Pilots

The target group of these pilots are older people and older adults across 5 pilot sites in Europe. In Spain and Italy the target group is formed by people over 65, with a diagnosis of a Parkinson's disorder or Parkinsonism. Autonomy in everyday life is limited by motor and cognitive limitations due to comorbidities linked to the disease and age (hypertension, diabetes mellitus, obesity, risks associated with smoking). Depending on the clinical profile, the person may need supervision for indoor activities (cooking, dressing, housework, remembering medications) and outdoor activities (walking outside, climbing stairs, grocery shopping).

This support could come from the family. In Italy family support (informal caregivers) play a strong role in the care of older adults but recently also formal private caregivers can be requested at home, either part-time or full-time.

People usually live at home with their wife/husband (informal caregiver) or with a formal caregiver. Contact with family by phone or in person is frequent even if not living together.

People are referred to a Primary Care Physician (PCP), in the National Health System, and according to their needs, they can be referred for a specialist visit (public or private). Visits with a specialist can take place at public hospitals, accredited private hospitals or outpatient dedicated structures, where instrumental tests can be carried out as well. Once older people are followed by a specialist (i.e. neurologist, physiatrist, geriatrician), they are re-evaluated every three-to-six months in the outpatient clinic. Among these evaluations, contacts with the specialist can be arranged informally by phone or via email if the caregiver can offer technological help. According to their needs, the specialist can occasionally suggest a revaluation or rehabilitation admission, i.e. for inpatient intensive rehabilitation programme or outpatient rehabilitation sessions.

During the rehabilitation stay, people and their families can be referred to a social worker according to their needs. Older people with reduced autonomy in everyday life activities can eventually reside at R.S.A. (Health Care Residence) or R.A. (Care residence). Care residencies are unequally distributed across the country. i.e there are more available structures in the Northern regions of Italy.

There is a need to adapt service to high levels of home care and to formal caregivers and older people who have never used a computer, so that provides information and training in health promotion / prevention of most frequent causes of mortality in population (i.e. smoking and obesity) and that allows coordination in the delivery of multi-specialized services.

A high percentage of older people live alone without anyone discussing their personal issues. Taking into account the risks of isolation of older people in the country, the service will include functionalities and communication structures to meet this. Below are some statistics gathered from Spain:

• Percentage of people aged 65 or more among total population (2016) was 18.7%.
• Life expectancy in Spain is the highest in the EU (4 years (EU average is 80.9).
• Although many years of life after age 65 are spent with some chronic diseases and disabilities (Nearly 60% of people over 65 have at least one chronic disease), adding pressure to health and long-term care systems.
• Alzheimer’s disease is growing.
• Between 2018 and 2050, older people in Spain is projected to increase at a particularly rapid pace, at least doubling.
• Highest number of older people live in urban regions (e.g. Madrid and Barcelona).
• Percentage of older people in the population who live alone (2015) was 1%
• Older people with high levels of home care (the share of people 85+ without anyone to ask for help, was lower than the average) and the highest shares of informal caregivers.
• Older people with low technology level and high expenditure level in households.
• Share of older people who use internet at least once a week in 2016 was 31%.

The scope of these pilots is to:

• Make a good alignment between user needs, requirements and technical development through testings and co-production/participatory design sessions.
• To test the feasibility (including people’s satisfaction, people’s perception of utility and safety) of the general recommendation provided by the system.
• To evaluate the usability of the monitoring devices (measurements made by sensors and wearable and fixed devices, application functionality) in the real life of older people with PD, AD and OD, their caregivers and healthcare professionals.
• To collect data, during iterative testing, that feed the system and allows developing other functionalities of the system.
• To evaluate the characteristics of the metrics generated by the PROCare4Life platform in real-life conditions.
• To get conclusions on the benefits of PROCare4Life approach towards integrated care and improved well-being and quality of life of older people, indicating possible ways to address frailty, cognitive impairment and prevention of neurodegenerative and other chronic diseases across different settings and institutions.