Wednesday, November 8, 2017

Technical report draft 2

Letter of transmittal

Date: 20th October 2017
From: Ho Yong Quan
To: Ministry of Social and Family Development
Cc: Brad Blackstone
Subject: Proposal to distribute Emergency Alert System

Dear Ministry of Social and Family Development,
I am Yong Quan, and I am part of Eldervists, a project group from Singapore Institute of Technology, consisting of three year-one students in sustainable infrastructure engineering.

As a project for one of our modules, SIE2016 Effective Communication, we are tasked to identify and come up with a solution for the identified issue. After careful deliberation, our project group decided to focus on elderly, specifically the risks that elderly bear when they are alone at home if there are no alert systems present in the house. Our primary focus would be on the potential problems that could arise and solutions that would resolve said problems.

Attached is a detailed proposal on the matter, which comprises of an introduction of our focus, the analysis of the issue, the problems it could pose and a comprehensive solution to the concerns. The proposal is completed with thorough and up to date research, in hopes of determining the best resolution to the matter.

Please do not hesitate to contact us if there are any queries, or require further information. We will assist you to the best of our efforts.

Thank you for your time and consideration.

Best regards,
Ho Yong Quan
Singapore Institute of Technology
Contents page

Biodata

Name: Ho Yong Quan

Yong Quan is currently a first-year student in Singapore Institute of Technology, pursuing a degree in sustainable infrastructure engineering, and has a diploma in business administration from Singapore Polytechnic. Welfare of the elderly is his top priority, and he is extremely keen to assist them with his best efforts..
Name: Glenna Woo Wan Tian

Glenna Woo is a first year student in Singapore Institute of Technology, pursuing a degree in sustainable infrastructure engineering (building services), and has a diploma in hotel and leisure facilities management from Ngee Ann Polytechnic. Growing up with her grandparents and witnessing incidents that happen when they are alone at home, Glenna sees a need for the elderly to receive medical attention when needed.
Name: Yeo Jie Ming

Jie Ming is currently a first-year student in Singapore Institute of Technology, pursuing a degree in sustainable infrastructure engineering (land). He believes that he can bring elderly the confidence to spend their days alone at home with or without supervision as going to a nursing home might not be an option for some of them.

 

 

 



 





Executive summary

The report aims to highlight the importance of having an emergency alert device in the homes of elderly citizens, and the drawbacks and risks of not having them. The report will explore different types of alert systems that are already in the market, and to choose one to be implemented in our proposal. The selection criteria include will be discussed in the proposal.

Upon selection, there will be a proposal to run trials with the selected model, to test the effectiveness and reliability of the medical emergency system. The report will continue to explain the rationale of the implementation and describe how it will be implemented.

Extensive researches were conducted to ensure that the selection of the emergency alert system is comprehensive, and to make sure that the proposal is feasible and beneficial. Primary research include interview with elderly, to have a clearer understanding of the prominent problems faced by them, and to gather constructive input to decide on the most vital features that an emergency alert system should possess.



















Introduction

On average, Low (2012) quoted that about one in four elderly above the age of 65 in Singapore will suffer a fall. Of those who fell, two-thirds had a single fall and one-third had recurrent falls. Khalik (2015) also reported that close to 100 elderly were admitted to hospital every month because of an injury from a fall. Sollitto (2017) further explains the reasons why elderly are more prone to falling or slipping. Namely their decline in physical fitness, the effects of medication, impaired vision and chronic diseases.

With the heightened risks of falling, there should be more precautions in ensuring the wellbeing of elderly, especially elderly living alone. With no one present to look after them, the emergency alert system would do well to keep them safe, in an event of a fall.

 Figure 1: Crude rate unintentional falls based on age group
                                                       
Table 2: Resident Households by Age Group of Head and Household Living Arrangement, Year 2010 to 2015

The results of both figure X and Y are alarming and dangerous, and we can conclude that the factors related to the risks of elderly injury are increasing exponentially. With more elderly staying alone over the years, the peril of fatal injuries involving elderly increases directly, as the number of elderly exposed to the risk rises.

