Existing and Emerging Healthcare Devices for Elders to Use at Home

摘要

Novel ways to meet everyday needs. Technology has long been an integral part of healthcare delivery, enabling clinicians to use increasingly sophisticated tools to detect, diagnose, monitor, and treat life's ailments. From simple mechanical devices such as syringes to complex systems involving magnetic resonance imaging or state-of-the-art surgical robotics, a tremendous array of health-related technologies is available today. Most of these technologies reside in the clinical arena-in hospitals, ambulatory care settings, and long-termcare facilities-where many healthcare providers and their patients use them. Over the past forty years, modified and ever smaller versions of technologies from the clinical arena have made their way into the home. Healthcare consumers and their family members have had to learn how to operate and maintain these devices, troubleshoot periodic malfunctions, and interpret device readings or responses. Clinicians, for their part, have had to provide guidance and encouragement about the effective and safe use of these devices on one's own. Within the past decade, the pace of technological innovation aimed particularly at addressing the everyday health needs of older adults has accelerated, prompted in large measure by several converging factors. These include the burgeoning aging population, rising healthcare costs and shorter hospital stays, greater emphasis on wellness, and growing consumer demand from an increasingly tech-savvy populace. In addition, computational devices of many different types and capabilities are becoming increasingly commonplace in both home and business settings, and networking protocols are being developed to enable information sharing among such diverse devices. Older adults represent a growing market segment with needs and capabilities that are often different from those of younger consumers. Many currently available healthcare devices require modification to ensure they can be used by older people. At the same time, researchers and entrepreneurs are inventing novel healthcare devices specifically aimed at preserving older adults' well-being, supporting their ability to engage in and take responsibility for recommended health behaviors, and extending their ability to remain functional and independent for as long as possible. REDEFINING HEALTHCARE DEVICES Existing and emerging technologies designed to promote positive health outcomes among older adults require an expanded view of what constitutes a healthcare device. Dishman, Matthews, and Dunbar-Jacob (2004) have proposed such a reconceptualization in a model that places all health-related technologies into categories for three dimensions: adaptation domain, level of prevention (according to public-health terminology), and site of operation. According to this model, a particular device could address one or several domains requiring adaptation, including health status, physical function, social interaction, and cognitive function. Further, the device could prevent a health problem from occurring in the first place (primary prevention), detect a previously undiagnosed health problem (secondary prevention), or help minimize morbidity and mortality from previously diagnosed disease (tertiary prevention). Finally, the device could be either personal-that is, worn, carried, implanted, or ingested- or based within an individual's living environment or at a distance from home. When a healthcare device is integral to a person or his surroundings, it functions within the context of the person's everyday life, unlike a device located in a traditional clinical setting. To address the myriad needs of older adults living in the community, technological solutions take many forms, ranging from safety features in the home that dynamically complement an individual's abilities to healthcare devices that accurately measure, communicate, and support health status, functional ability, and interaction with others. …