Portable Wireless Device for Automated Agitation Detection - E-Healthcare Systems and Wireless Communications - page 239

ways of coordinating and managing care. Inter-
disciplinary collaboration, bridging the home with
the hospital, and effective use of information and
technological systems are no more a luxury but
constitute at the moment a need. The advanced
worldwide use of mobile and wireless networks
has made them widely used in many current and
emerging healthcare services. Due to their reduced
size, portable wireless devices make it possible to
monitor patients in a transparent way with minimal
effect on the quality of life. By providing remote
monitoring capabilities, patients' hospitalization
duration is reduced, which has positive impacts
on both the patients and the healthcare system. In
addition, such devices enable immediate response
in case of emergency. Also, the data available from
the long term monitoring can be very valuable for
diagnostic purposes.
In the coming years, the number of older pa-
tients potentially accessing the healthcare system
is expected to double, increasing from 35 million
in 2010 to 72 million by 2030 (He, et al, 2005).
This population boom, a 78 percent increase, will
result in 1 in every 5 Americans being over the
age of 65 by the year 2030 (He, et al, 2005). The
rapidly growing elderly population brings new
healthcare issues into sharp view, particularly that
of caring for elders with Alzheimer's Disease,
which is the leading cause of dementia (He, et
al, 2005). Dementia is an acquired syndrome of
decline in at least one function of the cognitive
system such as language, attention, problem solv-
ing, visuospacial and memory, and is sufficient
to disturb the social and occupational life of an
alert person (Task Force, 1994). Dementia is very
common in aging population but can hit also at an
early age and at any stage of adulthood. A very
common sign of an advanced stage of dementia
is the disorientation in time and/or in place for
persons carrying this syndrome. It is in the long
term care setting that the effects of dementia are
particularly felt, as the disorder results in nega-
tive behavioral symptoms in 54% of patients (He

et al, 2005). This negative behavior is primarily
due to agitation, and can interrupt patient care
and frustrate caregivers. Caring for elders with
dementia is psychologically demanding, and
can result in psychiatric symptoms of caregiver
“burnout” (Rosenblatt, 2005). The loss of skilled
health care providers will undoubtedly be felt in
the often short-staffed world of long-term care.
The care of elders with Alzheimer's disease and
related disorders, such as agitation, carries high
costs. These costs in the United States only are
approximated at 80 to 100 billion dollars annu-
ally, which creates further burden on presently
strained healthcare delivery systems. In order
to control costs, provide optimal patient care,
and prevent the burnout of skilled professionals,
efficient methods of agitation measurement and
management must be implemented to aid nursing
staff in their efforts.
This chapter addresses portable intelligent
devices for healthcare. Specifically the chapter
details the design and experimental results of a
portable wireless device for automated agitation
detection. Section II provides a review of exist-
ing portable wireless devices for healthcare use
in general and of the different methods used for
agitation detection in particular. Section III de-
tails the design of the wireless portable device. It
introduces the device architecture, the sensors, as
well as the algorithm used to fuse these sensors
and predict the state of the patient. The hardware
and detection experimental results are presented
in section IV. Section V discusses the challenges
of both portable e-health devices and automated
agitation detection techniques.

BACKGROUND

In this section previous work is presented. The
work is addressed according to the two aspects
of the chapter: healthcare portable devices and
emotion detection or affective computing.