Hayadan > The future of care for the elderly: robotic wheelchairs, tissue regeneration and wearable computing

The future of care for the elderly: robotic wheelchairs, tissue regeneration and wearable computing

This is according to a meeting held by the researchers of the Center for Technological and Social Forecasting and the Faculty of Medicine at Tel Aviv University at the Gartner Institute that dealt with medical technologies and the care of the aging population

Blood pressure test for the elderly. Illustration: shutterstock

On 7/5/15, a meeting of researchers' club was held at the "Gertner Institute for Epidemiology and Health Policy Research" in Tel Hashomer to discuss the areas of technologies from injuries in the field of aging and predicting their use. The meeting was organized and moderated by Prof. Alik Aviram, the scientific director of the Gartner Institute, and we were presented with lectures by - Dr. Aaron Hauptman and Prof. Arthur Leibovitz - from the Technological and Social Forecasting Unit, and the Faculty of Medicine at Tel Aviv University. And the words of Prof. Mordechai Shani, founder and director of the Gartner Institute, about future technologies such as: therapeutic robots and medical monitoring bracelets, and nano-robotic medicines, and stem cells for rejuvenating and renewing tissues and blood cells.

At the meeting, a discussion developed regarding robots to help care for the aging population at home. From the words of the participants, we got the impression that this population would not so much accept the idea that a robot would take care of them instead of a human therapist (the psychological barrier).

An "inflatable wearable pillow" was mentioned, which is designed to protect the elderly person at home from physical harm if they fall. It seems that there is indeed a lot of sense and need for such a pillow, the use of which will prevent injuries in advance and reduce hospitalization days and the need for surgeries. At the end of the meeting, I called my parents and asked if they would like to try such a pillow - and their answer was: "In the Israeli summer in the extreme heat, can you imagine that someone would agree to wear such a pillow day and night?" "-an answer that is definitely worthy of discussion and thought.

A discussion developed regarding technologies for conjunctive treatment of the brain: electrodes to treat a certain brain area, helmets for external treatment, etc. The impression is created that there are differences of opinion on this issue between medical professionals and bioengineering professionals who research and develop medical devices. It is not so believed that it is possible to treat the brain with the help of electrodes and cauterization when the cause of the disease is still unknown. On the other hand, technology and engineering people (including the writer of these lines) claim that it already exists and is being done - I told those present about an Israeli company that, in joint research with scientists in the USA, succeeded in implanting with the help of a medical robot an electronic chip (transistor) into the brain in the area of the TENS gland to treat Parkinson's disease. And you see in the video how the person himself can control the turning on and off of the transistor in his brain - the video is attached below for you.

A discussion developed about sensors and alerts that should be installed for elderly people at home, ones that would remind them to take medication, and turn on a light for them as soon as they approached the bathroom, or notify family members and rescue forces as soon as the health condition begins to deteriorate (for example the bracelet that Prof. Shani told about). Some of the participants responded that it is difficult to convince an elderly person to get used to and use these sensors, and especially an elderly person who lives on a social security allowance and has to purchase medicine and pay for water and electricity will not be able to afford these technologies. It was also mentioned that the population aging at home and suffering from loneliness often suffers from depression, and this is actually a huge psychological barrier that affects their desire, if at all, for these injurious technologies.

*There was a discussion about sensors and alerts similar to those at home if it is necessary to install them in hospitals - which will alert the department center in advance about the beginning of deterioration of a certain patient, about an imminent risk of a stroke or a heart attack, and about wetness in his sheet that requires changing the sheet. It was mentioned that medical teams in a hospital claim that the many beeps, which are already present today from medical devices, are disturbing and interfere with the day-to-day work! So that any emotional bracelet that is connected directly to the patient, will make it difficult for the medical staff, who even today are under enormous pressure. - Indeed, food for thought and in-depth research.

A discussion developed on the need to make reliable medical and scientific information accessible to the public, and to hold a brainstorming session between relevant experts from both the medical and technological fields, in which issues of utmost importance will be discussed - with the aim of bringing about solutions and activities in the future.

"Implications of injurious technologies on the treatment of an aging population"

By Aharon Hauptman, Arthur Leibovitch, Noam Levithan - the Technological and Social Forecasting Unit, and the Faculty of Medicine, Tel Aviv University

Scientific background

The trend of significant growth in the elderly population (65 and over) in Israel, similar to all developed countries, creates new medical, nursing and social needs. Injurious and future technologies may have a significant impact on the quality of life of this population if society is able to utilize and utilize them properly. The potential of the technologies is especially great in providing a possible solution to problems for which there is currently no satisfactory solution, such as dementia treatment, replacement of damaged organs, prevention of falls, personal care, etc.

the purposes of the research

Identification, review and informed evaluation of harmful technologies even before they mature into practical use, and this is to enable early identification of the opportunities and potential inherent in them for all the factors responsible for the care of the elderly population.

research methods

Scanning publications in the professional literature for the purpose of locating and identifying relevant injury technologies in a number of application areas related to the treatment of the aging population; semi-structured interviews with experts in the relevant fields; A structured online survey among dozens of experts, with the aim of evaluating various applied aspects of selected injury technologies.

