DoorWatcher™ 1-minute Installation Guide

DoorWatcher™ anti-wandering system gives caregiver peace of mind when taking care of children with autism and adults with Alzheimer's disease or dementia who are at risk for wandering.

Wandering patients may get into trouble if they go out unattended. DoorWatcher™ will sound an audible and visual alert if they attempt to pass a door gate. This will remind the wanderer that they should not be exiting through the door, and alert caregiver that assistance may be needed.

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Predictive Healthcare - A bet for the next decade

Healthcare is a preventive measure

Over the last century, we have been investing an enormous amount of resources in developing cures for diseases such as cancer and flu. Many of the deadly diseases are curable these days, but at tremendously high cost. In the next few decades, would such preventive healthcare approach meet the drastically growing demand?

Seeing the growth of aging population, a huge surge of need is expected from patients waiting to receive a physical and mental diagnosis. Meanwhile, with a declining workforce, including doctor, nurse and researcher, any increase in medical resources following the same rule would seem difficult.

Predictive healthcare

Like predicting the spread of diseases, Google had attempted to estimate trends of flu and Dengue based on search patterns, alerting the society for preventive vaccination programs. A similar strategy can be deployed more holistically into the healthcare industry, with a set of anonymous health data collected from 24 x 7 sensors.

Sensors are everywhere these days. Smartphones keep track of your connectivity with your friends and family, as well as the change in your living and working environment, which detect potential causes of stress and mental illness.

Health monitoring sensors collect data such as body temperature, blood pressure, blood glucose, heart rate, sleep pattern and activity level and provide early warning for stroke and acute heart diseases.

Combining personal health record, demographics with environmental variables such as temperature and humidity, providing a full picture of health performance over time for doctors to understand real causes behind health issues, avoiding misdiagnosis and unnecessary medication.

Healthiness becomes a new competition

Just like a smartphone jogging application, your health condition could constantly match against other healthy individuals within your community over time. You can understand how well you are doing and receive personalized recommendations on what better can be done.

So, next time when your neighbor asks how well you are doing, you may launch your mobile app and tell her your result.

Is elderly fall prevention a cost, or a benefit for nursing home?

"Fall causes 1,800 death and US$34 billions each year"

According to U.S. Centers for Disease Control and Prevention (CDC), about 1,800 older adults living in nursing homes die each year from fall-related injuries and those who survive frequently sustain injuries that result in permanent disability and reduced quality of life, not including people living at home or other forms of nursing facilities. Each year, nursing home with 100 beds reports 100 to 200 falls. 35% fall inquiries occur among resident who cannot walk.

The number does not include people who were injured and hospitalized from these fall accidents. CDC reported that US$34 billion costs are incurred relating to direct medical cost, not including the costs for long term care such as disability, emotional health and reduction of productivity from their family caregiver.

Same statistics are shown in "Later Life in the United Kingdom", pointing out that 1/3 of people aged over 65 falls each year in UK. 3,653 death caused by fall were recorded in 2013. Around 70,000-75,000 hip fractures occur each year, mainly caused by fall accidents, costing for GBP 2 billion (~USD 2.88 billion) each year. 1 in 12 people died in 1 month after a fall while only half would return home. 50% of patients never regained the pre-accident mobility level.

The main cause of fall is muscle weakness due to lack of exercises, which accounts for 24% of falls. It could also be environmental factors such as poor lighting, tripping hazards and wet floors in bathrooms. Overuse of antipsychotics medication such as anti-anxiety drugs for patients with mental health issues could lead to adverse side effects in their central nervous system.

In fact, fall management measures can exist in different stages of elderly care. Therapists can estimate fall risk by conducting activities of daily living assessment and simple timed up and go test. Body motions can be monitored to detect fall risks in advance with motion alarm system, given in a skilled nursing facility or elderly home with a live-in caregiver. Panic buttons or mobile application with gyroscope are designed for immediate notification to caregivers for people who have just fallen.

While technology seems to be available, the trend of fall among elderly people does not seem to be improving. In the U.S., each full-time nurse has to look after approx. 1.75 beds with elderly care recipients. The number sounds reasonable for avoiding most of the accidents in nursing homes, but it is obviously not what is happening. How can the industry do better?