However, majority of senior citizens in Singapore whom are at risk, do not own the product. It will thus result in higher risks of fatal injuries, or even death. An emergency alert system that allows elderly to call for aid is extremely vital, and could very possibly be the one equipment that could save their lives.




Problem statement

An emergency alert device should be implemented for the elderly to ensure that they are safe in the case of an actual medical emergency. The majority of the elderly who spend most of their time at home alone do not have any form of emergency alert system. Without it, the elderly will continue to be at risk of not getting emergency attention or help in times of desperate need. An emergency alert device sends distress signals to their caregivers or nearby hospitals when the device detects a fall, or if the signal is sent directly from the elderly. This will allow the elderly to receive medical attention promptly.

Purpose statement

The purpose of this proposal is to explore the different types of emergency alert systems in the market and select the optimal system. The selected alert system will be recommended to Ministry of Social and Family Development, in hopes of it being sold or distributed to elderly or their family in need.

The proposal thus wishes that the product becomes more popular and widely used throughout households with senior citizens  in Singapore, to minimise the rate of fatal accidents occurring in households when the elderly are alone in the house.




Proposed solution

The proposed solution is to recommend a wearable emergency alert device for senior citizens who spend most of their time alone at home. This is to ensure that they are always equipped with the device to receive assistance from caregivers when emergencies occur. Caregivers can range from family members, trained professionals to volunteers.


Considerations and selection

The optimal emergency alert system should consist of the following five criteria:

  • Emergency button
The emergency button becomes handy, when seniors require help apart from falls. Examples could include other emergencies such as fire hazard or being generally unwell.

  • Global Positioning System (GPS)
GPS is essential, as it allows caregivers to easily and efficiently locate the whereabouts of the elder in times of medical emergency.

  • Long battery life
Long battery life is extremely favourable, simple because elderly may forget to charge their device from time to time. A longer battery life meant that they are protected for a prolonged amount of time, without new charges.

  • water resistance
Large number of falls occur in the bathroom, where it is often wet and slippery. Thus, it is advisable for the the device to be water resistant, as it would be unfortunate for it to malfunction in times of need.


Upon evaluating and weighing the functions and features, the emergency alert device that Eldervists have selected is the iHelp Adult GPS Tracker Device from OMG Solutions Pte Ltd which costs SGD $390. Refer to Appendix A and B for its specifications and dimensions.

Figure 3: iHelp Adult GPS Tracker Device

Benefits of Proposed Solution

Apart from the four functions and features that were mentioned above, iHelp Adult GPS Tracker Device possess even more advantages, that could benefit the user.

iHelp Adult GPS Tracker Device has an additional feature, named fall detection. It will automatically contact their respective caregivers when any fall or slippage is detected. This function is vital, as seniors may become unconscious or physically incapable of pressing the button to alert their caregivers. The detection utilises the accelerometer and gyroscope to identify a fall more accurately. Furthermore, it contains an in-built motionless detection, to sense any abnormality when no movement is detected for a set amount of time.

On top of that, iHelp Adult GPS Tracker Device provides a two-way communication through calls and text messages to up to five personnel with a press of the button. This allow the elder to be able to instantly voice their troubles in times of need, without the use of another device.

Lastly, the device is also linked onto mobiles devices through the application, DS Tracker, to allow family members or caregivers to know and track the whereabouts of the elderly, to effectively identify the location of the elder in an emergency. (Refer to Appendix C)

Drawbacks of Proposed Solution

Despite the long battery life, iHelp Adult GPS Tracker Device still has to be charged every 2 to 3 days. Elderly could forget about the device after charging it, which may put them at risk once again. Furthermore, because of the miniature size of the device, senior citizens may risk losing it.

iHelp Adult GPS Tracker Device operates using prepaid card or post-paid plan, which requires regular topping up when the amount runs low. Thus, caregivers will have to constantly check the available amount to ensure the device is still has enough value to be used properly.

