A Smart Home System for Information Sharing, Health Assessments, and Medication Self-Management for Older People: Protocol for a Mixed-Methods Study

Abstract

Background Older adults often want to stay in a familiar place, such as their home, as they get older. This so-called aging in place, which may involve support from relatives or care professionals, can promote older people’s independence and well-being. The combination of aging and disease, however, can lead to complex medication regimes and difficulties for care providers in correctly assessing the older person's health. In addition, the organization of health care is fragmented, which makes it difficult for health professionals to encourage older people to participate in their own care. It is also a challenge to perform adequate health assessments and to engage in appropriate communication between health care professionals. Objective The purpose of this paper is to describe the design for an integrated home-based system that can acquire and compile health-related evidence for guidance and information-sharing among care providers and care receivers in order to support and promote medication self-management among older people. Methods The authors used a participatory design approach for this mixed-methods project, which was divided into four phases. Phase I, Conceptualization, consists of the conceptualization of a system to support medication self-management, objective health assessments, and communication between health care professionals. Phase II, Development of a System, consists of building and bringing together the conceptualized systems from Phase I. Phase III, Pilot Study, and Phase IV, Full-Scale Intervention, are described briefly. Results Participants in Phase I were people who were involved in some way in the care of older adults and included older adults themselves, relatives of older adults, care professionals, and industrial partners. With input from Phase I participants, we identified two relevant concepts for promoting medication self-management, both of which related to systems that participants believed could provide guidance for the older adults themselves, relatives of older adults, and care professionals. The systems will also encourage information-sharing between care providers and care receivers. The first is the concept of the Intelligent Age-Friendly Home (IAFH), defined as an integrated residential system that evolves to sense, reason, and act in response to individuals’ needs, preferences, and behaviors as these change over time. The second concept is the Medication safety, Objective assessments of health-related behaviors, and Personalized medication reminders (MedOP) system, a system that would be supported by the IAFH, and which consists of three related components: one that assesses health behaviors, another that communicates health data, and a third that promotes medication self-management. Conclusions The participants in this project were older adults, relatives of older adults, care professionals, and our industrial partners. With input from the p...

Environmental and Psychosocial Interventions in Age-Friendly Communities and Active Ageing: A Systematic Review

“…The full texts of the remaining 380 manuscripts were reviewed based on the inclusion and exclusion criteria. As a result of this process, 11 studies were included in this review [60][61][62][63][64][65][66][67][68][69][70] (Figure 1).…”

“…The specialist fields of the retained publications' authors were dominated by multidisciplinary approaches (54.5%), such as nursing and architecture [64], architecture, geography and psychology [70], and nursing and innovation science [69], followed by health sciences (nursing, psychology, occupational therapy, sport sciences) [62,68] and social sciences (political sciences, social work, sociology) [60]. To a lesser degree, studies were identified in specific fields of social sciences (27.3%), such as social work [65,67] and geography [61], and health sciences (18.2%), such as nursing [66] and psychiatry [63].…”

“…Based on the paradigm of AFCC [5,7], the theoretical approach of AA [3,[71][72][73][74] was referred to in 54.5% of studies [60,61,65,66,68,70], and the approach of healthy ageing [4] was referred to in 54.5% of cases [60,61,63,66,68,69]. Additionally, in 36.4% of retained publications [60,61,66,68] the theoretical approaches of AA and healthy ageing were cited together [75].…”

“…Additionally, in 36.4% of retained publications [60,61,66,68] the theoretical approaches of AA and healthy ageing were cited together [75]. However, in other studies AA was ignored (45.5%) [62][63][64]67,69], and healthy ageing was not mentioned (45.5%) [62,64,65,67,70], and in 27.3% of cases both approaches were omitted [62,64,67].…”

“…From the perspective of environmental gerontology [76], emphasis is placed on the theoretical assumptions of the ecological model of ageing [39], which is cited in 27.3% of manuscripts [60,61,70]. Despite their importance, these theoretical assumptions were omitted, or lightly referred, to in almost two out of every three studies [62][63][64][65][66]68,69].…”