Wednesday, 8 November 2017

Technical Report Draft 1

Letter of transmittal

Date: 20th October 2017

From: Ho Yong Quan

To: Ministry of Social and Family Development

Cc: Brad Blackstone

Subject: Proposal To Distribute Emergency Alert System

Dear Ministry of Social and Family Development,
I am Yong Quan, and I am part of Eldervists, a project group from Singapore Institute of Technology, consisting of three year-one students in sustainable infrastructure engineering.

As a project for one of our modules, SIE2016 Effective Communication, we are tasked to identify and come up with a solution for the identified issue. After careful deliberation, our project group decided to focus on elderly, specifically the risks that elderly bear when they are alone at home if there are no alert systems present in the house. Our primary focus would be on the potential problems that could arise and solutions that would resolve said problems.

Attached is a detailed proposal on the matter, which comprises of an introduction of our focus, the analysis of the issue, the problems it could pose and a comprehensive solution to the concerns. The proposal is completed with thorough and up to date research, in hopes of determining the best resolution to the matter.

Please do not hesitate to contact us if there are any queries, or require further information. We will assist you to the best of our efforts.

Thank you for your time and consideration.
Best regards,
Ho Yong Quan
Singapore Institute of Technology



Executive summary

The report aims to highlight the importance of having an emergency alert device in the homes of elderly citizens, and the drawbacks and risks of not having them. The report will explore different types of alert systems that are already in the market, and to choose one to be implemented in our proposal. The selection criteria include will be discussed in the proposal.

Upon selection, there will be a proposal to run trials with the selected model, to test the effectiveness and reliability of the medical emergency system. The report will continue to explain the rationale of the implementation and describe how it will be implemented.

Extensive researches were conducted to ensure that the selection of the emergency alert system is comprehensive, and to make sure that the proposal is feasible and beneficial. Primary research include interview with elderly, to have a clearer understanding of the prominent problems faced by them, and to gather constructive input to decide on the most vital features that an emergency alert system should possess.


Introduction

On average, Low (2012) quoted that about one in four elderly above the age of 65 in Singapore will suffer a fall. Of those who fell, two-thirds had a single fall and one-third had recurrent falls. Khalik (2015) also reported that close to 100 elderly were admitted to hospital every month because of an injury from a fall. Sollitto (2017) further explains the reasons why elderly are more prone to falling or slipping. Namely their decline in physical fitness, the effects of medication, impaired vision and chronic diseases.

With the heightened risks of falling, there should be more precautions in ensuring the wellbeing of elderly, especially elderly living alone. With no one present to look after them, the emergency alert system would do well to keep them safe, in an event of a fall.

 Figure 1: Crude rate unintentional falls based on age group
                                         
Table 2: Resident Households by Age Group of Head and Household Living Arrangement, Year 2010 to 2015

The results of both figure X and Y are alarming and dangerous, and we can conclude that the factors related to the risks of elderly injury are increasing exponentially. With more elderly staying alone over the years, the peril of fatal injuries involving elderly increases directly, as the number of elderly exposed to the risk rises.

However, majority of senior citizens in Singapore whom are at risk, do not own the product. It will thus result in higher risks of fatal injuries, or even death. An emergency alert system that allows elderly to call for aid is extremely vital, and could very possibly be the one equipment that could save their lives.





















Problem statement

An emergency alert device should be implemented for the elderly to ensure that they are safe in the case of an actual medical emergency. The majority of the elderly who spend most of their time at home alone do not have any form of emergency alert system. Without it, the elderly will continue to be at risk of not getting emergency attention or help in times of desperate need. An emergency alert device sends distress signals to their caregivers or nearby hospitals when the device detects a fall, or if the signal is sent directly from the elderly. This will allow the elderly to receive medical attention promptly.

Purpose statement

The purpose of this proposal is to explore the different types of emergency alert systems in the market and select the optimal system. The selected alert system will be recommended to Ministry of Social and Family Development, in hopes of it being sold or distributed to elderly or their family in need.

The proposal thus wishes that the product becomes more popular and widely used throughout households with senior citizens  in Singapore, to minimise the rate of fatal accidents occurring in households when the elderly are alone in the house.