Implementation

To evaluate the effectiveness of the selected alert device, there will be a trial programme. 25 elderly would be selected to participate in the trial, where they will be equipped with the alert device for for a month. There will be an assessment once every 2 weeks to collect various feedbacks to determine the reliability of the selected alert device.

Figure (Please refer to Appendix D) shows and describes the time span of the entire trial programme, and the necessary actions to be taken.




Alternative solution

An alternative solution would be a wireless motion sensor which will be able to monitor senior citizens in real time and provide timely alert. Eldervists have chosen the Smart Activity Monitoring Service (SAMS) by M1 which will cost SGD $214 with a monthly subscriptions of SGD $14.66. SAMS works by monitoring the elder’s daily activities at home by using motion sensor detection and alerts the caregiver through text messages. SAMS consists of four main devices: wireless door sensor, wireless motion sensor, wireless portable panic button, and iNet mini smarthub. (Refer to Appendix E)
Figure 4. Operation of Smart Activity Monitoring Service (SAMS)

Benefits of Alternative Solution

The elder’s activity at home is monitored with wireless motion sensor and wireless door sensor.  Caregivers will be notified if the elderly is out of the house, or have been inactive for a long time as there could be a possibility of an emergency that requires immediate attention. Footages of the elder’s activities around the house are also recorded, to allow caregivers or families to identify any oddities present in the apartment.

Similar to iHelp Adult GPS Tracker Device, it has an in-built emergency button, that allows quick response from caregivers in an event of an emergency.

Limitations of Alternative Solution

A household will require more than one wireless motion sensor as there are many rooms such as the kitchen or toilet, which may end up becoming costly. Furthermore, because of the post-paid nature of the plan that costs a monthly subscription of $14.66, the cost will continue to be incurred and in the long run, may become too expensive.

SAMS requires an internet connection to function. Hence, when the internet connection is down, the elderly will be unable to alert the caregivers when emergencies occur. Regular maintenance has to be conducted as well to keep the system in good working condition.




Methodology

Two different methods of research, primary and secondary, were conducted, to allow our team to have a better understanding on the matter.

Primary research

Interviews with elderly were conducted for us to have a clearer understanding of the problem. Interviews are highly effective because our team got to interact directly with elderly who are facing the problems themselves. The information from the interview were thus very insightful.

Copy of the questionnaire (see Appendix F) and sample interviews (see Appendix F to H) can be found in the appendix.  

Secondary research

Secondary researches were conducted to obtain essential information required for us to efficiently prepare for and complete the proposal. The information gathered allowed us to identify the problem, come up with plausible solutions, judge the current situation with statistics and more.

Web links of the research materials can be found under “References”, and certain tables and figures can be found in “Appendix”.





Conclusion

The absence of any form of emergency alert system in a household where elderly are often alone is extremely perilous. Elderly will have no one present to assist them, in an unfortunate event of a fall. The injury suffered could become fatal quickly, if help does not come on time.

Thus, to overcome and to prevent such instances from occurring, we recommend iHelp Adult GPS Tracker Device to be distributed to senior citizens who are living alone, or spend most of their time alone in their homes. Said device is selected, because it has a wide variety of features and functions, namely:

  • Fall detection
  • Emergency button
  • Global Positioning System (GPS)
  • Long battery life
  • water resistance

The application of the trail is also accurately planned, to ensure the dependability and practicality of the selected product.

With the implementation of the proposal, we hope the emergency alert system becomes more prominent in Singapore, and eventually becoming imperative for senior citizens. Hence, rate of fatal accidents occurring in households when the elderly are alone in the house will be greatly minimised, or entirely eliminated.




