Transcript Slide 1

ANA ASLAN
INTERNATIONAL
ACADEMY OF AGING
ANA ASLAN
INTERNATIONAL
FOUNDATION
The development of Assistive Technology (AT)
for cognitively impaired persons.
A European attempt.
Luiza Spiru, MD, PhD
“Elias” University Emergency Hospital, Bucharest
Head of the Geriatric Department
Head of the Day Hospital of Memory Impairment Diseases
President of Ana Aslan International Foundation
Vice-President of Ana Aslan International Academy of Aging
Professor of Geriatric Dept. ”Carol Davila”
University of Medicine and Pharmacy
The 19th Alzheimer
Europe Conference
28-30.05.2009
Brussels
Topic: "Quality of life"
Camelia Ghita, MD; Ioana Ioancio, MD; Costin Nuta, MD; Psychol.
Mona Blacioti; Mariana Martin; Lucian Stefan, MD, Ileana Turcu, PhD
Ana Aslan International Academy of Aging,
Day Hospital of Memory Impairment Diseases
The development of Assistive Technology (AT) for cognitively impaired persons.
A European attempt. Luiza Spiru, MD, PhD et al
Assistive Technology (AT) – The Concept
the full range of products, services and strategies designed to:



support the activities of daily living for elderly / disabled people
maximize their personal autonomy and independence
monitor their health and enhance their quality of life
IHE (Intelligent home environment), issue n0 2, 2007
All rights reserved. No part of these slides can be reproduced, stocked or transmitted in no other form and through no other electronic, mechanic, or photocopy way, without the
approval of “Ana Aslan” International Academy of Aging®© “Ana Aslan” International Foundation ®© Brain Aging International Journal ®©.
The development of Assistive Technology (AT) for cognitively impaired persons.
A European attempt. Luiza Spiru, MD, PhD et al
The UNO’s International Plan of Action on Ageing (Madrid, 2002)
The development of Assistive Technology -- a priority direction and a valuable
answer to population aging
Imperatives :
•
•
•
•
•
achievement of secure ageing (Art. 12b)
provision of supportive environments for the elderly (Art.14)
provision of self-fulfillment and well-being opportunities in late life (Art. 12d)
provision of health care, support and social protection (Art. 12j)
focus of research & technology on the individual, social and health implications of ageing (Art. 12j)
Actions :
development of Assistive Technology (AT), Information and Communication Technology (ICT),
elderly e-Inclusion, Ambient Intelligence, Health Environmental Integration (HEI) etc.
http://www.un.org/ageing/madrid_intlplanaction.html
All rights reserved. No part of these slides can be reproduced, stocked or transmitted in no other form and through no other electronic, mechanic, or photocopy way, without the
approval of “Ana Aslan” International Academy of Aging®© “Ana Aslan” International Foundation ®© Brain Aging International Journal ®©.
The development of Assistive Technology (AT) for cognitively impaired persons.
A European attempt. Luiza Spiru, MD, PhD et al
Strategic aims of Assistive Technology (AT)
 Enhancement of integrated bio-psycho-social and
rehabilitative interventions
 Disability support for maximum independence and security
 Integration of elderly / disabled people within their social
environment and within the society
 Improvement of personal and family care
 Improvement of caregivers’ life quality
All rights reserved. No part of these slides can be reproduced, stocked or transmitted in no other form and through no other electronic, mechanic, or photocopy way, without the
approval of “Ana Aslan” International Academy of Aging®© “Ana Aslan” International Foundation ®© Brain Aging International Journal ®©.
The development of Assistive Technology (AT) for cognitively impaired persons.
A European attempt. Luiza Spiru, MD, PhD et al
Five essential ways to achieve the AT aims
New technologies:
ambient intelligence solutions, smart and advanced materials, nanoelectronics,
biomechatronics , bionics
Socio-economic issues:
to make AT products affordable to end-users
Human-centered design for AT applications
to take into account the heterogeneity of the end-users
Evidence-based practice:
by promoting knowledge and understanding of AT solutions claimed by the real
practice
Ageing and disability dynamics:
the population aging dynamics will permanently change the needs and demands
of care, support and prevention
All rights reserved. No part of these slides can be reproduced, stocked or transmitted in no other form and through no other electronic, mechanic, or photocopy way, without the
approval of “Ana Aslan” International Academy of Aging®© “Ana Aslan” International Foundation ®© Brain Aging International Journal ®©.
The development of Assistive Technology (AT) for cognitively impaired persons.
A European attempt. Luiza Spiru, MD, PhD et al
Key Notions and Requirements in Assistive Technology
Information & Communication Technology (ICT)
Includes all the technologies related to information processing &
communication
Involves study, design, development, implementation, support
and management of computer-based information systems
Involves the use of hardware and software in order to convert, store, protect,
process, transmit and securely retrieve information
All rights reserved. No part of these slides can be reproduced, stocked or transmitted in no other form and through no other electronic, mechanic, or photocopy way, without the
approval of “Ana Aslan” International Academy of Aging®© “Ana Aslan” International Foundation ®© Brain Aging International Journal ®©.
The development of Assistive Technology (AT) for cognitively impaired persons.
A European attempt. Luiza Spiru, MD, PhD et al
AT - Services and products
A great diversity of “high tech” solutions dedicated to:







Mobility support
Sensorial impairments support (visual and hearing)
Cognitive disability support
Cognitive and physical assessment, treatment and rehabilitation support
Support of daily living activities
Support for access to information and alternative communication
Enhancement of urban, work place and transport accessibility
All rights reserved. No part of these slides can be reproduced, stocked or transmitted in no other form and through no other electronic, mechanic, or photocopy way, without the
approval of “Ana Aslan” International Academy of Aging®© “Ana Aslan” International Foundation ®© Brain Aging International Journal ®©.
The development of Assistive Technology (AT) for cognitively impaired persons.
A European attempt. Luiza Spiru, MD, PhD et al
The market for ICT products and services for the elderly still faces critical matters:






the definition of end users’ profiles and needs,
the scarce attempt of cognitive disabilities
the insufficient sharing of experiences,
the fragmentation of reimbursement schemes,
lack of interoperability,
high costs of ICT systems’ development and validation.
All rights reserved. No part of these slides can be reproduced, stocked or transmitted in no other form and through no other electronic, mechanic, or photocopy way, without the
approval of “Ana Aslan” International Academy of Aging®© “Ana Aslan” International Foundation ®© Brain Aging International Journal ®©.
The development of Assistive Technology (AT) for cognitively impaired persons.
A European attempt. Luiza Spiru, MD, PhD et al
E-Inclusion & e-Accessibility
Europe's e-Inclusion policy for the elderly aims to:
empower their participation in the knowledge society and economy,
despite their physical and/or cognitive frailties,
ensure their access to:
 online health and other services
 online employment if desired .
eInclusion@EU, Strengthening eInclusion & eAccessibility across Europe, IST-502553,
http://www.empirica.com/themen/einclusion/documents/eInclusion_Analytic-framework.pdf
All rights reserved. No part of these slides can be reproduced, stocked or transmitted in no other form and through no other electronic, mechanic, or photocopy way, without the
approval of “Ana Aslan” International Academy of Aging®© “Ana Aslan” International Foundation ®© Brain Aging International Journal ®©.
The development of Assistive Technology (AT) for cognitively impaired persons.
A European attempt. Luiza Spiru, MD, PhD et al
E-Inclusion & e-Accessibility impact :
Enhancement of seniors’ social communication:
(phone / video conversations, overcoming social isolation )
Safety enhancement:
security systems (entrances, water and/or gas leaks, etc.)
Health services improvement:
(home telemedicine - wearable systems for monitoring the
chronically ill individuals)
Family and care givers support
All rights reserved. No part of these slides can be reproduced, stocked or transmitted in no other form and through no other electronic, mechanic, or photocopy way, without the
approval of “Ana Aslan” International Academy of Aging®© “Ana Aslan” International Foundation ®© Brain Aging International Journal ®©.
The development of Assistive Technology (AT) for cognitively impaired persons.
A European attempt. Luiza Spiru, MD, PhD et al
Other E-Inclusion outcomes:
 increase of older people autonomy and self-confidence
 extension of their independent life at home
 avoid hospitalization costs
 provide insights for further applications
(smart homes, telemonitoring, robotics, biosensors, etc.)
G. Eysenbach - What is e-health?, Editorial, J Med Internet Res 2001;3(2)
All rights reserved. No part of these slides can be reproduced, stocked or transmitted in no other form and through no other electronic, mechanic, or photocopy way, without the
approval of “Ana Aslan” International Academy of Aging®© “Ana Aslan” International Foundation ®© Brain Aging International Journal ®©.
The development of Assistive Technology (AT) for cognitively impaired persons.
A European attempt. Luiza Spiru, MD, PhD et al
Smart Homes for the Elderly
“a collective term for information and communication technology in homes, where
components communicate among them and through a local network”
Involves home automation systems that make possible the Activities of Daily Living
(ADL) for the elderly and disabled, enabling them to live on their own
'Smart' Homes To Help Elderly Remain Independent Longer, OPB
News, No.3, 2008, http://news.opb.org/article/3444-smart-homeshelp-elderly-remain-independent-longer/
All rights reserved. No part of these slides can be reproduced, stocked or transmitted in no other form and through no other electronic, mechanic, or photocopy way, without the
approval of “Ana Aslan” International Academy of Aging®© “Ana Aslan” International Foundation ®© Brain Aging International Journal ®©.
The development of Assistive Technology (AT) for cognitively impaired persons.
A European attempt. Luiza Spiru, MD, PhD et al
Two basic forms of home automation systems for the elderly:
 embedded Health Systems
integrate sensors and microprocessors in appliances,
furniture and clothing, in order to collect data for disease
diagnosis and risk patterns recognition
 private Health Networks
implement wireless technology connected to portable
devices, in order to store the data in a household health
database.
M Robart, IDC Reveals Rise in Home Automation Services, TMCnet.com, September
11, 2008, http://sip-trunking.tmcnet.com/topics/security/articles/39568-idc-reveals-risehome-automation-services.htm
All rights reserved. No part of these slides can be reproduced, stocked or transmitted in no other form and through no other electronic, mechanic, or photocopy way, without the
approval of “Ana Aslan” International Academy of Aging®© “Ana Aslan” International Foundation ®© Brain Aging International Journal ®©.
The development of Assistive Technology (AT) for cognitively impaired persons.
A European attempt. Luiza Spiru, MD, PhD et al
AT Sore topics
1.
2.
Development of the interdisciplinary skills to assess and select the most suitable AT
solution for the end-user.
Enhancement of human-centered design:
despite the multidisciplinary attempt, the end-user’s participation
is still poor
many developments are “technology driven”, rather than guided by
real needs
the actual developments are less oriented to cognitive disabilities
G. Eizmendi, J.M. Azkoitia - Technologies and active Strategies for an ageing population,
Issue N°2, April 2007
All rights reserved. No part of these slides can be reproduced, stocked or transmitted in no other form and through no other electronic, mechanic, or photocopy way, without the
approval of “Ana Aslan” International Academy of Aging®© “Ana Aslan” International Foundation ®© Brain Aging International Journal ®©.
The development of Assistive Technology (AT) for cognitively impaired persons.
A European attempt. Luiza Spiru, MD, PhD et al
3. The existing AT products are:
mainly oriented to mobility
don’t meet the epidemiologic trend, missing highlyprevalent disabilities - e.g. induced by Alzheimer’s
Disease, Parkinson etc.
ignore prevention and rehabilitation aspects
All rights reserved. No part of these slides can be reproduced, stocked or transmitted in no other form and through no other electronic, mechanic, or photocopy way, without the
approval of “Ana Aslan” International Academy of Aging®© “Ana Aslan” International Foundation ®© Brain Aging International Journal ®©.
The development of Assistive Technology (AT) for cognitively impaired persons.
A European attempt. Luiza Spiru, MD, PhD et al
4. Definition of users’ ontologies
Users: elderly, especially those physically and/or cognitively disabled.
and the care givers
Critical matters:
 extreme heterogeneity of functional (psycho-physical) profiles and
needs
 the selection of evaluation scales for tailoring Protocols of user
assessment
 the definition of personalized clusters of services
 the determination of the requirements for smart agents’ test and
validation
All rights reserved. No part of these slides can be reproduced, stocked or transmitted in no other form and through no other electronic, mechanic, or photocopy way, without the
approval of “Ana Aslan” International Academy of Aging®© “Ana Aslan” International Foundation ®© Brain Aging International Journal ®©.
The development of Assistive Technology (AT) for cognitively impaired persons.
A European attempt. Luiza Spiru, MD, PhD et al
5. Obstacles that prevent elderly people from benefiting of the information society