Proposed solution

The proposed solution is to recommend a wearable emergency alert device for senior citizens who spend most of their time alone at home. This is to ensure that they are always equipped with the device to receive assistance from caregivers when emergencies occur. Caregivers can range from family members, trained professionals to volunteers.

Considerations and selection
The optimal emergency alert system should consist of the following five criteria:

  • Fall detection
It will automatically contact their respective caregivers when any fall or slippage is detected. This function is vital, as seniors may become unconscious or physically incapable of pressing the button to alert their caregivers. The detection utilises the accelerometer and gyroscope to identify a fall more accurately.

  • Emergency button
The emergency button becomes handy, when seniors require help apart from falls. Examples could include other emergencies such as fire hazard or being generally unwell.

  • Global Positioning System (GPS)
GPS is essential, as it allows caregivers to easily and efficiently locate the whereabouts of the elder in times of medical emergency.

  • Long battery life
Long battery life is extremely favourable, simple because elderly may forget to charge their device from time to time. A longer battery life meant that they are protected for a prolonged amount of time, without new charges.

  • water resistance
Large number of falls occur in the bathroom, where it is often wet and slippery. Thus, it is advisable for the the device to be water resistant, as it would be unfortunate for it to malfunction in times of need.

Upon evaluating and weighing the functions and features, the emergency alert device that Eldervists have selected is the iHelp Adult GPS Tracker Device from OMG Solutions Pte Ltd which costs SGD $390. Refer to Appendix A and B for its specifications and dimensions.

Figure Z. iHelp Adult GPS Tracker Device

Benefits of Proposed Solution

Apart from the four functions and features that were mentioned above, iHelp Adult GPS Tracker Device possess even more advantages, that could benefit the user.

iHelp Adult GPS Tracker Device has an additional feature, named fall detection. It will automatically contact their respective caregivers when any fall or slippage is detected. This function is vital, as seniors may become unconscious or physically incapable of pressing the button to alert their caregivers. The detection utilises the accelerometer and gyroscope to identify a fall more accurately. Furthermore, it contains an in-built motionless detection, to sense any abnormality when no movement is detected for a set amount of time.

On top of that, iHelp Adult GPS Tracker Device provides a two-way communication through calls and text messages to up to five personnel with a press of the button. This allow the elder to be able to instantly voice their troubles in times of need, without the use of another device.

Lastly, the device is also linked onto mobiles devices through the application, DS Tracker, to allow family members or caregivers to know and track the whereabouts of the elderly, to effectively identify the location of the elder in an emergency. (Refer to Appendix C)

Limitations of Proposed Solution
Despite the long battery life, iHelp Adult GPS Tracker Device still has to be charged every 2 to 3 days. Elderly could forget about the device after charging it, which may put them at risk once again. Furthermore, because of the miniature size of the device, senior citizens may risk losing it.

iHelp Adult GPS Tracker Device operates using prepaid card or postpaid plan, which requires regular topping up when the amount runs low. Thus, caregivers will have to constantly check the available amount to ensure the device is still has enough value to be used properly.

Implementation

To evaluate the effectiveness of the selected alert device, there will be a trial programme. 25 elderly would be selected to participate in the trial, where they will be equipped with the alert device for for a month. There will be an assessment once every 2 weeks to collect various feedbacks to determine  the reliability of the selected alert device.

Figure (Please refer to Appendix D) shows and describes the time span of the entire trial programme, and the necessary actions to be taken.


Alternative solution

An alternative solution would be a wireless motion sensor which will be able to monitor senior citizens in real time and provide timely alert. Eldervists have chosen the Smart Activity Monitoring Service (SAMS) by M1 which will cost SGD $214 with a monthly subscriptions of SGD $14.66. SAMS works by monitoring the elder’s daily activities at home by using motion sensor detection and alerts the caregiver through text messages. SAMS consists of four main devices: wireless door sensor, wireless motion sensor, wireless portable panic button, and iNet mini smarthub. (Refer to Appendix E)
Figure X. Operation of Smart Activity Monitoring Service (SAMS)



Benefits of Alternative Solution

The elder’s activity at home is monitored with wireless motion sensor and wireless door sensor.  Caregivers will be notified if the elderly is out of the house, or have been inactive for a long time as there could be a possibility of an emergency that requires immediate attention. Footages of the elder’s activities around the house are also recorded, to allow caregivers or families to identify any oddities present in the apartment.


