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Mirror Reflective learning at work
Mirror Reflective learning at work
Mirror Reflective learning at work
Mirror Reflective learning at work
Mirror Reflective learning at work
Mirror Reflective learning at work
Mirror Reflective learning at work
Mirror Reflective learning at work
Mirror Reflective learning at work
Mirror Reflective learning at work
Mirror Reflective learning at work
Mirror Reflective learning at work
Mirror Reflective learning at work
Mirror Reflective learning at work
Mirror Reflective learning at work
Mirror Reflective learning at work
Mirror Reflective learning at work
Mirror Reflective learning at work
Mirror Reflective learning at work
Mirror Reflective learning at work
Mirror Reflective learning at work
Mirror Reflective learning at work
Mirror Reflective learning at work
Mirror Reflective learning at work
Mirror Reflective learning at work
Mirror Reflective learning at work
Mirror Reflective learning at work
Mirror Reflective learning at work
Mirror Reflective learning at work
Mirror Reflective learning at work
Mirror Reflective learning at work
Mirror Reflective learning at work
Mirror Reflective learning at work
Mirror Reflective learning at work
Mirror Reflective learning at work
Mirror Reflective learning at work
Mirror Reflective learning at work
Mirror Reflective learning at work
Mirror Reflective learning at work
Mirror Reflective learning at work
Mirror Reflective learning at work
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Mirror Reflective learning at work

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This presentation is a composite presentation developed by members of the UU MIRROR project co-ordinated by City University. It describes the use of technology to support reflective learning in care …

This presentation is a composite presentation developed by members of the UU MIRROR project co-ordinated by City University. It describes the use of technology to support reflective learning in care homes for the elderly.

Published in: Health & Medicine
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  • 1. MIRROR Reflective Learning at Work Exploiting Apps to Support Dementia and Residential Care © MIRROR Project - Co-Funded by EU IST FP7 – www.mirror-project.eu
  • 2. Event Agenda 1. 2. 3. 4. 5. Introduction of Mirror, reflective learning and app sphere The Digital life history app and manager The Yammer App extended with reflective learning The 3D Virtual care home App for carer training The CaReflect App with proximity sensors to provide evidence about care activities to reflect on 6. The Carer App for challenging behaviour 7. Adoption, exploitation and funding options 8. Collaborative buffet lunch for further discussions © MIRROR Project - Co-Funded by EU IST FP7 – www.mirror-project.eu
  • 3. MIRROR How technology can help care home staff reflect and learn Ian Turner Chairman RNHA © MIRROR Project - Co-Funded by EU IST FP7 – www.mirror-project.eu
  • 4. Registered Nursing Home Association ▪ ▪ ▪ ▪ ▪ 1000 small and medium Care Homes in membership Based in Birmingham with 10 staff 20,000 staff checks on DBS per annum Roadshow of current issues annually Represents members with government, regulator and other professional bodies © MIRROR Project - Co-Funded by EU IST FP7 – www.mirror-project.eu
  • 5. The Mirror Project ▪ ▪ ▪ ▪ ▪ Theme “Reflective Learning” Four year EC funded project Middle of the final year Collaboration of various european universities Testbeds also include european partners, eg italian emergency services and german neurological clinic © MIRROR Project - Co-Funded by EU IST FP7 – www.mirror-project.eu
  • 6. Why Dementia Care and Reflective Learning? ▪ Healthcare can offer limited support for dementia being task / intervention based ▪ Social Care “enabling” is the dominant model ▪ That enabling requires staff to understand the behaviour of the individual ▪ Requires staff to be a detective to reflect on information known about the person © MIRROR Project - Co-Funded by EU IST FP7 – www.mirror-project.eu
