Occupational Therapy News OTnews February 2020 | Page 25

TECHNOLOGY FEATURE pressure drops or if there are changes to someone’s VO2 values. This has been reported to be particularly helpful for those with heart and respiratory conditions and has empowered patients to take charge of their conditions and become more aware of changes as well as their baseline information. Falls detector: Working much like a traditional falls alarm, the Apple Watch can detect a fall, ask the person if they are fine, and give the option to contact emergency services. There is also the option to include an automatic call for help, which will be triggered if the person fails to respond. The 3G versions also have the option to call or message friends and family without the need for the phone, which allows a person to seek family help if they require it. Sleep and rest monitoring: A person’s sleep patterns and quality of sleep can be monitored with devices, including the ability to show how many hours a day a person is active for and what times of day. This could be useful if a person is reporting chronic fatigue, or highlighting any confusion over day/night for those with dementia, or issues in this area. Again a tool to start a conversation or investigation. Home environment: Information such as noise and temperature levels within the home can be monitored on some devices, along with their impact on the body allowing for adjustment if required. Options to record how many flights someone walks up may show someone is not going upstairs and the need for a home visit to establish why. GPS tracking: The 3G models of devices can record a person’s location, which can allow for easy recovery for emergency services or a concerned family member. The use of this to ‘track’ a person who wanders, or with dementia, throws up some ethical considerations, but no more than with traditional tools such as the Pebble. Reminders and alarms: These can be set up to remind a person to stretch, stand up, take their medication, drink or check in with a family member. The options are endless and on the Apple Watch Gelonch et al (2019) conducted an exploratory study, involving nine older adults with mild cognitive impairment (MCI) and their caregivers, to evaluate the acceptability of a lifelogging wearable camera to support memory. The mixed-method design comprised a self-report questionnaire, images recorded and downloaded each day, and focus group discussions. Findings included: people with MCI exhibited a good level of acceptance of the camera and downloaded an appropriate number of images; but some felt embarrassed or concerned about comments the camera might provoke. The authors conclude wearable cameras can be used by older adults with MCI when accompanied by a well-structured programme with specially adapted material, and they suggest privacy concerns are outweighed by potential benefits for memory. The data these devices gather can be downloaded into report format, which can be shared with a person’s health professional. This supports for comparisons to be drawn and the potential detection of any early warning signs allowing preventative intervention to be taken. Below are just some of the potential ways these tools could be used. Changes in activity levels: Apple has introduced a trends feature to its watch. This feature tracks someone’s activity levels for a three-month period and reports on whether the trend has improve or declined. This information could show that someone’s activity has declined or changed, or perhaps they have reduced motivation or increased pain, which is impacting on their mobility. This information could be used as a conversation starter to unpick and investigate any potential underlying causes. Medical alerts: There are options to set up alert systems, for example to report if the heart rate passes a certain level, blood Reference Gelonch O, Ribera M, Codern-Bové N, Ramos S, Quintana M, Chico G … Garolera M (2019) Acceptability of a lifelogging wearable camera in older adults with mild cognitive impairment: a mixed-method study. BMC Geriatrics, 19: 110, 1-10. doi: 10.1186/s12877-019-1132-0 can be programmed to give a short visual message or audio clip depending on the need. Where to next? Apple has teamed up with a pharmaceutical company on a study to explore how a watch app can accelerate the diagnosis of atrial fibrillation, a leading cause of stroke. A research team at the Open University has recently been awarded £40 million by the Economic and Social Research Council to study the impact of wearable technology on the wellbeing and quality of life for older adults and their carers. And this may well just be the tip of the iceberg, as there is clear evidence to suggest that this type of technology is not a fad and that it will likely continue to expand and develop. As with any assistive technology, considerations need to be made with regard to provision, use, data ownership and the accuracy of the information being collected. Can a smart watch replace a trained clinician and face-to-face assessment? No. You may recall an article last year in the Guardian that reported occupational therapy was on the list of professions that were least likely to be taken over by robots, so I think we are safe. However, it does give our patients another tool to take control of their own health and wellbeing and offer us an insight into their daily health that we may not have otherwise seen. Kirstie Hughes is an occupational therapist based in Warwickshire. Her professional interests include social media and accessible tools and technology for CPD and learning. You can contact Kirstie on Twitter @Kirstie_OT or email [email protected] OTnews February 2020 25