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Incapacitated and Alone: Tech Tools for the Most Vulnerable

14/7/2008

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Originally published on www.elderethics.org on October 13, 2010

Incapacitated and Alone: Tech Tools for the Most Vulnerable

Last week, I had the great fortune to participate in Health Camp as past of Health Innovation Week at Kaiser's Garfield Innovation Center.  An amazing day kicked off by Kaiser's visionary Jack Cochran, who heads the Permanente Federation and the dynamic Todd Park - CTO for HHS who invited hackers to envision new ways of seeing data using HHS data. 

In true innovation form, it was an unconference day. With everyone from entrepreneurial gamers to public health experts, clinicians to VCs, it was an AWESOME agenda created by the Health Campers. 

I invited people to join a conversation on Tech Tools for the Incapacitated Patient Alone- a person who lacks decision making capacity and who has no family or friends to assist them in daily living and/or in decision making in the clinical settings.  This is a front lines clinical reality and a highly vulnerable population.  Our unstructured conversation was dynamic and our group grew from 2 to 10 people curious and concerned about this unique group of patients.   

WHO?

We clarified whom we were talking about: People who have a disease condition that leaves them without decision making capacity (it may be Alzheimer's, aging, stroke, traumatic brain injury or developmental disability). With the increase in geo-mobility, increasingly people may become ill in an environment where they have no family, friends or adult children to provide care.  With advances in medicine, people are outliving their spouse and friends, and some may even survive their children, leaving them alone without anyone to represent their voice when they lose the capacity to make decisions.   

WHERE?

We explored the variety of settings where these people who rapidly become "patients" or "conservatees" of the system might reside and we considered how those environments might benefit from new technology.  People without capacity might be living at home or in a nursing home.  They might be acutely ill and in the hospital, and their circumstance becomes an issue upon discharge. 

WHAT? 

We  identified possibilities for technology to support this patient population from the clinical bedside to daily living in the community setting.  From household gadgets - is there a way to make a stove safe so that someone with fluctuating capacity can remain at home without being a risk to him/herself and neighbors? is there a way to use visual surveillance technology to allow people to safely remain at home while maintaining their privacy/dignity? are there better gadgets to detect & support decline that will make living at home longer possible for someone with fluctuating capacity? 


Thank you to all the people who participated!  This was an exciting & important initial conversation, and we look forward to it continuing! 

There is a "Post a Comment" link at the bottom of this entry for reflections, comments, and responses to the questions at the end.

Thoughts?  Reflections?  Reactions?  How can we best approach these situations?  What ideas do you have for technology tools that might help these vulnerable patients? When they are in the community? When they are in the hospital?



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