References

Appendix

Monday, October 30, 2017

Technical Report Draft 1

Background
On average, about one in four people above the age of 65 in Singapore will suffer a fall, said doctors. Of those who fell, two-thirds had a single fall and one-third had recurrent falls. In summary, the risk of falling among the elderly is relatively high. Most of these falls happen at home and often go unnoticed as they live alone. While some of these falls will be of minor consequence to the elderly, others, however, will incapacitate and reduce their ability to function independently during their everyday lives. Falls in the elderly have essentially become a significant cause of injury, disability and even death. It is understood that many of these falls are potentially preventable. While necessary precautions have taken place, accidents can still happen. This can be improved if the victims are able to get the medical attention shortly after the fall. This will require their caregivers to be alerted immediately so that necessary response can take place. Therefore, a device which automatically detects a fall and sends out a distress SMS to their caregivers can be the way forward to this problem. When the user is distress, the device worn have a panic button that the user can operate to notify their caregivers. This allows the caregivers to react and possibly prevent disability and even death of the elderly. Although there is a wide variety of such devices in the market, not all elderly who requires it gets to benefit from this technology. The high fall rates among elderly and the fact that elderly do not get the assistance they need immediately, highlight the need for these devices to be readily available for them.  

Problem statement
An emergency alert device should be implemented for the elderly, to ensure that they are safe in the case of an actual emergency.
Majority of the elderly who spend most of their time at home alone do not have any form of emergency alert system. Without it, the elderly will continue to be at risk of not getting emergency attention or help in times of desperate need.
Possible reasons why emergency alert systems are not widely used could be due to their high costs, complete unawareness of the product, or the that they do not feel the need to own one.
An emergency alert device sends distress signals to their caregivers or nearby hospitals when the device detects a fall, or if the signal is sent directly from the elderly. This will allow the elderly to receive medical attention promptly.

Purpose statement
The purpose of this proposal is to firstly explore the different types of emergency alert systems in the market, and select the optimal system. The selected alert system will be recommended to Ministry of Social and Family Development, and to propose the idea of distributing said emergency alert system to households with elderly.

The idea is implemented in hopes of minimising the rate of fatal accidents occurring in households when the elderly are alone in the house.

2.6 Proposed Solution
The proposed solution is to distribute an emergency alert device in a wearable form to all elderly living alone. This is to ensure that the elderly is always equipped with the device, so that they are able to call for help during emergencies as they live alone with no one to assist them. The emergency alert device makes use of accelerometer and gyroscope which can detect between a normal activity and an actual fall to prevent false alarm. The emergency alert device that Eldervists have chosen is from GuarDay which costs SGD $399.

Figure Z. GuarDay SOS and Fall Detection Device

Before implementing the device, there are a few plan of action to achieve the ideal situation. The device should be on a pilot program on a few groups of elderly and occasionally get feedbacks from them to review and improve in terms of the medical attention that will be provided. Meanwhile, caregivers should be equipped with the necessary skills such as Cardiopulmonary Resuscitation (CPR), Automated External Defibrillator (AED), emergency numbers, and navigation to the elderly’s home.

2.6.1 Considerations
The emergency alert device has to meet a few criteria which are automatic alerting, Global Positioning System (GPS), an emergency button, long battery life, and be waterproof.

When a fall is detected, an alert and a text message will be transmitted to the caregiver automatically while the GPS detects the elderly’s location. GuarDay’s device allows numerous phone numbers to be pre-nominated into the system, and the first number will be the most important number.

The emergency button should provided to allow the elderly to call for help when they do not feel well or if something is wrong. Similarly, GuarDay’s device will call and text message the pre-nominated numbers.

The device also requires a long battery life as it is meant to alert the caregivers on the elderly’s emergencies. GuarDay’s device has a battery life of up to 15 days with easy charging.

The device should also be waterproof as most accidents happen in the bathroom where the floor is wet and slippery. GuarDay’s device is waterproof in the shower.

2.6.2 Technical Specifications





2.6.3 Benefits of Proposed Solution
The elderly will be able to receive assistance faster with the emergency alert device. GuarDay works on 89 countries, making it convenient for family members who are going overseas or living abroad to be notified of any emergencies. GuarDay can also alert the elderly’s private clinic.

