4.3.1 Health-related quality of life (QoL) and user satisfaction (quality of experience) measurement metrics

In order to measure and asses the impacts of the proposed solution on the quality of life, a set of quality of life metrics were defined. The results of the experiment were analyzed in light of these metrics.

#### 4.4 Ethical approval

Authorization and written informed participant consents were received from all major participants and their parents. An ad-hoc ethics committee at the involved clinics examined the request to conduct such an interview involving home's residents and approved it. Resident's parents also approved the study.

### 5. Findings and discussion

This section presents the study findings and discusses the results in light of data analytics.

#### 5.1 Literature review on smart home automation for homecare

The literature review has pointed out that only a few previous types of research consider the multidimensionality of the concept of the smart home. Mostly the studies are focused on one aspect of smart home such as energy management [11].

IoT-Enabled Health Monitoring and Assistive Systems for in Place Aging Dementia Patient… DOI: http://dx.doi.org/10.5772/intechopen.86247

A total of 656 abstracts and 239 full papers (journal and conference papers) were reviewed. Only 41 papers were retained having met the requirement of the present study. Unfortunately, only two papers have discussed many dimensions of smart homes. The rest mostly handle the topic of energy management at home. Smart home for elderly people is well considered in many papers, but the papers have failed to consider the multidimensionality of the concept of "aging at home".

Regarding the results, a novel solution considering the multidimensionality is therefore highly needed.

#### 5.2 Interview findings

#### 5.2.1 Patient's preferences

The interview with nursing home residents has revealed that elderly people prefer staying at home in their familiar and usual social environment (familiarity) and take care of their health by themselves as long as they are able to though only participants with good family support and those who have children, grandchildren, and good social contacts have the wish to stay at home as long as possible. However, alone living people, poor people, and people having no family support feel comfortable at the nursing residence.

Table 10 summarizes the results of the interview. Up to 91% of people living alone prefer residing in nursing homes, while more than 91% of people with good family support prefer staying at home with their family members.

#### 5.2.2 Tendency toward homecare and nursing homes

Beyond the research questions, three (03) hypotheses were set. One hypothesis concerns the tendency for homecare as well as for nursing care home.

H1: The tendency to care for patients in homecare is on increase since the nursing crisis.

The study verifies on the light of interview results the hypothesis H1. The survey was carried out to investigate the impact of the nursing crisis on the family member behavior toward the nursing care option for their patients.


The surveys point out the following results:

#### Table 10.

Participant's preferences toward living in nursing homes or staying at home.

4.3.1 Health-related quality of life (QoL) and user satisfaction (quality of experience)

In order to measure and asses the impacts of the proposed solution on the quality of life, a set of quality of life metrics were defined. The results of the experiment

Authorization and written informed participant consents were received from all major participants and their parents. An ad-hoc ethics committee at the involved clinics examined the request to conduct such an interview involving home's resi-

This section presents the study findings and discusses the results in light of data

The literature review has pointed out that only a few previous types of research consider the multidimensionality of the concept of the smart home. Mostly the studies are focused on one aspect of smart home such as energy management [11].

dents and approved it. Resident's parents also approved the study.

5.1 Literature review on smart home automation for homecare

measurement metrics

Quality of life measurement metrics.

Bio-signal gathering and

data quality

Table 9.

5. Findings and discussion

analytics.

88

4.4 Ethical approval

Quality of life measurement metrics

Room temperature management

Description

Internet of Things (IoT) for Automated and Smart Applications

as prescribed?

Socialization How many social contacts the patient has?

Familiarity How familiar is the place to the individual

emergency?

water.

home?

Food and water intake This metric verifies how many times the participant failed to take food and

Medication intake Does the participant follow the medical instructions and take the medicine

Does he connect to other people or is he isolated?

Accident rate Does the system assist and prevent the participant from accident such as injury with a knife, fall down, etc.?

Emergency management Does the system correctly detect emergency cases and thus manage the

Does the system correctly learn from the participant preferences and set

Physical activities Does the participant go out for physical activities or perform some at

the temperature accordingly? Noise and lighting control Noise and light can make the individual feel uncomfortable

were analyzed in light of these metrics.

There exist two categories of care: (i) stationary and (ii) ambulant nursing care [34].

People traditionally choose nursing residences for many reasons: (i) many people are living alone or have poor family support, (ii) the patient is at the end of life and needs severe intensive and palliative care, (iii) the care level (Ger. Pflegestufe).

A total of 118 healthcare staffs were interviewed. A total of 397 individuals on the street were also interviewed. A total of 56.78% of the interviewed care personnel admitted that the number of applicants for being admitted to a nursing home is


### Table 11.

Tendency viewed by healthcare staff.