lack of affordability, accessibility and skills,
lack of motivation and
unwillingness to embrace new technologies
impairments that increase their sense of frustration
and dependency
All rights reserved. No part of these slides can be reproduced, stocked or transmitted in no other form and through no other electronic, mechanic, or photocopy way, without the
approval of “Ana Aslan” International Academy of Aging®© “Ana Aslan” International Foundation ®© Brain Aging International Journal ®©.
The development of Assistive Technology (AT)
The development of Assistive Technology (AT)
for cognitively impaired persons.
A European attempt. Luiza Spiru, MD, PhD et al
The development of Assistive
The development of Assistive Technology (AT) for cognitively impaired persons.
A European attempt. Luiza Spiru, MD, PhD et al
The EC’s Ageing Well in the Information Society Action Plan (2007)
responds to Europe’s “graying” by measures:
•
against barriers that prevent older people from using ICT
products and services
•
for a greater uptake of ICTs by senior citizens
•
for stimulate the industry to produce technologies
appropriated to hem
http://ec.europa.eu/information_society/activities/einclusion
All rights reserved. No part of these slides can be reproduced, stocked or transmitted in no other form and through no other electronic, mechanic, or photocopy way, without the
approval of “Ana Aslan” International Academy of Aging®© “Ana Aslan” International Foundation ®© Brain Aging International Journal ®©.
h attempt. Luiza Spiru, MD, PhD et al
Contribution of Ana Aslan International Academy of Aging
as medical partner in the European FP6-2006-IST-6 Projects
K4CARE and SHARE-it
All rights reserved. No part of these slides can be reproduced, stocked or transmitted in no other form and through no other electronic, mechanic, or photocopy way, without the
approval of “Ana Aslan” International Academy of Aging®© “Ana Aslan” International Foundation ®© Brain Aging International Journal ®©.
The development of Assistive Technology (AT) for cognitively impaired persons.
A European attempt. Luiza Spiru, MD, PhD et al
Main principles of cooperation




