transforming health & wellness for seniors · transforming health & wellness for seniors:...
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Transforming Health & Wellness For Seniors:
The Role For Technology And Web 2.0 Tools
Steve Hopkins, Executive Director, LifeChoices™ Evangelical Homes of Michigan
Are we really prepared to serve the current
and future older adult?
• Generation wants more choices
• I want to be the decision maker
• Generation wants more choices;
• want to be the decision maker;
• love their home and wish to stay
What Does the Future Look Like?
The number of persons aged 65 and older is expected to increase from 35 million to an (estimated) 71 million in 2030, a remarkable 100% growth rate.
Projected Growth in the Population Aged 65 and Older
What does it look like…?
Lifestyle
Lifestyle
Lifestyle
Lifestyle
Lifestyle
Lifestyle
Lifestyle
Wellness
Wellness
LIFE
EMOTIONAL
PHYSICAL
VOCATIONAL
INTELLECTUAL
SOCIAL
SPIRITUAL
Wellness
Wellness
Technology
Technology
Technology
Technology
Technology
Technology
Technology
Actual Solutions
Actual Solutions
Actual Solutions
Actual Solutions
How do you Discern…?
1a.IDENTIFY
SOLUTION OPPORTUNITY
1b.INITIAL CONTACT WITH
A SOLUTION
2.
RESEARCH
-USERS -WEB
-DIRECT
3.
DISCERN VALUE ADD
4.
RESEARCH POTENTIAL FEASIBILITY
5.
DEEP SOLUTIONS INVESTIGATION
6.
DISCERNMENT COMPANY
7.
PILOT MAPPING
8.
MARKET PILOT
9.
PILOT
10.
OUTCOME ANALYSIS
11.
POTENTIAL FIX
Implementation Roadmap
11.
IMPLEMENTATION MAPPING
YES
NO
12.
MARKET
IMPLEMENTATION
13.
IMPLEMENTATION
If Negative ( -)
If Positive (+)
Implementation Roadmap (1-6)
1a.
IDENTIFY SOLUTION
OPPORTUNITY
1b.
INITIAL CONTACT WITH
A SOLUTION
2.
RESEARCH
-USERS -WEB
-DIRECT
3.
DISCERN VALUE ADD
4.
RESEARCH POTENTIAL FEASIBILITY
5.
DEEP SOLUTIONS
INVESTIGATION
6.
DISCERNMENT COMPANY
Implementation Roadmap (7-10)
7.
PILOT MAPPING
8.
MARKET PILOT
10.
OUTCOME ANALYSIS
9.
PILOT
Implementation Roadmap (11-End)
13.
IMPLEMENTATION If Positive ( +)
If Negative ( -)
YES
NO
11.
POTENTIAL FIX
11.
IMPLEMENTATION MAPPING
12.
MARKET
IMPLEMENTATION
1a.IDENTIFY
SOLUTION OPPORTUNITY
1b.INITIAL CONTACT WITH
A SOLUTION
2.
RESEARCH
-USERS -WEB
-DIRECT
3.
DISCERN VALUE ADD
4.
RESEARCH POTENTIAL FEASIBILITY
5.
DEEP SOLUTIONS INVESTIGATION
6.
DISCERNMENT COMPANY
7.
PILOT MAPPING
8.
MARKET PILOT
9.
PILOT
10.
OUTCOME ANALYSIS
11.
POTENTIAL FIX
Implementation Roadmap
11.
IMPLEMENTATION MAPPING
YES
NO
12.
MARKET
IMPLEMENTATION
13.
IMPLEMENTATION
If Negative ( -)
If Positive (+)
Are we really prepared to serve the current
and future older adult?
Technologies that
Promote Independence
and Autonomy at Home
Bridget Gallagher, GNP, MSN
Senior Vice President, Community Services
Jewish Home Lifecare
Healthcare Unbound
San Diego, CA
July, 2010
Home is Where the Heart Is
Home is a word that connotes
warmth, belonging and peace.
It is no surprise that in survey
after survey aging Americans
(which by the way is everyone
in this room) state that their
deepest hope is to spend their
“golden years” in their own
home.
Home is Where the Heart Is
The conflict between this
desire and the reality is that
aging is often viewed as a
process of inevitable decline.
Subsequently, too often
opportunities are missed that
would foster a concept of
“Healthy Aging” that would
promote greater autonomy
and independence, and an
ability to remain at home.
Healthy Aging Initiatives
Today, gerontologists are discovering that age in years doesn’t necessarily correlate with physiological age.
In fact, normal physiological aging is quite variable.