Similar to iHelp Adult GPS Tracker Device, it has an in-built emergency button, that allows quick response from caregivers in an event of an emergency.




Limitations of Alternative Solution

A household will require more than one wireless motion sensor as there are many rooms such as the kitchen or toilet, which may end up becoming costly. Furthermore, because of the post-paid nature of the plan that costs a monthly subscription of $14.66,  the cost will continue to be incurred and in the long run, may become too expensive.

SAMS requires an internet connection to function. Hence, when the internet connection is down, the elderly will be unable to alert the caregivers when emergencies occur. Regular maintenance have to be conducted as well to keep the system in good working condition.
Methodology

Two different methods of research, primary and secondary, were conducted, to allow our team to have a better understanding on the matter.

Primary Research

Interviews with elderly were conducted for us to have a clearer understanding of the problem. Interviews are highly effective because our team got to interact directly with elderly who are facing the problems themselves. The information from the interview were thus very insightful.

Copy of the questionnaire (see Appendix F) and sample interviews (see Appendix F to H) can be found in the appendix.  

Secondary Research

Secondary research were conducted to obtain essential information required for us to efficiently prepare for and complete the proposal. The information gathered allowed us to identify the problem, come up with plausible solutions, judge the current situation with statistics and more.

Web links of the research materials can be found under “References”, and certain tables and figures can be found in “Appendix”.




Conclusion
The absence of any form of emergency alert system in a household where elderly are often alone is extremely perilous. Elderly will have no one present to assist them, in an unfortunate event of a fall. The injury suffered could become fatal quickly, if help does not come on time.

Thus, to overcome and to prevent such instances from occurring, we recommend iHelp Adult GPS Tracker Device to be distributed to senior citizens who are living alone, or spend most of their time alone in their homes. Said device is selected, because it has a wide variety of features and functions, namely:

  • Fall detection
  • Emergency button
  • Global Positioning System (GPS)
  • Long battery life
  • water resistance

The application of the trail is also accurately planned, to ensure the dependability and practicality of the selected product.

With the implementation of the proposal, we hope the emergency alert system becomes more prominent in Singapore, and eventually becoming imperative for senior citizens. Hence,  rate of fatal accidents occurring in households when the elderly are alone in the house will be greatly minimised, or entirely eliminated.



References

Chan K. M. (1997). Epidemiology of falls among the elderly community dwellers in Singapore. National Centre for Biotechnology Information. Retrieved October 20, 2017, from https://www.ncbi.nlm.nih.gov/pubmed/9529954


Khalik, S. (2015, July 3). Project to reduce seniors' risk of falling. The Strait Times. Retrieved October 17, 2017, from http://www.straitstimes.com/singapore/health/project-to-reduce-seniors-risk-of-falling

Low. F. (2012, March 22). Hospitals help elderly reduce risk of falling. The Strait Times. Retrieved October 17, 2017, from https://www.ttsh.com.sg/uploadedFiles/TTSH/About_Us/Newsroom/News/220311%20ST%20Hospitals%20help%20el.pdf

Marlo S. (2017, July 9). 7 Things That Cause Elderly to Fall. Aging Care. Retrieved October 17, 2017, from https://www.agingcare.com/articles/falls-in-elderly-people-133953.htm

OMG Solutions. (2015) iHelp 3G/4G GSP Tracking Keychain, Waterproof , Motionless & fall Detection. Omega Marketing Group. Retrieved October 17, 2017 from http://omg-solutions.com/gps-tracker/ihelp-3g4g-gsp-tracking-keychain-waterproof-motionless-fall-detection-elderly-with-dementia-omggps10d/

OMG Solutions. (2015) OMGGPS10DW 3G/4G GPS TRACKER KEY CHAIN FOR ELDERLY. Omega Marketing Group. Retrieved October 17, 2017 from