the tailoring of the new SHARE-it assistive platforms on the profile
of the end-user
the extreme variability of physical and especially cognitive
disabilities in the elderly, and the consecutive extreme variability of their
needs
the demands of the multidisciplinary cooperation
to actively contribute to the promotion and dissemination of these two
endeavors related to the development of the European models of
Assistive Technologies
All rights reserved. No part of these slides can be reproduced, stocked or transmitted in no other form and through no other electronic, mechanic, or photocopy way, without the
approval of “Ana Aslan” International Academy of Aging®© “Ana Aslan” International Foundation ®© Brain Aging International Journal ®©.
The development of Assistive Technology (AT) for cognitively impaired persons.
A European attempt. Luiza Spiru, MD, PhD et al
Supported Human Autonomy for
Recovery and Enhancement of
cognitive and motor abilities using
information technologies – SHARE-it
IST-2005-2.6.2
www.ist-shareit.eu/shareit
All rights reserved. No part of these slides can be reproduced, stocked or transmitted in no other form and through no other electronic, mechanic, or photocopy way, without the
approval of “Ana Aslan” International Academy of Aging®© “Ana Aslan” International Foundation ®© Brain Aging International Journal ®©.
The development of Assistive Technology (AT) for cognitively impaired persons.
A European attempt. Luiza Spiru, MD, PhD et al
SHARE-it Project
 A STREP project co-funded in the EU's FP6, in the IST (Information Society Technologies)
Thematic Priority, project number FP6-045088, Contract number 045088, started on 1st
January 2007, and fulfilled by 8 partners from 4 European countries (Spain, Italy, Germany,
Romania), until 2009
 Project Coordinator: Universitat Politecnica de Catalunya
 The Romanian partner: Ana Aslan International Academy of Aging,
under the leadership of Prof. Luiza Spiru, MD, PhD
All rights reserved. No part of these slides can be reproduced, stocked or transmitted in no other form and through no other electronic, mechanic, or photocopy way, without the
approval of “Ana Aslan” International Academy of Aging®© “Ana Aslan” International Foundation ®© Brain Aging International Journal ®©.
The development of Assistive Technology (AT) for cognitively impaired persons.
A European attempt. Luiza Spiru, MD, PhD et al
SHARE-it goals
To develop a scalable, adaptive and easy to use system of add-ons to sensor and
assistive technology, able to be modularly integrated into an intelligent home
environment and to enhance the individual’s autonomy by informing and assisting
the user and his/her caregivers through monitoring and mobility help
To contribute to the development of the next generation of assistive devices for
older and/or disabled people, with special attention to the cognitive impairments
All rights reserved. No part of these slides can be reproduced, stocked or transmitted in no other form and through no other electronic, mechanic, or photocopy way, without the
approval of “Ana Aslan” International Academy of Aging®© “Ana Aslan” International Foundation ®© Brain Aging International Journal ®©.
The development of Assistive Technology (AT) for cognitively impaired persons.
A European attempt. Luiza Spiru, MD, PhD et al
SHARE-it objectives
 To explore the benefits of the concept of situated intelligence
 to build elements (add-ons) that will enhance the autonomy of the target user
group in their preferred environment
 To investigate and implement innovative forms of shared autonomy
 To build appropriate add-ons to standardized technologies to provide ubiquitous
sensing, computation and assistance
 To build adaptive interfaces for the target group
 To target the various human-delivered assistance and caretaking services as
effectively as possible
All rights reserved. No part of these slides can be reproduced, stocked or transmitted in no other form and through no other electronic, mechanic, or photocopy way, without the
approval of “Ana Aslan” International Academy of Aging®© “Ana Aslan” International Foundation ®© Brain Aging International Journal ®©.
The development of Assistive Technology (AT) for cognitively impaired persons.
A European attempt. Luiza Spiru, MD, PhD et al
SHARE-it impact
Important issues / contributions in the field of:
 sensor networks
 assisted mobility
 knowledge engineering
 Ambient Intelligence
 long-term research
All rights reserved. No part of these slides can be reproduced, stocked or transmitted in no other form and through no other electronic, mechanic, or photocopy way, without the
approval of “Ana Aslan” International Academy of Aging®© “Ana Aslan” International Foundation ®© Brain Aging International Journal ®©.
The development of Assistive Technology (AT) for cognitively impaired persons.
A European attempt. Luiza Spiru, MD, PhD et al
Contribution of Ana Aslan Academy
as medical partner in the SHARE-it project
Share of knowledge and expertise regarding :
• “State of the art” in intelligent assistive devices
• Stipulations contained in the International Plan on Aging and other
UNO and WHO documents
• Problems concerning the compliance of the frail elderly and cognitively
impaired persons to the usage of assistive devices
• Bioethical matters
All rights reserved. No part of these slides can be reproduced, stocked or transmitted in no other form and through no other electronic, mechanic, or photocopy way, without the
approval of “Ana Aslan” International Academy of Aging®© “Ana Aslan” International Foundation ®© Brain Aging International Journal ®©.
The development of Assistive Technology (AT) for cognitively impaired persons.
A European attempt. Luiza Spiru, MD, PhD et al
Contribution of Ana Aslan Academy
as medical partner in the SHARE-it project
Contributions to disability profiling:




Presentation of the scales suitable to define the Target Population
(SHARE-it’s Workshop “Aging of the population, chronic conditions, disability and
their assessment” from Rome)
Meanings about the psycho-physical functions of the patients with cognitive
impairments (e.g. moderate-severe to severe Alzheimer’s Disease and other
related dementias)
Meanings about the psycho-physical functions of the patients with cognitive
impairments
Information regarding pathophysiological changes due to cognitive
impairment provided for “Definition of the user and activity, tasks and ADLs”
All rights reserved. No part of these slides can be reproduced, stocked or transmitted in no other form and through no other electronic, mechanic, or photocopy way, without the
approval of “Ana Aslan” International Academy of Aging®© “Ana Aslan” International Foundation ®© Brain Aging International Journal ®©.
The development of Assistive Technology (AT) for cognitively impaired persons.
A European attempt. Luiza Spiru, MD, PhD et al
Contribution of Ana Aslan Academy
as medical partner in the SHARE-it project
Contribution to the establishment of SHARE-it Target Population by sharing expertise
related to:
•
Disability (Gender and demographic differences, Prevalence, Causes and incidence of
disability in women)
•
Aphasia (the localizationist model, Lichtheim's classification, Fluent, non-fluent and
"pure" aphasias)
•
Speech Therapy (Evaluation, Treatment, The Evidence-Based Aphasia Clinic (EBAC),
The “life participation approach to aphasia” )
•
Occupational Therapy (Definition, Approach)
All rights reserved. No part of these slides can be reproduced, stocked or transmitted in no other form and through no other electronic, mechanic, or photocopy way, without the
approval of “Ana Aslan” International Academy of Aging®© “Ana Aslan” International Foundation ®© Brain Aging International Journal ®©.
The development of Assistive Technology (AT) for cognitively impaired persons.
A European attempt. Luiza Spiru, MD, PhD et al
Contribution of Ana Aslan Academy
as medical partner in the SHARE-it project
Contributions to the assessment of disability
 User’s multidimensional assessment
Provision of scales and procedures to assess individuals’ functions - a battery of
standardized neuropsychological tests licensed to AAIAA
Provision of scales for the assessment of memory, attention, reasoning, language
and perception, neglect, agnosia, aphasia and the executive functions.
 Provision of a set of up-to-date assessment and evaluation scales for
the design of “Protocols of user assessment” :
Clinical / Physical Exam; GSE, MMSE, MNA, Tinetti Static & Tinetti Dynamic
Scales, Yesavage Geriatric Depression Scale, GBS, IADL, SIB for the demented
patients with MMSE <10, RUD, NPI, etc.
All rights reserved. No part of these slides can be reproduced, stocked or transmitted in no other form and through no other electronic, mechanic, or photocopy way, without the
approval of “Ana Aslan” International Academy of Aging®© “Ana Aslan” International Foundation ®© Brain Aging International Journal ®©.
The development of Assistive Technology (AT) for cognitively impaired persons.
A European attempt. Luiza Spiru, MD, PhD et al
Contribution of Ana Aslan Academy
as medical partner in the SHARE-it project
Contribution to the Protocols of user assessment:
•
Classification of disability
•
Multidmensional Evaluation
•
•
The Scales
o Instrumental Activities of Daily Living (IADL)
o The Barthel ADL Index Tinetti Scale
o Mini Mental State Examination (MMSE)
o Gorel-Brane Scale (GBS)
o 15-words (Verbal episodic memory)
o Rey’s Figure (Visual-spatial episodic memory)
o Verbal Fluency (Executive functions)
o Rey’s Figure (copy) (Constructional praxis)
o Neuropsychiatric Inventory (NPI) (Behaviour assessment)
o Geriatric Depression Scale (Yesavage)
Assessment of the user
•
Assessment of the environment
•
Assessment of user’s compliance to AT applications
All rights reserved. No part of these slides can be reproduced, stocked or transmitted in no other form and through no other electronic, mechanic, or photocopy way, without the
approval of “Ana Aslan” International Academy of Aging®© “Ana Aslan” International Foundation ®© Brain Aging International Journal ®©.
The development of Assistive Technology (AT) for cognitively impaired persons.
A European attempt. Luiza Spiru, MD, PhD et al
Contribution of Ana Aslan Academy
as medical partner in the SHARE-it project
The Gorel-Brane Scale – GBS has been proposed and implemented as one of the most
important tool for patient’s evaluation and selection, due to its high potential to
describe cognitive deficits aside the physical ones and instrumental activities
deterioration degree.
Görel Bråne, Carl-Gerhard Gottfries, Bengt Winblad;
"Ana Aslan" International Academy of Aging®; "Ana Aslan" International Foundation®;
all rights reserve for the GBS scale in 18 languages: English, Swedish, Bosnian/Croatian/Serbian,
Czech, Danish, Dutch, Finnish, French, German, Greek, Icelandic, Italian, Norwegian, Polish,
Romanian, Russian, Spanish - published in BAIJ, ISSN 1582-8352, 2002
All rights reserved. No part of these slides can be reproduced, stocked or transmitted in no other form and through no other electronic, mechanic, or photocopy way, without the
approval of “Ana Aslan” International Academy of Aging®© “Ana Aslan” International Foundation ®© Brain Aging International Journal ®©.
The development of Assistive Technology (AT) for cognitively impaired persons.
A European attempt. Luiza Spiru, MD, PhD et al
Contribution of Ana Aslan Academy
as medical partner in the SHARE-it project
Cooperation with other partners in the project for:

Users’ and caregivers’ ontologies and performance criteria

The Target population requirements
Working with experts in neuropsychological issues to define
the instruments for the Assessment in the SHARE-it population
All rights reserved. No part of these slides can be reproduced, stocked or transmitted in no other form and through no other electronic, mechanic, or photocopy way, without the
approval of “Ana Aslan” International Academy of Aging®© “Ana Aslan” International Foundation ®© Brain Aging International Journal ®©.
The development of Assistive Technology (AT) for cognitively impaired persons.
A European attempt. Luiza Spiru, MD, PhD et al
Knowledge-Based
Homecare eServices
for an Ageing Europe
K4CARE
IST-2004-026968
www.k4care.net
All rights reserved. No part of these slides can be reproduced, stocked or transmitted in no other form and through no other electronic, mechanic, or photocopy way, without the
approval of “Ana Aslan” International Academy of Aging®© “Ana Aslan” International Foundation ®© Brain Aging International Journal ®©.
The development of Assistive Technology (AT) for cognitively impaired persons.
A European attempt. Luiza Spiru, MD, PhD et al
K4CARE Project
–A STREP project co-funded in the EU's FP6, in the IST (Information Society
Technologies) Thematic Priority, project number IST-2004 -026968 started on
01.03.2006, and fulfilled by 13 partners from 7 European countries (Spain, Italy,
Germany, England, Czech Rep., Romania, Hungary) until 2009
–Project Coordinator: Universitat Rovira i Virgili, Spain
–The Romanian partner: Ana Aslan Intl. Academy of Aging under the leadership of
Prof. Luiza Spiru, MD, PhD
All rights reserved. No part of these slides can be reproduced, stocked or transmitted in no other form and through no other electronic, mechanic, or photocopy way, without the
approval of “Ana Aslan” International Academy of Aging®© “Ana Aslan” International Foundation ®© Brain Aging International Journal ®©.
The development of Assistive Technology (AT) for cognitively impaired persons.
A European attempt. Luiza Spiru, MD, PhD et al
K4CARE goal
To improve the capabilities of the new EU society to manage and respond to the needs
of the increasing number of senior population requiring a personalized HC assistance.
Main tasks in achieving the project’s goal:

gather the scientific and technical knowledge,

develop the intelligent technologies to manage that knowledge,

supply the ICT infrastructure for anticipating and hastening the medical assistance,

implement a web-based platform to approach these technologies to healthcare
professionals, patients, and citizens,

assess the platform services in a scenario of combined old and new EU healthcare
institutions: home care providers, hospitals, rehabilitation centres, geriatric
departments, and town councils.
All rights reserved. No part of these slides can be reproduced, stocked or transmitted in no other form and through no other electronic, mechanic, or photocopy way, without the
approval of “Ana Aslan” International Academy of Aging®© “Ana Aslan” International Foundation ®© Brain Aging International Journal ®©.
The development of Assistive Technology (AT) for cognitively impaired persons.
A European attempt. Luiza Spiru, MD, PhD et al
K4CARE objectives
 Generate a new ICT Sanitary Model (K4CARE model) for assisting HCPs in the enlarged
Europe, by integrating services, healthcare practices, and assistance knowledge from old (Italy,
UK) and new (Czech Republic, Romania, Hungary) European Community countries.
 Propose a telematic and knowledge-based platform to implement the K4Care model,
using the technologies developed in the project and the human actors involved (physicians,
nurses, social workers, rehabilitative professionals, patient relatives, patients themselves, and
citizens in general).
 To test and validate the K4Care platform through pilots on west (Italy, UK) and east (Czech
Rep., Romania, Hungary) areas.
 To elaborate the K4Care EHCR (Electronic Health-Care Record) containing information about
physicians, patients, citizens and other agents involved in the K4CARE model (hospitals,
laboratories, consultation files, specialists, relatives and patients at home).

To create a test bench with real data.
All rights reserved. No part of these slides can be reproduced, stocked or transmitted in no other form and through no other electronic, mechanic, or photocopy way, without the
approval of “Ana Aslan” International Academy of Aging®© “Ana Aslan” International Foundation ®© Brain Aging International Journal ®©.
The development of Assistive Technology (AT) for cognitively impaired persons.
A European attempt. Luiza Spiru, MD, PhD et al
K4CARE scientific objectives

Define the K4CARE Actor Profile Ontologies (APO) involving healthcare professionals,
patients and relatives, citizens, and social organisms.

Define the patient-Case Profile Ontologies (CPO) for representing symptoms, diseases,
syndromes, case mix.

Integrate APOs and CPOs (symptoms, signs, drugs, medical and surgical procedures,
nutrition, physical and hygienic requirements, cognitive functions, self-dependency
etc.) in "know-what" knowledge about agents accessing the K4CARE model.

Define Formal Intervention Plans (FIP) for a number of disease and syndrome
treatments, based on the available geriatric guidelines
FIPs are the explicit expressions of how the Home-Care-Practice
must be provided in a growing ageing EU.
All rights reserved. No part of these slides can be reproduced, stocked or transmitted in no other form and through no other electronic, mechanic, or photocopy way, without the
approval of “Ana Aslan” International Academy of Aging®© “Ana Aslan” International Foundation ®© Brain Aging International Journal ®©.
The development of Assistive Technology (AT) for cognitively impaired persons.
A European attempt. Luiza Spiru, MD, PhD et al
K4CARE fundamental outcomes

Integrate information of different types and from different sources, whilst ensuring
private and customized data access

Define the K4Care ontologies of the end-users (e.g. physicians, patients) and
objects (e.g. disease, case study)

Elaboration of a mechanism to combine and refine the ontologies in order to
personalize the system, depending on the way a physician works and on the
individual patient characteristics

Incorporate 'know-how' from geriatric clinical guidelines as K4Care Formal
Intervention Plans (FIPs)

