Eldercare Technology for Clinical Practitioners

234 Pages·2007·5.93 MB·english

by  Majd Alwan

Eldercare Technology for Clinical Practitioners
A M
GING EDICINE
RobertPignolo,MD,PhD;MaryAnnForciea,MD;JerryC.Johnson,MD,
SeriesEditors
Age-RelatedChangesoftheHumanEye,editedbyCarloA.CavallottiandLucianoCerrulli,2008
ClassicPapersinGeriatricMedicine,editedbyRobertPignolo,MaryAnneForciea,andMonica
Crane,2008
EldercareTechnologyforClinicalPractitioners,editedbyRobinA.FelderandMajdAlwan,2008
HandbookofPainReliefinOlderAdults:AnEvidenceBasedApproach,editedbyMichaelF.Gloth,
2004
·
Majd Alwan Robin A. Felder
Editors
Eldercare Technology
for Clinical Practitioners
Editors
MajdAlwan RobinA.Felder
CenterforAgingServices DepartmentofPathology
Technologies(CAST) UniversityofVirginaHealth
Washington,DC SciencesCenter
Charlottesville,VA
SeriesEditors
RobertJ.Pignolo,MD,PhD JerryC.Johnson,MD
AssistantProfessorofMedicine ProfessorofMedicine
DepartmentofMedicine Chief,DivisionofGeriatricMedicine
DivisionofGeriatricMedicine SeniorFellow,InstituteonAging
UniversityofPennsylvaniaHealthSystem UniversityofPennsylvaniaHealthSystem
MaryAnnForciea,MD
ClinicalAssociateProfessorofMedicine
DivisionofGeriatricMedicine
UniversityofPennsylvaniaHealthSystem
ISBN:978-1-58829-898-0 e-ISBN:978-1-59745-233-5
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Preface
Background:The majority of our increasing elder adult population requires some
degree of formal and/or informal care because of loss of function as a result of
failing health. Accordingto the Centers for Disease Control (CDC), nearly three-
quartersofelderadultssufferfromoneormorechronicdiseases.Examplesinclude
arthritis,hypertension,anddiabetes,tonameafew.Thecostandburdenofcaring
forelderadultsissteadilyincreasing.
ChangesintheMedicaresystemledtoashiftintheresponsibilityforcarefrom
institutions(nursinghomes,etc.)tothecommunity(individualsandfamilies).The
roleofinformalcaregiversinprovidingcaretotheelderadultpopulationhasgreatly
increasedinthepasttwodecades.Consequently,informalcaregivershavecometo
beviewedasanunpaidextensionofprofessionalcaregivers,providingmostofthe
caretoelderadultsrequiringlong-termcare.Infact,nationaldatabasesderivedfrom
differentsourceshaveprovidedunequivocalevidencethatfamilyandfriendsarethe
solecareprovidersforaboutthree-quartersofallcommunity-dwellingelderadults.
Informal caregivers have experienced increased physical burdens and emotional
strains because of this shift in long-term elder care responsibilities. Furthermore,
healthcareprovidersarefacedwithashrinkingprofessionalcaregivingworkforce
atthesametime.
Onthecontrary,theproportionoftheworld’spopulationofindividualsoverthe
ageof60yearsisexpectedtodoubleby2030to20%.IntheUSA,thenumberof
elder adultsis expectedto growto 108millionoverthe next15 years, whichrep-
resents45%oftheadultpopulation.Elderadultscurrentlyaccountfor60%ofthe
overallhealthcarespendingintheUSA.Appropriatemanagementofchronicdisease
inolderadultscanreducetheUShealthcarebillbyupto50%.Furthermore,92%
oftheseelderadultslivealoneintheirownapartments,homes,independentliving
facilities, or assisted living facilities, including about 50% of those 75 years and
older.Such statistics demonstratean urgentneedfor innovativetelehealth/telecare
tools that enable elder adults to live independentlyand maximize caregivers’effi-
cacybyprovidingtimelyhealthinformationanddeliveringmoreeffectivecare.This
change in the demographics and its potential economic impact on industrialized
nationshaspromptedactiveresearchinautomatedsystemsforfunctionalandhealth
statusmonitoringandassistance,enabledbyrecenttechnologicaladvancement.
v
vi Preface
Inthemeantime,advancesinsensor,communication,andinformationtechnolo-
gies have created opportunities to develop novel tools enabling remote manage-
ment and monitoring of chronic diseases, emergencyconditions, and the delivery
ofhealthcare.In-homehealthassessmentandmonitoringhastheaddedbenefitof
measuringindividualizedhealthstatusandreportingittotheprimarycareprovider
andcaregiversalike,allowingtimelierandtargetedpreventiveinterventions.Health
monitoringinhomeenvironmentscanbeaccomplishedbya)ambulatorymonitors
that utilize wearable sensors and devices to record physiological signals; b) sen-
sors embedded in the home environmentand furnishings to unobtrusively collect
behavioralandphysiologicaldata;orc)acombinationofthetwo.
