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. 2024 Mar 12;24(1):71.
doi: 10.1186/s12911-024-02468-5.

Implementation difficulties and solutions for a smart-clothes assisted home nursing care program for older adults with dementia or recovering from hip fracture

Chung-Chih Lin  1 , Ching-Tzu Yang  2 , Pei-Ling Su  2 , Jung-Ling Hsu  3   4 , Yea-Ing L Shyu  5   6   7   8   9 , Wen-Chuin Hsu  3   4
Affiliations

Implementation difficulties and solutions for a smart-clothes assisted home nursing care program for older adults with dementia or recovering from hip fracture

Chung-Chih Lin et al. BMC Med Inform Decis Mak. .

Abstract

Background: Wearable devices have the advantage of always being with individuals, enabling easy detection of their movements. Smart clothing can provide feedback to family caregivers of older adults with disabilities who require in-home care.

Methods: This study describes the process of setting up a smart technology-assisted (STA) home-nursing care program, the difficulties encountered, and strategies applied to improve the program. The STA program utilized a smart-vest, designed specifically for older persons with dementia or recovering from hip-fracture surgery. The smart-vest facilitated nurses' and family caregivers' detection of a care receiver's movements via a remote-monitoring system. Movements included getting up at night, time spent in the bathroom, duration of daytime immobility, leaving the house, and daily activity. Twelve caregivers of older adults and their care receiver participated; care receivers included persons recovering from hip fracture (n = 5) and persons living with dementia (n = 7). Data about installation of the individual STA in-home systems, monitoring, and technical difficulties encountered were obtained from researchers' reports. Qualitative data about the caregivers' and care receivers' use of the system were obtained from homecare nurses' reports, which were explored with thematic analysis.

Results: Compiled reports from the research team identified three areas of difficulty with the system: incompatibility with the home environment, which caused extra hours of manpower and added to the cost of set-up and maintenance; interruptions in data transmissions, due to system malfunctions; and inaccuracies in data transmissions, due to sensors on the smart-vest. These difficulties contributed to frustration experienced by caregivers and care receivers.

Conclusions: The difficulties encountered impeded implementation of the STA home nursing care. Each of these difficulties had their own unique problems and strategies to resolve them. Our findings can provide a reference for future implementation of similar smart-home systems, which could facilitate ease-of-use for family caregivers.

Keywords: Dementia; Hip fracture; Home health; Remote monitoring; Smart care; Smart clothing; Wearable device.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Views of the smart vest with the four locations for the sensors: cervical spine, upper abdomen, body mass center, and both sides of the waist (I, II, III, and IV, respectively) The images on the far right show the conductive knitted fabric containing the buckle used to secure the vest and complete the circuit
Fig. 2
Fig. 2
Illustration of the smart technology-assisted home health care system
See this image and copyright information in PMC

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