mPower has shown that many older people are willing to embrace technology, if given the right level of support and especially if they can see the benefits of how it can improve their health and wellbeing.
Such was the case in Dumfries and Galloway where the mPower team led on a large trial of a digital application called ARMED, aimed at supporting older people to best self-manage their condition through improving their activity levels. 69 mPower beneficiaries, all aged over 65, took part in this trial and almost all found it of benefit to their health and wellbeing.
ARMED stands for Advanced Risk Remodelling for Early Detection. It is an innovative prevention and self-management certified medical device. It combines pioneering predictive analytics modelling with a wearable technology and health and social care data. The tool enables people to live independently and in their own homes and provides them with data about their health to allow them to make more informed and pro-active choices to increase their health and wellbeing. Data includes steps, sleep, heart-rate and other health and movement indicators. The tool’s data can also help health practitioners and clinicians with their decision making in identifying escalating patient risk and directing resources to the area of greatest need. There is a particular focus on the risk of falls and the aim is to reduce this risk.
Research shows that 34% of people aged over 65 are deemed to be at risk of having a fall. This rises to 45% of people over 80. The main reasons for this susceptibility to falls is a reduction in activity as people get older and muscle wastage. In Dumfries and Galloway 34 frail people aged 75 and over are admitted to Dumfries and Galloway Royal Infirmary each week.
The mPower team offered the 69 beneficiaries the opportunity to maintain or improve their activity levels by participating in the trial. It also gave them experience in how wearable technology may benefit them and help them understand their health better by getting feedback from ARMED. ARMED is used on a wrist device called Polar Ignite which measures health and fitness including metrics on activity and sleep patterns.
Initial planning was supported by a previous study within Dumfries and Galloway which suggested ARMED could play a role in managing an individual’s frailty and focusing on exercise and activity levels which can lead to the prevention of falls.
The aim in the trial was to test whether ARMED could achieve similar results in different settings where a level of care and support is provided. The trial approached and created a number of partnerships, with the aim of ensuring delivery could be co-produced and the technology could be used to fit each partner’s aims. At the same time the trial further enhanced the project by including ongoing Health and Wellbeing support.
The trial with mPower beneficiaries took place across four settings:
- Residential care
- Telecare response service
- STARS reablement service
- Pulmonary Rehab
Beneficiaries within the reablement services and Pulmonary Rehab received weekly/fortnightly wellbeing calls from Community Navigators. On the calls they received coaching around the use of the ARMED smartwatch, but were also referred to other services. For example, one beneficiary was able to be paired with local volunteers to allow him to be supported to walk to a local cafe to see friends; another was able to get online through Connecting Scotland and then was supported to learn how to use the device.
More generally, these check-ins and reviews offered beneficiaries the opportunity to be reviewed on a regular basis, with a particular focus placed on preventative measures being taken. For example, if someone was identified as high risk they could be referred back into STARS (local reablement service) for a review or for external support.
Returns from the people who participated in the trial were exceptionally high. The main results were that:
- People were more confident about living at home
- They were more confident in using technology
- They were more active and as a consequence their sleep was better
- There was a massive drop in the number of people who had a fall since their last assessment
Initial findings suggest that if used as part of a wider continuity of care, such devices can play a crucial role in allowing older people to self manage, visibly see change for the better and enhance their conversations about their health or support needs with the people that matter to them. To do this they must be given support from the outset to use the device; understand the information produced, and then be given clear advice when they endeavour to use it to improve or maintain their health.
However, Practitioners must consider a range of factors before introducing this technology – including whether the device is suitable in relation to an individual’s specific health conditions and if they and the people around them have the confidence and resources to support and to manage the general maintenance of the device, so that they may continue to produce useful information.
One of the trial participants was Rosemary who is 80 years old. She took part in the trial and the ARMED app lifted her mood. She now moves more than she did in the past, she sleeps better and her legs are less swollen than beforehand. She found that the feedback given to her from the wrist device helped to make her feel better.
Also see the case study of Shirley Prahms using ARMED in Castle Douglas, Dumfries and Galloway.
All seven health authorities are now aware of ARMED and its success in Dumfries and Galloway Health Board and considering how it might help with fall prevention locally.