#### Table 12.

Preference of caring for a patient at home.


being slowly decreasing, while 58.69% of people interviewed on the street prefer to

Comparison of patient's quality of life before and after applying the proposed solution.

The quantitative results regarding challenges and the number of people that reported these challenges and issues by caring for a family member are summarized in Table 13 (Diagram 1). The quantitative data analysis reveals that very few people in home care are faced with data collection issues. This means data are rarely

Tables 11 and 12 show the tendencies of nursing care. The results obtained have

care for relatives in homecare.

Diagram 1.

Table 14.

91

Number of participants facing challenges and issues in homecare.

DOI: http://dx.doi.org/10.5772/intechopen.86247

IoT-Enabled Health Monitoring and Assistive Systems for in Place Aging Dementia Patient…

confirmed the hypothesis H1.

5.2.3 Challenges and issues faced

Table 13. Challenges and issues faced in homecare. IoT-Enabled Health Monitoring and Assistive Systems for in Place Aging Dementia Patient… DOI: http://dx.doi.org/10.5772/intechopen.86247

#### Diagram 1.

There exist two categories of care: (i) stationary and (ii) ambulant nursing

Care personnel 67 (56.78%) 23 (19.50) 28 (23.72)

Assessment method N = 118

Internet of Things (IoT) for Automated and Smart Applications

200 experienced with nursing homes

197 not experienced with nursing homes

Pos. N = 397

6 Loss of quality of life 397 (100%) 7 Limited social activities 290 (73.04%) 8 Depression 15 (3.8%)

People traditionally choose nursing residences for many reasons: (i) many people are living alone or have poor family support, (ii) the patient is at the end of life and needs severe intensive and palliative care, (iii) the care level (Ger. Pflegestufe). A total of 118 healthcare staffs were interviewed. A total of 397 individuals on the street were also interviewed. A total of 56.78% of the interviewed care personnel admitted that the number of applicants for being admitted to a nursing home is

> Application for being admitted in nursing care residence Decreasing Increasing Stable

> > N = 397

233 (58.69%)

Challenges and issues Number (%) Comments 1 Nocturnal rest 397 (100%) The family members have no rest.

2 Emergency issues 375 (99.5%) Patient-centric data are collected.

5 Combining job and care for a family member The system shows potential to assist

aging in place Only part-time 317 (80.01%)

3 Limited round the clock nursing 397 (100%) x 4 Inaccurate collected data 40 (10.07%) x

> Stress 397 (100%) Financial issue 298 (74.81%)

Care experience Care for sick family members in homecare

Prefer Do not

prefer

97 (24.43%) 67 (16.87%)

They can sleep well since assisted by the machine

people in caring for their in parents

Prefer going abroad

care [34].

Table 11.

Assessment method

People on the street

Table 12.

Table 13.

90

Challenges and issues faced in homecare.

Tendency viewed by healthcare staff.

Preference of caring for a patient at home.

Number of participants facing challenges and issues in homecare.


Table 14.

Comparison of patient's quality of life before and after applying the proposed solution.

being slowly decreasing, while 58.69% of people interviewed on the street prefer to care for relatives in homecare.

Tables 11 and 12 show the tendencies of nursing care. The results obtained have confirmed the hypothesis H1.

#### 5.2.3 Challenges and issues faced

The quantitative results regarding challenges and the number of people that reported these challenges and issues by caring for a family member are summarized in Table 13 (Diagram 1). The quantitative data analysis reveals that very few people in home care are faced with data collection issues. This means data are rarely collected in home care. Thus, patients laying at home do not produce patient-centric data. The few data there produce is patient-centered. It is though known that patient-centered data are subjective, incomplete, and sometimes biased [27, 35].

The solution shows positive impacts on the quality of life (Good++, 36.6% started physical activities and 43.33% re-socialize). Due to the solution, 36.6% reconnect to physical activities, which means an increment of 23.3%. Nevertheless,

IoT-Enabled Health Monitoring and Assistive Systems for in Place Aging Dementia Patient…

The solution has the pottential to assist people in combining full-time or parttime job with caring for a family member in home care. Since many people

> (Survey + 5 days observation)

Bad Good

Bad Improved

After the test (Data provided by the system + observation)

Good (mostly full time)

about 62% remains without physical activities.

DOI: http://dx.doi.org/10.5772/intechopen.86247

5.3.2 Family members

Diagram 3.

Impact of family support on the QoL.

N = 45 (patient's relatives)

Emergency management (quick

Quality of communication with

medical assistance)

doctors

Table 16.

93

Metrics Before the test

Job situation Worst (no job,

Quality of life Average Very good Socialization Few Good Nocturnal rest Bad Very good

Bio-signal gathering and data quality Worst Improved (good)

Comparison of family member's quality of life before and after applying the proposed solution.

Financial issues Bad Improved Depression Highly depressive Less depressive

part-time job)
