How ACTIVAGE is contributing to the Covid-19 crisis management?

DS GALICIA
1- How the services already deployed in the GALICIA DS are helping the older population to manage the pandemic?

The daily activity monitoring solution deployed in Galicia has become even more useful for current participants.

For Healthcare professionals & older adults.

The main objective achieved was to have at the older adult’s home the precise tools that allow a welfare action as an extension of the health centers through activities and care that promote the development of formulas that contemplate the integral care at home. In this way, care centers are linked to the home of the older adult so health professionals can perform remote and continuous monitoring of the older adults, maintaining their quality of life, avoiding hospital admissions and reducing on-site activity and unnecessary visits.

Some concrete examples:

Avoid saturation in hospital

They avoid saturation in hospital by using the telemonitoring platform at home to monitor older adult’s status helping the hospitals to maintain free up beds for critical cases that requires hospital admission.

This solution was already running, and now with the COVID-19, it has been orientated to help the older adults with coronavirus at two different levels: from one side in primary care for the users who are positive, and in the other hand other for those who have been discharged and needs a regular control.

Since it is known that hospital beds are needed, this solution helps them to keep those two or three days that they used to spend in the hospital under control at home.

With the COVID-19 two new use cases have emerged:

1- Program for hospital discharges

The Galicia solution was adapted to older adults with coronavirus who have been discharged. In specialized care, the program is a support program for discharges. These are especially complicated older adults who want to be guaranteed adequate and more supervised care. Pneumologists, internists and infectious disease specialists are on the other side of the screen to monitor for changes.

Professionals have stated that this solution provides older adults with security.

Older adults are safe because if there are any values that are higher than the established thresholds (for example, a sudden rise in fever) professionals can already call them directly when they are connected to them.

“It is a telemonitoring platform at home that already existed for some years in certain health areas and now with the COVID-19 it has been oriented to help coronavirus patients at two different levels: one in primary care, for people who have tested positive, and another for those who have been discharged and need regular monitoring given their cases,” explains CHUAC (Complejo Hospitalario Universitario A Coruña) pulmonologist Pedro Marcos Rodríguez. The doctor adds that, in this way, “since it is known that hospital beds will be needed, this application helps us so that those two or three days that were previously spent in the hospital can now be controlled at home”.

Once the health crisis passes Rodriguez stresses that the application “will have much more use than it has been created for. It is a tool for the future that will ease the workload and, above all, will prevent the displacement of older people. Sometimes it’s very sad to see the difficulties they have in going to their health centres just to take their blood pressure”.

2- Program for care homes for older people.

The Department of Social Policy (Government of Galicia) decided in March 2020, due to the health situation, to move the older people living in the Porta do Camiño Gerontological Complex to the Congreso Hotel.

The Spanish Red Cross carried out the transfer of the 55 residents who did not suffer from the illness derived from COVID-19, to the hotel.

Given the infrastructure of the hotel, there was no means for the older adults to communicate with the social and health personnel from their rooms in the event of needs derived from the Basic Activities of Daily Living or in the event of an emergency.

From the Galicia DS, the possibility of using the ACTIVAGE solution (UC4) was offered to communicate the residents’ rooms with the social and health care personnel.

The adapted solution has been effective for such communication, having very good acceptance by both residents and staff involved.

For Social professionals, older adults & carers/relatives.

The ACTIVAGE solution piloted on the DS-GAL is an advanced remote assistance system, to ensure the care and quality of life of people in the home, where the home becomes a reference point for care, not only in the health field, but also in the social field.

It also includes a system that analyses the life model according to daily routines (time in the bedroom, in the bathroom, outside the home…) proactively detecting dangerous situations that may occur at home.

Some concrete examples:

Monitoring and follow-up of the older adult in your home

Thanks to having a system that allows monitoring and analysing the daily routine of a person, generating basic information for their care but without interfering in their daily life (identifying possible falls, sleep problems, malnutrition, etc.) and also helping in small tasks (reminders to take medication, etc.), the Spanish Red Cross has launched this service for people vulnerable to COVID-19 through the Spanish Red Cross program.

