Community-based management and monitoring system for senior care.

Buddy Homecare was launched by the Foundation for Older Persons’ Development (FOPDEV) in 2012. In 2020 the social enterprise won a Healthy Aging Prize for Asian Innovation (HAPI) in the category "Technology and Innovation" for its monitoring application. In a short interview, CEO Sawang Kaewkantha explains why Buddy Homecare is so special.

The year 1999 was declared the International Year of Older Persons by the United Nations (UN). This inspired the establishment of the FOPDEV Foundation, which later initiated the Buddy Homecare (BHC) concept. After the three-year development phase, the government funded a two-year pilot project in 2015. The aim was to ensure good home care services for all the elderly, including those with a low income. The BHC program offers an inclusive solution to various problems of elderly people, as well as indigenous youth living in poverty and with limited educational opportunities in the mountains. Sawang Kaewkantha explains, "They have no chance to study because they would have to come to the city. That means it would be very expensive for the family in the village. Many of them might be exploited from outside or get cheap daily wages." These are Karen, Lahu und Hmong, minoritized ethnic groups with own language, living in northern Thailand and Myanmar. The BHC offers them training as caregivers. This way they can contribute to the well-being of seniors and get better career prospects at the same time. When the younger generation becomes financially independent, it’s a great relief for their families. BHC provides them with a three-month training course at Chiang Mai University's Faculty of Nursing. "We call them caregivers because they are not volunteers, they are paid for their work. These caregivers can share their knowledge with community volunteers, who only attend a five-day course on age care. (...) At the same time, they fulfill a supervisory function" says the BHC director, describing other advantages of the concept. In Thailand, responsibility for older people belongs to basic social norms. Many people give up their jobs to care for their family members. Sawang Kaewkantha, for example, is very happy that he can continue to work thanks to BHC caregivers. His wife had a stroke 2 years ago and has needed constant care ever since.

The successful innovation
The HAPI award was not given to the BHC project for its enormous social achievements but for the innovative use of a digital monitoring application. Years of experience in community-based care were used to develop a new monitoring system. What sets BHC's system apart from the others is its social entrepreneurial approach, which strives for a just society for all while impacting multiple target groups. Thanks to digital tools, the work can be carried out systematically and efficiently. The app includes features for conducting health screenings, creating individualized health programs, and enabling follow-up visits. The dashboard covers assessment, care program planning, care practice and data collection. Data is accessible to caregivers and volunteers, and family members can access the information in real-time. Caregivers or BHC volunteers perform basic health screenings, such as blood pressure checks, and can assist with activities of daily living, such as bathing, cutting nails and hair, and household work. Thanks to systematic recording and monitoring of health data, anomalies can be noticed and treated quickly. In addition, there is a performance evaluation of the caregivers and an overview of the state of development and the situation of the elderly.

Further development
The social impact of the project is broad and diverse. Officially, Buddy Homecare's social return is five times the government's investment. In addition, the program is highly cost-effective and sustainable because it provides both paid and free-of-charge community services. The foundation continues to pursue four strategies. "One is community and organizational development. The second is information sharing and knowledge management. And the third is networking," Sawang Kaewkantha lists and concludes, "the last point is fundraising; this is very significant because Buddy Homecare plans to expand its business model to Bangkok and other regions of the country in the future." They received a grant from the Thai company "Prueksa" for a model nursing home with ten beds. "We are working on the project together with a local church. But the goal is still to support the elderly locally in familiar surroundings for as long as we can. The retirement home is intended to be only an emergency option. Single seniors in need of care who cannot count on help from the neighborhood will be placed there."

Interview: Samira-Salomé Hüsler, Rhea Braunwalder
Text und Übersetzung: Monika Freund Schoch

Other articles:
Buddy HomeCare EN
Healthy Aging Prize for Asian Innovation EN

On the photo: The CEO of "Buddy HomeCare" Sawang Kaewkantha.