Aim and scope: This book addresses technologies targeted at the assessment,
earlydetection,andthemitigationofcommongeriatricconditionsincludingdecline
infunctionalabilities,gait,mobility,sleepdisturbance,visionimpairment,hearing
loss, falls, and cognitive decline. This book not only describes the state of both
embedded and wearable technologies, including technologies under research and
onthebrinkoftranslationintoproducts,butalso focusesonresearchshowingthe
potentialutilityofthesetechnologiesinthefield.
Chapter 1 presents an introductionand reviews the statistics that make a com-
pelling case for developmentand utilization of technologiesfor the geriatric care.
Chapter 2 presents a comprehensive review of functional assessment instruments
andpromisingtechnologiesusedinfunctionalassessmentofelders.Chapter3cov-
ersmobilityandgaitassessmenttechnologies,whereasChapter4reviewsmobility
aidtechnologiesfortheelderly.InChapter5,wereviewsleepdisordersinolderage
andsleepassessmenttechnologies,withemphasisonin-homeassessmenttechnolo-
gies. Chapter 6 presents a comprehensivereview of age-related changes in vision
andcorrectivetechnologies,whereasChapter7addressesthemanagementofhear-
inglossinolderage.Chapter8isdedicatedtofalls,falldetection,andfallpreven-
tiontechnologies.Finally,Chapter9addressesemergingcomputer-basedcognitive
assessmenttechnologies.
Webelieve,andhope,thatthisworkwillfillagapintheknowledgeandwillbe
invaluabletoEldercarepractitioners,aswellasmedicalstudentstudyingGeriatrics
and interested in gerotechnology, social studies, students studying gerontology
and interested in gerontechnology, and nursing students interested in Geriatric
Nursing, in addition to engineeringstudents interested in Eldercare Technologies,
andresearchersfroma broadspectrumofdisciplines,particularlythose interested
in field experience and the end-user’s perspective. This volume comes at a time
when interest in Eldercare Technology and the need for effective and appropriate
technologiesespeciallyarepeaking.
Washington,DistrictofColumbia MajdAlwan
Charlottesville,Virginia RobinA.Felder
Contents
Preface........................................................... v
Contributors...................................................... ix
ListofAcronymsandAbbreviations................................. xi
1 Introduction................................................... 1
RichardLindsay
2 FunctionalAssessmentTechnologies.............................. 5
Marilyn Rantz, Marjorie Skubic, Kathryn Burks, Jie Yu,
George Demiris, Brian K. Hensel, Gregory L. Alexander,
Zhihai He, Harry W. Tyrer, Marc Hamilton, Jia Lee,
andMarybethBrown
3 MobilityandGaitAssessmentTechnologies ....................... 33
PatrickO.Riley,KateW.Paylo,andD.CaseyKerrigan
4 IntelligentMobilityAidsfortheElderly .......................... 53
GlennWasson,PradipSheth,CunjunHuang,andMajdAlwan
5 SleepandSleepAssessmentTechnologies ......................... 77
StevenM.Koenig,DavidMack,andMajdAlwan
6 VisionImpairmentAssessmentandAssistiveTechnologies ..........121
StanleyWoo
7 ManagingHearingLossinOlderAdults:Assessment,Intervention,
andTechnologiesforIndependenceandWellBeing .................143
Matthew H. Bakke, Claire M. Bernstein, Scott J. Bally,
andJanetL.Pray
8 Falls,FallPrevention,andFallDetectionTechnologies..............187
Prabhu Rajendran, Amy Corcoran, Bruce Kinosian,
andMajdAlwan
vii
viii Contents
9 ComputerizedMethodsforCognitiveTesting......................203
VeredAharonsonandAmosD.Korczyn
Index ............................................................217
Contributors
VeredAharonson,Ph.D.,Department KathrynBurks,R.N.,Ph.D.,
ofSoftwareEngineering,TelAviv SchoolofNursing,Universityof
Academic College of Engineering, Missouri,Columbia,MO
