SMART TECHNOLOGIES ARE THE KEY TO ENABLING … · 2014-09-11 · Older people (n = 32*) •56 to 91...

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SMART

TECHNOLOGIES

ARE THE KEY TO

ENABLING

SUSTAINABLE

AGEING IN PLACE

© Simavita Limited

| © ARCARE |

TECHNOLOGY WILL BE KEY TO THE AGED CARE INDUSTRY OF THE FUTURE

• Recent Australian Productivity Commission’s Caring for Older Australians report highlights the need "to harness new cost effective assistive and information technologies that offer opportunities for productivity gains and higher quality care“

• Due to expected labour shortages in the sector it is expected that productivity gains would need to be in the order of 20-30% per annum

• Key areas identified by the productivity commission report include tele-health, remote monitoring and sensor networks

• The inference of the report is clear, government funding will be directly linked to efficiency gains with incentives for the introduction of technology to deliver them

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WHY THE NEED FOR SMART TECHNOLOGIES?

• In 2010, 13% of the population was over the age of 65 years and by 2050 this is predicted to rise to around 20%.

• Estimate 2.6 million careers, providing 1.32 billion hours of care annually

• By 2017-18, the number of home care places will increase from around 60,000 today to more than 100,000 places

• The number of people requiring aged care is expected to increase by 250% over the next 40 years, with around 3.5 million Australians using aged care services by 2050

• The rising rates of age-related and other chronic illnesses equal more complex care services

OLDER AUSTRALIANS WANT TO STAY IN THEIR OWN HOMES

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SMART TECHNOLOGIES ARE THE KEY?

• Technology is needed to create a care system to provide the appropriate type and necessary level of intervention for the client

• The care system accommodates for a clients declining health and increasing physical and cognitive impairment

• A minimally viable system requires the deployment of basic medical and social support services for monitoring and maintenance of physical and psychological wellbeing, safety, accessibility and mobility

• Technology to consider both sides of the care service model (cared-for and carer)

AGEING-IN-PLACE TECHNOLOGY WITH HUMAN TOUCH

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INDEPENDENT LIVING WITH DECLINING HEALTH AND FRAILTY ?

• Age-related chronic co-morbidities often are accompanied by physical and cognitive impairments that are liable to affect, with varying severity, basic and instrumental activities of daily living

• Independent living becomes unsustainable without physical support and intervention

• There also is an increased risk of social isolation and loneliness that accompanies reduced mobility

• Smart Home Technologies is key for this support

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SMART HOME TECHNOLOGIES IS KEY FOR THIS SUPPORT?

WHAT IS MISSING IN SMART TECHNOLOGIES?INCONTINENCE IS A FUNDAMENTAL FUNCTION OF COMMUNITY AGED CARE SERVICES

87%OF REGISTERED NURSES RECORDED URINARY INCONTINENCE AS A ‘VERY SIGNIFICANT’ OR ‘SIGNIFICANT’ REASON FOR RELOCATING INTO A NURSING HOME

50% OF WOMEN LIVING IN THE COMMUNITY WITH INCONTINENCE ARE AGED OVER 50 YEARS

$9,014/ppIN 2010, THE TOTAL FINANCIAL COST OF INCONTINENCE ESTIMATED TO BE $42.9 BILLION

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CURRENT CONTINENCE MANAGEMENT PRACTICE?

Primary goal is to identify, treat and manage a client’s incontinence

Establish individual Care Plan

PAPER BASE CONTINENCE ASSESSMENTS - CARER

Continence Assessment

• 1-2 hourly checks

• Visual identification

• Manual recording

• Carers/family motivation

effects the outcome of the

assessment

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STUDY: MEASURING OUTCOMES OF TELEMONITORING SYSTEM?Nursing home

• Melbourne, Victoria x 1

• 120 x high care places

• 78% women and 21% men

Older people (n = 32*)

• 56 to 91 years (mean 81 years)

• 40 to 101 kilograms (mean 65 kilograms)

• Aged Care Funding Instrument score of 4 across all categories

• All participants living with a dementia

Experiment

• Telemonitoring system adopting 72 hour assessment

• Telemonitoring system recommendations for new care plans

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SIM™ CONTINENCE MANAGEMENTREFLECTS PUBLISHED RECOMMENDATIONS

Overall goal: 3 days of accurate continence assessment to facilitate 365 days of effective care

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THE TELEMONITORING SYSTEM – SIM™

(SMART INCONTINENCE MANAGEMENT )

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STUDY: QUANTITATIVE DATAURINARY INCONTINENCE PATTERNS?