An interview with the founder of “CareTable”, Mr. Christoph Schneeweiss

The progressive ageing of society sets major challenges for care facilities. Many new technologies are currently being developed as an attempt to provide relief in this area - one of them is the CareTable. This oversized touchscreen device has been specially developed to improve the quality of life of residents in geriatric care centers and care institutions. An interview with the founder of the dynamically growing company provides an insight into the development of CareTable, its functions, challenges and ethical considerations.

Monika Freund Schoch (MFS): Today we have the pleasure of welcoming Mr. Christoph Schneeweiss and talk about an exciting technology in the field of elderly care - the CareTable. Thank you very much for taking the time to talk to us. Can you perhaps tell us a little about the product?
Christoph Schneeweiss (CS): Yes, with pleasure. Thank you very much for having me here. I'm really pleased to be able to talk about the CareTable, a product that we launched almost four years ago. CareTable - what exactly is it? You must imagine it as an oversized tablet. It's a large touchscreen, almost like a TV, that stands on wheels and can be ergonomically adjusted in height and angle to meet the needs of residents in nursing and retirement homes. This tablet does not have the classic apps that we are familiar with from an iPhone or Android device, but rather applications specially developed for geriatric care. The range is wide: from biography work, trough sport and exercise, to entertainment in the form of games - all designed to make everyday life in care facilities more varied and enjoyable.

MFS: That sounds interesting. How was the idea for the CareTable born? What was the starting point for its development?
CS: The original idea came from a master's thesis at Martin Luther University Halle, or more precisely from the Faculty of Nursing Science. When we founded our company in 2019, we initially had something completely different in mind. We wanted to become an IT service provider for the care sector, but that didn't work out as we had hoped. Then the university approached one of our customers and suggested working with one of the students who wanted to write his master's thesis on how older people cope with a large touchscreen compared to normal tablets. We then developed a prototype, which was surprisingly well received by the residents and was used for up to four hours a day. That was a sign for us that we were on the right track, and so we continued to develop the product. Today, the CareTable is used in around 1,000 facilities in Germany, Austria, Switzerland (e.g. Zurich, Dietlikon, Wallisellen, Erlinsbach, Willisau and Spiez) and Luxembourg.

MFS: What was your role in the development of the CareTable and how has the product evolved?
CS: I am one of the two founders and created the CareTable together with Tobias Jecht. Tobias mainly takes care of customer advice and sales, while I am responsible for internal processes, product development and HR and financial issues. When developing the CareTable further, it was clear from the outset that we had to work very closely with user feedback - both from care staff and residents. This feedback made a significant contribution to designing the product in such a way that it meets the needs of care homes.

MFS: Were there any challenges or difficulties in developing the CareTable?
CS: Yes, definitely. Initially, we had little experience and a lot to learn. A big mistake at the beginning was that the first version of the CareTable was stationary - a table with four legs that was neither mobile nor adjustable in height or tilt angle. This meant that many residents, especially wheelchair users or bedridden people, were unable to use the device at all. At the beginning of 2021, we then developed a mobile, ergonomically adaptable version that is in use today. There were also only a few applications on the software side at first, but we have steadily expanded this. Our original idea was to use the CareTable primarily as a “play table”, but it quickly became clear that it had much more potential, like biography work or cognitive and physical exercise.

MFS: To what extent do the CareTable and its applications contribute to residents' quality of life?
CS: The CareTable opens completely new digital worlds for residents. It is fascinating to see that, contrary to many preconceptions, older people really enjoy working with digital devices if they are introduced to them appropriately. In care facilities, there is often a care ratio of one full-time employee for every 20 residents. This can easily lead to some residents missing out or withdrawing. The CareTable makes it possible to start an activation program that covers different interests and levels of difficulty with just a few clicks. This allows more residents to be involved in the care, which benefits both the residents and the care staff.