Afeka,Israel
AmyCorcoran,M.D.,Geriatric
GregoryL.Alexander,Ph.D.,R.N.,
Fellow,DepartmentofMedicine,
AssistantProfessor,SinclairSchoolof
DivisionofGeriatrics,Universityof
Nursing,Columbia,MO
Pennsylvania,Philadelphia,PA
MajdAlwan,Ph.D.,Director,Center
GeorgeDemiris,Ph.D.,Associate
forAgingServicesTechnologies
Professor,Biobehavioral
(CAST),Washington,DC
NursingandHealthSystems,Schoolof
MatthewH.Bakke,Ph.D.,Associate Nursing&Biomedicaland
Professor,GallaudetUniversity, HealthInformatics,SchoolofMedicine,
DepartmentofHearing,Speechand UniversityofWashington,Seattle,WA
LanguageSciences,Director,
RehabilitationEngineeringResearch MarcHamilton,Ph.D.,Associate
Center(RERC)onHearing Professor,Biomedical
Enhancement,Washington,DC Sciences,DaltonCardiovascular
ResearchInvestigator&Collegeof
ScottJ.Bally,Ph.D.,Associate
VeterinaryMedicine,Universityof
Professor,GallaudetUniversity,
Missouri,Columbia,MO
DepartmentofHearing,Speechand
LanguageSciences,Washington,DC
ZhihaiHe,Ph.D.,AssistantProfessor,
DepartmentofElectricalandComputer
ClaireM.Bernstein,Ph.D.,Research
Engineering,UniversityofMissouri,
Audiologist,GallaudetUniversity,
Columbia,MO
DepartmentofHearing,Speechand
LanguageSciences,Washington,DC
Brian K. Hensel, Ph.D., M.S.P.H.,
MarybethBrown,Ph.D.,Professor, Post-DoctoralFellowin
PhysicalTherapy,SchoolofHealth Health Informatics, University of
Professions,Columbia,MO Missouri-Columbia,Columbia,MO
ix
x Contributors
CunjunHuang,Ph.D.,Departmentof PrabhuRajendran,M.S.,Graduate
MechanicalandAerospace ResearchAssistant,Medical
Engineering,Universityof Virginia, AutomationResearchCenter,
Charlottesville,VA UniversityofVirginia,
Charlottesville,VA
D.CaseyKerrigan,M.D.,M.S.,
UniversityofVirginia,Schoolof
MarilynRantz,R.N.,Ph.D.,F.A.A.N.,
Medicine,DepartmentofPhysical
Professor,SinclairSchoolofNursing
MedicineandRehabilitation,
andFamilyandCommunityMedicine,
Charlottesville,VA
S406SinclairSchoolofNursing,
BruceKinosian,M.D.,Associate UniversityofMissouri-Columbia,
Professor,DivisionsofGeneralInternal Columbia,MO
MedicineandGeriatrics,University
ofPennsylvania,SchoolofMedicine, PatrickO.Riley,Ph.D.,Research
Philadelphia,PA AssociateProfessor,Universityof
Virginia,SchoolofMedicine,
StevenM.Koenig,M.D.,FCCP,
DepartmentofPhysical
ProfessorofInternalMedicine,
MedicineandRehabilitation,
UniversityofVirginiaHealthSystem,
Charlottesville,VA
TheDepartmentofInternalMedicine,
DivisionofPulmonary&CriticalCare, PradipSheth,Ph.D.,Department
Charlottesville,VA ofMechanicalandAerospace
AmosD.Korczyn,M.D.,B.Sc., Engineering,UniversityofVirginia,
Professor,SieratzkiChairofNeurology, Charlottesville,VA
Tel-AvivUniversityMedicalSchool,
MarjorieSkubic,Ph.D.,Associate
Ramat-Aviv,Israel
Professor,Electricaland
JiaLee,Ph.D.,R.N.,Assistant ComputerEngineeringDepartment,
Professor,SinclairSchoolofNursing, Columbia,MO
Columbia,MO
HarryW.Tyrer,Ph.D.,Professor,
RichardLindsay,M.D.,Former
DepartmentofElectrical
ChairofGeriatricMedicine,School
andComputerEngineering,University
ofMedicine,UniversityofVirginia,
ofMissouri,Columbia,MO
Charlottesville,VA
DavidMack,M.S.,Ph.D.,Graduate GlennWasson,Ph.D.,Departmentof
ResearchAssistant,Medical ComputerScience,Universityof
AutomationResearchCenter, Virginia,Charlottesville,VA
UniversityofVerginia,
Charlottesville,VA StanleyWoo,Ph.D.,Clinical
AssociateProfessor,Chief,LowVision
KateW.Paylo,D.O.,University
RehabilitationServices,Director,
ofVirginia,SchoolofMedicine,
CenterforSightEnhancement,
DepartmentofPhysicalMedicineand
UniversityofHoustonCollegeof
Rehabilitation,Charlottesville,VA
Optometry,Houston,TX
JanetL.Pray,Ph.D.,
Professor,GallaudetUniversity, JieYu,B.S.N.,R.N.,DoctoralStudent,
DepartmentofSocialWork, SinclairSchoolofNursing,
Washington,DC Columbia,MO