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Lussier M, Couture M, Giroux S, Aboujaoudé A, Ngankam HK, Pigot H, Gaboury S, Bouchard K, Bottari C, Belchior P, Paré G, Bier N. Codevelopment and Deployment of a System for the Telemonitoring of Activities of Daily Living Among Older Adults Receiving Home Care Services: Protocol for an Action Design Research Study. JMIR Res Protoc 2024; 13:e52284. [PMID: 38422499 PMCID: PMC10940984 DOI: 10.2196/52284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 01/22/2024] [Accepted: 01/24/2024] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND Telemonitoring of activities of daily living (ADLs) offers significant potential for gaining a deeper insight into the home care needs of older adults experiencing cognitive decline, particularly those living alone. In 2016, our team and a health care institution in Montreal, Quebec, Canada, sought to test this technology to enhance the support provided by home care clinical teams for older adults residing alone and facing cognitive deficits. The Support for Seniors' Autonomy program (SAPA [Soutien à l'autonomie des personnes âgées]) project was initiated within this context, embracing an innovative research approach that combines action research and design science. OBJECTIVE This paper presents the research protocol for the SAPA project, with the aim of facilitating the replication of similar initiatives in the future. The primary objectives of the SAPA project were to (1) codevelop an ADL telemonitoring system aligned with the requirements of key stakeholders, (2) deploy the system in a real clinical environment to identify specific use cases, and (3) identify factors conducive to its sustained use in a real-world setting. Given the context of the SAPA project, the adoption of an action design research (ADR) approach was deemed crucial. ADR is a framework for crafting practical solutions to intricate problems encountered in a specific organizational context. METHODS This project consisted of 2 cycles of development (alpha and beta) that involved cyclical repetitions of stages 2 and 3 to develop a telemonitoring system for ADLs. Stakeholders, such as health care managers, clinicians, older adults, and their families, were included in each codevelopment cycle. Qualitative and quantitative data were collected throughout this project. RESULTS The first iterative cycle, the alpha cycle, took place from early 2016 to mid 2018. The first prototype of an ADL telemonitoring system was deployed in the homes of 4 individuals receiving home care services through a public health institution. The prototype was used to collect data about care recipients' ADL routines. Clinicians used the data to support their home care intervention plan, and the results are presented here. The prototype was successfully deployed and perceived as useful, although obstacles were encountered. Similarly, a second codevelopment cycle (beta cycle) took place in 3 public health institutions from late 2018 to late 2022. The telemonitoring system was installed in 31 care recipients' homes, and detailed results will be presented in future papers. CONCLUSIONS To our knowledge, this is the first reported ADR project in ADL telemonitoring research that includes 2 iterative cycles of codevelopment and deployment embedded in the real-world clinical settings of a public health system. We discuss the artifacts, generalization of learning, and dissemination generated by this protocol in the hope of providing a concrete and replicable example of research partnerships in the field of digital health in cognitive aging. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR1-10.2196/52284.
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Affiliation(s)
- Maxime Lussier
- Centre de recherche de l'Institut universitaire de gériatrie de Montréal, Université de Montréal, Montreal, QC, Canada
- École de réadaptation, Faculté de médecine, Université de Montréal, Montréal, QC, Canada
| | - Mélanie Couture
- Centre for Research and Expertise in Social Gerontology, Integrated Health and Social Services University Network for West-Central Montreal, Côte- Saint-Luc, QC, Canada
- School of Social Work, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Sylvain Giroux
