Behavior
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Using a Real-Time Locating System to Measure Walking Activity Associated with Wandering Behaviors Among Institutionalized Older Adults
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Summary February 8th, 2019
This paper discusses the use of a continuous and objective real-time locating system to measure walking activity associated with wandering behaviors, focusing on older adults with cognitive impairment. Walking activity is measured by walking distance, sustained walking distance, and sustained gait speed. Also assessed are gait quality and balance ability.
Transcript
Healthcare staff cannot distinguish between physical activity and wandering, and only identify wandering when a patient is at risk for leaving the facility. Changes in walking activity are associated with cognitive impairment, falls, wandering, and other poor health outcomes. The real-time locating system continuously and objectively tracks walking activity.
This includes beneficial physical activity as well as wandering. Wandering is pattern walking that's associated with poor health outcomes. Before assigning a tag to a resident, open the Tag Association tab in the real-time locating system graphic use interface and assign a unique patient ID number to each consenting ambulatory or foot-propelled resident at random.
Use the number provided on each tag to link a tag with each patient ID for wireless tracking, leaving the tag positions at origin and confirming that Allowed tag swaps is selected. Choose the type of tag, the mini tag, and click Save. In Location System Config, click View trace messages.
Then, Get trace messages to make sure the system is recording events from the tags. Under the Sensor status tab, confirm that all of the sensors are running. In Location System Config, click Review location events.
In the window, click Start listening to gather data in real time from tags. To turn on a tag, hold the magnet under the right side of the tag until the light begins to continuously blink. Then attach the activated tags to an area of the body of each resident with a small cross-sectional area for a more limited absorption of the radio frequency energy and to provide a better tracking accuracy.
Once a day, visually check all of the sensor light indicators on the real-time location system sensors and tags and all of the system supplementary equipment, and confirm that the tags have not been submerged in water. Also daily, open the Map tab in the graphic user interface of the system and check that all of the tagged residents are visible and being tracked. To view more immediate events, use the Used last button in the Location System Config to adjust the amount of trace data.
Set the time to the last 10 or fewer minutes, and click Start listening. When batteries are replaced, click on the associated tag and the Tag battery replaced button in the right-hand corner of the Smart Space Config. If a resident is missing from the tracking area and they are wearing an active tag, the report function can be used to determine the last time the resident was seen by the system by clicking on the daily, weekly, and monthly reports.
Here, the travel of one resident over the course of a 24-hour period is shown. It is important to check that there are no jumps through walls and that all of the stationary activity is recorded without jumps. Given that the walking distance is a measure of all of the walking activity and that the sustained walking distance is measured only when the resident walks for at least 60 seconds, it is important to confirm that the walking distance mean data is higher than the sustained walking means for all of the tracked residents.
Supplemental paper and pencil, cognitive, and getting balance tools can be used to further refine patient risk profiles. Real-time locating systems can provide continuous and objective measures of walking activity, predictive of falls, wandering, and other adverse events in high-risk patient populations.
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