Mobility, Communication, Location, and Personal Assistance 24 hours a day
The service philosophy of
Vivofácil emerged to respond to the needs of society in the 21st century. This century can be seen as the timeframe of a different world, with different social and collective needs.
Our primary objective is to be able to respond to the new care needs people, families, and dependents have today.
The senior generation and its new needs
The roles of family members have changed. Men and women alike have their own personal and professional aspirations, which are also now protected by equal rights legislation.
The family, as the basic unit of coexistence around which society is structured, requires the same care as always, and even more, because certain social changes have increased the need for intensive care for certain family members.
These social changes in the current century have led to the emergence of a changing environment in which new values, and therefore new needs, have flourished. These changes have been greatly driven by advances in medicine and scientific research, as well as society’s attention to new conditions that had previously been more neglected.
A new paradigm in care for older people
1. The steadily growing older population, which has doubled over the past 30 years, reaching more than 6.6 million people over 65 in 2000.
2. The spread in our society of what is known as the “aging of aging”—that is, the unstoppable increase in the number of people over 80, which has also doubled over the past 20 years. We must bear in mind that the proportion of dependents among those over 80 is three times that among dependents over 65.
3. The mass entry of women into the labor market, with a very significant increase since 1995, resulting in changes to family structures and the provision of care for dependent people.
4. The increase in professional demands in a context of enormous corporate and global competition, which requires the country and companies to draw on all available human resources to remain competitive. This is compounded by the increasingly significant “talent shortage,” which means that a society like today’s cannot afford to waste any of the personal potential at its disposal.
CHANGES IN FAMILY STRUCTURE AND CARE FOR DEPENDENT PEOPLE
This social transformation mentioned in the previous chapter primarily affects social culture and forms of family organization.
Spain, together with other countries in the Latin context, such as Italy and, to a lesser extent, France, started from a “familialist” concept of meeting people’s care and support needs, meaning that the obligation to care for older adults and dependent people generally fell outside the scope of public mechanisms. These tasks and obligations were assumed by the families themselves, as they were understood to be an inherent responsibility of each person as a member of the family group.
However, as mentioned above, this traditional model has evolved in recent years toward greater independence and autonomy among its members. All family members are entering the labor market irreversibly, and consequently moving away from services that traditionally remained within the “home” (household tasks, care for older adults, personal care for dependent people, etc.).
At the same time, today’s society and businesses demand a rapid increase in professional expectations. Given the still immature development of work–life balance policies, this also leads people away from traditional care models. Finally, today’s fast-paced and stressful lifestyle makes it extremely difficult to combine two tasks that are equally demanding in terms of the intensity and number of hours of care required: professional activities and caring for dependent people, older adults, and children.
In addition to all the social factors mentioned above, the Law on Effective Equality between Men and Women came into force in March 2007. Its principles and provisions clearly conflict with the care provided to all these groups by women in their own families, which reduced their opportunities to integrate and develop professionally. For all these reasons, at Alares we considered it absolutely necessary to develop products and services to support families.
THE DEPENDENCY LAW
The Official State Gazette published Law 39/2006 on the Promotion of Personal Autonomy and Care for People in Situations of Dependency on 15 December 2006; it entered into force on 1 January 2007.
For the first time in our country, this law recognizes a subjective right for people in situations of dependency to receive benefits tailored to their needs.
As a sociological premise regarding the need for this law among the Spanish population, we would highlight the following:
The 2004 survey by the Centre for Sociological Research indicated that:
- 68.5% of Spaniards cited support for dependent people among the three most important measures the Government should undertake to make family life easier.
- 70% of the population supports accepting tax increases if they are used to expand social care services.
From our perspective as an organization specializing in family assistance, the dependency law distinguishes the services it recognizes according to their purpose.
One purpose would be focused on Services to Promote Personal Autonomy, in which telecare, regulated by Article 15 of the law, stands out as the flagship resource.
Another purpose of the law is to provide effective care and support services through specific resources such as home-help services, day and night centers, and residential care services. The defining feature of this last type of service is that it addresses the ongoing or chronic needs of dependent people who have previously been assessed as such.
However, the dependency law does not cover all those specific situations in which other people and families need assistance but do not have a permanent dependency situation. Examples include postoperative recovery, medical convalescence, periods of rest, temporary illnesses affecting children, minors who are alone for certain hours of the day, situations of gender-based violence, and other similar circumstances.
All these specific or temporary care needs can be addressed through technology applied to traditional telecare services, which we will discuss from this point onward.
SERVICES TO PROMOTE PERSONAL AUTONOMY: 21ST-CENTURY TELECARE
First, we would like to highlight two important considerations regarding the definition of the new telecare system.