- Computer Science Department, Faculty of Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Aline Aboujaoudé
- Centre de recherche de l'Institut universitaire de gériatrie de Montréal, Université de Montréal, Montreal, QC, Canada
- École de réadaptation, Faculté de médecine, Université de Montréal, Montréal, QC, Canada
| | - Hubert Kenfack Ngankam
- Computer Science Department, Faculty of Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Hélène Pigot
- Computer Science Department, Faculty of Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Sébastien Gaboury
- Department of Mathematics and Computer Science, Université du Québec à Chicoutimi, Chicoutimi, QC, Canada
| | - Kevin Bouchard
- Department of Mathematics and Computer Science, Université du Québec à Chicoutimi, Chicoutimi, QC, Canada
| | - Carolina Bottari
- École de réadaptation, Faculté de médecine, Université de Montréal, Montréal, QC, Canada
| | - Patricia Belchior
- Centre de recherche de l'Institut universitaire de gériatrie de Montréal, Université de Montréal, Montreal, QC, Canada
- School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
| | - Guy Paré
- Research Chair in Digital Health, HEC Montréal, Montréal, QC, Canada
| | - Nathalie Bier
- Centre de recherche de l'Institut universitaire de gériatrie de Montréal, Université de Montréal, Montreal, QC, Canada
- École de réadaptation, Faculté de médecine, Université de Montréal, Montréal, QC, Canada
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Tannou T, Lihoreau T, Couture M, Giroux S, Wang RH, Spalla G, Zarshenas S, Gagnon-Roy M, Aboujaoudé A, Yaddaden A, Morin L, Bier N. Is research on 'smart living environments' based on unobtrusive technologies for older adults going in circles? Evidence from an umbrella review. Ageing Res Rev 2023; 84:101830. [PMID: 36565962 DOI: 10.1016/j.arr.2022.101830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 12/17/2022] [Accepted: 12/19/2022] [Indexed: 12/24/2022]
Abstract
CONTEXT AND AIMS To enable ageing in place, innovative and integrative technologies such as smart living environments may be part of the solution. Despite extensive published literature reviews on this topic, the effectiveness of smart living environments in supporting ageing in place, and in particular involving unobtrusive technologies, remains unclear. The main objective of our umbrella review was to synthesize evidence on this topic. METHODS According to the PRIOR process, we included reviews from multiple databases that focused on unobtrusive technologies used to analyze and share information about older adults' behaviors and assessed the effectiveness of unobtrusive technologies to support ageing in place. Selection, extraction and quality appraisal were done independently by two reviewers. RESULTS By synthesizing 17 published reviews that covered 191 distinct primary studies, we found that smart living environments based on unobtrusive technologies had low to moderate effectiveness to support older adults to age in place. Effectiveness appears to be strongest in the recognition of activities of daily living. The results must, however, be interpreted in light of the low overall level of evidence, i.e., low methodological value of the primary studies and poor methodological quality of the literature reviews. Most reviews concluded that unobtrusive technologies are not mature enough for widespread adoption. CONCLUSION There is a necessity to support primary studies that can move beyond the proof-of-concept or pilot stages and expand scientific knowledge significantly on the topic. There is also an urgent need to publish high quality literature reviews to better support policy makers and funding agencies in the field of smart living environments.
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Affiliation(s)
- Thomas Tannou
- Centre de recherche de l'Institut Universitaire de Gériatrie de Montréal, CIUSSS Centre-sud-de l'île-de-Montréal, Montreal, Quebec, Canada; Service de Gériatrie, Besançon University Hospital, F-25000, France; Inserm CIC 1431, CHU Besançon, F-25000 Besançon, France; Laboratoire de Recherches Intégratives en Neurosciences et Psychologie Cognitive - UR LINC, UFC, UBFC, Besançon, France.
