ElderWeb

A recent study evaluated the feasibility of providing telemedical wound care using a mobile telephones with integrated cameras as a way to reduce the cost of care and make it easier to work with patients at a distance. A team of doctors led by Dr. Ralph Peter Braun of the University Hospital of Geneva set up three physicians to evaluate 61 leg ulcers. One physician did a face-to-face consultation that was used to determine the quality of the remote evaluations, and the other two physicians worked from pictures taken with a cell phone camera and sent to them by email. The researchers found that results from the remote evaluations were nearly as reliable as the face-to-face evaluation. The physicians considered the camera image to be good 59% of the time, and very good 20% of the time, and said they felt comfortable making a diagnosis based on the pictures in 82% of the cases.

The article is available in the Archives of Dermatology at: http://archderm.ama-assn.org/cgi/content/short/141/2/254

Paro, a robot that looks like a baby harp seal and is covered in fur like a stuffed animal, is being used to provide therapy for some elderly Japanese nursing home residents. Paro has sensors to help it recognize its master's voice and hand gestures, and it coos and flaps at gentle touches and but squeals in anger if handled roughly. The developers state their purpose in creating Paro was to provide the benefits of animal therapy in environments where there are concerns about using live animals because of allergies, infection, scratching, and biting.

They state, "Almost everyone has touched or played with cats and dogs, so when they experience the robotic form of these animals, they can not help but compare the robot to the real creatures. If the robot does not respond in a familiar way or if it feels different from the real animal, people often become critical of the robot and lose the chance to experience its therapeutic qualities. We selected baby harp seals as the model for our robot because most people have not had any contact with such animals. When considering human-robot interaction, we envisioned a robot that could sit in a person's lap so that it could be held or stroked. That is how Paro came to be."

A March 10, 2005 article in the Washington Post said, "Researchers have been testing the robot's effect on the elderly at a nursing home in Tsukuba, about 40 miles northeast of Tokyo. During a recent visit by a reporter, the sad eyes of elderly residents lit up as the two resident robot seals were brought out. Tests have shown that the cute newcomers indeed reduce stress and depression among the elderly."

Read more about Paro at: http://www.aist.go.jp/aist_e/museum/science/6/6.html

'Going Through the Motions' To Better Treat Dementia

Doctors are turning to wireless technology in an effort to better treat people with Alzheimer's disease and other forms of dementia. Thanks to a $200,000 grant from the Alzheimer's Association and Intel Corp., psychiatrist Adrian Leibovici, M.D., will explore whether gadgets such as motion sensors and wearable motion detectors can give doctors and nurses a clear picture of patients' lives in their own homes.

The team is focusing on movements of patients with dementia and will compare the findings from the technology to results of traditional methods where doctors and nurses discuss a patient's activities with the patient and his or her family. Such information is crucial for patients to receive appropriate care.

"Behavior changes hour to hour, or even minute to minute, in patients with dementia," says Leibovici, associate professor of Psychiatry at the University of Rochester Medical Center. "It happens all the time. One minute the patient is quiet and calm, and the next minute she might be agitated, anxious or loud. Our traditional ways of evaluating and documenting such behavior may not be adequate. A family might report that a patient has been calm for two weeks, when really the patient was calm only that morning."

Leibovici's team will compare current traditional interviewing methods to the results from the high-tech devices. For one week each month during the three-year study, patients will have their movements monitored inside their home as they go about their daily routines; they and their caregivers will also answer questions about the patient's activity during those weeks. Then Leibovici's team will check whether the reports by patients and family members correlate with information generated by motion sensors.

Even though our movements are so simple and routine that we hardly notice them - actions that are numbingly routine are referred to as simply "going through the motions" - our everyday movements offer a wealth of information to a trained eye. To Leibovici, who often works with older people who are depressed or have dementia, a patient who is pacing back and forth a great deal may be showing signs of agitation, while someone suddenly moving very little might be sinking into depression.

"The greatest source of disability, and the main reason families place a demented patient in a nursing home, is not the loss of cognitive skills," says Leibovici. "It's the psycho-behavioral symptoms of dementia, such as agitation, or depression, or even psychosis. Developing new ways to help such patients is crucial for them as well as their caregivers."

The first stage of the study involves testing technology in the smart medical home located in the University's Center for Future Health.
Once calibrated, the wireless technology will be installed inside the homes of patients who volunteer to take part in the study.

The technology has been provided by HomeFree Systems of Milwaukee and GE Infrastructure, Security. HomeFree Systems Ltd. is a global provider of wireless monitoring solutions for the senior housing and homecare markets. GE Infrastructure, Security, is a wholly owned subsidiary of the General Electric Co. focused on communication and information technologies for security, safety and lifestyle enhancements.

The grant was awarded to Leibovici and the Center for Future Health through the Everyday Technologies for Alzheimer Care (ETAC) Consortium, which was founded last year by Intel and the Alzheimer's Assn. This award is one of the first five grants given by ETAC.

"Today, 70 percent of the 4.5 million Americans with Alzheimer's disease live at home where family and friends provide most of their care,"
says William Thies, Ph.D., vice president for medical and scientific affairs at the Alzheimer's Association. "It is imperative that we explore how technology can be used to save costs associated with institutional care, ease caregiver anxiety and help those with Alzheimer's improve their daily living."

For more information, contact:
Tom Rickey
(585) 275-7954

A study by Mayo Clinic researchers studied whether cellular telephones interfered with the operation of external devices that monitor the heart and lungs. Researchers found that when the cell phone was 5 feet or more away from medical devices, it did not appear to have any impact, but closer proximity created problems with some devices. Cell phone-related interference was seen in the electrocardiographic (ECG) tracings displayed on the physiologic monitor when a cell phone was 6 to 33 inches from the monitor, and when the phones were held two inches away from a communication port on the back of the ventilator, the ventilator shut down and restarted. They suggest that hospitals might be wise to restrict cell phone use in places like the ICU, but that such restrictions may not be necessary in all areas of the hospital. They don't address the use of medical devices in homes and other settings, but the same issues would certainly apply.

Japan is developing a satellite-based global positioning system and a cellular phone network which could be used to track the whereabouts of older people with dementia who have wandered off. Local governments in Tokyo and Japan's Kikuchi City plan to test the device, developed by a group led by trading house Mitsui & Co "We are definitely expecting a market to develop for the system,'' a Mitsui spokesman said.