Smart solution to support home living

Older Australians have a strong preference to stay in their own home should they ever have a need for care, according to the Royal Commission into Aged Care and Safety. The benefits of home comforts cannot be underestimated, but living at home does come with complications as we age. Now, CSIRO has developed a solution that could allow older Australians to realise the dream of living safely at home for longer.

The Smarter Safer Homes system consists of a digital portal and in-home sensors which provide objective information on a client’s eating habits, hygiene, mobility, sleep and social interactions to professionals, such as aged care service providers (ACSPs), so that older Australians can be supported to remain at home.

A 12-month trial of the platform, The Dementia Aged Care Services Trial, commenced in 2019 with 195 clients, aged 65 and over, from partner providers Anglicare Southern Queensland, integratedLiving Australia and All About Living. They concluded, “This technology has enabled us to actually see things that the client may not be telling us.”

All participants received either a Commonwealth Home Support Programme or a Home Care Package. Overall, for participants with Home Care Packages, the Smarter Safer Homes system greatly benefited social care-related quality of life (10 times less ASCOT score yearly drop), thus helping them to stay independently in their own home for longer.

Motion, humidity, temperature and electrical power sensors sent data to a digital platform allowing carers to ascertain what type of behaviours were regularly occurring — such as bathroom visits, meal preparation and opening the wardrobe or front door.

A change in behaviour triggered a warning in the digital portal in the form of different coloured rays. If the client was not achieving their expected goals, a small red segment would appear in the appropriate category; a larger green ray indicated that the client was meeting or exceeding their target.

This supplementary knowledge led to more targeted support. In one case, the client wasn’t moving around as much as usual and so the platform triggered an additional care conversation. The case manager was able to specifically ask about the change in movement and discovered that the participant “didn’t feel easy on their feet at the moment”.

The case worker said, “We were able to go in and do an OT assessment and put some grab rails in and provide a wheelie walker, things like that — really quite fundamental preventative measures.”

In another case, one care service staff member said, “I noticed that somebody was up a lot during the night, so going to the toilet a lot and so we were able to talk about that, which is a conversation that these people don’t necessarily volunteer that sort of information, so he was then able to have a medical review, some medications/equipment to help with that.”

Some participants reported that visitors were worried “big brother was watching them” at first, but most said they forgot the sensors were even there.

When the sensors did record a behaviour change, this was shown on the client dashboard in one of five categories — health checks, sleep, social, walking or daily activity. This result was visible to participants, their nominated family members and the ACSP who could choose a course of action such as contacting the client or emailing the case worker.

Many new technologies come with some challenges, as the trial demonstrated: almost half of all system triggers were due to technical issues.

CSIRO scientist David Silvera said, “Some sensors ran out of battery and, due to COVID, we were not able to change the batteries for some time.

“In some cases this could have interfered with the results, as those wouldn’t have been properly monitored by all sensors.”

Although ‘action’ was taken for only 0.17% of system triggers, it resulted in 20 instances where additional support was sourced for issues that may otherwise have gone under the radar.

“There were different actions, such as a request to increase current supports to individuals. From our perspective that is a successful outcome, but we didn’t collect data past the study to know if the additional supports made a difference to the individuals,” Silvera said.

Some participants made suggestions on how to improve the technology by including an emergency trigger warning.

One service provider said that participants did think that if they had a fall, then someone would know and be able to help them — even though the system was only checked once a day for five days per week.

“I had a fall before last Christmas, and this doesn’t register. I was on the floor for about 10 minutes,” said one participant.

CSIRO plans to expand the scope of the technology by using smart analytics to provide richer information to clinicians. This would involve the use of machine learning within the algorithm to provide a prediction functionality.

Liesel Higgins, CSIRO project manager, said, “We are looking at social isolation, agitation, frailty, end-of-life care and more. We have lots of plans, some project proposals waiting for funding and many conversations with service providers, but nothing is set in stone.”

Image credit: iStock.com/JLco - Ana Suanes