Unattended autonomous surveillance in community-dwelling older adults: a field study

Abstract

Home automation that allows for telecare services is increasingly becoming a tool to help older adults live independently and to improve perceived safety and security. The number of older adults receiving professional care, in relation to housing, on a daily basis is not very large. Only 15% receives home care, 5% lives in a care home, and about 2.5% resides in a nursing home. The majority of older adults live in the community. The Unattended Autonomous Surveillance system by TNO Defense is an integrated system that combines many functionalities for community-dwelling (older) adults, who are entitled to receiving nursing home care based on official assessments. The technology is implemented among people in the towns of Baarn and Soest in the centre of the Netherlands. The UAS system aims to support Ageing-in-Place and delaying the demand for expensive institutional care. Besides the benefits for the care recipient, informal or family carers are supported in care through the technology installed as well. Professional carers, for instance, home care, can benefit from the increased self care capabilities of the care recipient. In cases of emergency, i.e., when alarms are activated, people in the care centre can access the home via a camera. The aim is to study the perceptions of independent living, the role and quality of care received, and how people think technology can support them in their daily lives. This is the first round of interviewing on a total of three rounds. Methods In order to investigate the needs of the users, phenomenological qualitative research is carried out among a group of 30 independently living older adults (some with mild psychogeriatric health problems) and their (family) carers, using semi-structured questionnaires on home care received, demand for care, use and need of assistive technologies and perceived safety and security. The questionnaires were based on earlier work by Bijsterveld1 and Demeris et al.2. The first part of the study, performed between May and September 2007, included 14 subjects. The transcripts were analysed using the MAXQDA program. First, each transcript was read in its entirety. Then, they were read a second time to develop codes that were grouped into themes consistent with the interviews, which emerged from the narratives and the interview guides. To be considered a major theme, the code had to have appeared in more than 25% of the narratives and more than once in each of the narratives. Third, quotes that summarised the essence of each person’s subjective experience were recorded. Finally, a master list of themes from each interview was developed to allow for easy cross-interview examination. Results and discussion Preliminary results showed a positive attitude of older adults towards the system as a means to provide additional telecare and to increase perceived security in their surroundings. The fact that professional carers are immediately available after an emergency call, for instance via video communication, eases their feelings of insecurity. Family carers were more enthusiast about the system than many older adults, because the UAS system that is always present and vigilant takes away a part of the care burden. The over-time contribution of the UAS system to independence is to be studied.