Tellus You Care
[U.S.-based Tellus] Introduction of health indicators to quantify the danger signs of individual elderly people, contributing to early intervention and health maintenance and improvement of about 60% of elderly people in facilities
～Announcement of a survey on behavioral characteristics of elderly people in facilities and their improvement revealed by our
high-performance radar～
Tellus You Care LLC, which provides monitoring services for nursing care facilities using technology, has developed its own
high-performance radar “Tellus Monitoring Sensor” (hereafter referred to as the Tellus device). We are pleased to inform you that we have conducted a survey on the behavioral characteristics of elderly people in facilities * 2 and their improvements in cooperation with customer facilities that introduce * 1, and announced it on June 1, 2023. The Ministry of Health, Labor and Welfare is expected to increase the demand for nursing care services in the FY2021 revision of long-term care fees (enforced on April 1, 2021). We are promoting initiatives based on scientific methods for service outcomes, etc. [1]In addition, in order to realize nursing care based on scientific evidence (= “scientific nursing care”), there is a demand for the accumulation and utilization of data. The Ministry of Health, Labor and Welfare aims to realize these goals, and when users enter information such as the status of users of nursing care services and the plans and details of care provided at nursing care facilities and offices in a certain format, they are sent to the Ministry of Health, Labor and Welfare via the Internet and input. We are promoting the use of an information system (LIFE) that analyzes the content and feeds it back to the facility.
On the other hand, the introduction of ICT and nursing care robots is progressing at nursing care sites. Efforts are being made to reduce the burden on caregivers and increase knowledge for appropriate interventions for the elderly by using these tools to digitize and analyze on-site information.
In this survey, we used the Tellus monitoring sensor developed and provided by Tellus You Care LLC to accumulate and analyze information collected from nursing care sites in Japan. Here are some examples of how we were able to find predictors from data. In addition, we implemented an intervention program for some of the facility elderly who had signs of danger*2, and as a result, about 60% of the facility elderly were maintained or improved. I will report that.
*1The Tellus monitoring sensor does not require wearables, and can sense the heart rate, breathing, sleep, activities in the room, etc. of the elderly 24 hours a day, 365 days a year.
*2 In this paper, the elderly in facilities are defined as those who receive nursing care services at nursing homes, including housing for the elderly with services.
About this survey
In an article published by the World Economic Forum in 2023, it became possible to store patient data for a long period of time and analyze it using AI, etc. due to the low price of monitoring sensors, etc. It is reported that being able to know the value immediately and knowing the patient’s normal value will lead to early detection of potential health crises for the patient. [2] It is also noted to help spot health signs (data from electrocardiograms (ECGs) and pulse oximeters) that may be missed by fixed-point measurements taken in the clinic. I’m here. [3]
Therefore, using the Tellus device, we independently selected the health indicators necessary for nursing care from the data of 139 facility elderly people whose data was collected for more than 30 days, referring to papers. A survey was conducted to analyze the data of 139 institutional elderly according to each health index. In addition, it has been shown that by implementing evidence-based medicine in the medical field, early treatment and reduction of unnecessary medical intervention can reduce adverse events by 20% and costs by 18%. [4] Efforts toward evidence-based interventions are also being promoted in the field of nursing care, so we set targets for 10 out of 139 facility elderly in cooperation with nursing care staff. By thinking about interventions, we have created a modern proactive aged care service. This research report also introduces some of these cases.
health index
The health indicators used in this survey are information that is important for monitoring the health of the elderly and that can be obtained with the Tellus device. was organized into three categories, and a survey analysis was conducted.