  • 7. Caring for those Living with Dementia ▪ In the late stages of the disease all the medical model can offer is sedation ▪ Task based care will usually lead to confrontation between resident and carer ▪ Supervision and enabling care is the aim ▪ Care Planning is not just task / issue based © MIRROR Project - Co-Funded by EU IST FP7 – www.mirror-project.eu
  • 8. Care for those Living with Dementia ▪ Carers need to know as much about the person in order to understand the behaviour and preferences of the individual ▪ Gentleman wakes at 4am every day ▪ Devon lady becomes agitated in early evening Currently record life history on paper but life histories only started on admission © MIRROR Project - Co-Funded by EU IST FP7 – www.mirror-project.eu
  • 9. Care for those Living with Dementia ▪ Memory from this morning will be minimal, if at all, which means the person will not remember the last meal or drink ▪ They will not remember their visitors or probably where they are living ▪ Long term memory will be much clearer ▪ Boredom and inactivity can result ▪ Need to start data capture on diagnosis © MIRROR Project - Co-Funded by EU IST FP7 – www.mirror-project.eu
  • 10. Care for those Living with Dementia ▪ A range of “meaningful activity” is required ▪ Activity cannot be restricted to 2-5pm on weekday afternoons ▪ All care staff must be responsible for such activity in partnership with activity staff ▪ A part time secretary ▪ Childcare remembered ▪ Swimming for a resident © MIRROR Project - Co-Funded by EU IST FP7 – www.mirror-project.eu
  • 11. Care for those Living with Dementia ▪ We need a range of therapies: ▪ ▪ ▪ ▪ ▪ ▪ ▪ Music Doll Complimentary therapies, eg reflexology Garden based Hobby based DIY – the man’s shed etc © MIRROR Project - Co-Funded by EU IST FP7 – www.mirror-project.eu
  • 12. Care for those Living with Dementia ▪ Staff cannot be “robotic” in delivering care to those living with dementia ▪ Staff must think about how to approach residents ▪ Staff must see the whole person they are caring for ▪ Staff must think about why residents are reacting to them in a particular way © MIRROR Project - Co-Funded by EU IST FP7 – www.mirror-project.eu
  • 13. Care for those Living with Dementia ▪ NICE have set an English standard for dementia which concentrates on diagnosis and early stages of the disease with some elements applicable to the later stages. ▪ My three major factors for later stages are ▪ Life Histories ▪ Meaningful activities, and ▪ Reflective practice © MIRROR Project - Co-Funded by EU IST FP7 – www.mirror-project.eu
  • 14. The Carer Role ▪ ▪ ▪ ▪ ▪ ▪ Demanding role People skills are vital Values are central Person centred Technical skills can be taught Staff training is significant effort © MIRROR Project - Co-Funded by EU IST FP7 – www.mirror-project.eu
  • 15. Standards in Social Care in England ▪ Regulatory standards – 360 of them in Essential Standards of Quality and Safety ▪ Just about to start another set where the inspectors judgement will be about is the service safe, is it effective, is it caring, is it responsive to people’s needs, and is it well led? ▪ This will be the fourth major upheaval in ten years © MIRROR Project - Co-Funded by EU IST FP7 – www.mirror-project.eu
  • 16. Standards in Social Care in England ▪ Whilst these standards are not prescriptive (and will not be in the future) this means that everyone has got a different angle / statement / value ▪ Take medication, is it zero tolerance to recorded administration, zero tolerance to medication not being available or some other measure. Compare with general compliance. © MIRROR Project - Co-Funded by EU IST FP7 – www.mirror-project.eu
  • 17. Standards in Social Care in England ▪ Consequence is ▪ Staff nervousness of not doing the right thing ▪ Lack of confidence in many homes ▪ Different views and performance levels being demanded by regulators, commissioners, environmental health or safeguarding staff ▪ Hence providers need to be very clear to staff about the standard of performance expected of them, which is a challenge © MIRROR Project - Co-Funded by EU IST FP7 – www.mirror-project.eu