MFS: What challenges and limitations still exist with the CareTable today?
CS: Of course, not everything is perfect. The CareTable is a valuable tool, but it doesn't solve all the problems. One major challenge that we are currently working on is the individualization of the device. In future, it should be possible to create profiles of residents so that their personal preferences and biographies can be incorporated into the activation program. We are currently working with general levels of difficulty, but the aim is to make individual suggestions based on residents' preferences and previous activities. We would also like to further expand the range of applications, particularly in the area of sport and exercise. There will always be residents who are unable or simply unwilling to use the device due to motoric or cognitive limitations. It is therefore important to remain realistic and not raise excessive expectations.

MFS: What about the issue of data protection? Were there any concerns?
CS: Data protection is an important issue in the care sector, and of course we take that into account. There were initial concerns, particularly with applications such as video calls or the picture gallery, because they involve personal data. However, we have corresponding order data processing contracts and updated data protection declarations so that these functions can be used without hesitation. If individualization is based on resident data in the future, we will have to take another very close look at how we can ensure data protection.

MFS: Is there anything else you would like to say to our readers or listeners?
CS: Yes, it is important to me to convey a different image of old age. Technology and digitalization are also very popular in residential care for people over 80. It's wrong to generalize and say that older people have no interest in technology. On the contrary, if you introduce them to it properly, they really enjoy it. We should therefore stop excluding older people from such offers based on an outdated image of old age.

MFS: Thank you very much, Mr. Schneeweiss, for this interesting interview!
CS: Thank you.

Interview and text: Monika Freund Schoch
Translations
EN: Monika Freund Schoch
FR: Rhea Braunwalder
IT: Lisa Kortmann
Mit Unterstützung der KI

Website of the manufacturer DE

On the picture below: Christoph Schneeweiss with CareTable

In 2017 DFree launched a wearable ultrasound sensor that measures the bladder fullness. Through a connected app users or care givers are alerted when it is time to go to the bathroom. In 2020/2021, the wearable was tested in a pilot study of the Martin-Luther-University Halle-Wittenburg, Germany with 18 urologic patients with urinary incontinence in a period of three months (Schönburg et al. 2023). The feedback to the product was positive, even if some suggestions were made for user-friendliness. Further in 2023, DFree was tested in an in-patient setting with nurses at the University Medicine Halle, Germany (Hofstetter et al. 2023). The interview with Vice President of Marketing of DFree USA, Ty Takayanagi, shows us more about this unique wearable ultrasound sensor.

Mr. Takayanagi, what is DFree and how did it come about?
The project began in 2015, where we looked at the market for urinary incontinence and saw a huge potential. 500 million people worldwide, many of these seniors, are affected by urinary incontinence. The solutions available are pads, diapers, medication, or invasive surgeries. Our wearable device attaches to the lower abdomen and is secured with a tape. It’s connected to a smartphone-app where a number indicates how full the bladder is on a scale from 1-10. It’s kind of like an alarm clock for your bladder. When the notification threshold is reached, a notification is sent to visit the bathroom.

“It’s kind of like an alarm clock for your bladder”

Who was involved in the product development and what was their feedback?
Our Team-members are all from different fields: The CEO was a consultant in the health-care industry, and came up with the idea. Our CTO brought a lot of technical knowledge and experience. And I have a background in sales and marketing.
Before we launched the first product in 2017 there were multiple different prototypes. We tested our device with many seniors and with our main customers, nursing homes, and got feedback about what they liked and didn’t like. The first product was a big sensor with a battery pack and cable. It was too bulky, and the size of the wearable matters a lot for comfort. So now everything is integrated into this small device. Also, the device needed to be made waterproof in case of leaks.

How does DFree contribute to the life of older people?
It comes down to having more confidence and dignity. We have spoken to seniors who feel ashamed of their incontinence. Some people stop socializing or reduce water intake because of these concerns. We want people to have a little more confidence in themselves and continue to do what they like to do. Of course, we are aware that DFree doesn’t heal urinary incontinence. People with severe incontinence still must consider other options.

“It comes down to having more confidence and dignity.”