What Services Should Be Covered?
Based on various research studies conducted by the Alares Foundation, which is dedicated to researching and promoting topics such as disability and dependency, we have identified, among Telecare service users and their families, a growing demand for services that meet current needs, such as:
- Monitoring and surveillance needs in emergency situations, arising from exceptional circumstances as well as everyday life.
- Services that address the day-to-day, situational needs of older or dependent people who live alone (illness, postoperative recovery, etc.)
- Personalized services tailored to each individual and adapted to their personal circumstances.
- Services specifically linked to certain groups, such as people with disabilities, minors, victims of gender-based violence, etc.
With What Technology?
Technology for reliable positioning and mobile telecare is developing very rapidly, but it is still insufficient. We must also bear in mind that not all users require the same technological features; rather, these must be suited to the service being provided and, above all, aligned with the needs and level of dependency of the end user.
The traditional telecare offered at home by
Paco, your trusted assistant is a service that provides the user, 24 hours a day, with two-way communication with a specialized response and care center, as well as an immediate response to certain events, either directly or by mobilizing external resources.
The main advantage of this service is that it provides the user with SECURITY at home, as well as the monitoring and assistance described above 24 hours a day/365 days a year. At the same time, it enables the person to maintain their autonomy and independence within their home, a benefit that is valuable to both the user and their family and also provides peace of mind.
However, this resource has one drawback or deficiency: its lack of mobility. It is spatially limited to the user's home and does not allow communication, monitoring, or social and healthcare assistance inside and OUTSIDE their home.
MOBILE TELECARE
The philosophy guiding the design of an appropriate mobile telecare system should be to complement home telecare and eliminate its deficiencies, allowing the person maximum freedom, autonomy, and safety. Likewise, the following essential characteristics define a good telecare system:
a) Mobility: control inside and outside the home
b) Reliable positioning: A-GPS system supported by GSM-LBS
c) Communication: they can call him, and he can make calls. It is a mobile phone without keys or numbers, easy to use.
Clearly, all these requirements are viable only if technology evolves accordingly and improves each of these processes.
Furthermore, this development must be based on maximizing user mobility while improving performance. It must also be completely reliable for positioning through the introduction of the technologies we will mention later. It must also be competitively priced, making it an accessible resource for most of the population without restricting its use. Finally, we should also highlight battery efficiency as a key factor in mobile telecare, since it has historically been severely affected by GPS positioning systems.
All these factors have evolved very rapidly in recent times and currently enable us to have equipment that meets all the conditions and technical specifications mentioned above.
Location System Analysis
Alares carried out this entire part of the location project together with NAVENTO, an Avanzit Group company and leader in location research and innovation. Nevertheless, all the working assumptions were established taking into account Alares’s studies and experience in the social and healthcare field. As a primary requirement, we established that the device’s positioning or location must be maximized in emergency situations. However, until very recently, integrating A-GPS alone into a small, portable device was not sufficient to guarantee a service providing maximum location security.
Only the combination of A-GPS technology—an assisted-device location system—with a series of key factors in the definition, conception, and design of the device makes it possible to achieve all the desired capabilities.
At the established intervals, the system transmits its location and the speed reading from an accelerometer via GPRS to a central server. In addition to the Telecare Center, each authorized user can consult and view this information through their GPRS mobile phone or PC, using an interface developed on Google Maps. This device can generate a report containing the mechanism ID (and allows several to be tracked simultaneously), the date, time, position, speed at that moment, and battery charge level.
The following development assumptions were used for the technical development of the system:
- First, A-GPS guarantees 100% location outdoors, whereas location availability is not guaranteed 100% indoors, such as in parking garages, subway stations, buildings, etc.
- Based on this premise, different usage scenarios for the user are identified:
1. In state 1, the user is outdoors, on the street, in a car, etc., with permanent location tracking (with guaranteed GPS satellite location).
2. In state 2, the user is at home, in a building, garage, …, where GPS coverage is not guaranteed 100%. In this case, the system stores the last position of the mobile device that received a satellite signal and keeps it recorded for as long as the device cannot be located. Likewise, the device reactivates and records the first point at which the satellite receives the device’s signal again. This provides two location points—the last and the first positions—and simultaneously combines these two moments with traditional GSM cell-based location systems (LBS).
Combining the two states mentioned in the operation of the tracking device maximizes safety across all mobile teleassistance services, especially those for locating older people and dependent individuals with special needs wherever they may be, anywhere in the world.
This technology enables location tracking to become part of everyday life through portable, comfortable, autonomous trackers, using the Internet or a mobile phone with GPRS technology.
All the development studies mentioned have enabled the full potential of the system to be refined, ensuring that the person can be located in 100% of cases.
