Telehealth Monitoring for Senior Patients at Homes

The focus on building smart city technologies have gained in significance in recent years due to the demographic changes in life expectancy of the seniors staying in an urbanized community. With the increasing ease and affordability of using technology, it is a necessity to create cities that are aware of the special needs of seniors in order for them to age in place. The benefits of emerging technological supports are to promote health and increase quality of life for the seniors. For instance, the setting up of smart home technologies will encourage and allow seniors to live longer in their own homes safely and independently. According to Thang (2011), social isolation can lead to loneliness, having smaller social networks, poorer health status and difficulty to access to healthcare services. Therefore, the use of smart technology and devices such as internets or mobile applications encourage social integration and maintain community connectedness among the seniors to reduce loneliness and prevent social isolation.

Not only that, technology such as telehealth and telemedicine can empower seniors to take charge of their own health and delay the onset of long-term complications while having one or more chronic diseases. Despite its potential to generate benefits for the seniors, caregivers and service providers, the technologically assisted lifestyle innovation comes with risks and challenges. The older population is not a homogenous group and setting up smart home does not allow one size fit all solution. The implementation of technology in the home varies such as user conditions, lifestyles and needs in order to maintain functional and quality of life for the seniors. There is a need to build technology models to be more sustainable in the long run. The critical issues of accessibility and privacy of the users need to be considered. This includes financial affordability, technical accessibility and user friendly of the system, trust and acceptance from the users. Seniors who do not live in the age of information technology may not be comfortable and familiarized with the advanced technologies of smart homes. A lack of knowledge and skill on how to operate the applications may lead to confusion and fear among the older people. Another issue is the aging process that affects the physical dexterity of older people. They are cognitively slower in learning and hence more averse to technology use. They also have different difficulties and expectations of the types of aids used, as compared to the younger users. There are concerned that less educated seniors could end up being marginalized because of their lack of computer literacy skills.

This highlights the importance of addressing the physical, psychological and social needs of the end-users adequately. Singapore is embracing technology and focusing more on personal health, as it forces our city to become more vibrant on how it approaches the challenges in making eldercare more efficient. Many of the technologies have being deployed under our Smart Nation initiative have helped our seniors to age safely in their own homes while enabling them to receive help from their own support network. For example, the use of Smart Elderly Monitoring and Alert System (SEMAS), developed by HDB and four vendors has the capability of tracking the abnormal behavior of an elderly through text messages and trigger alarms via motion sensor feeds to alert his or her caregivers.

At the same time, the elderly has been taught to wear a panic button for emergency usage. This system has been tested in 12 public rental flats in Woodlands, Yishun, Clementi and Marine Parade. Positive feedback has been noted for its user friendly and at the same time maintain the privacy of the users. Another home based tele-rehabilitation project, a NUS-led initiative aids in the recovery of post-stroke patients undergoing rehabilitation treatments has been reported using technology as a platform for the stroke patients. These patients have been connected with their therapists through a virtual web form that run on a tablet, while videos and motion sensors guide and measure their progress in a tailored rehabilitation exercise program. In healthcare settings, the sharing of electronic health record (EHR) between care providers by joining an existing EHR instance owned and operated by another organization from acute hospitals to primary care and community hospitals, general practitioners (GPs) etc., allows for rapid co-opting of leading practice clinical content, such as documentation templates, order sets, and decision support in planning of care for elderly patients with chronic conditions.

Telehealth monitoring for patients at homes also promotes self-management of chronic conditions. These systems use digital devices to take vital readings, then transmit them securely to the telecare nurses in another location for assessment so that early interventions can be done to reduce complications or hospitalizations. Using technology to transform our urban environment in a more meaningful way will require new thinking about governance. Technology is only be effective that puts it to work to enhance the quality of life for the seniors .To ensure technology interventions are well designed and able to meet research-documented user requirements, there is a need to have a more specific, actionable model to provide guidance for cities leaders to develop and design interventions suitable for seniors using the technology. One of the solution is to involve seniors or end users in all stages of smart home development such as its design, implementation and testing. Further research is also needed on the technical and psychological accessibility to smart home technologies for seniors in the near future when majority of the baby boomers who are more technical savvy turned 65 in the year of 2030.