Technology within healthcare.
  • Complex Interagency Collaborative Working
  • Person Centred Service Provision
  • Context in which People Live
  • Geographical Location
  • Environmental Design of Home
  • Technology Specification
  • Functional Limitations of Disability

41
NetWell Project
  • Area
  • Exploitation of emerging ICT Technologies for
    Ageing in Place
  • Funder
  • INTERREG IIIA
  • Description
  • The NETWELL project is a pilot component part of
    the larger Nestling Technology Initiative
    programme aimed at developing an all-island
    centre of excellence for models for
    ageing-in-place based on the appropriate
    exploitation of emerging ICT technologies.
    Initally focussed in the East-Border Region, the
    project envisages growth throughout the eligible
    area in future stages, and ultimately into
    pan-european networks.

42
CPVS
  • Area
  • Providing Video support via mobile phones to
    ageing people with dementia
  • Funder
  • ETAC (US Alzeimers Association, Intel Corp and
    Agilent)
  • Role
  • Technical development, Prompting, Home-based,back
    end analysis

43
Mobile Phone-based Video Streaming
  • Area
  • Providing Video support via mobile phones to
    ageing people with dementia
  • Funder
  • HPSS RD RRG
  • Role
  • Back end analysis

44
COGKNOW Helping People With Dementia Navigate
Their Day
  • Area
  • Decision support and decision reinforcement for
    people with dementia
  • Funder
  • EU FP6 eInclusion STREP
  • Role
  • Technical coordinator
  • Description
  • The challenging aim of our proposal is to
    breakthrough with research that addresses these
    needs, for the percentage of those with mild
    dementia in Europe. At about 2 of the elderly
    population, this equates to around 1,900,000
    people. In order to achieve our aim, practically
    this means helping people navigate through their
    day. This entails cognitive reinforcement, and
    may be expressed as the social objectives of our
    research for the needs of people with dementia,
    helping people to remember, maintain social
    contact, perform daily life activities and
    enhance their feelings of safety.

45
i-Living labs
46
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47
Communication is important
48
Challenges
  • Recurrent Funding for Mainstreaming
  • Prioritising Service Developments in Line with
    HPSS and Corporate Targets
  • Managing Changed Mode of Service Delivery
  • Staff Expectations
  • Service User Expectations

49
Challenges
  • Understanding Available Evidence
  • Telemedicine, Telecare, Teleconsultation, Smart
    Home, EAT, ICT, Ambient Home Environment,
    Ubiquitous Intelligence.
  • Development of Health and Social Care or Move of
    Acute Sector Provision into Community Setting ?
  • Health Promotion with Fit Healthy ?
  • Risk Management Devices Services

50
Opportunities
  • World Health Organisation (2002) International
    Classification of Functioning Disability and
    Health
  • Evolving Social Model of Disability-
    biopsychosocial model
  • Challenges of delivering Health and Social Care
    to future populations with a changing demographic
    profile

51
Opportunities
  • Service Process Re-engineering
  • Target Priority Areas
  • Learn from Available Examples
  • Lead Innovative Service Developments

52
What is a Smart Home ?
IT IS NOT JUST SIMPLY
TECHNOLOGY
53
Electronic Assistive Technology in Health and
Social Care
Supported Independent Living Via Tailored
Integrated Services Technologies
54
Concluding aspirations
  • Strategic policy to support innovative
    aspirations
  • Robust research methodologies applied to emerging
    applications to provide evidence to support
    further development
  • Funding
  • Provision and clarity

55
  • Thank You
  • s.martin_at_ulster.ac.uk

56
Websites
  • Review of public administration
  • http//www.rpani.gov.uk/
  • Bamford review
  • http//www.rmhldni.gov.uk/
  • Living fuller lives
  • http//www.rmhldni.gov.uk/dementia-consultation-j
    uly06.pdf

57
  • Dementia service development centre
  • http//www.dementia.stir.ac.uk/
  • PASA
  • http//www.pasa.nhs.uk/PASAWeb/Productsandservices
    /Telecare/LandingPage.htm
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