What does the future hold for DFree?
We have shipped over 5000 units in Japan and the USA. Over 500 senior care facilities use DFree, mostly in Japan, as we are originally a Japanese company. Now we want to introduce the product in Europe. So, it would be great to get more visibility in Europe and find fitting partners.

How do you see the role of technology in the field of ageing?
I think it’s huge. In Japan 25% of population will soon be older than 65. There’s a shortage of people of take care of older people. And we have to rely on technology and robotics to support them.

Interview and translation: Rhea Braunwalder

Further reading:
Schönburg, Sandra Helen; Hofstetter, Sebastian; Buhtz, Christian; Paulicke, Denny; Stoevesandt, Dietrich; Jahn, Patrick et al. (2023): Der Einsatz des DFree-Ultraschallsensors für ein ausgewogenes Blasenmanagement. In: Aktuelle Urologie 54 (6), S. 457–463. DOI: 10.1055/a-2107-8947. Available Online: https://www.thieme-connect.de/products/ejournals/abstract/10.1055/a-2107-8947

Hofstetter, Sebastian; Ritter-Herschbach, Madeleine; Behr, Dominik; Jahn, Patrick (2023): Ultrasound-Assisted Continence Care Support in an Inpatient Care Setting: Protocol for a Pilot Implementation Study. In: JMIR research protocols 12, e47025. DOI: 10.2196/47025.
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Orange Links: Bringing wandering dementia patients back home safely

Orange Links was founded in 2015 in Saitama prefecture, Japan. Director Mrs. Yukiko Yoshida developed a jell nail sticker sporting a QR code with an identity verification system. Wandering patients wearing the sticker can quickly be identified by passers-by using a smartphone.

According to the Federal Office of Public Health (BAG) around 153 000 people in Switzerland live with dementia. Most of these people live at home and are taken care of by family members and other close persons. Wandering, can mean a high burden and stress for all people involved. In comparison to other means of identification, such as GPS devices, stickers on clothing or keychains, which can be forgotten or removed, the jell nail sticker offers a low-tech, low-cost and failproof method to identify wandering people. The product won the Grand Prize in “Technology and Innovation” of the Asian Health and Longevity Innovation Awards 2022. In a written interview with Kazuhiko Sugimoto, the brother of founder Mrs. Yukiko Yoshida, we learn more about this product.

Institute for Ageing Research (IAF): Mr. Sugimoto, could you tell us more about how the project started?

Kazuhiko Sugimoto (KS): An acquaintance of Mrs. Yoshida’s with dementia was found 20 km away from their home after having wandered away with a bike. At first everyone was surprised at why the fatigued person had erred so far, but it turned out, the place where the person was found, was near their old working place. Mrs. Yoshida, at the time a fan of stylish nail stickers, came up with the idea of making a QR code nail sticker with an identity verification system to identify wandering people with dementia and contact their close ones.

IAF: Where there any difficulties in developing the product?

KS: As we are originally into IT consulting and developing, we had no prior knowledge of the care-sector. For around one year, we emersed ourselves into nursing homes, dementia hospitals, the Japan college of social work and community centers to gain a better insight into the field.

IAF: How does the product and technology in general contribute to the lives of older people?

KS: On a general level, we believe Technology is one of the tools to reach the Sustainable Development Goals set by the United Nations. In relation to our project, we relate to the SDG 3 “ good health and well-being” and SDG 11 “sustainable cities and governments”. Further, statistics show, that even if families pay close attention to a relative with dementia, it still happens that people with dementia wander away. Using the QR sticker, relieves the family of stress.

Here are other reasons why we believe the product contributes to the lives of people with dementia:

IAF: Where is the product sold and is it available outside of Japan?

KS: The product is sold in city halls and nursing homes throughout Japan. We would like to expand primarily in Asia and, in a second step, also in Europe. We work with local partners in each country. For example, we have contacted a dementia organisation in South Korea. Such an organisation is needed to distribute the product locally and we would also be happy to be contacted by organisations and companies in Europe that want to help us with this goal.

