Abstract
The care of dementia patients presents a large challenge for caregivers and family members. Whether it is at home or in institutional care, patients have problems with spatial and environmental cognition. It often leads to abnormal behaviors such as a route recognition problem, wandering, or even getting lost. These behaviors require caregivers to keep an eye on the movement of the cognitively impaired elderly and the safety of these movement processes, to avoid them approaching dangerous areas or leaving the care environment. This paper used qualitative research methods (i.e., participatory interviews, case studies, and contextual observation methods) in the demand exploration phase and quantitative research methods in the product’s technological verification phase. In this study, we implemented a three-stage service design process—demand exploration, demand definition, and design execution—to analyze the care status and route recognition obstacles of elders with dementia, to identify hidden needs as a turning point for new product innovations in care management and guidance security. This study summarizes six service needs for care management and guides the surveillance and safety of elders with dementia: (1) offering indoor user-centered guidance, (2) providing the instant location information of elders with dementia to caregivers, (3) landmarks setting, (4) assistance notification, (5) environmental route planning, (6) use of a wearable device as a guide for indoor route guidance. Based on the potential deficiencies and demands of observation, the care management and guidance security system (CMGSS) was designed. The experimental results show that the use of ultra-wide band positioning technology used in the indoor guiding system can accurately guide the behavior of patients to the right position, provide accurate information for caregivers, and record their daily behavior. The error range of this technology was not only within 42.42 cm in indoor static positioning but also within 55 cm in dynamic positioning, even where wall thickness was 18 cm. Although the device was designed for institutional care, it can also be applied to the management and care of general home-based patients.
Highlights
According to Alzheimer’s Disease International (ADI), globally, the number of patients with dementia increases once every three seconds, and approximately 9.9 million people suffer from dementia each year
The care management issues noted mainly involved the following five points: (1) insufficient care manpower: each caregiver was required to care for eight patients, and the needs of patients were ignored; (2) over-reliance on caregivers; (3) inability to immediately grasp the patient’s problems because of human problems, with patients going to the toilet, drinking water, or walking on their own, resulting in care safety problems; (4) guidance labeling problems: some patients with mild dementia went to the toilet or for a drink by themselves, but they were unable to return on their own; (5) active regional cognition: assisting patients in identifying public areas and private areas could reduce the difficulty of care management
The black points shown in the figure were the preset positions, the blue dots were the measurement positioning within the range (60 × 60 cm), the red dots represent the measured positioning pressing to the boundary line, and the purple dots indicate that the measured positioning exceeded the boundary
Summary
According to Alzheimer’s Disease International (ADI), globally, the number of patients with dementia increases once every three seconds, and approximately 9.9 million people suffer from dementia each year. According to the Ministry of Health and Welfare, by the end of 2017, the number of people with dementia in Taiwan exceeded 270,000. In the 46 years, the number of cognitively declined individuals in Taiwan will increase at an average rate of 36 per day [2]. In order to alleviate the impact of dementia on society and families, Taiwan provides for the medical and care needs of the cognitively declined and their families [2]. Providing friendly treatment and a long-term care environment for the elderly with dementia is one of the important factors for the sustainable development of society
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