Shyamala T. (2015, May) Health Promotion Board–Ministry of Health Clinical Practice Guidelines: Falls Prevention among Older Adults Living in the Community. Singapore Medical Journal. Retrieved October 17, 2017, from https://www.researchgate.net/publication/277600079_Health_Promotion_Board-Ministry_of_Health_Clinical_Practice_Guidelines_Falls_Prevention_among_Older_Adults_Living_in_the_Community




Appendices

Appendix A. Specifications of iHelp Adult GPS Tracker Device

Appendix B. Dimensions of iHelp Adult GPS Tracker Device

Appendix C. iHelp Mobile Application, DS Tracker, and Website
Appendix D. Gantt Chart of Trial Programme


Appendix E. Four Devices of the Smart Activity Monitoring Service (SAMS)

Friday, 13 October 2017

Reader Response Final Draft


In the article "Floor lights help ‘smartphone zombies’ keep eye on the road", Tan (2017) reported that the newly installed LED strips at crossing junctions could help smartphone addicts stay alert on the road. It described that the LED strips, visible in the day, flash the prominent red and green of a traffic light. The article stated that the Land Transport Authority (LTA) implemented this half year-pilot program at two of the popular vicinities in Singapore due to its heavy human traffics. The program would allow the authority to evaluate the suitability and effectiveness of the LED strips before implementing them on other crossings. In the article, statistics from Traffic Police showed a rise in pedestrian-related accidents, where a substantial amount is comprised of the elderly. While the LED strips enhance road safety awareness for 'smartphone zombies', they do not help minimize the rise in pedestrian-related accidents amongst the elderly.

To understand the reasons behind the rise in pedestrian-related accidents, there is a need to examine the traffic report in Singapore. In 2016, the Singapore Police Force reported in the "Annual Road Traffic Situation 2016" news release, a decrease in pedestrian-related deaths between 2015 and 2016. However, there has been a 19.6 percent increase in pedestrian-related deaths amongst the elderly population. In which, 16 out of 28 elderly deaths are attributed to jaywalking. In the span of a year, accidents involving elderly who jaywalk have climbed from 57 to 81 cases. Although the news release highlighted the elderly as the primary reason for such rise, it does not mention smartphone addicts. Therefore, efforts should be directed towards the persistent rise in jaywalkers rather than placing 'smartphone zombies' in the spotlight.
 
Although LED strips provide pedestrians with an additional signal to cross the road, they do not deter the elderly from jaywalking. In the article “Elderly man killed by bus outside interchange” Lee (2017) reported that an elderly man was knocked down by a bus outside the traffic crossing at Toa Payoh bus depot. It was believed that the elderly man ignored traffic light signals while crossing the road. Interviews conducted at the bus depot revealed that the inconvenience of having to cross two junctions before reaching the train station encouraged pedestrians to jaywalk to save time. In another Straits Times article, “Jaywalking accidents up by 21% in the first half of year, 30% involving elderly pedestrians”, Seow (2017) interviewed Mr Sim, a 67-year-old dishwasher about why he chose to jaywalk and risk his safety when there was a crossing nearby. Mr Sim replied it was “more convenient” to jaywalk. Therefore, instead of implementing LED stripes to improve pedestrians’ road safety awareness, the focus should shift to promoting personal responsibility for one’s safety to reduce the numbers of pedestrian-related accidents. 
 
While the implementation of LED stripes acts as a measure to enhancing road safety awareness for ‘smartphone zombies’, it does not solve the rise in pedestrian-related accidents amongst the elderly. Instead, the LTA should come up with solutions to prevent the public from jaywalking, which would reduce pedestrian-related accidents. 
 
References
Lee, M K (2017). Elderly man killed by bus outside interchange. The Straits TimesRetrieved, October 9, 2017, from

Seow, B Y (2017). Jaywalking accidents up 21% in first half of year, 30% involving elderly pedestrians. The Straits Times. Retrieved, October 13, 2017 from http://www.straitstimes.com/singapore/jaywalking-accidents-up-21-in-first-half-of-year-30-involving-elderly-pedestrians
 
Singapore Police Force (2016). Annual Road Traffic Situation 2016. Retrieved, September 26, 2017, from

Tan, C (2017). Floor lights help 'smartphone zombies' keep eye on the road. The Straits Times. Retrieved, September 20, 2016, from

Last edited on 13 October 2017