  • 18. Information Technology in Care Homes ▪ Generally restricted to the manager and administrator ▪ Typically payroll and accounts ▪ If care plans are stored electronically they will not be available to care staff outside office hours ▪ 98% of Care Home had internet access 3yrs ago, but access very limited © MIRROR Project - Co-Funded by EU IST FP7 – www.mirror-project.eu
  • 19. Social Care and Information Technology ▪ We are at the data capture stage in the sector overall ▪ Systems are percieved as for the administrator and manager ▪ Outside MIRROR - medication is a good example – the first systems are just coming into use ▪ Infrastructure, eg WiFi, in most homes, not available © MIRROR Project - Co-Funded by EU IST FP7 – www.mirror-project.eu
  • 20. Issues Arising from Research ▪ There is little formal reflection in most homes (“too busy”), but widely accepted as needed. ▪ Significant change in acceptance of care staff to technology. Now, often ahead of management! ▪ Many care homes lacking IT infrastructure, with poor provision for carers, and hardly any for residents, but the demand is coming. ▪ A need for care staff training, including how to help and mediate the technology for residents. © MIRROR Project - Co-Funded by EU IST FP7 – www.mirror-project.eu
  • 21. Current Position ▪ All MIRROR apps were received positively by homes and staff. ▪ Now second round of testing in residential care homes. Again, positive responses, particularly among new and inexperienced staff. ▪ New & novel apps for staff are seen as a refreshing change. They won’t replace traditional training, but can have a part to play. ▪ MIRROR believes that, at last, the time for technology in residential care homes has come. © MIRROR Project - Co-Funded by EU IST FP7 – www.mirror-project.eu
  • 22. NHS Number ▪ Department of Health wishes to encourage the collection and use of NHS Number to facilitate data exchange between all parties. ▪ Currently only asking for collection and storage of NHS number ▪ Validation rules at http://systems.hscic.gov.uk/nhsnumber/stafffaqs.p df © MIRROR Project - Co-Funded by EU IST FP7 – www.mirror-project.eu
  • 23. The Digital Life History App © MIRROR Project - Co-Funded by EU IST FP7 – www.mirror-project.eu
  • 24. The Digital Life History App Tablet-based app providing resident life information ▪ Paper-based storybooks difficult to update and share ▪ Existing digital solutions insufficiently flexible Key app features ▪ ▪ ▪ ▪ Life history information updates by carers and relatives One-stop for information, videos and external links Supports reminiscence through stories with residents Guiding personal care on myhomelife care values © MIRROR Project - Co-Funded by EU IST FP7 – www.mirror-project.eu
  • 25. The Digital Life History App: Architecture and Evaluation Carers Carer Resident life Resident life history history information information database database Relatives Resident life history manager Server Server Resident life history app Early use in one residential home ▪ Digital Life History Manager used to document full resident life histories from physical books © MIRROR Project - Co-Funded by EU IST FP7 – www.mirror-project.eu Resident
  • 26. The Extended Yammer App © MIRROR Project - Co-Funded by EU IST FP7 – www.mirror-project.eu
  • 27. Extended Yammer App Replace paper notebook with mobile app ▪ Adapt enterprise microblogging as prototype ▪ Direct in-situ care note entry on mobile device ▪ Direct access to all care notes about resident ▪ Real-time supervision of care progress ▪ Integration with electronic care record systems © MIRROR Project - Co-Funded by EU IST FP7 – www.mirror-project.eu
  • 28. Extended Yammer App Architecture Exported care notes Carers Resident care Resident care record record database database Care note reflections Device Device © MIRROR Project - Co-Funded by EU IST FP7 – www.mirror-project.eu Server Server