A: Sleep health index
Because sleep is a key factor influencing human health, and because healthy sleep is essential for healthy aging, a recent joint statement by the American Academy of Sleep Medicine and the Society for Sleep Research stated that health Regular sleep is defined as “adequate duration, good or bad quality, appropriate timing and regularity, and absence of sleep disturbances or disturbances”. [Five]
The Tellus device monitors sleep time, bedtime/wake-up time, weekly sleep rhythm status, and daytime sleep time. Among them, we analyzed sleep deprivation and excessive sleep, which are said to be the main risk factors for dementia, cardiovascular disease, type II diabetes, obesity, and depression [6]. We also analyzed daytime sleep, which has been shown to be one of the risk factors associated with poor health and dementia.
[Image 1: https://prtimes.jp/i/61603/5/resize/d61603-5-b469b33b8ad3d6af041b-2.png&s3=61603-5-1de679d213c795ff8691496bd6e7ca4c-448×584.png]
As a result of analyzing the average hours of sleep per day, it was found that 27% of the elderly in the facility had insufficient sleep (less than 6 hours of sleep) (see Figure 1). This increases the risk of multiple complications, including dementia, by 30%. [7] In addition, about 11% of institutionalized elderly people have excessive sleep (9 hours or more sleep), which is also a factor that increases the risk of developing dementia. [8]
[Image 2: https://prtimes.jp/i/61603/5/resize/d61603-5-37553e2cd0db76dadff3-2.png&s3=61603-5-4d8c2686f34d2ff38ca508bb62614a4e-448×584.png]
Analysis of average daytime sleep duration revealed that approximately 46% of the elderly in nursing homes took a nap for 1 to 3 hours, and 17% took a nap for 3 hours or more (Fig. estimated)). The health consequences of daytime sleep are severe, with one study estimating that older adults who nap for an hour or more a day have a 40% higher risk of developing Alzheimer’s disease. [9]
B: Health indicators related to room and bed activities
Patients’ social isolation and loneliness are said to be modifiable risk factors for cognitive decline. [10] Also, during the COVID-19 pandemic, collective action and communal dining opportunities were significantly reduced to limit the spread of the virus.
The Tellus device monitors various activities such as how long you are in the room, how long you spend in bed when you are in the room, and how many times you leave the bed. In particular, we believe that monitoring the activity status in the room and on the bed will also be one of the indicators for monitoring the social interaction of the elderly. Therefore, here we analyzed the average time spent in the room and the average time spent in bed per day.
As a result of analyzing the time in the room and the time in bed per day, 14% of the elderly in the facility spent more than 18 hours a day in the bedroom (see Figure 3), and 55% spent more than 14 hours a day in bed. (see Figure 4). Even now that many COVID-19 restrictions have been lifted, nursing homes report that the behavior of elderly residents has not yet returned to pre-pandemic social levels.
[Image 3: https://prtimes.jp/i/61603/5/resize/d61603-5-716fe62bb51d16b53d30-7.png&s3=61603-5-bc9e06ce2942099c6f531c9dc8f11197-1498×868.png] C: Health index related to excretion behavior
[Image 4: https://prtimes.jp/i/61603/5/resize/d61603-5-8a47eceb562770f5ff21-2.png&s3=61603-5-a6525d6736ab000e9720519a13d7e478-448×584.png] Since nocturia requires movement to the bathroom at night, there is a risk that the risk of falling will increase depending on the physical conditions of the elderly, such as changes due to aging, physical illness, and medication usage. [11] Nocturia (defined here as using the toilet more than once a night) is associated with increased risk of hospitalization for falls and fractures, associated cognitive decline, and increased medical costs. doing. [12]
The Tellus device monitors how many times you use the toilet per day, how many times you use the toilet at night, and how long you stay in the toilet. Here, we analyzed the number of times the toilet was used at night. Analyzes show that approximately 67% of institutionalized elderly leave their beds, on average, two or more times per night to go to the toilet during hours when caregivers are less available, from 10:00 p.m. to 6:00 a.m. (see Figure 5). ) has been clarified. proactive care
By obtaining long-term data related to individual institutional elderly, it is now possible to understand the condition of each individual institutional elderly. In addition, by defining health indicators with reference to papers, etc., it has become possible to immediately grasp whether an individual has risk factors, which is a major step toward evidence-based intervention. have become.