SOURCE: Baltimore Longitudinal Study of Aging
Technology: Telehealth
Blood
Glucose
Monitors Blood
Pressure
Monitors
Peak Flow
Meters *Digital
Weight
Scale
Pulse
Oximeter *
Non-Video Telehealth
Remote Monitoring
Technology Platform
A “one to many” daily patient monitoring system to improve
self-care, promote early intervention, increase medication
adherence and reduce overall costs.
Web-based Care Management Tools
Population Summaries Patient Results Patient Trend Plots
Patient Notes Daily Compliance Monthly Compliance
Care Providers Patient Status Payor/Insurance Information
Technology: Telehealth
Please tell us why you didn't take your medicines as instructed
16.4%
10.6%
18.5%
54.5%
0.0%
10.0%
20.0%
30.0%
40.0%
50.0%
60.0%
I'm out of medicine I'm having a problem
with the medicine
I forgot Another reason
Have you had any falls
in the last month? HEALTHY BUDDY DATA
Have you had any falls in the last month?
91.4%
8.6%
Yes No
0.0%
2.0%
4.0%
6.0%
8.0%
10.0%
12.0%
14.0%
16.0%
18.0%
YTD 2002 YTD 2003 YTD 2004 YTD 2006 YTD 2007 Q1-Q3
Benchmark
JHL Outcomes: Congestive Heart
Failure Related Hospitalization Rate
Overall how would you rate the ease of using the
Health Buddy?
50%48%
2%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Very Easy Easy Not Very Easy
Since using the Health Buddy, do you feel there is improved
communication between you and your Doctor or Nurse?
87%
11%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Yes No
The Introduction of
Medication Dispensers
JHL was fortunate enough to receive two grants from the NYSDOH to fund our Diabetes pilot endeavors.
We had been very successful with our non-video units, and wanted to explore the impact of the addition of a medication dispenser to the treatment modality.
Medication Management & Technology
Medication Dispensers
are fully automatic
medication dispensing
units that organize,
remind, and track
dispenses.
NYS DOH Grant 2007-2008
DOH 1 & 2 Results
5467 74
0
20
40
60
80
100
Control Non-video Telehealth Non-video Telehealth +
Medication Dispenser
%
Decrease in A1C
Case Study: Mrs. M
Mrs. M is a 86-year-old woman who is legally blind with uncontrolled diabetes. When we began this program, her A1C was at 8.2.
At the beginning of the program, patient’s daughter had some concerns with utilizing technology to help her mother take her medications.
Case Study: Mrs. M
The Nurse made several visits to explain
the benefits of the MD2 and the importance
of medication adherence in glycemic
control.
Mrs. M had a very strong support system
which included her home health aide, family
and home care team. With the MD2 her
compliance rate was a 97.4% and her A1C
went down to a 7.2.
Telehealth Monitoring Kiosk
Telehealth Monitoring Kiosk
One Nurse is able to
monitor many patients at
one time, and then do
appropriate follow-up as
needed for clients at
high-risk.
Telehealth Monitoring Kiosk
Ms. O’s Nurse was able to
immediately connect with her to
explore the fluctuation in the
blood sugar values.
They were able to work with the
Community MD and modify her
medications and plan of care
expeditiously, which prevented
further complications.
Diabetic Clinical Impact of Kiosk
69%
25%
6%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Decreased Increased No Change
Technology: Nintendo Wii
Implement a universal
approach for those
clients identified at risk
for Falls:
·Rehab evaluation and
gait/balance training
·Home Safety
Assessment and
modifications
·Medication Review
with Community MD
Technology: Nintendo Wii
Potential therapeutic
effects of playing the
Nintendo Wii
·Dexterity,
·Concentration,
·Eye-Hand Coordination,
and
·Self Esteem
Day Care Wii Best Practice
Self Esteem and Balance and Gait Assessments
100.00%
62.50%
0
37.50%
0 00.00%
20.00%
40.00%
60.00%
80.00%
100.00%
120.00%
Rosenberg Self-Esteem Scale Tinetti Balance and Gait Assessment
% of patients with improvement % of patients with no change % of patients with decline in score
MyHalo: An Advanced Personal Health
Monitoring System
Easy to use, web-
based monitoring
increases connection
to clients.
Enhancing the Touch Factor
Myth : Telehealth
replaces the caregiver-to-
patient interactions.
Reality: Telehealth
enhances the caregiver-
to-patient interactions.
How Can We Help…
Inspiring the Next Generation
As our population continues to age, it is vital that we stay abreast of program initiatives and technology that can promote incorporation of healthy aging and wellness.