Turning from hospitalization to fall prevention

According to CDC, the average cost of hospitalization due to fall injury is over USD35,000. There is a great monetary initiative for nursing home owners to enhance their fall management capability. By stopping residents from being hospitalized, nursing homes could extend the period of stay for their residents, and possibly charge a premium for better elderly protection at the beginning during admission.

The key is to collect 24 x 7 behavioral data from residents through wireless sensing technology, with motion sensors in living areas, pressure sensors in bed, chair and toilet. Data such as the number of times a panic button is pressed during the day, or a resident get up from bed at night, or the duration of activity (or inactivity). Further analysis can be conducted and compared by long term care professional based on residents' health and medication records. As long as abnormal behavioral patterns can be spotted from residents who have changed in their daily activities, more attention and resources can be shifted to prevent them from falling. For example, nursing homes may separate residents with abnormal behavior into an environment with intensive care.

Data tells no lies.

For elderly people who appears to have signs of dementia, it is sometimes difficult for doctors or caregivers to find out the real problem as they tend to ignore or deny about their worsening health condition. With actual behavioral data available, nurse and family members can better understand the health status of the elderly residents, while doctors can prescribe more accurate accordingly.

Acceptance is the key

The key to deploy sensors successfully in nursing homes and on the elderlies is acceptance. Most elderlies are reluctant to move from their familiar living environment, into nursing homes, not to mention wearing panic buttons or tracking sensors on their body. Therefore, designers and manufacturers of elderly care devices have to put much greater effort to "hide" the sensor device in normal home settings. Wearable device can be personalized and turned into a warm gift that everyone (elderly, nurse, family) uses and loves.

Source:
http://www.cdc.gov/HomeandRecreationalSafety/Falls/nursing.html
http://www.cdc.gov/nchs/data/nsltcp/long_term_care_services_2013.pdf
"Later Life in United Kingdom", by ageuk.org.uk, Feb 2016

A Poem for the Alzheimer's

Do not ask me to remember

Don't try to make me understand

Let me rest and know you are with me

Kiss my cheek and hold my hand

My confusion is beyond your concept

I am sad, and sick, and lost

All I know is that I need you to be with me 

at all cost...

Do not lose your patience with me

Do not scold or curse or cry

I can't help the way I am acting

Can't be different though I tried

Just remember that I need you

The best of me is gone

Please don't fail to stand beside me

Love me till my life is done...

The Lancet: Depression in old age—the first step to dementia?

When your old parent consistently feels unhappy and depressed, it could be cause for dementia. According to the latest study, people aged 54 or older may have a higher risk of dementia than the others. Only people with depression worsening over time are affected, excluding patients with only once or twice depression experience.

Psychiatrists and gerontologist tend to believe that there is a hidden correlation between dementia and depression, but this is the first research which tried to segment the group according to different levels of depression.

In this study, researchers had collected 3,325 people aged over 55 and traced their health condition from 1993 to 2004. None of the depressed elderlies have dementia at the beginning, but 434 eventually developed dementia and 348 of which had Alzheimer's disease.

Source: The Lancet Psychiatry

Healthy Diet for Preventing Dementia

Dementia is a chronic disorder caused by brain injury or disease, which gradually reduce the cognitive ability of a person. In Hong Kong, most dementia cases are found in the people aged over 65.

Sally Poon, certified dietitian, suggested that dementia has a strong correlation with heart diseases and stroke. The key to preventing dementia is to control blood pressure, glucose level, heart diseases and stroke. In additional, regular exercise, balanced diet, avoid smoking and drinking are essential. Also, intake of trans fat and saturated fat should be reduced.

Mediterranean diet has been popular among the anti-dementia or elderly care groups. As the food provides plenty of antioxidant and omega 3, which are showed effective against dementia.

See below.

1. Grains: Whole Grain Bread, Red Rice, Brown Rice
   
   
    
2. Fruit & Vegetables
   
   
    
3. Nuts (Moderate amount for omega 3)
   
   
    
4. Fish (avoid red meat)
   
   
    
5. Olive Oil
   
   
    
6. Wine
   
   
   

Though it is not suggested to drink alcohol. If a habit is already formed, two glasses of wine per day or few grapes with skin can help. And of course, not the glass below!

 

Source: Apple Daily