2.6.4 Drawbacks of Proposed Solution
Firstly, on the elderly’s part, the elderly may forget to wear the device as it needs to be removed and charged when the battery runs out. Hence, when accidents occurs, no alerts will be transmitted to the caregivers. Since the device is small in size, the chances of losing it is high. Some elderly may also refuse to use the device to get assistance as they find that they are being a burden. Some elderly may not know how to use the device even after demonstrating.

Secondly, maintenance of the device have to be conducted regularly to ensure that it is in good working condition. An example of the problems that may occur with the device is long response time to the caregivers. Regular maintenance would mean that visits to the elderly have to be made. During the visits, caregivers may come along and communicate with the elderly. However, it may be an inconvenience to the elderly as some of them do not like to be disturbed.

Thirdly, caregivers are needed to take care of these elderly who live alone. Their main task will
be to act on the SMS alerts.

2.7 Alternative Solution
An alternative solution would be a wireless motion sensor whereby an alert will be sound when no movement is detected for an unusually long time, which could mean something has happened that caused the elderly to not move. Eldervists have chosen the Elderly Monitoring System (EMS) which was developed by Ngee Ann Polytechnic staff and students. The EMS monitors the elderly’s daily activities at home using wireless sensor networks that will alert the caregiver through text message when no movement is detected for a period of time.


2.7.1 Benefits of Alternative Solution
The EMS is a non-contact, non-invasive and low cost methodology system which is able to monitor the elderly in real time and provide timely alert. There is no need for the elderly to wear or press any device button to alert the caregivers.

2.7.2 Limitations of Alternative Solution
A household will require more than one EMS as there are many rooms, which may be expensive. Similar to GuarDay’s SOS and Fall Detection Device, the EMS requires regular maintenance to ensure that it is in good working condition to detect motion of the elderly.

2.8 Solution implementation
The proposed solution would be to promote the selected emergency alert system to households with elderly living in them.
The system can be distributed in many ways. However, we recommend for the alert systems to be distributed during an awareness event.
Local GRC should conduct said awareness event in their respective areas, with booths for free food and games. The focus of the event should be to spread the awareness of the importance of the emergency alert system, the benefits they will bring, and the risks elderly are exposed to if they do not own one. There will be booths that specialises in selling the devices, and households with elderly will be able to purchase the alert system at a highly subsidised rate. There would also be professionals present to promote the product, and explain how they work to the families or the elderly.
The emergency alert device should be given free of charge to families with income below a certain percentage, and to elderly who are staying alone. Volunteers should be dispatched to individual households that houses elderly who stay alone, or elderly with disabilities, to distribute and explain the emergency alert systems to them.

Table X (Please refer to the appendix) shows the resident population of elderly, aged 60 and over. This will give an estimation of how much emergency alert devices to purchase, and the numbers to accurately divide the devices throughout the island. figure aims to present an image of how households with elderly are distributed across the island, in hopes of identifying the areas that require the most quantity of the alert device, and the scale of their awareness events.
Figure Y (Please refer to the appendix) is a visual representation of the distribution of elderly across the island.
2.8.1
Benefits
As mention the problem statement, one of the prominent reason why elderly do not wish the purchase an emergency alert system, is due to the high cost, and they do not feel that it is worth their money. Furthermore, elderly do not own the alert system is because they do not know the product exist, or they do not feel that there is a need for it.
The awareness event eliminates the problems mentioned above. Since the devices are sold at a subsidised rate, it would become much affordable for family to afford them. Moreover, the aims of the event is the primary spread awareness of the alert device, and the benefits that comes with it.
With emergency alert system present in the homes of elderly, there would be no risk of fatal injuries, or injuries that goes unattended when elderly were to fall or injure themselves when they are alone at home. The alert system will automatically contact their kin or medical professionals to the scene to assist them, to prevent escalation of the problem.
2.8.2
Drawbacks
The drawback of the proposal, could be the possibility that the awareness event does not reach out wide enough to the elderly. Possible reasons why could be elderly not being aware that the event is ongoing, or are not interested in the event.