Enhancing care homes with assistive video technology for distributed caregiving

Abstract

Dementia care is becoming increasingly important in Japan as the elderly population grows. Care homes are designed so that caregivers can easily observe and subsequently respond to the needs of people with dementia.However, the layout of care homes can become overly restrictive for residents, for example, by not providing intermediate spaces where people can spontaneously interact and initiate conversations. We present a case study that explores the implementation of video monitoring in two purpose-built care homes in which we were asked to help overcome the blind spots presented by the layout. We collected data both before and after the implementation of the video monitoring in order to understand its effect. The balance between people's sense of security and the concerns about loss of privacy through video monitoring is well established. However, we found that video monitoring had a beneficial effect on both the caregivers and the residents if implemented sensitively. Furthermore, the implementation of video monitoring could support the design of more beneficial care home layouts. In conclusion, we propose that the sensitive implementation of video monitoring be considered alongside design of the physical layout of care homes.

Implementing monitoring technologies in care homes for people with dementia: A qualitative exploration using Normalization Process Theory

“…Staff in other homes were also susceptible to rumours that technologies were being used for this purpose even if not the case. These findings are supported by previous literature ( Niemeijer et al, 2010 , Robinson et al, 2007 , Schikhof et al, 2010 , Sugihara et al, 2015 ) and add to a picture that paints blame as the default response to poor quality health and social care ( Baker, 2015 ). The present study clearly demonstrates that there is a need for greater involvement of staff in discussions about use of monitoring technologies at an early stage of the implementation process to avoid creating a negative culture of an ‘eavesdropping employer’ ( Ciocchetti, 2011 ).…”

“…In contrast, the location-based system at Conifer Gardens was beleaguered by false alarms and technical problems, and its full range of data collection capabilities were considered too time-consuming to add value to practice and facilitate successful implementation, particularly when weighed against its financial cost. These findings are supported by the overall picture in the literature which suggests there is a balance between increased confidence, control and coordination in practice delivered by monitoring technologies with overburden from alarms ( Engström et al, 2009 , Niemeijer et al, 2010 , Nijhof et al, 2012 , Sugihara et al, 2015 ). From an ethical perspective, we have discussed above the attractiveness of monitoring technologies for care homes deemed to facilitate fast response to, rather than prevention of, an adverse event.…”

“…This suggested a dominant model of care which accepts the monitoring of residents as a core part of practice, and ascribes less value to developing a shared understanding of additional benefits from the use of technologies, or of ethical issues surrounding their use. This finding is supported by a mixed picture from the literature which highlighted some understanding of a range of simultaneous potential benefits such as increased safety and resident freedom ( Engström et al, 2009 , Niemeijer et al, 2011 , Niemeijer et al, 2015 , Sugihara et al, 2015 , Zwijsen et al, 2012 ), but which emphasised a perception that the primary (or only) role for monitoring technologies should be to enhance safety ( Aud, 2004 , Niemeijer et al, 2014 , Zwijsen et al, 2011 , Zwijsen et al, 2012 ). Despite this emphasis, many staff members appeared to recognise that bed-monitoring technologies could not prevent falls, which is supported by other research ( Zwijsen et al, 2012 ).…”

“…More recently, literature within health and social sciences and engineering and computer sciences reports upon projects involving real-world implementation of monitoring technologies in care homes (e.g. Zwijsen et al, 2012 , Sugihara et al, 2015 , Niemeijer et al, 2014 , Niemeijer et al, 2015 ). This literature shows that there seems to be more emphasis placed upon safety, which may be easier to ‘see’ than other potential benefits such as freedom of movement in residents with dementia and concomitant physical impairments.…”

Electronic Video Monitoring in Medicaid Home and Community‐Based Services Waivers for People With Intellectual and Developmental Disabilities

“…In addition to these benefits for residents, it can also help streamline caregiver roles and responsibilities. For example, when Sugihara, Fujinami, Jones, Kadowaki, and Ando () used cameras in the common spaces of a group home for the elderly, caregivers there reported it helped with their work as they needed to check up on people less. However, Sugihara et al () also found that the amount of caregiving time with the cameras did not change; thus, it is possible that this system actually allowed the caregivers to use their time more efficiently by allowing them to just look at the monitors and not requiring physical oversight.…”