| | | | - Mélanie Couture
- Centre for Research and Expertise in Social Gerontology, CIUSSS West-Central Montreal, Côte Saint-Luc, Quebec, Canada
| | - Sylvain Giroux
- Laboratoire DOMUS, Université de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Rosalie H Wang
- Department of Occupational Science & Occupational Therapy, University of Toronto, Toronto, Ontario, Canada
| | - Guillaume Spalla
- Centre de recherche de l'Institut Universitaire de Gériatrie de Montréal, CIUSSS Centre-sud-de l'île-de-Montréal, Montreal, Quebec, Canada; Laboratoire DOMUS, Université de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Sareh Zarshenas
- Department of Occupational Science & Occupational Therapy, University of Toronto, Toronto, Ontario, Canada
| | - Mireille Gagnon-Roy
- Centre de recherche de l'Institut Universitaire de Gériatrie de Montréal, CIUSSS Centre-sud-de l'île-de-Montréal, Montreal, Quebec, Canada; Ecole de réadaptation, Université de Montréal, Montreal, Quebec, Canada; Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Institut universitaire sur la réadaptation en déficience physique de Montréal du CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Montreal, Quebec, Canada
| | - Aline Aboujaoudé
- Centre de recherche de l'Institut Universitaire de Gériatrie de Montréal, CIUSSS Centre-sud-de l'île-de-Montréal, Montreal, Quebec, Canada; Ecole de réadaptation, Université de Montréal, Montreal, Quebec, Canada
| | - Amel Yaddaden
- Centre de recherche de l'Institut Universitaire de Gériatrie de Montréal, CIUSSS Centre-sud-de l'île-de-Montréal, Montreal, Quebec, Canada; Ecole de réadaptation, Université de Montréal, Montreal, Quebec, Canada
| | - Lucas Morin
- Inserm CIC 1431, CHU Besançon, F-25000 Besançon, France
| | - Nathalie Bier
- Centre de recherche de l'Institut Universitaire de Gériatrie de Montréal, CIUSSS Centre-sud-de l'île-de-Montréal, Montreal, Quebec, Canada; Ecole de réadaptation, Université de Montréal, Montreal, Quebec, Canada
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Pinard S, Bottari C, Laliberté C, Pigot H, Olivares M, Couture M, Aboujaoudé A, Giroux S, Bier N. Development of an Assistive Technology for Cognition to Support Meal Preparation in Severe Traumatic Brain Injury: User-Centered Design Study. JMIR Hum Factors 2022; 9:e34821. [PMID: 35925663 PMCID: PMC9389386 DOI: 10.2196/34821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 04/29/2022] [Accepted: 06/13/2022] [Indexed: 11/17/2022] Open
Abstract
Background Although assistive technology for cognition (ATC) has enormous potential to help individuals who have sustained a severe traumatic brain injury (TBI) prepare meals safely, no ATC has yet been developed to assist in this activity for this specific population. Objective This study aims to conduct a needs analysis as a first step in the design of an ATC to support safe and independent meal preparation for persons with severe TBI. This included identifying cooking-related risks to depict future users’ profiles and establishing the clinical requirements of the ATC. Methods In a user-centered design study, the needs of 3 future users were evaluated in their real-world environments (supported-living residence) using an ecological assessment of everyday activities, a review of their medical files, a complete neuropsychological test battery, individual interviews, observational field notes, and log journals with the residents, their families, and other stakeholders from the residence (eg, staff and health professionals). The needs analysis was guided by the Disability Creation Process framework. Results The results showed that many issues had to be considered for the development of the ATC for the 3 residents and other eventual users, including cognitive issues such as distractibility and difficulty remembering information over a short period of time and important safety issues, such as potential food poisoning and risk of fire. This led to the identification of 2 main clinical requirements for the ATC: providing cognitive support based on evidence-based cognitive rehabilitation to facilitate meal preparation and ensuring safety at each step of the meal preparation task. Conclusions This needs analysis identified the main requirements for an ATC designed to support meal preparation for persons with severe TBI. Future research will focus on implementing the ATC in the residence and evaluating its usability.
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Affiliation(s)
- Stéphanie Pinard
- École de réadaptation, Université de Montréal, Montréal, QC, Canada.,Centre de réadaptation Estrie, CIUSSS de l'Estrie-CHUS, Sherbrooke, QC, Canada
| | - Carolina Bottari
- École de réadaptation, Université de Montréal, Montréal, QC, Canada.,Centre de recherche interdisciplinaire en réadaptation du Montréal Métropolitain, Institut universitaire sur la réadaptation en déficience physique de Montréal, CIUSSS Centre-Sud-de-l'Île de Montréal, Montréal, QC, Canada
| | - Catherine Laliberté
- DOMUS Laboratory, Department of Computer Science, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Hélène Pigot