Configure a knowledge-based decision support tool to supply eServices to all
subjects involved in the Home Care model.
All rights reserved. No part of these slides can be reproduced, stocked or transmitted in no other form and through no other electronic, mechanic, or photocopy way, without the
approval of “Ana Aslan” International Academy of Aging®© “Ana Aslan” International Foundation ®© Brain Aging International Journal ®©.
The development of Assistive Technology (AT) for cognitively impaired persons.
A European attempt. Luiza Spiru, MD, PhD et al
Contribution of Ana Aslan Academy
as medical partner in the K4CARE project
1.
Collaboration in defining the Home Care Nuclear Structures (HCNS) and the actors involved
All rights reserved. No part of these slides can be reproduced, stocked or transmitted in no other form and through no other electronic, mechanic, or photocopy way, without the
approval of “Ana Aslan” International Academy of Aging®© “Ana Aslan” International Foundation ®© Brain Aging International Journal ®©.
The development of Assistive Technology (AT) for cognitively impaired persons.
A European attempt. Luiza Spiru, MD, PhD et al
Contribution of Ana Aslan Academy
as medical partner in the K4CARE project
Home Care (HC) is based upon the synergic actions of the actors : the assessment of the
problem, the definition of an Individual Intervention Plan, its accomplishment through the
proper procedures and the evaluation of results.
All rights reserved. No part of these slides can be reproduced, stocked or transmitted in no other form and through no other electronic, mechanic, or photocopy way, without the
approval of “Ana Aslan” International Academy of Aging®© “Ana Aslan” International Foundation ®© Brain Aging International Journal ®©.
The development of Assistive Technology (AT) for cognitively impaired persons.
A European attempt. Luiza Spiru, MD, PhD et al
Contribution of Ana Aslan Academy
as medical partner in the K4CARE project
3. Collaboration in defining the k4Care services
Access Services
organization of the actors and groups involved in the care of home patient
Patient Care Services
assessment of the problem, identification of patient’s needs, definition of the
individual intervention plan (IP), its accomplishment , the evaluation of results
Information Services
allow access to the information and the knowledge that the system contains, in
order to be used for services monitoring, social issues, clinical issues, health care
related topics
All rights reserved. No part of these slides can be reproduced, stocked or transmitted in no other form and through no other electronic, mechanic, or photocopy way, without the
approval of “Ana Aslan” International Academy of Aging®© “Ana Aslan” International Foundation ®© Brain Aging International Journal ®©.
The development of Assistive Technology (AT) for cognitively impaired persons.
A European attempt. Luiza Spiru, MD, PhD et al
Contribution of Ana Aslan Academy
as medical partner in the K4CARE project
4. Collaboration in defining the K4Care procedures
Procedure  the chain of events that leads an actor in performing actions to provide services.
Example: Problem Assessment and Re-evaluation Procedures
Comprehensive Assessment
Multi-Dimensional Evaluation
Clinical Assessment
Physical Examination
Request of Diagnostic Examination
Request of Laboratory Analysis
Consultation
Social Needs and Social Network Assessment
Follow-up
All rights reserved. No part of these slides can be reproduced, stocked or transmitted in no other form and through no other electronic, mechanic, or photocopy way, without the
approval of “Ana Aslan” International Academy of Aging®© “Ana Aslan” International Foundation ®© Brain Aging International Journal ®©.
The development of Assistive Technology (AT) for cognitively impaired persons.
A European attempt. Luiza Spiru, MD, PhD et al
Contribution of Ana Aslan Academy
as medical partner in the K4CARE project
Example: Intervention Plan Definition Procedures
Planning of Intervention Plan
Prescription of Pharmacological Treatment
Prescription of Non-Pharmacological Treatment
Prescription of Nursing Care
Prescription of Assistive Devices
All rights reserved. No part of these slides can be reproduced, stocked or transmitted in no other form and through no other electronic, mechanic, or photocopy way, without the
approval of “Ana Aslan” International Academy of Aging®© “Ana Aslan” International Foundation ®© Brain Aging International Journal ®©.
The development of Assistive Technology (AT) for cognitively impaired persons.
A European attempt. Luiza Spiru, MD, PhD et al
Contribution of Ana Aslan Academy
as medical partner in the K4CARE project
5. Collaboration in elaborating the K4Care documents to support the actors in the delivering of services
Examples:
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
Actor Assignment
Actor Confirmation
Patient Consent
Multidimentional Evaluation Scales
Natural history
Physical Examination Report
Request of Diagnostic Examination
Request of Laboratory Analysis
Request of Consultation
Consultation Report
Social Report
Medical follow-up form
Nursing follow-up form
Prescription of Pharmacological Treatment
Prescription of Non-Pharmacological Treatment
Prescription of nursing care
All rights reserved. No part of these slides can be reproduced, stocked or transmitted in no other form and through no other electronic, mechanic, or photocopy way, without the
approval of “Ana Aslan” International Academy of Aging®© “Ana Aslan” International Foundation ®© Brain Aging International Journal ®©.
The development of Assistive Technology (AT) for cognitively impaired persons.
A European attempt. Luiza Spiru, MD, PhD et al
Contribution of Ana Aslan Academy
as medical partner in the K4CARE project
6. Specific Collaboration to the MultiDimensional Evaluation