(1) weight of urine voided into the continence pad(episode of urinary incontinence void);

(2) number of prescribed toileting events in the care plans;

(3) number of actual toileting events;

(4) number of successful toileting events, that is, the number of voiding events into the toilet

(5) % of successful toilet visits

(6) adherence to care plans by staff

SIX OUTCOME MEASUREMENT INDICATORS WERE USED AS FOLLOWS: .

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STUDY II: QUANTITATIVE DATA URINARY CONTINENCE PATTERNS?

FIG 1: SIM™ ASSESSMENT (T1)

FIG 2: SIM™ ASSESSMENT (T2)

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STUDY: SIGNIFICANT FINDINGS

Positive continence management leads to patient’s regaining independence, improved socialisation and overcomes depression associated with incontinence. Study outcome; Using the SIM™ caregivers were able to greatly improve incontinence management in a short-time frame - within 2 weeks:

PUBLISHED JOURNAL OF CLINICAL NURSING

• reduced volume of urine voided into continence pads

• reduced number of prescribed toileting visits

• increased number of actual toilet visits

• increased number of successful toileting events

• increased adherence to urinary continence care plans by staff

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STUDY: SIGNIFICANT FINDINGS

Effective continence management can significantly improve the patients’ health outcome through early detection and management of urinary incontinence reducing a range of associated problems including:

PUBLISHED JOURNAL OF CLINICAL NURSING

• Reduce risk of urinary tract infections,

• Reduce risk of skin breakdown,

• Reduce risk of falls and adverse or aggressive behaviours

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WHAT WERE THE STAFF VIEWS?

• Before the intervention, staff tended to treat a request by an older person for toileting assistance as merely an attempt to seek social interaction.

• The telemonitoring system raised awareness about Urinary Continence care needs of the older people.

• Care staff became more person centred and responsive to toileting requests.

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WHAT WERE THE VIEWS OF THE OLDER PEOPLE AND THEIR FAMILIES?

Naomi said

• “Jeremy and Isaac did not have one episode of incontinence for a whole 8 hour period. That’s never happened before.”

Douglas family

• “We’re happier because Dad doesn’t feel like he needs to come so early each morning to make sure Mum is helped to go to the toilet. He trusts the electronic system and knows Mum doesn’t need help to go to the toilet so many times in the day.”

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ARCARE COMMUNITY PILOT

• Aged Care shift in focus towards Consumer Directive Care environment

• Family members are looking towards Aged Care for a solution in providing a standard of continence care they can no longer provide at home.

• Arcare has adopted a Holistic vision combines resources and expertise of both home care and residential care

• Arcare inconjunction with Active Rehab physiotherapy are establishing a continence clinicspecifically designed for home care clients to conduct continence assessments.

• Processes and procedures are being established to determine the best implementation of the continence clinic

• Results….

CURRENT MANUAL ASSESSMENT AND MANAGEMENT PRACTICES NEED TO BE IMPROVED WITHIN THE COMMUNITY

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ARCARE PILOT COMMUNITY MODEL

Results to be presented at the next ACSA national conference

CURRENT MANUAL ASSESSMENT AND MANAGEMENT PRACTICES NEED TO BE IMPROVED

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REFERENCES

Ostaszkiewicz J, Chestney T, Roe B (2010) Habit retraining for the management of urinary incontinence in adults (Review) Oxford: Cochrane Collaboration

O'Connell, B.; Ostaszkiewicz, J. & Hawkins, M. (2011) A suite of evidence-based continence assessment tools for residential aged care Australasian Journal on Ageing 30(1); 27–32

Yu, P; Zhang, Z; Hailey, D.; Fleming, R. & Traynor, V. (2011) Urinary continence (UC) assessment and management practices: Mapping improvements for older people living Residential Aged Care Services in Australia Unpublished report; Wollongong: University of Wollongong and Under review for the Journal of Clinical Nursing

Yu, P; Zhang, Z; Hailey, D.; Fleming, R. & Traynor, V. (2012) Comparison of continence (UC) assessment and management practices for older people living Residential Aged Care Facilities in Australia : A new telemonitoring system and standard manual techniques Unpublished report; Wollongong: University of Wollongong

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SIM™

• SIM™ is a world first instrumented incontinence assessment medical device

• SIM™ identifies bladder patterns to develop evidence-based care plans

• SIM™ streamlines operational efficiency while mitigating risk

• SIM™ supports ACFI claims while providing high quality care

SMART INCONTINENCE MANAGEMENT

SMART TECHNOLOGIES ARE THE KEY TO ENABLING … · 2014-09-11 · Older people (n = 32*) •56 to 91...

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