- DOMUS Laboratory, Department of Computer Science, Université de Sherbrooke, Sherbrooke, QC, Canada.,Centre de recherche sur le vieillissement, CIUSSS de l'Estrie-CHUS, Sherbrooke, QC, Canada
| | - Marisnel Olivares
- DOMUS Laboratory, Department of Computer Science, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Mélanie Couture
- Centre for Research and Expertise in Social Gerontology, CIUSSS West-Central-of-Montreal, Côte Saint-Luc, QC, Canada.,Department of Psychology, Université de Sherbooke, Sherbrooke, QC, Canada
| | - Aline Aboujaoudé
- École de réadaptation, Université de Montréal, Montréal, QC, Canada.,Research Center, Institut universitaire de gériatrie de Montréal, CIUSSS Centre-Sud-de-l'Île de Montréal, Montréal, QC, Canada
| | - Sylvain Giroux
- DOMUS Laboratory, Department of Computer Science, Université de Sherbrooke, Sherbrooke, QC, Canada.,Centre de recherche sur le vieillissement, CIUSSS de l'Estrie-CHUS, Sherbrooke, QC, Canada
| | - Nathalie Bier
- École de réadaptation, Université de Montréal, Montréal, QC, Canada.,Research Center, Institut universitaire de gériatrie de Montréal, CIUSSS Centre-Sud-de-l'Île de Montréal, Montréal, QC, Canada
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Aboujaoudé A, Couture M, Moreau M, Lussier M, Laliberté C, Bottari C, Giroux S, Belchior P, Paré G, Bier N. The challenges of aging in place for older adults at risk of self‐neglect and expectations regarding smart environments: Perspectives of older adults and their caregivers. Alzheimers Dement 2021. [DOI: 10.1002/alz.054232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Aline Aboujaoudé
- Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal (CRIUGM) Montreal QC Canada
| | - Mélanie Couture
- Centre for Research and Expertise in Social Gerontology Côte St‐Luc QC Canada
| | | | - Maxime Lussier
- Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal (CRIUGM) Montreal QC Canada
- University of Montreal Montreal QC Canada
| | | | | | | | - Patricia Belchior
- Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal (CRIUGM) Montreal QC Canada
- McGill University Montreal QC Canada
| | | | - Nathalie Bier
- University of Montreal Montreal QC Canada
- Research Centre, Institut Universitaire de Gériatrie de Montréal Montreal QC Canada
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Lussier M, Aboujaoudé A, Couture M, Moreau M, Laliberté C, Giroux S, Pigot H, Gaboury S, Bouchard K, Belchior P, Bottari C, Paré G, Consel C, Bier N. Using Ambient Assisted Living to Monitor Older Adults With Alzheimer Disease: Single-Case Study to Validate the Monitoring Report. JMIR Med Inform 2020; 8:e20215. [PMID: 33185555 PMCID: PMC7695528 DOI: 10.2196/20215] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 08/10/2020] [Accepted: 09/26/2020] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Many older adults choose to live independently in their homes for as long as possible, despite psychosocial and medical conditions that compromise their independence in daily living and safety. Faced with unprecedented challenges in allocating resources, home care administrators are increasingly open to using monitoring technologies known as ambient assisted living (AAL) to better support care recipients. To be effective, these technologies should be able to report clinically relevant changes to support decision making at an individual level. OBJECTIVE The aim of this study is to examine the concurrent validity of AAL monitoring reports and information gathered by care professionals using triangulation. METHODS This longitudinal single-case study spans over 490 days of monitoring a 90-year-old woman with Alzheimer disease receiving support from local health care services. A clinical nurse in charge of her health and social care was interviewed 3 times during the project. Linear mixed models for repeated measures were used to analyze each daily activity (ie, sleep, outing activities, periods of low mobility, cooking-related activities, hygiene-related activities). Significant changes observed in data from monitoring reports were compared with information gathered by the care professional to explore concurrent validity. RESULTS Over time, the monitoring reports showed evolving trends in the care recipient's daily activities. Significant activity changes occurred over time regarding sleep, outings, cooking, mobility, and hygiene-related activities. Although the nurse observed some trends, the monitoring reports highlighted information that the nurse had not yet identified. Most trends detected in the monitoring reports were consistent with the clinical information gathered by the nurse. In addition, the AAL system detected changes in daily trends following an intervention specific to meal preparation. CONCLUSIONS Overall, trends identified by AAL monitoring are consistent with clinical reports. They help answer the nurse's questions and help the nurse develop interventions to maintain the care recipient at home. These findings suggest the vast potential of AAL technologies to support health care services and aging in place by providing valid and clinically relevant information over time regarding activities of daily living. Such data are essential when other sources yield incomplete information for decision making.
