INDEPENDENCE FOR DAILY LIVING

Rakel Poveda Puente^(1), Ricard Barberà i Guillem^(1), Heidrun Becker^(2), Inge Schädler^(3), Arno Wienholtz^(4), Miguel Ramírez^(5).

1.  IBV:Instituto de Biomecánica de Valencia

2.  ZHAW:Zürcher Hochschule für Angewandte Wissenschaften

3.  VASOS Vereinigung aktiver Senioren- und Selbsthilfe-Organisationen der Schweiz

4.  KASSA:Kaasa health GmbH

5.  CPMTI:Centro de Producción Multimedia para la Televisión Interactiva S.L.

The WETAKECARE project is funded by the AAL European Program (Call AAL -2012- 5 ref :AAL -2012- 5-036) and the Spanish Ministry of Industry, Energy and Tourism. It began in June 2013 and has a duration of three years.
The main objective of the project is to empower older persons and their caregivers in healthy self-care and promotion of independent living, through the development of an interactive, multimodal system for training the Activities of Daily Living (ADL).

The target group of the system is people over 50 years, with mild to moderate loss of functional capabilities. WETAKECARE fosters autonomous performance of ADL by the older person during training and helps the caregiver in providing support. As a result, the quality of care received is improved and the carer welfare is also safeguarded.
IBV coordinates this project, which involves a total number of five partners from Spain, Germany and Switzerland. The background of the partners includes research in gerontology, ICT development and older persons.
During the first year, the work has focused on the definition of criteria for usability and accessibility of the interface and the identification of the ADL that are more difficult for the family caregiver – older person binomial. In addition, several profiles and scenarios based on the functional characteristics, social-emotional and physical environment to which the ecosystem WETAKECARE addresses have been defined.

INTRODUCTION

The biological aging process leads to a reduction of functional capability that varies with each person and stage of life.

The reduction in range of movement, muscle strength or sensory capabilities leads to difficulties when performing Activities of Daily Living (ADL), whether these are basic or instrumental. According to different studies, between 6.8% and 14.1% of the adult population has a mild to moderate physical limitation that hinders their ability to carry out ADLs independently. This situation is exacerbated by the onset of disabilities resulting from falls, strokes, illnesses or environments that are inadequate for the person’s new functional reality. The difficulty faced by the older person in performing ADLs usually results in them being left or done badly and eventually being carried out by a family carer. Caring for the older person and carrying out ADLs can overload the carer and have a negative impact on their physical and psychological health.

The main objective of the WETAKECARE project is to train older persons and their carers in healthy self-care and encourage independent living by developing an interactive and multimodal system for ADL training.

The system is aimed at people over 50 years of age with a mild to moderate loss of functional capabilities. The training function proposed aims to encourage older persons to carry out ADLs independently, while at the same time supporting carers in the performance of their duties. Thus, the quality of care received is improved and the carer’s welfare is safeguarded.

The development of WETAKECARE is based on the use of different devices such as the TV, Kinect, PC, Tablet and Smartphone. The system’s functionalities will be: gestural exercises for ADLs controlled with the Microsoft Kinect system, a web platform with courses, workshops and links to major blogs, forums and social media, calendar and reminders, etc.

This project is being coordinated by the IBV and includes the participation of a total of five partners from Spain, Germany and Switzerland. The partners’ specialized fields include research in gerontology, ICT development and older persons.

DEVELOPMENT

The project consists of six work phases. The first, carried out during the first few months, and presented here, has the following main objectives: to identify the needs and difficulties of older persons and their non-professional carers in performing ADLs and to define the best strategies to support them with the WETAKECARE system. All of this follows a comprehensive user-centered approach.

This first phase of the project involved a review of the bibliography, an analysis of four databases and discussion groups with older persons, carers and professionals.

The databases used were: The German Aging Survey (DEAS), the Austrian Health Interview Survey 2007, the Survey of Health, Aging and Retirement in Europe, the Swiss Household Panel (SHP) and the Assessment of Motor and Process Skills (AMPS).

Six discussion groups have been created, as shown in table 1.

   Table 1: Breakdown of discussion group participants.

As a result of the review and discussion groups, a list of the most important ADLs was obtained and these were then prioritized by a group of experts made up of three occupational therapists and a social scientist.

In order to conceptualize the WETAKECARE program and define the environments for use and type of end-user profiles, PERSONAL and SCENARIO techniques were used, applied to an innovation workshop in which all members of the consortium took part. The results of this phase were presented, discussed and finally approved by the project’s review-advisory group, which is made up of older persons and experts from the gerontology sector.

PRELIMINARY RESULTS

Many of the problems identified when performing ADLs are related to complex tasks such as climbing stairs, lifting, carrying or moving heavy objects.

There are cultural and gender differences when identifying the ADLs that cause the greatest difficulties. For example, a higher percentage of Spanish respondents report more difficulties than German-speaking respondents and a higher percentage of women have difficulties performing tasks that demand motor skills, with the exception of domestic chores such as cooking or doing laundry.

The information analyzed in the databases was confirmed in the discussion groups, and the main results are as follows:

♦ Most problematic ADLs:From a complete list of ADLs, 15 were prioritized as very important and 5 as important. Bodily functions such as resistance, mobility, strength, balance and coordination were also rated as important because they support the maintenance of performance and independence. For each activity it was determined whether it would be possible to develop exercises, strategies and/or devices to support the performance of ADLs.In Spain, the basic ADLs such as eating, drinking, bathing and going to the toilet are identified as difficult. Among the Swiss population those related to movement, getting dressed, cleaning and preparing food were identified as the most problematic.

♦ Analysis of the older person – carer interaction.In all the cases the idea of a joint system was well received. The carers want to be relieved of their daily care burden through relaxing activities and looking after their own health.

♦ Motivation through fun.The crucial aspects established for the success of the WETAKECARE system include particularly the need to increase motivation to use it through relaxation exercises, strategies for integrating exercises and products that facilitate daily life (for example, reports with positive feedback).

♦ Suitability of the user and carer profile.The system needs to be adapted to the characteristics and expectations of users and their carers. To address this need, 8 profile types and 4 scenarios have been defined that include basic aspects related to identification data, history and lifestyle, main activities of daily living and problems in performing them, as well as expectations and motivations for using the system. The first step in using the system will include its customization based on these important aspects.

♦ Suitability of the system’s usability and accessibility.Specific criteria for usability and accessibility have been generated and will be implemented in developing WETAKECARE. These will ensure its proper use in terms of the ICT knowledge and functional diversity of the system’s potential users.

The methodology based on the active participation of older persons with ADL limitations and their carers during the first phase of the project has helped to define the needs, demands and characteristics that will underpin the technological and content development of the WETAKECARE system. This ensures that the implementation conforms to the actual expectations of older persons and their carers.

For more information, visit http://www.wetakecare.ibv.org/

ACKNOWLEDGMENTS

We would like to thank the older persons, their families, the organizations taking part in the project and especially the Office for Older Persons in Mislata for their dedication and active involvement in the project.

The WETAKECARE project is funded by the AAL European Program (Call AAL -2012- 5 ref :AAL -2012- 5-036) and the Spanish Ministry of Industry, Energy and Tourism. It began in June 2013 and has a duration of three years.