  • 29. Extended Yammer App Evaluation Used effectively in residential homes ▪ Carers able and willing to use app during and after shifts ▪ Increased number and detail of captured care notes ▪ Some increases in number of reflections about care Important contextual factors ▪ Fitted with flexible care work practices ▪ Used before shift to prepare for care activities ▪ Perceptions of relatives sometimes negative Future app evolutions ▪ More explicit support for reflection about residents ▪ Contextualise care notes in digital life history © MIRROR Project - Co-Funded by EU IST FP7 – www.mirror-project.eu
  • 30. Virtual Care Home App • 3D game for the health and care sector to train carers deal with difficult dialogues and stressful situations at work • To facilitate the reflection process during the training and to giving users a virtual tutoring support during the gameplay. © MIRROR Project - Co-Funded by EU IST FP7 – www.mirror-project.eu
  • 31. Virtual Care Home Components Serious Games User Tools for reflection 3D Virtual Care Home Mini Games Branching Stories Virtual Tutor Wizard tool for content Self-evaluation; Global feedback; Graphic comparison; Learning diary. © MIRROR Project - Co-Funded by EU IST FP7 – www.mirror-project.eu
  • 32. The CaReflect App and Proximity Sensors © MIRROR Project - Co-Funded by EU IST FP7 – www.mirror-project.eu
  • 33. CaReflect © MIRROR Project - Co-Funded by EU IST FP7 – www.mirror-project.eu 33
  • 34. Architecture ▪ CaReflect     Configures Sensores Visualizes Data for Carers Overview for management Runs on a PC  Sensors     Small and light weight Robust casing, no buttons 7 days on one battery No further infrastructure required 2-3m (7-10ft) 34 © MIRROR Project - Co-Funded by EU IST FP7 – www.mirror-project.eu
  • 35. Summary ▪ Measure and Quantify Care  Wearable sensors  Visualize contact times ▪ Current state – after test in two care homes  Very positive feedback, e.g. initiated group discussion  No privacy concerns but various benefits are envisioned  Neglect monitoring  Evidence to relatives  Preparing for next study «CaReflect does not try to provide the answers but helps to ask the questions» © MIRROR Project - Co-Funded by EU IST FP7 – www.mirror-project.eu 35
  • 36. The Carer App © MIRROR Project - Co-Funded by EU IST FP7 – www.mirror-project.eu
  • 37. Carer App Personal support to resolve challenging behaviour with creative thinking that personalises care 1. Other, less-constrained worlds to resolve case 2. Analogical cases to transfer ideas to resolve case 3. Previous dementia cases to reuse ideas to resolve case Case base of good practices ▪ Natural language descriptions of successful care work Simple audio-recording of ideas ▪ Structure, playback and export care plans to share © MIRROR Project - Co-Funded by EU IST FP7 – www.mirror-project.eu
  • 38. Carer App Architecture Case-based reasoning Case-based reasoning discovery service discovery service Analogical reasoning Analogical reasoning discovery service discovery service Carers Creativity prompt Creativity prompt generation service generation service Server Server © MIRROR Project - Co-Funded by EU IST FP7 – www.mirror-project.eu Good care Good care practice xml practice xml repository repository
  • 39. Carer App Evaluations Used effectively in residential care homes ▪ Carers used retrieved dementia cases over others ▪ Generated, played back, improved and shared audio ideas ▪ Led to care improvements attributed to recorded ideas Important contextual factors ▪ More app use outside of shifts – time and space ▪ Align app use with care home values, practices Future app evolutions ▪ Integrate idea generation with digital life histories ▪ Enhanced web support for collecting good care practices © MIRROR Project - Co-Funded by EU IST FP7 – www.mirror-project.eu
  • 40. Third-Source Funding Options © MIRROR Project - Co-Funded by EU IST FP7 – www.mirror-project.eu
  • 41. Third-Source Funding Options 1. Knowledge Transfer Partnerships ▪ Fund 50-67% of project for 1-2 years ▪ Product development, service rollout ▪ Incremental proposal process 1. Collaboration with Charities ▪ For example Leverhulme Trust, Joseph Roundtree Foundation, Dementia Action Alliance 1. Bilateral Development Projects ▪ Seek University resources to support © MIRROR Project - Co-Funded by EU IST FP7 – www.mirror-project.eu

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