Findings

In the research summarized in this report, various injury technologies were identified, reviewed and evaluated that may make a significant contribution to improving the treatment of the elderly population in the future and their quality of life. The study included the following steps:

Review, mapping and description of about 60 technologies from injuries, divided according to the following seven "families": (1) preventive medicine and early diagnosis, (2) regenerative medicine, (3) prostheses, wearable assistive technology and implants, (4) monitoring for safety, ( 5) monitoring for health, (6) encouragement for self-care, independence and creating relationships, (7) assistive robots. A review of these technologies is included in Chapter A of this report.
Interviews with 12 experts in the fields relevant to the treatment of the aging population. The summaries of the interviews were presented in chapter B of this report.
An online expert survey in which 20 representative injury technologies were evaluated as follows:

Robotic wheelchair
Robots assist nursing care workers
Early diagnosis of neurodegenerative diseases
Magnetic or electrical stimulation to treat degenerative diseases of the brain and/or improve cognitive function
The sadness of blood cells and/or tissues
tissue regeneration
Wearable equipment to assist the blind in walking and orientation in the environment
Wearable equipment to assist walking, standing and holding objects for those with mobility disabilities
Wearable systems to assist dementia patients
Implantation of devices to restore the balance system
Electronic implants for the restoration of cognitive abilities
Accompanying and remote monitoring with the help of computing and communication
Means for monitoring and controlling medication intake
Light and cheap portable sensors for effective early identification of fall risks and to help prevent them
Smart contact lenses for monitoring health indicators and controlled drug release
Technology to prevent fall damage
Integrating measures to monitor health status on a smart cell phone
Darvon systems for activity and encouraging self-care

Conclusions

The estimates of the experts in the survey referred to the estimated time when each technology will be widely used, the degree of its contribution to the quality of life of the users, the main barriers that may delay the use of the technology, and the main actions that should be taken to promote the use.

The results of the online survey show that, according to the experts, all the technologies discussed in the survey are expected to be widely used by 2030. Most of them (14 out of 20) are expected to be widely used between 2021 and 2025, four will be widely used by 2020, and two will be widely used later, Between the years 2026 and 2030.

The experts attribute to all the technologies discussed a fairly high contribution to improving the quality of life of the aging population. In particular, five technologies stand out whose contribution to the quality of life is perceived as particularly high: electronic implants for the restoration of cognitive abilities, cheap wearable sensors for detecting the risk of falling, implants for the restoration of the balance system, early diagnosis of neurodegenerative diseases, and tissue regeneration.

There is an overwhelming agreement among the experts that the main barrier that may delay the use of all the technologies discussed is financial. The high weight of the economic barrier is particularly noticeable in relation to two technologies: (1) the grafting of blood cells and/or tissues and (2) electronic implants for the restoration of cognitive abilities.

In light of the economic distress that the health system has experienced in the last decade, it is not surprising that all the experts attribute a particularly high weight to the financial barrier. This is probably related to the spirit of "managed care" that is blowing in the health care system.

The organizational barrier also has a fairly high weight, with reference to all the technologies discussed. The psychological, ethical and cultural/religious barriers are also important, but the weight of these barriers is relatively low compared to the economic and organizational barriers.

The various actions that may promote the use of harmful technologies (support for industrial R&D, support for academic research, acquisition of knowledge abroad, education, outreach and training, and training of personnel) are attributed by the experts to a medium to very high importance, with certain differences in emphasis between the technologies the difference

Implications for policy and recommendations for decision makers

The findings of this study may help the decision makers in the health care system in raising awareness of the potential inherent in relevant injury technologies, and in starting and increasing various actions to promote the use of these technologies in the coming years.

In light of the spirit of "managed care" that is blowing in the health system and which causes a decisive weight to be attributed to the budgetary factor as the main barrier that hinders the widespread use of new technologies, it is appropriate to deal with the question of whether, to what extent and at what point in the development path it is appropriate or not to disconnect from this "spirit" when evaluating the potential contribution of harmful technologies. This point deserves to be considered for every initiative and every development. Providing a training package for the medical staff, which is offered below, will also provide an answer to this.

It is recommended to formulate a training package intended for the medical and nursing staff, with the help of which they can be updated about the tools for the evaluation of technologies that cause injuries. Such a package may include topics such as the basics of technological forecasting, ways to absorb technologies in health systems, basics of cost/benefit assessment, and more. It is appropriate that the construction of the package and the manner of its distribution be in the hands of a steering committee composed of researchers in charge of technological forecasting in academia, representatives from the Gartner Institute and the Ministry of Health.

It is important to act to make the knowledge about the medical technologies that injure the consciousness of the medical community more accessible. One of the ways to do this is to encourage the systematic publication of relevant information in the leading medical newspapers that appear in Israel, in a permanent section that will be dedicated to technologies that prevent injuries and that will also include dealing with the standards for their evaluation. The development of medical technologies in Israel is active and vibrant and all parties may benefit from this.

Technological forecasting in any field, and especially in the medical field, should be a continuous systematic process and not end in a one-time study that is naturally limited in time and resources. In the current study, an effort was made to review and evaluate a fairly wide range of technologies. But it certainly does not pretend to cover all the relevant technologies, and we are in a period where the pace of technological developments is faster than ever before. Therefore, it is appropriate to initiate follow-up studies in light of the dynamic technological developments and the needs of the health system. Requested follow-up research may deal more deeply with the issues raised in the current survey and/or include the evaluation of additional technologies, while involving experts with high expertise in these technologies. It is also possible to consider building alternative scenarios of the penetration of new technologies to treat the aging population, while referring to various driving forces such as budgetary constraints, social changes, etc. In the first stage, it is recommended to hold a discussion and brainstorming session with relevant experts (both from the medical-therapeutic field and from the technological field) where the findings of the current research will be presented, important issues will be discussed, and follow-up activities will be considered.