Transforming Health & Wellness for Seniors
Allen Mehta
Vice President of Information Technology
Chief Information Officer
The Role for Technology and Web 2.0 toolsJuly 19th, 2010San Diego, CA
© Southern California Presbyterian Homes
© Southern California Presbyterian Homes
© Southern California Presbyterian Homes
iPad
• Social and Educational
Wii
• Social and Physical activities
Socially Assistive Robots
© Southern California Presbyterian Homes
© Southern California Presbyterian Homes
The computer was so intimidating because I was allowing it to manage me," she said. "I kept thinking, 'if I don't do this just right, something bad's going to happen.' I have a computer at home just waiting for me — I haven't turned it on for months. (85-year-old J. Conley )
•Its not the technology, but the complicated nature of it
© Southern California Presbyterian Homes
But Seniors are not Dummies© Southern California Presbyterian Homes
Pro’s Con’s
Simple to use Needs wifi infrastructure or 3G networks
Natural navigation Can be damaged easily
Many Apps Many apps are free, but others require payment up front to try
Low Cost of Purchase * 3G networks are priced on usage
E-books with Natural viewing capabilities
Requires a mac or PC toactivate or upgrade
Lightweight
Freedom of using it wherever you want *
© Southern California Presbyterian Homes
Millions have discovered the fountain of youth - the secret to feeling better and living longer.
It can be found by staying active. Finding a program that works for you can pay big dividends. Regular exercise can prevent or delay the onset of dementia or Alzheimer . It can also reduce arthritis pain, anxiety and depression. It can help seniors stay independent and engaged.
There are four main types and seniors need some of each
Endurance activities - like walking, swimming, or riding a bike - which build "staying power" and improve the health of the heart and circulatory system
Strengthening exercises which build muscle tissue and reduce age-related muscle loss
Stretching exercises to keep the body limber and flexible
Balance exercises to reduce the chances of a fall
© Southern California Presbyterian Homes
It’s not just for kids
It has many games that seniors will be attracted to like Golf, tennis, bowling, yoga, hula hoops, balance games
Getting to participate in group games and interactions
Inter-generation participation
Provides low impact exercise and mental focus
The Wii
© Southern California Presbyterian Homes
Residents Playing the Wii
Partnering With The University of Southern California
© Southern California Presbyterian Homes
Get residents to do something different
Assist residents that were not willing to exercise in group settings
Allow them to feel wanted and part of something exciting
© Southern California Presbyterian Homes
American Alzheimer’s Association: Currently over one million residents in assisted living residences have some form of dementia
26 million people with Alzheimer’s worldwide, and 100 million projected by 2050
Nursing staff shortages already becoming an issue
No cure for dementia, but medical and special therapy (physical and cognitive) can improve disease symptoms
Exercise activity is one of the key elements for good dementia care
© Southern California Presbyterian Homes
Their aproach is based on a hypothesis-testing pilot study of Socially Assistive Robotics (SAR) technology aimed at providing affordable personalized cognitive assistance, motivation, and companionship to users suffering from cognitive changes related to aging, dementia and/or Alzheimer’s disease
Robot aids through social rather than physical interaction
© Southern California Presbyterian Homes
To validate that a robotic system can establish a productive interaction with the user, and can serve to motivate and remind the user about specific tasks/cognitive exercises
For the robot to successfully encourage individuals with dementia and/or cognitive impairment to perform their daily fitness programs through social rather than physical interaction
© Southern California Presbyterian Homes
Exercise/Imitation:
Vision-based upper body kinematics extraction software completed
Robot is able to recognize and imitate user movements
© Southern California Presbyterian Homes
A social robot is an autonomous robot that interacts and communicates with humans or other autonomous physical agents by following social behaviors and rules attached to its role
© Southern California Presbyterian Homes
© Southern California Presbyterian Homes
Physical activity:
Robot encourages users to perform mild exercise.
Imitation is used as a means to engage user and capture attention
Robot Platform:
Bandit II – Humanoid torso mounted on Pioneer (19 DOF)
© Southern California Presbyterian Homes
© Southern California Presbyterian Homes
Residents were excited to participate.
Felt like they were helping in the progress of technology
Interacted with the robot as though it was a person
Provided the researchers with critiques
Learned simple exercises to help them be more active
© Southern California Presbyterian Homes
( Maybe not)
© Southern California Presbyterian Homes
Allen Mehta
Vice President of Information Technology
Chief Information officer
Southern California Presbyterian Homes
© Southern California Presbyterian Homes