The product is available in different languages. Go ahead and scan the QR codes below, to see different language versions:

Interview, Text and translation: Rhea Braunwalder,
llustrations: Orange Links

Further Reading FR:
Jelly Nails FR

A conversation about “Joy for all” and other technologies used in the field of ageing

Each year the consequences of social isolation are associated with an additional $6.7 billion in health care spending in the United States of America - comparable to spending on arthritis, heart disease, high blood pressure and diabetes. An award-winning initiative in the US is delivering robotic pets to isolated older adults across New York State. We spoke with Josef Huber, an expert in age-technologies, about the “Joy for all” cat and other innovations. He shared a comprehensive insight into the challenges and opportunities in implementing technologies that can provide a sustainable and positive impact on the lives of elderly people.

Robotic pets have long been successfully used in various therapies, particularly in improving the cognitive abilities of individuals suffering from Alzheimer's or other forms of dementia. The NYSOFA (New York State Office for Aging) pilot program has shown that these pets positively impact the health and well-being of older adults on a broader level. During a pilot program in 2018, 60 individuals in 12 counties received animatronic pets through their respective county's Office for Aging. By applying the DeJong Loneliness Scale at various points during the project, it was found that 70 percent of these older adults experienced a (sometimes significant) reduction in loneliness and a 75 percent decrease in pain. Therefore, the project is being continued and expanded.

Josef Huber, head of SimDeC (Simulation in Dementia Care), is familiar with various technologies designed to help people of advanced age live independently in their own homes. “Joy for all” has also found a place in his showroom. The robot cat does not excite Josef Huber personally, as he is “not a cat person”, but he has observed many people who enjoy playing with it. In his research, this animatronic pet serves more as a catalyst for discussion and aims to promote an ethical discourse on the use of technology. By using a hand puppet as an alternative means of communication, efforts are made to simplify the dialog on such topics and break down inhibitions: “We want to encourage people to say: it is not important to understand exactly how the technology works, but it is important to see what impact it has.” His personal experience with the robotic cat makes it clear that its appealing appearance not only brings positive reactions, but also some challenges. Although it evokes positive responses in elderly people, and seems to create a certain emotional bond, it is noted that it does not meet all expectations in terms of haptics. Interestingly, some people refuse to turn off “Joy for all” because it feels “like killing the cat”, says Josef Huber.

Mr. Huber reflects on the practicability and role of technology in the field of ageing: “Technology or engineering? When we talk about electronics, we must start extrapolating: What does that mean in terms of energy? What about data? What opportunities and risks do we need to consider?” The expert sees great potential in the little things that can make everyday life easier and in individualizing offers based on needs analysis (e.g., customized pepper mill). He emphasizes how crucial it is to understand the specific requirements of older people and wants to highlight “the everyday added value of technology”. He justifies his opinion: “These needs remain the same. Technology, on the other hand, has very fast innovation cycles, it changes all the time. If we talk more about needs, then we can also master the complexity of technology. And these are the common themes that run through my work. I want to tell stories and thereby learn more about needs. A person after a stroke has completely different requirements for a bottle opener than a person who is blind or in pain. And that's where it becomes interesting to develop technology further”.

Just like other technological solutions, “Joy for all” can make a significant contribution to the field of ageing. However, these technologies must be used in a way that is beneficial to people's daily lives and/or tailored to their needs. For example, a person who does not like cats is unlikely to be pleased with this robotic solution. The comparison of different technologies - including more expensive alternatives to the robotic cat such as the robotic seal “Paro” - underlines the importance of personal choice and acceptance. Another issue is the negative connotations associated with the use of assistive devices. One does not want to be seen as “old” or “helpless”. “We need a stigma-free access to technical solutions”, says the experienced lecturer. In the context of accessibility, Josef Huber talks about his Citizen Lab with the Innovation Center for Participation (simdec.ch/page/izm) as an innovative initiative to bring objects into the neighborhoods together with a story. This allows local recognition of needs in the population and offers advice from various perspectives. “SimDeC is a place where we can meet. (...) We have space here for people to meet at eye level to discuss technology. Our mission is to convey which technical products, and more specifically which needs there are and how we can deal with them through technology or other assistance options to enable “Age(ing) in place”, sums up Mr. Huber.

