JMIR Publications

ABSTRACT

Background:

Many older adults choose to live independently in their home for as long as possible, despite psychosocial and medical conditions that compromise their independence in daily living and safety. Faced with unprecedented challenges in allocating resources, home care administrators are increasingly open to using monitoring technologies known as ambient assisted living (AAL) to better support care recipients. To be effective, these technologies should be able to report on clinically relevant changes in order to support decision-making at an individual level.

Objective:

This project examined the concurrent validity of AAL monitoring reports and information gathered by care professionals using triangulation.

Methods:

This longitudinal single-case study spans over 490 days of monitoring of a 90-year-old woman with Alzheimer’s disease (AD) receiving support from local health-care services. A clinical nurse in charge of her health and social care was interviewed three times during the project. Linear mixed models for repeated measures were used to analyze each daily activity (i.e. sleep, outing activities, periods of low mobility, cooking related activities and hygiene-related activities). Significant changes observed in data from monitoring reports were compared with information gathered by the care professional to explore with concurrent validity.

Results:

Over time, the monitoring reports showed evolving trends in the care recipient’s daily activities. Significant activity changes occurred over time regarding sleep, outings, cooking, mobility and hygiene-related activities. While the nurse observed some trends, the monitoring reports highlighted information that she had not yet identified. Most trends detected in the monitoring reports are consistent with clinical information gathered by the nurse. Also, the AAL system detected changes in daily trends following an intervention specific to meal preparation.

Conclusions:

Overall, trends identified by AAL monitoring were found to be consistent with clinical reports. They helped answer the nurse’s questions and helped her develop interventions to maintain the care recipient at home. These findings suggest the vast potential of AAL technologies to support health care services and aging in place by providing valid and clinically relevant information over time about activities of daily living. Such data is essential when other sources yield incomplete information for decision-making.