Integrating an Ambient Assisted Living monitoring system into clinical decision-making in home care: An embedded case study

Lussier, Maxime; Couture, Mélanie; Moreau, Maxim; Laliberté, Catherine; Giroux, Sylvain; Pigot, Hélène; Gaboury, Sébastien; Bouchard, Kévin; Belchior, Patrícia; Bottari, Carolina; Paré, Guy; Consel, Charles; Bier, Nathalie

doi:10.4017/gt.2020.19.1.008.00

Cited by 14 publications

(22 citation statements)

References 34 publications

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“…Transparency is critical for commercial, legal, and clinical applications because professionals must justify their decisions on the basis of tangible observations [ 38 ]. This finding was supported in preliminary focus groups conducted within the context of this study, as care professionals explicitly stated that they did not wish to be provided a conclusion or told what to do; instead, they wished to receive valid information that could be used to enhance their decision making [ 27 ].…”

Section: Introductionmentioning

confidence: 63%

“…This longitudinal single-case study is part of a larger project designed to understand how AAL monitoring can be successfully implemented in home care services and support the decision making of health and social care professionals in the public social and health care system [ 27 ]. The case in this study comprised one care recipient ( Lisette ) and the health and social care professional responsible for her home care support (referred to here as the care professional ).…”

Section: Methodsmentioning

confidence: 99%

“…The care professional was interviewed on January 24, 2017 (before any monitoring report was sent); June 14, 2017; October 25, 2017; and October 26, 2018 (after Lisette’s hospitalization). These interviews were conducted by a researcher specializing in qualitative research (MC) and triangulated with the monitoring report outcomes [ 27 ]. The final interview took place 3 months after Lisette’s hospitalization due to uncertainty about Lisette’s transfer during that period.…”

Section: Methodsmentioning

confidence: 99%

“…AAL monitoring has many uses, such as detecting the occurrence of unusual or hazardous events (eg, a fall, cardiac arrest, or bradycardia) and alerting a dedicated resource person to provide immediate support and prevent dangerous situations. Another approach uses rich and reliable data from AAL monitoring to support clinical decision making regarding a care recipient’s state [ 25 - 27 ]. For example, home care professionals have used home monitoring to adjust their care plan on the basis of clinical and home monitoring data [ 27 ].…”

Section: Introductionmentioning

confidence: 99%

“…Another approach uses rich and reliable data from AAL monitoring to support clinical decision making regarding a care recipient’s state [ 25 - 27 ]. For example, home care professionals have used home monitoring to adjust their care plan on the basis of clinical and home monitoring data [ 27 ]. For instance, they could add interventions if through monitoring they observe that a care recipient is sleeping too much or skipping meals.…”

Section: Introductionmentioning

confidence: 99%

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Using Ambient Assisted Living to Monitor Older Adults With Alzheimer Disease: Single-Case Study to Validate the Monitoring Report

Lussier¹,

Aboujaoudé²,

Couture³

et al. 2020

JMIR Med Inform

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Background Many older adults choose to live independently in their homes for as long as possible, despite psychosocial and medical conditions that compromise their independence in daily living and safety. Faced with unprecedented challenges in allocating resources, home care administrators are increasingly open to using monitoring technologies known as ambient assisted living (AAL) to better support care recipients. To be effective, these technologies should be able to report clinically relevant changes to support decision making at an individual level. Objective The aim of this study is to examine the concurrent validity of AAL monitoring reports and information gathered by care professionals using triangulation. Methods This longitudinal single-case study spans over 490 days of monitoring a 90-year-old woman with Alzheimer disease receiving support from local health care services. A clinical nurse in charge of her health and social care was interviewed 3 times during the project. Linear mixed models for repeated measures were used to analyze each daily activity (ie, sleep, outing activities, periods of low mobility, cooking-related activities, hygiene-related activities). Significant changes observed in data from monitoring reports were compared with information gathered by the care professional to explore concurrent validity. Results Over time, the monitoring reports showed evolving trends in the care recipient’s daily activities. Significant activity changes occurred over time regarding sleep, outings, cooking, mobility, and hygiene-related activities. Although the nurse observed some trends, the monitoring reports highlighted information that the nurse had not yet identified. Most trends detected in the monitoring reports were consistent with the clinical information gathered by the nurse. In addition, the AAL system detected changes in daily trends following an intervention specific to meal preparation. Conclusions Overall, trends identified by AAL monitoring are consistent with clinical reports. They help answer the nurse’s questions and help the nurse develop interventions to maintain the care recipient at home. These findings suggest the vast potential of AAL technologies to support health care services and aging in place by providing valid and clinically relevant information over time regarding activities of daily living. Such data are essential when other sources yield incomplete information for decision making.

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Section: Introductionmentioning

confidence: 63%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Using Ambient Assisted Living to Monitor Older Adults With Alzheimer Disease: Single-Case Study to Validate the Monitoring Report

Lussier¹,

Aboujaoudé²,

Couture³

et al. 2020

JMIR Med Inform

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NEARS-Hub, a Lightweight Edge Computing for Real-Time Monitoring in Smart Environments

Ngankam

Lussier

Aboujaoudé

et al. 2022

Proceedings of the International Conference on Ubiquitous Computing &Amp; Ambient Intelligence (UCAmI 2022)

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Remote Technologies and Filial Obligations at a Distance: New Opportunities and Ethical Challenges

Tian,

Jotterand,

Wangmo

2023

ABR

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The coupled growth of population aging and international migration warrants attention on the methods and solutions available to adult children living overseas to provide distance caregiving for their aging parents. Despite living apart from their parents, the transnational informal care literature has indicated that first-generation immigrants remain committed to carry out their filial caregiving obligations in extensive and creative ways. With functions to remotely access health information enabled by emergency, wearable, motion, and video sensors, remote monitoring technologies (RMTs) may thus also allow these international migrants to be alerted in sudden changes and remain informed of their parent’s state of health. As technological solutions for caregiving, RMTs could allow independent living for older persons while any unusual deviations from normal health patterns are detected and appropriately supported. With a vignette of a distance care arrangement, we engage with concepts such as filial piety, in-absentia caregiving distress, and the social exchange theory, as well as the upholding of shifting cultural ideals to illustrate the complex dynamic of the satisfaction and quality of the informal caregiving relationship. This paper extends the traditional ethical issues in technology-aided caregiving, such as autonomy, privacy, and justice, to be considered within the context of distance care. We also posit newer ethical considerations such as consent in power imbalances, harm to caregivers, and stigma. These known and new ethical issues aim to encourage further ethically conscious design and use of RMTs to support distance care for older persons.

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Integrating an Ambient Assisted Living monitoring system into clinical decision-making in home care: An embedded case study

Cited by 14 publications

References 34 publications

Using Ambient Assisted Living to Monitor Older Adults With Alzheimer Disease: Single-Case Study to Validate the Monitoring Report

Using Ambient Assisted Living to Monitor Older Adults With Alzheimer Disease: Single-Case Study to Validate the Monitoring Report

NEARS-Hub, a Lightweight Edge Computing for Real-Time Monitoring in Smart Environments

Remote Technologies and Filial Obligations at a Distance: New Opportunities and Ethical Challenges

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