An analysis of the user’s life model in their home - depending on their daily habits - detecting risk situations that may occur (falls, lack of movement, not returning home…), in which case the system proactively alerts the Red Cross Care Centre so that, if necessary, it can notify relatives, people in the vicinity or emergency services.

With this service, older adults receive calls as part of the special care and follow-up campaign.

Identification of potential health problems

The service implemented in AUC1 and AUC2 is used for older adults (with or without COVID) to encourage self-care thanks to the monitoring of health (stress, temperature, weight…) to promote physical, mental and emotional well-being.

The aim is to guarantee the safety, care, tranquillity and company of the people assisted and their families.

The alerts that are shown by values outside the predetermined thresholds, generate an alert that is attended by the Spanish Red Cross and is put in contact with the older adult.

Routine changes

At this time of forced confinement some older adults are suffering from palpitations, nervousness, anxiety, the feeling that the house is falling on them.

These days the routine that many were used to has been broken and they have started another one that they cannot manage.

Thanks to the AUC1 and AUC2 home habit monitoring solution, the relatives/carers can identify those erroneous or exaggerated thoughts that generate discomfort in older adults, and make them change their routine.

Relatives are detecting how the COVID is affecting older adults into a healthy sleep pattern and this may be the cause of frequent waking up, waking up with chest tightness.

Control of exits of house by disorientation

In the exceptional situation that we are experiencing, confinement to the home means that we cannot continue with some of the usual routines, such as attending the day centre, going for walks, visiting (or receiving visits from) friends or family, etc.

In this new generation of new routines, we detect that some older adults become disoriented and leave home when it is not possible to do so.

The ACTIVAGE system alerts the relatives/carers so that the older adult can be told to return home or be picked up.

Applicable in all cases.

This information is also visible to the carers or relatives who are connected in real time to the activity of the older adult, as well as the monitoring of their vital signs.

Carers report that this solution gives them peace of mind in these moments of uncertainty and greater concern for their older adult.

The solution also brings them peace, because they visualize the habits of the older adult and their routine, thus detecting situations of depression or unwanted loneliness. This causes the older adults to have more calls and support from the service provider and from relatives/carers, preventing situations from worsening.

In this way, the technology makes it possible to effectively apply the necessary support services in each case and to guarantee the security and privacy of the users. The idea is to help older people to continue living in their homes, having all the attention and care they need.

2- How the current solutions can be scaled up for contributing to the outbreak management?

OBJECTIVE

Solutions help users to cope with the situation, as indicated in the examples in the previous section.

The ACTIVAGE solutions deployed in the SD-GAL are aimed at the most vulnerable population group affected by COVID-19: older people who generally live alone, or occasionally in isolation during the period of confinement. Both in urban and rural settings, away from relatives or carers.

But it is also proving effective in the rest of the population who are confined to their homes by the COVID-19 pandemic, with the health and social problems it brings. People who live alone and people who have to be isolated because they are infected with the COVID-19 virus.

The main objective is to have in the user’s home the precise tools that allow a welfare action as an extension of the health centres through activities and care that promote the development of formulas that contemplate the integral care at home. In this way, care centres are linked to the older adult’s home so that health professionals can carry out remote and continuous monitoring of the older adult, maintaining his or her quality of life, avoiding avoidable hospital admissions and reducing on-site activity and unnecessary visits.

The solution would allow:

Remote socio-sanitary assistance

  • Avoiding hospital saturation
  • Follow-up of hospital or primary care at home.
  • Follow-up program for hospital discharges.
  • Control and follow-up of the older adult at home
  • Identification of possible health problems
  • Identification of health problems of the older adult (changes in routine, control of exits from the house due to disorientation, …)

Providing peace of mind for family members/caregivers who are concerned about their loved ones.

  • Allows caregivers to follow up on their family members without the need to travel to the family home.
  • Access to information on their lifestyle through the system that analyses the life model according to the daily routines (time in room, in bathroom, out of house…) detecting proactively in dangerous situations that may occur in the home.