However, another major problem with the tracker remained to be solved: energy consumption.
Operating the device according to the steps described in States 1 and 2 requires the GPS to operate continuously, with constant point-to-point location updates, which significantly reduced the mechanism’s energy savings.
Therefore, all the studies conducted were aimed at introducing low-power factors that would achieve significant energy savings and increase battery life.
To achieve this, two corrective factors were introduced:
A. Factor 1: Autonomy Maximization Mode: the tracker operates solely and exclusively when the User presses the emergency button, calls the teleassistance center, or when the center sends a location signal for the User.
B. Factor 2: Motion Sensor. The device enters very low-power mode when it detects that no movement is occurring, while the GSM system for making voice calls remains permanently switched on.
The simultaneous combination of these two factors allows the battery to last up to 4 days.
THE FINAL RESULT
The combined integration of all these developments, together with the work carried out by Alares and Navento, ultimately resulted in the device we commercially named: GHOST.
This result combines Alares®’s knowledge of the needs of Users requiring mobility with the technology, development expertise, and A-GPS location system developed by Navento. In addition, the global mapping configuration was carried out through an agreement with Google to provide its easy-to-use worldwide maps and cartography (Google Maps).
Alares defined all the care services based on our experience providing private care services to individuals, especially dependent people. The results of the research program on the needs of dependent people conducted by the Alares Foundation were also vital. Defining the specific needs and requirements of people with Alzheimer's was likewise extremely useful, for which we had the collaboration of AFAL Contigo (National Alzheimer's Association).
The main features of the Alares-Ghost Mobile Telecare device are as follows:
- Weight: 94 grams.
- Dimensions: 96.5 x 43.5 x 27.5 mm.
- It is configured like a regular mobile phone and can receive and make calls.
- It has a large, easy-to-identify emergency button.
- It has 3 direct-call buttons (for 3 programmed numbers).
- It has configurable hands-free functionality.
- It features a highly sensitive omnidirectional microphone.
- It has audible and visual call alerts.
- Remote programming guaranteed through GPRS.
- Total equipment price under €200
As a specific distinguishing feature, it includes Motion, Inactivity, and Fall Sensor programming, which makes it possible to detect potential falls or accidents involving the phone's user. We also considered it advisable to introduce an additional battery for particular situations involving users who require intensive use, by connecting it to the system.
Through the map-based cartographic location system, the Ghost device can be configured with predefined safety zones. This device is especially useful when we want the system to send us an alert when the user leaves a previously defined zone (for example, in the case of people with Alzheimer's), since this real-time location can be authorized by certain family members or other permitted individuals, such as a professional caregiver.
CONCLUSIONS
From our perspective, mobile telecare can play a very important role in our society today. We believe it should become a key care resource because of the benefits it brings to families and their members, whose roles are very different from those in the past, and in a context where older people are increasingly mobile and, at the same time, increasingly isolated. It offers the major advantage of providing a response, security, and care both inside and outside the user's home, and serves as a means of communication in any situation.
Mobile telecare overcomes the limitations of traditional in-home telecare. It is a cutting-edge technological resource that enables intergenerational communication and provides psychological support in situations of loneliness. In addition, Alares® Mobile Telecare with A-GPS location tracking can meet both the ongoing needs of dependent individuals and occasional assistance needs arising from illness or postoperative recovery.
From Alares’ perspective, mobile telecare should also help meet the needs of today’s society by combining basic emergency response and monitoring with a range of occasional support services that improve users’ daily quality of life and provide autonomy and independence. In this way, the care system is not limited solely to emergency telecare, but serves to address all users’ specific day-to-day care needs.
This catalog of additional social and healthcare services, which we at Alares have called FAMILY CARE COVERAGE, includes access, in situations requiring occasional assistance, to home-help services providing personal care for users and domestic assistance due to illness, postoperative recovery, etc. It also includes specialized treatment services (psychologists, physiotherapists, and others). Personnel-selection services for social and healthcare assistance and in-home care are also included, both for specific periods and on an open-ended basis.
In addition, Alares® Mobile Telecare provides preferential access to the management of minor home repair services, responding to urgent needs that may occasionally arise at home and cause great distress to users who find themselves in such situations.
Finally, we would like to highlight the inclusion in the Alares® mobile telecare service of the international second medical opinion program for diagnosing serious illnesses and determining their treatment, with complete privacy and confidentiality for users. It also includes a telephone advice service covering medical, legal, psychological, social, and dietary and nutritional matters, always provided by trained and experienced professionals, with users’ anonymity fully guaranteed.
The combination and joint provision of telecare and these social and healthcare services provide greater Quality of Life, Security, Independence, Autonomy, and Peace of Mind for users and their families.