Here, 10 out of 139 elderly people in nursing homes who showed signs of danger were asked to set goals using health indicators in cooperation with caregivers, and to develop and implement intervention measures using the latest professional technology. Implemented active geriatric care. Six out of 10 institutionalized elderly were found to benefit from the intervention. From the cases where the effect was seen, we will introduce cases according to three categories. Sleep case
It was previously assumed that elderly people in nursing homes wake up at night and sleep during the day due to the progression of dementia. became. Awakening at night puts the elderly at the facility at risk of falling and puts a burden on caregivers.
When the elderly in the facility began to sleep during the day, the nursing staff visited the room and as a result, the sleep time during the day decreased and the sleep time at night increased by about 1 hour.
By knowing when individuals fall asleep, this is a case where we were able to implement interventions for the elderly in facilities while preventing unnecessary visits.
Cases of time in bed
With the introduction of the Tellus device, it became clear numerically that the elderly in the facility, who were reluctant to leave their rooms, spent long hours in bed. Since the elderly in the facility had a decline in physical ability, we set a goal to reduce the time spent in bed as a measure to prevent this decline.
As one of the solutions, I proposed adding a new nursing care service to the family. , understand the activity situation in the user’s room, and agree to receive the home-visit rehabilitation service first. First of all, we introduced home-visit rehabilitation for 40 minutes and proceeded with a short-term goal of “getting out of bed first.” After that, we are proceeding with a long-term plan of “getting out of bed” ⇒ “walking in the hallway” ⇒ “walking outdoors” ⇒ “participating in the day service”.
By monitoring the time spent in bed, we can see a clear numerical difference before and after the intervention. By being able to see the results in numbers, not only the elderly in the facility, but also various people such as nursing staff and family members can confirm the effects, which is a good result.
Examples of the number of nighttime toilet visits
With the introduction of Tellus, it became clear that the elderly in the facility go to the bathroom 1-3 times every night. In addition to the number of times, it is possible to grasp the time to go to the toilet, so when we checked the time to go to sleep and the time to visit the toilet with the nursing staff, we found that he was up to go to the toilet several hours after falling asleep.
Therefore, with the goal of reducing the number of toilet visits, we implemented an intervention to encourage the elderly in the facility to visit and go to the toilet before going to bed. As a result, after about a week, we succeeded in reducing the number of nighttime toilet visits to 0-1 times a night. This is an example of how an intervention could be devised while looking at the correlation of multiple data. Conclusion
In this survey, we used our Tellus device to accumulate and analyze information collected from nursing care sites, so that we were able to not only monitor but also find signs of dangerous situations from the data on an individual basis. rice field. In addition, an intervention program was implemented for some of the facility elderly who had signs of danger, and about 60% of the facility elderly had maintenance and improvement. We introduced three categories: activity and excretion behavior.
Long-term and continuous life data linked to individuals will be an index for understanding the health status of the elderly, and by utilizing them in elderly care interventions, it will be possible to maintain and improve health. It also became clear that it is possible to connect In the future, we aim to increase the number of cases, such as further examination of health indicators and intervention methods. Our future plans are to expand overseas, expand usage scenes (private homes that support Aging-in-Place), and respond to new groups (e.g., discharge from hospitals to reduce unnecessary readmissions). Elderly people who have just started training) are scheduled. Tellus has also won a US$250,000 grant in 2022 provided by the a2PilotAwards for research in artificial intelligence, technology and aging. The grant was funded by the National Institute on Aging, a division of the National Institutes of Health, and this research project explores the feasibility of using Tellus services for home aged care in the United States. We aim to prove.
