Joanne Chung School of Nursing The Hong Kong Polytechnic University hsjchung@inet.polyu.hk

1. Technological Innovation: Optimizing the Living Environment and Aids Joanne Chung School of Nursing The Hong Kong Polytechnic University hsjchung@inet.polyu.edu.hk

2. Challenges of the 21st Century Ageing population Sources of photos: Jockey Club Hong Kong and Yahoo

3. New initiative for Primary Health Mobile Integrative Health Centre for Older Adults

4. Optimal Living Environment Framework Foundation: Individual

5. Mobile Integrative Health Centre Our Target: Deprived Groups

6. Unengaged not registered with any kind of networked programme under mainstream services; and, have genuine needs of support services; and, unmotivated to receive assistance Partially unengaged has registered with anetworked  programme under mainstream services before; and, have genuine needs of support services; and, unmotivated to receive assistance /services Our Target: Deprived Groups Unique Features Prevent unnecessary admission to hospitals and enhance independence by optimizing their living environment: • Self care, family care and community care • Participative care focusing on empowerment • Evidence based and protocol driven services • Integrative Western, complementary and TCM practice, and technology • Integrated cultural elements

7. The Team and Community Partners Community partners (NGOs, Police, Estates, District Board) Advanced Practice Nurse Academics & Students Medical Practitioner TCM Doctor Nutritionist IT Engineer Biostatistician Researcher Publicity Staff Video Conference

8. MIHC – the Hub PolyU server Telehealth System (local server) • Web-based Info Centre • Health Promotion & Education Activities • Protocol development Health Statistics Centre Individual & Family Health Profiling Community Health Profiling

9. Interface

10. Dental Assessment Diabetes mellitus consultation Nutrition talk with food samples Psychosocial counselling Interview Exercise Blood oxygen saturation (SpO2) Health education Blood pressure measurement Concentration and small muscle training Cognitive training Pain assessment Visual acuity assessment Foot massage Followup Some Snapshots Pain Management

11. MIHC – the Hub PolyU server Telehealth System (local server) • Web-based Info Centre • Health Promotion & Education Activities • Protocol development Health Statistics Centre Individual & Family Health Profiling Community Health Profiling

12. Optimizing Living Environment Life-long Health Record

13. Health Profile • Mobile Integrative Health Centre started its service on 16 Jan 2008 • 953 older adults (327 male, 626 female) registered for the service @31 August 2008

14. Age (years)

15. Social participation 10.6% of the older people in HK are unengaged (12 Jan 2008) Source: http://www.takungpao.com.hk/news/08/01/21/GW-853769.htm

16. 5 major health problems *include gout, degenerative joints and rheumatic arthritis

17. Mini Nutritional Assessment (MNA) Screening * Subjects with Mini Nutrition Assessment (screening) score <12 is considered as possible malnutrition and require to conduct the further assessment.

18. Malnutrition Indicator Score (MIS) * Subject with MIS <17.0 is considered as malnourished and MIS 17.0 is considered as “at risk of malnutrition”.

19. Abbreviated Mental Test (AMT) * Subject with AMT score < 6 is considered as possible dementia and further test such as Mini Mental State Examination (MMSE) is required. Subject with AMT score  6 is considered as normal.

20. Mini Mental State Examination (MMSE) * MMSE score < 10 = Severe dementia, 10-19 = Moderate dementia, 20-26 = Mild dementia and 27 = normal.

21. Geriatric Depression Scale (GDS) • GDS score < 8 = without depression • GDS score 8 = depression

22. Activities of living Focus assessment 1. Concentration 2. Visual-spatial co-ordination

23. Subjective Happiness Score * Subjective happiness score of 4 and 28 represent lowest and highest happiness respectively.

24. Pain Bowen therapy, exercise Telehealth System ++ Life long health record: a. self-administered health assessment b. continuity of care c. participatory health management Hypertension Drug compliance, monitoring, exercise, education, diet Pain Bowen therapy, exercise Telehealth System ++ Life long health record: a. self-administered health assessment b. continuity of care c. participatory health management DM Drug compliance, monitoring, exercise, education, diet Hypertension Drug compliance, monitoring, exercise, education, diet Outcome in terms if optimizing living environment Nutrition Dietary modification, education, dental care DM Drug compliance, monitoring, exercise, education, diet Problems (at risk/actual) Technology applied Intervention Nutrition Dietary modification, education, dental care Bowen therapy, exercise Pain Telehealth System ++ • Life long health record: a. self-administered health assessment b. continuity of care c. participatory health management Hypertension Drug compliance, monitoring, exercise, education, diet DM Drug compliance, monitoring, exercise, education, diet Nutrition Dietary modification, education, dental care

26. Problems (at risk/actual) Intervention Technology applied Outcome in terms if optimizing living environment Activities of living Safe environment Haptics • Concentration • Visual-spatial co-ordination • Small muscles training

28. Problems (at risk/actual) Intervention Technology applied Outcome in terms if optimizing living environment Perception of self MIHC ‘Blended mode’ 1.Empowerment

30. What's next?

31. External Internal

32. Thank You