based on a selected set of standardized evaluation scales largely accepted and used by international
teams for clinical, care and research purposes
Evaluation Scales I level
Evaluation Scales II level Cognitive Impairment
Barthel Index
Instrumental Activities Of Daily Living Scale (IADL)
Mini Mental State Examination (MMSE)
Mini Nutritional Assessment (MNA)
Tinetti Static Scale
Yesavage Geriatric Depression Scale (GDS)
GBS
Digit span
Clock Drawing Test (CDT)
Addenbrooke’s Cognitive Examination (ACE-R)
Neuropsychiatry Inventory (NPI-Q)
Norton Scale
Evaluation Scales II level Immobility Syndrome
Modified Cumulative Illness Rating Scale (CIRS)
Home Assessment Checklist
Social Assessment Scale
SF-36
Rivermead Mobility Index (RMI)
Canadian Neurological Scale (CNS)
Motor Examination of Unified Parkinson’s Disease
Rating Scale (UPDRS)
Caregiver Burden Inventory (CBI)
Follow-up scales
CGIC-PF
Nursing Follow-up
All rights reserved. No part of these slides can be reproduced, stocked or transmitted in no other form and through no other electronic, mechanic, or photocopy way, without the
approval of “Ana Aslan” International Academy of Aging®© “Ana Aslan” International Foundation ®© Brain Aging International Journal ®©.
The development of Assistive Technology (AT) for cognitively impaired persons.
A European attempt. Luiza Spiru, MD, PhD et al
Contribution of Ana Aslan Academy
as medical partner in the K4CARE project
The number of patients provided by the K4CARE partners for EHCR data entry:
All rights reserved. No part of these slides can be reproduced, stocked or transmitted in no other form and through no other electronic, mechanic, or photocopy way, without the
approval of “Ana Aslan” International Academy of Aging®© “Ana Aslan” International Foundation ®© Brain Aging International Journal ®©.
The development of Assistive Technology (AT) for cognitively impaired persons.
A European attempt. Luiza Spiru, MD, PhD et al
Contribution of Ana Aslan Intl. Academy of Aging
to the K4CARE and SHARE-it projects’ dissemination
Publications:
•
Knowledge-Base HomeCare eServices for an Aging Europe, K4CARE fact sheet, Brain Aging International
Journal, ISSN 1582-8352; Vol. 1, No. 1/2007, L. Spiru, K4Care group
•
Intelligent ambiance for the cognitively and physically impaired elderly. The European model;
Alzheimer's & Dementia: The Journal of the Alzheimer's Association, ISSN: 1552-5260, Vol: 4, Issue: 4,
Pages: T650-T650; Date: 2008-7, Luiza Spiru, Ileana Turcu, Ioana Ioancio, Costin Nuta, Camelia Ghita,
Mariana Martin, Mona Blaciotti, Ulises Cortes
•
Supported Human Autonomy for Recovery and Enhancement of cognitive and motor abilities using
information technologies - SHARE-it. Contribution as medical partner during the 1st year of project-2007;
Brain Aging International Journal; pg. 52-53, ISSN 1582-8352; no1/Sept 2008, Luiza Spiru
•
Legal concerns regarding AmI Assisted Living in the elderly, worldwide and in Romania, Proceedings of
The International Work Conference on Artificial Neural Networks, Salamanca, June 10-12th, 2009,
Lecture Notes in Computer Science (LNCS), ISSN: 1867-8211, Springer Verlag, 2009, Luiza Spiru, L
Stefan, I Turcu, C Ghita, Ulises Cortes
All rights reserved. No part of these slides can be reproduced, stocked or transmitted in no other form and through no other electronic, mechanic, or photocopy way, without the
approval of “Ana Aslan” International Academy of Aging®© “Ana Aslan” International Foundation ®© Brain Aging International Journal ®©.
The development of Assistive Technology (AT) for cognitively impaired persons.
A European attempt. Luiza Spiru, MD, PhD et al
Contribution of Ana Aslan Intl. Academy of Aging
to the K4CARE and SHARE-it projects’ dissemination
Publications:
•
Normal versus pathological cognitive aging. Variability as a constraint of patients profiling for AmI design,
Proceedings of The International Work Conference on Artificial Neural Networks, Salamanca, June 10-12th,
2009, Lecture Notes in Computer Science (LNCS), ISSN: 1867-8211, Springer Verlag, 2009, Luiza Spiru, C Ghita,
I Turcu, L Stefan, Ulises Cortes
•
AmI devices and their impact in the long term care of the cognitively impaired persons. A Romanian experience
and partnership.; EHB 2009 International Conference on E-HEALTH And Bioengineering, Sept. 17-18, 2009,
Constanta, Romania, WSEAS Press ISSN: 1790-5109, L. Spiru, I. Turcu, C. Ghita, L. Stefan
•
Ambient Assisted Living for the cognitively impaired elderly.Concepts, platforms and legal aspects.; EHB 2009
International Conference on E-HEALTH And Bioengineering, Sept. 17-18, 2009, Constanta, Romania, WSEAS
Press, ISSN: 1790-5109, L. Spiru, I. Turcu, C. Ghita, L. Stefan;
•
e-Health and Assistive Technology (AT) as suitable answers to global aging, Spiru Luiza, Turcu Ileana, Ioancio
Ioana, Nuta Costin, Ghita Camelia, Martin Mariana, Annicchiarico Roberta, Cortes Ulises, Riano David,
International Conference on Alzheimer’s Disease, Viena, 11.07 - 16.07.2009, Alzheimer's & Dementia, ISSN
1552-5260, June 2009
•
Concerns regarding legislation and ethics related to AmI Assisted Living (AAL) of cognitively impaired patients,
Luiza Spiru, Ileana Turcu, 13th Congress of the European Federation of Neurological Societies – EFNS 2009,
Sept. 12-15, 2009, Florenta, European Journal of Neurology, ISSN: 1468-1331
All rights reserved. No part of these slides can be reproduced, stocked or transmitted in no other form and through no other electronic, mechanic, or photocopy way, without the
approval of “Ana Aslan” International Academy of Aging®© “Ana Aslan” International Foundation ®© Brain Aging International Journal ®©.
ANA ASLAN
INTERNATIONAL
ACADEMY OF AGING
Healthy
Brain Aging
ANA ASLAN
INTERNATIONAL
FOUNDATION
Thank you for attention
and your feedback
Healthy Aging
Luiza Spiru, MD, PhD