In Situ Monitoring of Health in Older Adults: Technologies and Issues

Abstract

With the upcoming reform of the healthcare system and the greater emphasis on care in the home and other living environments, geriatric providers will need alternate ways of monitoring disease, activity, response to therapy, and patient safety. Current understanding of the dynamic nature of chronic illnesses, their effects on health over time, and the ability to manage them in the community are limited to measuring a set of variables at discrete points in time, which does not account for the dynamic interactions between physiological systems and the environments of daily life. Recent developments of sensors, data recorders, and communication networks allow the unprecedented measurements of physiological and sociological data for use in geriatrics care. This article identifies and discusses the important issues regarding the use of monitoring technologies in elderly patients. The goals are fourfold. First, some emerging technology that may improve the lives of older adults and improve care are highlighted. Second, the possible applications of technology in geriatrics settings are discussed, with a focus on acute falls, dementia, and cardiac conditions. Third, real and perceived concerns in using monitoring technology are identified and addressed, including technology adoption by elderly people; stigma; and the reduction in social contact; ethical concerns of privacy, autonomy, and consent; concerns of clinicians, including information overload, licensure, and liability; current reimbursement schemes for using technology; and the reliability and infrastructure needed for monitoring technology. Fourth, future approaches to make monitoring technology useful and available in geriatrics are recommended.

Older adults and mobile technology: Factors that enhance and inhibit utilization in the context of behavioral health

“…Many of these stereotypes are perpetuated by older adults, who may believe themselves incapable of learning to use technology [34]. Interestingly, within healthcare, older adults are often required to engage with technology, ranging in complexity from wireless heart monitors to feeding tubes [21,32,35], with little thought to their comfort with or ability to utilize it.…”

A Systematic Review of Clinician and Staff Views on the Acceptability of Incorporating Remote Monitoring Technology into Primary Care

“…2,3 Despite the critical role primary care professionals may play in responding to RMTs, few studies explore their views. [9][10][11] For RMT to improve clinical practice, primary care clinicians must be involved in product development and testing. 12 To our knowledge, the factors associated with the adoption of RMT in ambulatory care have not been rigorously explored.…”

A Review of Contemporary Work on the Ethics of Ambient Assisted Living Technologies for People with Dementia

“…In a discussion of the use of robots, Decker (2012) emphasises that although it is recommended that a veto function should exist to allow users to stop the robots' actions, this view has been challenged where persons with cognitive impairment are concerned. Also, some authors point out that during a trial, the participants had to be protected against information overload (Duquenoy and Whitehouse, 2006;Kang et al, 2010). Zaad and Ben Allouch (2008) also mention the possible 'compassionate interference' between the user and care-giver.…”

“…During the clinical trials, an important aspect for medical researchers is the meaningfulness of the data gathered, both from a scientific and a medical point of view, in order to be able to translate it into valid knowledge (Allen et al, 2008;Conley et al, 2008;Cook et al, 2009;Darwish and Hassanien, 2011;Kang et al, 2010;Kaye, 2010;Noury et al, 2011;Romdhane et al, 2012;Viswanathan et al, 2012;Wherton and Monk, 2008). The accuracy and reliability of such data has to be prioritised, according to their relevance, importance and urgency (Darwish and Hassanien, 2011;Viswanathan et al, 2012).…”