Home Technology Plus Nurse Oversight May Allow for Timely Detection of Health Events

When used in combination with nurse oversight, smart home technology may promote timely management of and intervention for older patients with at least 2 chronic conditions, says a new study.

Results from this new series of cases, coming from 25 homes equipped with ambient sensors, suggest that the use of technology can help nurses remotely identify relevant health events that could be indicative of exacerbations or changes in their condition.

These findings were published recently in International Journal of Nursing Studies Advances.

“Smart homes offer features that are being employed by assisted living facilities, such as monitoring access to medication dispensers and supporting voice-activated calls for assistance,” explained the researchers. “Technologies that can distinguish normal behavior from a health crisis remain in the research phase. However, nurses should know about such forthcoming technologies so they can envision their use with various populations and participate in technology development to optimize clinical application.”

Each patient included in the study had multiple chronic conditions, including congestive heart failure, dysphagia, anemia, asthma, and osteoporosis. The sensors placed throughout the homes documented various bathroom use and sleep disruption patterns, and they included passive infrared motion detectors, light, magnetic door use, and temperature sensors.

Five cases were detected related to bathroom use, including 2 cardiac events, a urinary tract infection (UTI), and ulcerative colitis. Using the 2 cardiac cases, in which both female patients were using a diuretic for congestive heart failure, the researchers highlighted the importance of a nurse’s analysis of the sensor data. For example, significant changes in bathroom use can allow for correcting issues with diuretic efficacy, in turn allowing nurses to initiate more focused support for a patient’s self-management.

“Using sensor-based monitoring of bathroom use for older adults with congestive heart failure can provide nurses near real-time information about the use of prescribed diuretics at home, between office visits,” wrote the researchers. “Although weight scale data provides data about exacerbations in congestive heart failure, it is common for individuals to forget to weigh themselves and report changes to their provider. Smart home sensor monitoring does not require diuretic use reporting. A nurse managing individuals with diuretic treatment could monitor sensor-derived bathroom use measures to detect large departures from baseline.”

In another case, a female patient with various chronic conditions had a fall in her apartment resulting from a UTI. The researchers explained that by using the smart home technology, nurses would be able to detect bathroom changes on the first day of a UTI, leading to evaluation for other signs or symptoms of exacerbation before a fall happens.

The researchers also emphasized the use of smart home technology to identify sleeping patterns that may indicate exacerbations of chronic conditions. In their case series, the researchers identified 3 cases of restless leg syndrome, which they underscored may be an important observation, as frequent sleep interruptions and restless sleep may increase fatigue and confusion, thus leading to falls and impaired ability to manage health. They also noted the ability to treat restless leg syndrome, with smart home technology allowing for early intervention.

Reference

Fritz R, Wuestney K, Dermody G, Cook D. Nurse-in-the-loop smart home detection of health events associated with diagnosed chronic conditions: a case-event series. Int J Nurs Stud Adv. Published online May 25, 2022. doi:10.1016/j.ijnsa.2022.100081