Interview, Text and translation: Monika Freund Schoch

Further Reading (EN):
NYSOFA Delivers Animatronic Pets to Older Adults in the North Country | Office for the Aging
Further Information about SimDeC:
SimDeC

An Interview with Ali Reza Humanfar

In an increasingly digitalized world, the care sector is also becoming more and more permeated by innovative technologies. One proven example of this is Livy Care, a digital assistance system designed to support care staff and increase the safety of people in need of care. Ali Reza Humanfar, developer and mastermind behind this project, provides insights into the history, challenges and future plans of Livy Care.

Livy Care was developed to meet the growing demands in the healthcare sector. “Livy Care is a digital assistance system primarily aimed at supporting healthcare professionals and enhancing the safety of those in need of care,” explains Humanfar. The idea was born out of a personal experience when his father suffered a stroke after several heart attacks. This family challenge led Humanfar, as an engineer, to think about technical solutions that could provide quick assistance in emergencies and inform relatives.

Developing a Revolutionary Technology
The journey from idea to finished technology was long and challenging. Humanfar began his initial considerations as early as 2010, but it wasn't until 2020 that his work in sensor technology led to the development of Livy Care. “We used sensor fusion to combine various sensors, ensuring precise and reliable monitoring,” he explains. Sensor fusion, a principle from autonomous driving, allows Livy Care to maximize the strengths of individual sensors and compensate for their weaknesses by combining sensor data.

Challenges in Development
Developing such a complex system brought numerous challenges, particularly the issue of false alarms. “We wanted to develop a solution that does not produce false alarms,” emphasizes Humanfar. It took about two years to develop hardware that could optimally combine the various sensors. In parallel, intensive work was done on the software, which reliably detects dangerous situations using machine learning, reducing the false alarm rate to less than one percent.

Involvement of the Target Group
During the development of Livy Care, the team placed great importance on involving the target group. Elderly people and healthcare facilities were integrated into the process to ensure that the technology met their specific needs. “We conducted many interviews to precisely identify the niche and market segment,” explains Humanfar. Particularly in the area of night shifts in healthcare facilities, the developers saw a pressing need that Livy Care addresses.

Limitations and Future Prospects
Despite the many advantages of Livy Care, there are also limitations. “One limitation is that our solution is confined to indoor areas,” Humanfar admits. Livy Care currently does not cover outdoor monitoring. However, wearables can be a useful addition, as they can be combined with Livy Care. Looking to the future, Humanfar and his team are focused on further relieving healthcare professionals. “We are working on solutions that reduce or eliminate routine tasks, allowing more time for actual care,” says Humanfar.

Ethics and Data Protection
Another important aspect in the development of Livy Care is data protection. The data is processed locally, so it does not leave the room. “This ensures the highest possible level of data security,” emphasizes Humanfar. With the support of data protection experts like Professor Dr. Thomas Jeschke and Thomas Althammer, a system has been developed that meets the highest data protection standards.

Mission
Livy Care shows how technology can help to improve the care sector and improve the everyday lives of care staff and people in need of assistance. Despite the challenges and limitations, Reza Humanfar is convinced that Livy Care can make an important contribution to solving the care crisis. “Our mission is to relieve the burden on care workers while ensuring the safety of those in need of care,” he concludes the interview.

Interview and text: Monika Freund Schoch
Translations
EN: Monika Freund Schoch
FR: Rhea Braunwalder
IT: Lisa Kortmann
With AI support

Website of the manufacturer

On the photo below: Amir and Reza Humanfar (the founders)