Smart Way of Living for People with Dementia
New Intermediate
Care Smart Flat in Bristol
A
groundbreaking new 'smart flat' at Hillside Court in St George,
Bristol, is using the latest technology to give people with dementia
and those with other serious long term health conditions greater
independence.
Part of the Hillside Court extra
care sheltered housing scheme, the equipment in the flat has been
developed over several years by the Bath Institute of Medical
Engineering (BIME) at Bath University, in consultation with people
with dementia and their carers. Known as an 'enabling smart home',
it is a joint project between BIME, Bristol City Council's Adult
Community Care service, Bristol PCT's Intermediate Care Service,
Dementia Voice, dementia services development centre for the south
west and Housing 21.
The partnership between BIME, DV
and Housing21 began in 1999 with the opening of the Gloucester Smart
House. This was a demonstrator home (formerly the court managers
house) for demonstrating the potential for this smart technology. In
late 2004 the decision was made to close the Smart house and install
the smart technology in an intermediate care flat in Hillside Court
in Bristol.
The aim of the intermediate care
flat is to help people readjust to living on their own after a stay
in hospital, special sensors in the home talk directly to support
devices such as, cooker controllers and light switches. The system
is able to respond to many different situations within the flat,
without having to contact care staff, often just using simple voice
prompts. It therefore provides a very quick response and gives
residents a greater feeling of control as it doesn't rely on people
coming in from outside to resolve problems, with outside help only
called in for real
emergencies.
The flat has been set up as a two
year pilot to assess how the technology helps give people more
independence and control, reducing the risk of users being
readmitted to hospital or going into long term care. Individual
components of the system have been tested by people with dementia,
but the complete installation has previously only been used at one
other Housing 21 property in Cinnamon Court, Lewisham, south London.
The important difference between the two flats is that whilst the
sensors and support devices used in Lewisham are physically wired
together, the new Bristol flat uses the latest state of the art
wireless technology. Employing the same standard of technology as
that use to manage the heating and lighting facilities on the
Jubilee Line of the London Underground.
The sensors in the flat will 'act'
in the same way a carer might, giving gentle prompts and or
reminders to the person. These prompts will be given as a recorded
message. This could be the voice of close relative and or anyone of
the tenant's choosing. Some people have suggested that the person
but be alarmed by hearing a disconnected voice coming from a speaker
mounted on the wall. The research that has been done by BIME appears
to demonstrate that providing the person understands that it is a
recorded message, they are not alarmed. Interviews with the tenant
in Cinnamon Court smart flat, indicated that he understood
the technology and found the support it provided helpful. "It's very
useful….if you get out of bed and it's dark and can't see where you
are about and it's a good thing to have the lights come on." If the flat's intelligence
smart systems consider that the tenant has not been able to respond
to the prompts and may get into difficulties, the flat will send a
call to the hand set that that care staff have, requesting help.
Operating in the same way as if the tenant had pulled the
court manager pull cord.
Professor Roger Orpwood, of BIME,
explains: “The really smart thing about the wireless technology we
have used in this flat is that we can take the elements that clients
find particularly useful and install them in their own home. The
whole installation is quite unique because it is designed to empower
the resident rather than relying on outside help to deal with
problems. The idea is that residents will stay in the flat for a
short period of around three months, before returning to their own
home.”
The technology can be configured
to the individual needs of the tenant and it can be changed very
easily and quickly should there be a sudden change in the tenant's
needs.
Early evaluations of the way the smart technology is
working in Cinnamon Court
indicate the following has been improved (this will also be
in conjunction with the trained care staff who continued to visit as
per his care needs)
- An improvement in the tenants sleep (the voice prompts
encouraged him to return to bed in the night-prior to the
technology being switched on the tenant was very active during the
night getting very little sleep)
- An improvement in levels of incontinence (helped by a
lighted pathway to the bathroom in the middle of the
night)
- A reduction in 'wandering' in and out of the flat at night
(helped by the voice prompts by the front
door)
- An small increase the cognitive levels as measured by the
mini mental state examination score (MMSE) from 10 to 16 out of 30
(this could be attributed to all the environmental factors that
contributed to his overall quality of life, including the use of
the smart technology).
It is important to note that the
technology does not replace the need for a carer but can continue to
provide enabling support during the times the tenant is on their
own, providing improved quality of live and reassurance for the
tenant, his family and carers
David Self, Dementia Services
Advisor at Dementia Voice said: “The work we have already done in
Lewisham has shown that by using technology we can improve
independence and quality of life for people with dementia and reduce
anxieties for relatives, without increasing the burden on care
staff. We hope this latest project will take things a step further
with the opportunity to install the successful 'smart' elements of
the flat in people's own homes.”
What can the technology
do?
·
If the
occupant was detected opening the main door at inappropriate times
they would be given a voice prompt to let them know the time and
encourage them to go back to bed. If they continued to go out, care
staff would be alerted by the house.
·
If the
occupant got out of bed at night, the bedroom lights would be gently
faded up.
·
If the
occupant got back into bed and left the lights on, the house would
wait a couple of minutes and then fade the lights off. The user
could turn the lights on and off anytime they wanted
themselves.
·
If the
occupant moved around the house when it was dark, appropriate room
lights would be turned on to help orientate them and prevent
falls.
·
If taps were
accidentally left on they would be turned off (these have not been
installed in the Bristol flat).
·
If the cooker
was left on the occupant would be prompted to turn it off. This
would be done twice but if they didn't respond, or if smoke was
detected near the cooker, it would be turned off and care staff
alerted.
·
If the
occupant was detected moving around a lot at night, they would be
prompted to encourage them to go back to bed. If they continued to
behave restlessly care staff would be
alerted.
·
Care staff
would be alerted through the normal warden call
system.
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