ANA ASLAN INTERNATIONAL ACADEMY OF AGING ANA ASLAN

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, Ph. D The 19 th Alzheimer Europe Conference 28 -30. 05. 2009 Brussels Topic: "Quality of life" “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 Camelia Ghita, MD; Ioana Ioancio, MD; Costin Nuta, MD; Psychol. Mona Blacioti; Mariana Martin; Lucian Stefan, MD, Ileana Turcu, Ph. D 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, Ph. D 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 n 0 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, Ph. D 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. 12 b) provision of supportive environments for the elderly (Art. 14) provision of self-fulfillment and well-being opportunities in late life (Art. 12 d) provision of health care, support and social protection (Art. 12 j) focus of research & technology on the individual, social and health implications of ageing (Art. 12 j) 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, Ph. D 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, Ph. D 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, Ph. D 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, Ph. D 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, Ph. D 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, Ph. D 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. e. Inclusion@EU, Strengthening e. Inclusion & e. Accessibility across Europe, IST-502553, http: //www. empirica. com/themen/einclusion/documents/e. Inclusion_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, Ph. D 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, Ph. D 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, Ph. D 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, Ph. D et al Two basic forms of home automation systems for the elderly: q embedded Health Systems integrate sensors and microprocessors in appliances, furniture and clothing, in order to collect data for disease diagnosis and risk patterns recognition q 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, Ph. D 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, Ph. D 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, Ph. D 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, Ph. D 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) for cognitively impaired persons. A European attempt. Luiza Spiru, MD, Ph. D et The development of Assistive al

The development of Assistive Technology (AT) for cognitively impaired persons. A European attempt. Luiza Spiru, MD, Ph. D 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, Ph. D et al Contribution of Ana Aslan International Academy of Aging as medical partner in the European FP 6 -2006 -IST-6 Projects K 4 CARE 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, Ph. D et al Main principles of cooperation q q 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, Ph. D 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, Ph. D et al SHARE-it Project § A STREP project co-funded in the EU's FP 6, in the IST (Information Society Technologies) Thematic Priority, project number FP 6 -045088, Contract number 045088, started on 1 st 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, Ph. D 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, Ph. D 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, Ph. D 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, Ph. D 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, Ph. D 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, Ph. D 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, Ph. D 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, Ph. D 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, Ph. D 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, Ph. D 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, Ph. D 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, Ph. D et al Knowledge-Based Homecare e. Services for an Ageing Europe K 4 CARE IST-2004 -026968 www. k 4 care. 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, Ph. D et al K 4 CARE Project –A STREP project co-funded in the EU's FP 6, 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, Ph. D 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, Ph. D et al K 4 CARE 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, Ph. D et al K 4 CARE objectives § Generate a new ICT Sanitary Model (K 4 CARE 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 K 4 Care 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 K 4 Care platform through pilots on west (Italy, UK) and east (Czech Rep. , Romania, Hungary) areas. § To elaborate the K 4 Care EHCR (Electronic Health-Care Record) containing information about physicians, patients, citizens and other agents involved in the K 4 CARE 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, Ph. D et al K 4 CARE scientific objectives § Define the K 4 CARE 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 K 4 CARE 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, Ph. D et al K 4 CARE fundamental outcomes § Integrate information of different types and from different sources, whilst ensuring private and customized data access § Define the K 4 Care 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 K 4 Care Formal Intervention Plans (FIPs) § Configure a knowledge-based decision support tool to supply e. Services 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, Ph. D et al Contribution of Ana Aslan Academy as medical partner in the K 4 CARE 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, Ph. D et al Contribution of Ana Aslan Academy as medical partner in the K 4 CARE 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, Ph. D et al Contribution of Ana Aslan Academy as medical partner in the K 4 CARE project 3. Collaboration in defining the k 4 Care 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, Ph. D et al Contribution of Ana Aslan Academy as medical partner in the K 4 CARE project 4. Collaboration in defining the K 4 Care 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, Ph. D et al Contribution of Ana Aslan Academy as medical partner in the K 4 CARE 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, Ph. D et al Contribution of Ana Aslan Academy as medical partner in the K 4 CARE project 5. Collaboration in elaborating the K 4 Care 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 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, Ph. D et al Contribution of Ana Aslan Academy as medical partner in the K 4 CARE project 6. Specific Collaboration to the Multi. Dimensional 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, Ph. D et al Contribution of Ana Aslan Academy as medical partner in the K 4 CARE project The number of patients provided by the K 4 CARE 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, Ph. D et al Contribution of Ana Aslan Intl. Academy of Aging to the K 4 CARE and SHARE-it projects’ dissemination Publications: • Knowledge-Base Home. Care e. Services for an Aging Europe, K 4 CARE fact sheet, Brain Aging International Journal, ISSN 1582 -8352; Vol. 1, No. 1/2007, L. Spiru, K 4 Care 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: T 650 -T 650; 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 1 st year of project-2007; Brain Aging International Journal; pg. 52 -53, ISSN 1582 -8352; no 1/Sept 2008, Luiza Spiru • Legal concerns regarding Am. I Assisted Living in the elderly, worldwide and in Romania, Proceedings of The International Work Conference on Artificial Neural Networks, Salamanca, June 10 -12 th, 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, Ph. D et al Contribution of Ana Aslan Intl. Academy of Aging to the K 4 CARE and SHARE-it projects’ dissemination Publications: • Normal versus pathological cognitive aging. Variability as a constraint of patients profiling for Am. I design, Proceedings of The International Work Conference on Artificial Neural Networks, Salamanca, June 10 -12 th, 2009, Lecture Notes in Computer Science (LNCS), ISSN: 1867 -8211, Springer Verlag, 2009, Luiza Spiru, C Ghita, I Turcu, L Stefan, Ulises Cortes • Am. I 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 Am. I Assisted Living (AAL) of cognitively impaired patients, Luiza Spiru, Ileana Turcu, 13 th 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, Ph. D