Supporting People with Dementia During Night Time

The NOCTURNAL (Night Optimised Care Technology for UseRs Needing Assisted Lifestyle) Project

Maurice Mulvenna, University of Ulster

29 November 2010, Coventry

Outline

•  Background •  Introduction to the project •  Objectives, approach and methodology •  Person-centred approach •  Findings •  Conclusions

Fold & Telehealthcare

•  Provide lower cost – easily accessed – always on – telehealthcare services

•  Position telehealthcare services as front-line preventative and assessment services as well as real time life critical services supporting and supported by community networks

•  Monitor and enable intervention within the home and by the client prior to escalation outside the home requiring intervention by others

Research Impetus

•  Ageing population •  Assisted technology used to improve the

quality of life for older people •  Day time support for people with dementia •  Limited activity on technologies that

provide night time support for people with dementia

•  Lack of service

NOCTURNAL Project

•  Period: October 2008 - September 2011 •  Funding Body: TSB/EPSRC, UK •  Partners:

–  Fold Housing Association (one of the leading telecare service providers throughout the UK and Ireland, providing telecare services to around 20,000 households and supporting 100,000 carers through handling around 1,000 calls a day)

–  University of Ulster •  School of Computing and Mathematics •  School of Life Sciences

–  Northern Health and Social Care Trust

Research objectives

•  NOCTURNAL is designed to address the needs of people at the early stages of dementia, specifically to provide therapeutic support and guidance to this group of people during the hours of darkness

•  Broad Objectives: –  to provide new technological capabilities that

support sophisticated service offerings –  investigation of the needs of people with

dementia at night time

Research approach, methodology

•  NOCTURNAL will –  Utilise technology which will largely be

invisible to the users, but will empower the carer. It will adopt appropriate assistive technologies from daytime usage

–  Provide lighting guidance to assist with the trip from bedroom to toilet (and back!) during the night

–  Offer therapeutic interventions using music and familiar images of loved ones at bedside device

Research approach, methodology

•  NOCTURNAL system – components –  Motion monitoring devices –  Bedside audio/video system –  Web-based interface and DSS –  Database and intelligent data analysis tools

Research approach, methodology

Person Centred Application

•  Requirements –  Promote independence, dignity and choice –  Maximise social inclusion –  Provide lower level information and support

services •  Expected outcomes

–  Expanded portfolio of service interventions for persons with dementia based on assessed need

Lifestyle Monitoring informing Service User Needs

•  Evidence of night time activity but no memory of it.

•  Unexplained wandering and unable to return home.

•  Puts walking aid at front door hoping that this will stop her leaving the house.

•  Aware of memory loss but wants to remain at home.

•  Prone to falling •  Goes into the kitchen but can’t remember

why.

Developing Solutions •  Understanding and interpreting the data. •  What can we do to guide and prevent an

incident •  How can care giver participate in the

intervention/care plan? •  How can we adapt the system to signal

change? •  Who needs to know what? •  The role of the response centre

Developing Solutions

•  Sleep measurements variables –  Quantity of sleep –  Quality of sleep –  Rhythm of sleep

•  Sleep Events detection •  Visualisation

Detection and visualisation of sleep patterns

Trends

Conclusions and outlook

•  NOCTURNAL aims to work closely with people who have dementia and their carers to develop a system based on their needs

•  The solution may provide lighting guidance and therapeutic intervention, all of which have merit in the hours of darkness

•  NOCTURNAL will seek an ambient solution, using tried, tested and familiar technology where possible

Thanks & Acknowledgements

•  This research is supported by a research grant from the Technology Strategy Board and Engineering and Physical Sciences Research Council, UK (TS/G002452/1).