Encourage self-care through health monitoring (stress, weight…) to promote physical, mental and emotional well-being.

That local and regional governments attend to and care for the most vulnerable population, mitigating the effects on physical and mental health.

To confront the feeling of loneliness and lack of protection that older people fear in this stressful situation.

TARGET GROUPS

  • Older adults living alone and their family members or informal caregivers who are currently participating benefit from DS services.
  • People who, because of their new conditions (people who are especially vulnerable to VIDOC-19, people who live alone even if they are not older adults, people who have to be isolated because they have contracted the virus, …)
  • Family members and carers concerned about the physical and mental health of their loved ones.
  • Both social and health service providers can also benefit from new services to offer to their users.
  • Governments must provide new care services, monitor and reach the most vulnerable people.

TECHNICAL INFRASTRUCTURE REQUIRED

Home devices: the possible sensors to be installed (not all of them are necessary): presence sensors, door opening sensor, emergency button, medical devices (blood pressure monitor, scale, coagulometer, glucometer, thermometer, …), technical alarm devices (gas sensor, CO, smoke, water flood). Ethernet connection or SIM card.

Technical, per user/service provider: device connected to the internet to consult a web application.

Technical, Internet connection: It is possible to send the information collected to different information systems of health or social systems.

HR and organization, by user: Installers, caregivers/service provider only to monitor usage and create events.

HOW TO RUN THE SOLUTION

Installation in a situation of confinement could to be substituted by online and video tutorials instructions.

ACTIVAGE works in four easy steps.

1. Personalization: ACTIVAGE facilitates an environment of care tailored to each user promoting the participation of family and authorized caregivers. ACTIVAGE allows configuration: permissions access, alarms, sensors medical data, etc.
2. Collection of information: ACTIVAGE captures information from the different sensors.
3. Intelligence and home security: The communication gateway receives, stores and processes information.
4. Reception and analysis of information: All the information is available for those authorized (family, caregivers, professionals) and is analyzed in depth by the systems intelligence to adapt the service to the needs of the user.

3- What will be the main benefits for the users?

It is an innovative solution that allows contact with professional teams of older adults, their families, and the user himself, which increases the effectiveness of the action, empowering older adults and extending their stay safely in their own home, ensuring a truly personalized provision of health and social care, while supporting significant efficiency improvements based on results in the provision of health and care services.

ACTIVAGE puts technology at the service of people, improves control by the Health Service, enhancing continuity of care, facilitating follow-up and preventing complications. It increases the safety of users in their homes and prevents them from travelling to the health centre.

This concept is addressed through the implementation of information devices and systems, aimed at prevention and health promotion, surveillance and monitoring of pathologies (especially chronic), which constitute a channel for access to health services by older adults or their caregivers.

ACTIVAGE supports the implementation of organisational care systems that allow consultations and non-presential reviews by users and carers through the use of information and communication technologies. And it also support the conciliation of family and work life of the user and his/her environment. This means an economic saving for the user and his/her family environment.

The telemonitoring platform allows caregivers to track their relatives without the need to travel to the family home, once the older adult knows how to use the medical devices to record clinical variables.

It allows individualized telemonitoring of home constants according to a specific care plan adapted to chronic older adults, following the clinical variables relevant to their disease.

It improves user control, facilitating follow-up and enhancing the work of health professionals, improving continuity of care and speeding up consultations.
It creates a new service model and involves the interested parties in the care of older adults, increasing the safety of older adults in the home.

It is a solution to promote active and healthy aging by improving and expanding existing services, for the promotion of independent living, the mitigation of frailty, and the preservation of quality of life and autonomy.

It works to anticipate future needs, moving from reactive to proactive care. It focuses the detection of fragility on functional and physical decline, and aims to prevent a person’s progress towards fragility.

The telemonitoring platform in the Galician Health System has become widespread in record time, to include the monitoring by healthcare professionals of all those isolated in their homes because of Cov19.

ACTIVAGE improves the quality of life and care of people.

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