About Tellus You Care
[Image 5: https://prtimes.jp/i/61603/5/resize/d61603-5-b11a137cf84a01e41379-6.png&s3=61603-5-4a257dee2c2bf4bb2cc1b3ec83c66685-816×938.png] Our company has developed a technology that enables both continuous remote health management and privacy protection for the elderly. The Tellus device combines radar and artificial intelligence to not only detect falls, but also track sleep, behavioral patterns, breathing, and heart rate in chronological order. The device includes a self-developed radar module and firmware to support elderly care. This product can be used simply by attaching it to the wall of the bedroom or toilet and plugging it into an outlet. Data captured by the radar is sent to the cloud and machine learning algorithms are applied. Web services and mobile apps also provide real-time status reports and trend analysis to families and caregivers. Currently, it is used in nursing care facilities in Japan, and we plan to expand it to the home sector in the future.
Company name: Tellus You Care LLC
Year of establishment: February 2020
Representative: Tania A. Cork
Location: Umezaki Building 3F, 4-4-4 Hatchobori, Chuo-ku, Tokyo 104-0032 Business description: Monitoring service for nursing homes
The Tellus service aims to support elderly care in two ways: Rapid detection of emergencies – The Tellus service detects
emergencies such as falls and acute risk factors, enabling care workers to respond immediately to emergencies and efficiently divert resources to avoid future anxiety. Assist in assigning.
Early detection of changes in health status – By analyzing historical data for older people, the Tellus service can help identify problems such as poor sleep, nocturnal wandering, social isolation, reduced mobility, frequent toilet use, and changes in vital signs. Caregivers can be notified of changes in key health indicators, such as abnormalities. This data is particularly useful for risk
stratification to better understand which older people are appropriate for particular interventions at particular times.
Citation
[1] Scientific Nursing Care and LIFE
https://www.mhlw.go.jp/content/12301000/000949376.pdf
[2] World Economic Forum, “Telemedicine could help the world achieve health equity by bringing care to the home – here’s how”, 2023. https://www.weforum.org/agenda/2023/01/telemedicine-global-health -equity-at-home-davos23/
[3] HIMSS, “Continuous monitoring of patients provides versatile, improved care case studies”, 2023.
https://www.himss.org/resources/continuous-monitoring-patients-provides-versatile-improved-care-case-studies [4] Walewska-Zielecka B, Religioni U, Soszyński P, Wojtkowski K. Evidence-based care reduces unnecessary medical procedures and healthcare costs in the outpatient setting. Value Health Reg Issues, 2021.
[5] Recommended Amount of Sleep for a Healthy Adult: A Joint Consensus Statement of the American Academy of Sleep Medicine and Sleep Research Society, Sleep. 2015 Jun 1; 38(6): 843-844.
[6] Stone KL, Xiao Q. Impact of poor sleep on physical and mental health in older women. Sleep Med Clin., 2018.
[7]Sabia S, Dugravot A, Leger D, Ben Hassen C, Kivimaki M,
Singh-Manoux A. Association of sleep duration at age 50, 60, and 70 years with risk of multimorbidit
[8] Winer JR, Deters, KD, Kennedy, G, et al. Association of short and long sleep duration with amyloid-β burden and cognition in aging. JAMA Neurology, 2021.
[9] LiP, Gao L, Yu L, Zheng X, Ulsa MC, Yang HW, Gaba A, Yaffe K, Bennett DA, Buchman AS, Hu K, Leng Y. Daytime napping and Alzheimer’s dementia: A potential bidirectional relationship. Dement, 2022. [10] Cacioppo JT, Cacioppo S. Older adults reporting social isolation or loneliness show poorer cognitive function 4 years later. Evid Based Nurs., 2014.
[11] Recognize fall risk and prevent falls
https://www.almediaweb.jp/expert/feature/1911/index02.html
[12] International Continence Society, “Impact of nocturia on medical care use and its costs in an elderly population: 30 month prospective observation of national health insurance benefits in Japan”, 2009. https://www.ics.org/Abstracts/ Publish/47/000280.pdf
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