Telecare Workshop

Significant progress that is being made in telecare device development for ensuring safety and comfort of the elderly living at home, is described in this essay by Andrew McIntosh, an engineer long involved in telecare development.

Telecare Products for the Elderly: Efforts to Ensure Safety and Comfort at Home

By Andrew McIntosh
Product Marketing Manager, the Tunstall Group, Ltd.
Contact: A_McIntosh@tunstall.co.uk

Personal Emergency Response Systems (PERS) as the standard for safety at home.
Many people involved in caring for and supporting elderly people will be familiar with the Personal Emergency Response System (PERS), which for years has been a means of providing greater reassurance and helping people live independently at home. The PERS represents the first generation of telecare technology and continues to support millions of people around the world.

PERS and Telecare Sensors: An extension of safety assurance.
By working with care provider organisations we have identified applications where new sensor technology can most usefully be employed, and we have developed products which extend the role of the PERS service as a means of supporting independent living. We call these telecare sensors, and the care providers often refer to their services as telecare services. This article describes examples of some of the telecare sensors being used in the UK.

Telecare sensors, work in conjunction with the PERS system and complement its function by providing additional passive monitoring around the home. Telecare sensors monitor risks and hazards that are associated with independent living. They are wireless, battery operated and simple to install. The sensors can be mixed and matched according to the needs of the individual being supported, and can be added to or changed as the individual’s care needs change.

Telecare Sensors & Monitoring Functions: Needs for the elderly at home. Telecare sensors fall into two categories, those that monitor the environment in the home, and those that monitor the activities of the person living there.

When a sensor detects a specific event or sequence of events, it sends a radio signal to the PERS unit which in turn dials to the 24 hour support service or directly to a care giver, depending on the rules assigned within the PERS unit. In most cases there is a visual and audible indication to the user which makes them aware that a call is being made and provides assurance that the equipment is working on their behalf. Once the call is established, the recipient at the response centre or the care giver can talk to their client and ascertain what help is required.

For instance, if an emergency event such as smoke in the bedroom or rapid rise of temperature in the kitchen is detected, the call can be directed to the center whose personnel can react swiftly and liase with the emergency services. Alternatively, a call triggered by a more personal or non emergency event such as an enuresis detection or a person leaving the house at 3:00 am can be directed to a care giver who lives close by.

Telecare-directed Customized Response Systems .
An important part of supporting independence is to be able to recognise quickly if the person has suffered an accident or become incapacitated or unconscious for medical reasons. Telecare can play an important role here because monitoring of activities can give an important indication that such an event may have occurred. Various devices are used to passively monitor in a way that does not intrude on the person’s privacy.

For example, a passive infra red (PIR) motion detector is a simple means of detecting the movement of a person as they pass from one part of the home into another. Every time the PIR sensor detects motion, it sends a radio signal to the PERS unit which can use this information as the input to an activity monitoring algorithm. A motion detector strategically placed in the kitchen or hallway, for instance, can detect that somebody has risen in the morning and begun their daily routine. The PERS unit can be configured to monitor for a period during the early part of the day coinciding with the persons usual routine and to report the exceptions-- for example, when the person has not left their bedroom in the morning.

Fall Detection and Response; Devices to assist the elderly.
Our customers told us early on that falls are the biggest risk to manage, and of the importance of identifying and intervening rapidly when a serious fall has occurred. Prompted by our customers we developed a fall detector. The fall detector is a small device which clips onto the wearer’s belt or waistband. It contains sensors and a microprocessor which recognise the change of orientation and impact of a fall. If it detects the wearer falling, it will automatically transmit a radio signal to the PERS unit which in turn will make a call to the 24 hour response service. The fall detector is perhaps unusual because it requires the user to wear it, whereas the other telecare sensors are fixed within rooms. However, for those who are comfortable wearing it while they are around the home it can provide instant detection of a fall which may otherwise leave someone in trauma for hours.

For many people who become prone to falls in the home, the risk of falling at night time, for instance while getting out of bed, or in the bathroom is also significant. In this case a bed occupancy sensor is used to provide an indication of an abnormal event. The bed occupancy sensor is a smart device which can be configured for an individual according to their normal pattern of bed usage-- i.e., the time they normally go to bed, the time they normally rise in the morning and the time period that would be normal for them to leave the bed during the night.

This device uses a pressure sensor under the mattress to detect when the person is in bed, and it constantly monitors for activity. It can be configured to trigger a call on the PERS system if an exceptional event occurs. For example, these exceptional events may be detected if the person does not get up in the morning, or if the person rises from bed during the night and does not return within the safe period. The device can also interface to an X10 lighting controller to automatically dim up the lights when the person gets up in the night and automatically dim them back down when they return.

Next Steps in Assisting in Home Safety for the Elderly: New sensors for customizing and targeting needed responses.
The next generation of telecare takes the application of sensors even further. The third generation of telecare currently being piloted in the UK, uses the PERS unit and sensors described above with some additional sensors and software. Known as the MIDAS II system, it enables events corresponding to an individual’s activities of daily living to be automatically recorded and analysed. The system uses all the raw information collected from the passive infra red detectors, bed, chair and door sensors, plus sensors for detecting the use of fridge and kitchen cupboard, kettle/coffee maker and TV.

The MIDAS II system combines the sensor data to develop a set of indexes which relate to important aspects of lifestyle – Nutrition, Grooming, and Daytime and Nighttime activity. The system learns a normal range for a particular client and automatically reports to a caregiver by email or text message when it recognises that an index has deviated outside of that range.

Providing that sensors and other types of telecare product can be made cost effectively and are designed to be simple to install and maintain, there are endless possibilities to extend this concept. The products are widely accepted by the people who have them installed in their homes and by the care organisations that provide and use them as part of their services. Encouraged by this, we continue to work with professional caregivers and technology developers to identify and meet new needs, and expand the range of available products.

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