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Affiliation(s)
- Maxime Lussier
- Research Center of Institut universitaire de gériatrie de Montréal, Integrated Health and Social Services University Network for South-Central Montreal, Montreal, QC, Canada
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada
| | - Aline Aboujaoudé
- Research Center of Institut universitaire de gériatrie de Montréal, Integrated Health and Social Services University Network for South-Central Montreal, Montreal, QC, Canada
| | - Mélanie Couture
- Integrated Health and Social Services University Network for West-Central Montreal, Université de Sherbrooke, Sherbrooke, QC, Canada
- Department of Psychology, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Maxim Moreau
- Research Chair in Digital Health, High Commercial Studies of Montreal, Montreal, QC, Canada
| | - Catherine Laliberté
- Faculty of Sciences and Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Sylvain Giroux
- Faculty of Sciences and Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Hélène Pigot
- Faculty of Sciences and Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Sébastien Gaboury
- Department of Mathematics and Computer Science, Université du Québec à Chicoutimi, Chicoutimi, QC, Canada
| | - Kévin Bouchard
- Department of Mathematics and Computer Science, Université du Québec à Chicoutimi, Chicoutimi, QC, Canada
| | - Patricia Belchior
- Research Center of Institut universitaire de gériatrie de Montréal, Integrated Health and Social Services University Network for South-Central Montreal, Montreal, QC, Canada
- School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada
| | - Carolina Bottari
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada
| | - Guy Paré
- Research Chair in Digital Health, High Commercial Studies of Montreal, Montreal, QC, Canada
| | - Charles Consel
- Bordeaux Institute of Technology & Inria, Bordeaux, France
| | - Nathalie Bier
- Research Center of Institut universitaire de gériatrie de Montréal, Integrated Health and Social Services University Network for South-Central Montreal, Montreal, QC, Canada
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada
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Aboujaoudé A, Bier N, Lussier M, Ménard C, Couture M, Demers L, Auger C, Pigot H, Caouette M, Lussier-Desrochers D, Belchior P. Canadian Occupational Therapists' Use of Technology With Older Adults: A Nationwide Survey. OTJR (Thorofare N J) 2020; 41:67-79. [PMID: 33016216 DOI: 10.1177/1539449220961340] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
As rehabilitation specialists, occupational therapy practitioners play a gateway role regarding recommendation of various technologies for homecare. However, no study has investigated current occupational therapy practices concerning information and communication technology (ICT) for older adults in Canada. The objective of this study was to identify Canadian occupational therapists' (OTs) knowledge and practices of ICT with older adults as well as factors associated with its recommendation. A Canada-wide, cross-sectional, online survey was conducted. Of 387 OTs, only 12.4% reported recommending ICT in practice. ICTs supporting communication and cognition were the main types recommended. The reported barriers to use in practice differed between ICT familiar users and nonusers. Multivariate logistic regression analyses showed that clinicians with more years of clinical experience were more likely to recommend ICT. Clinicians' services, work environments, and client diagnosis were also factors associated with ICT recommendation. Additional research is needed to understand how to overcome barriers to ICT recommendation in OT practice.
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Affiliation(s)
- Aline Aboujaoudé
- McGill University, Montreal, Quebec, Canada.,CIUSSS-CSMTL site Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, Quebec, Canada
| | - Nathalie Bier
- CIUSSS-CSMTL site Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, Quebec, Canada.,Université de Montréal, Quebec, Canada
| | - Maxime Lussier
- CIUSSS-CSMTL site Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, Quebec, Canada.,Université de Montréal, Quebec, Canada
| | | | - Mélanie Couture
- Université de Sherbrooke, Quebec, Canada.,Centre for Research and Expertise in Social Gerontology, Montreal, Quebec, Canada
| | | | - Claudine Auger
- Université de Montréal, Quebec, Canada.,Center for Interdisciplinary Research in Rehabilitation of Greater Montreal, Quebec, Canada
| | | | | | | | - Patricia Belchior
- McGill University, Montreal, Quebec, Canada.,CIUSSS-CSMTL site Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, Quebec, Canada
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Aboujaoudé A, Belleudy P, Vauclin M. A numerical study of infiltration through crusted soils: Flat and other surface configurations. ACTA ACUST UNITED AC 1991. [DOI: 10.1016/0933-3630(91)90036-m] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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