Abstract

We had started offering our own unique training service which uses robots called Telenoid as a learning tool. It is expected to develop communication and observation skills for caregivers.

Telenoid is a remotely-operated android robot developed by Prof. Hiroshi Ishiguro (Professor and Fellow ATR, Osaka University Graduate School Mathematical Science department of Engineering Science). It is characterized by minimal design, also the combination of linguistic (voice call)  and non-linguistic communication (hug).

When Telenoid are interposed in communication between an elderly and a caregiver, it creates communication of different quality, and builds innovative life of a older adult with dementia. Currently, we are developing related applications tailed for operational model at nursing care facilities.The lack of visual information because of the minimal design.We imagine things positively when we are in healthy state, and vice versa.

Video: Life With A Robot from Kengo Doi

English edition / Versión en español / Versão em português

Utako Miyazaki(=Mia) CEO

She had cared for her grandmother with dementia at home for fifteen years from her early twenties. She explored know-how and and communication skills to find some amusement and wit in caring a patient at home. Drawing on the skill to guide for consensus-building among people concerned, she launched a consultation service for health care companies. She was involved with designing the service model of Telenoid ™ and became CEO in 2017. Motivational speaker, social media power Influencer and author of “Cultivating Old Age ~ Matters at Home-Care” and others.

2004 President, Taketori-Monogatari Co., Ltd.
2000 Family Representative, Tokyo Home Care Promotion Committee
2012 Adviser, Azuma-Dori Clinic (Consultation for patients’ families)
2014 Manager, Medipass Co., Ltd.(Architecting documentary record for medical care personnels and
patients’ families)
2014 Founder and Director (-present) The Association of the Dialogue Methods for Patients
2017 CEO, Telenoid Healthcare Company

Dr. Akihiro Nakao (=Aki)

2006 Doctor’s License, Miyazaki University School of Medicine
2006 Application Engineer, mixi, Inc.
2008 Founder and CEO (-present) Hymena&Co.
2008 CTO/Board of Director, Hikaku.com, Inc.(TYO:2477)
2012 Founder and CEO (-present) DoctorsMobile, Inc. doctorsmobile.jp
2018- Director, Telenoid Healthcare Company

Telenoid

2.7Kg 50cm

Telenoid ™ is a remotely-operated android robot developed by Prof. Hiroshi Ishiguro (Professor and Fellow ATR, Osaka University Graduate School Mathematical Science department of Engineering Science). It is characterized by minimum design, also language (voice call) and non-language (hug) are mixed.

When Telenoid ™ are interposed in communication between an elderly and a caregiver, it creates communication of different quality, and builds innovative life of a older adult with dementia. Currently, we are developing related applications tailed for operational model at nursing care facilities.

Background

Needs in dementia care

There is a demand from caregivers for providing proper care to people with dementia.The major symptom of dementia is brain dysfunction(memory disorder). 

The real-life effects(called BPSD*which refers to delusions, rants, wanderings, etc.) caused by core symptoms are complex and individual, and difficult to control.   This is because aging (change of body over time) and social factors are added. It can be said that most of the stress associated with dementia care is due to BPSD.

* BPSD: Behavioral and Psychological Symptoms of Dementia

Pros and Cons of Technology Intervention for

Past failures, spaghetti syndrome

In the past few decades, combinations of several dementia care methods ,such as ventilator, tube feeding, and drugs, have been used, which caused a problem to reflect upon called “spaghetti syndrome”.It is also regarded as a hotbed for rising social security costs, and it is necessary to break away from this trend. 

Therefore,if technology is to intervene in the care of dementia patients, it must be a model that achieves higher levels of dignity, efficiency and autonomy than it is today.

Person Centered Care

Person Centered Care is a philosophy of dementia care advocated by Professor Tom Kitwood (Bradford University), which emphasizes the individuality, life and dignity of patients with dementia and aims at the best care for each individual.He also proposes an observation method called DCM for understanding dementia.

 In the UK, it has become the national standard and care standard for providing services for the elderly, and has spread to countries around the world such as the United States, Germany, Australia, Denmark, and Japan. However, learning DCM requires time and money. Therefore,the limited number of Japanese domestic facilities can put DCM into effect.

Utako Miyazaki’s Care Perspective

People with cognitive symptoms sensitively sense information in the surroundings.We believe that most important thing to manage symptoms peripheral to dementia is to control the amount of information from the surroundings and to optimize the external environment, since stimuli like presence of the person can be effect it. This is in line with the idea of ​​person-centered care, but using the technology, we aim to achieve sufficient results even if the caregiver’s observation skills are in the average level.

Problem

What the user (care facility manager) wants to solve

A model in which a person-centered care practitioner supervises the field and creates a virtuous cycle of care by training the younger generation, the burden on the caregiver is reduced and satisfaction of elders is increased,is the basic mode that maximizes economic efficiency, which leads to suppression of turnover and promotion of recruitment and retention.

However, the rapid increase in the number of elderly people with dementia makes the person-centered care practitioners relatively scarce, leading to a decline in the quality of care. Under such circumstances, many nursing facilities are facing difficulties in acquiring nursing care personnel. In addition, in the current long-term care insurance system, if the number of nursing care staff decreases,the number of patients facilities can accept will be limited and revenue will decrease, which results in outflow of nursing staff and business difficulties. 

By constructing a system using technology,it is necessary to and to breakaway from the old model and implement a new model in which anyone can easily become a person-centered care practitioner.

Verification

Development policy of Telenoid Healthcare Company

Controlling “human presence”

 In our model “Telenoid care”, we focus on controlling “human presence”. So far, we have adopted “Telenoid” (a remote-controlled robot developed by Professor Hiroshi Ishiguro of Osaka University) as a dedicated speech transmission device. 

Based on the findings of Utako Miyazaki (our representative) who has experience in family care, the dementia care teaching materials and the recording method were developed, and the trial operation was implemented. It has been highly evaluated by institutions that are aiming or practicing person-centered care, and introduced in 6 nursing homes,and two clinical research institutions (Griffith University Australia, National Center for Neurology and Psychiatry). 

The highly evaluated aspects

  • “Telenoid” is accepted by the people with dementia
  • The strong restlessness last more than one has been resolved just in 10 minutes
  • Worth as a teaching tool of dementia understanding

Survey of the problems for practical use

The importance of the following four points was clarified according to the continuous customer behavior analysis. In particular, the introduction of IT at nursing care site is slow, and there is a situation where no mobile device and no email address assigned to each staff member, the use of personal smartphones during work is prohibited, and FAX is still the main method to communicate.Moreover, there is a large variation among facilities facilities.

1Educational contentImplementation of individual education for caregiversProgram organization according to practical experience and ability characteristics
2SoftwareIndividual recording and sharing of elderly peopleSpecialized in information on optimization of external environment
3HardwareImprovement of devicecommunication setting, remote Ease of operation, quality of collected data
4ConsultingIntroducing a system that matches the actual situation of IT at the site of introductionProposals with a view to promoting IT in the future

Efforts

Consultation Products from Telenoid Care

We are working on the development of a dissemination model so that it can be introduced at facilities where it is difficult to practice person-centered care. In particular, we will analyze the data obtained through the recording application and proceed with research and development on the comfortable amount of external information for each individual. If the basis and the care method are associated, it is possible to contribute to the establishment of non-drug therapy for dementia, and it will be possible to realize automatic analysis.

Of service scheduled to start in the fall of 2020

  1. Subscription service of recording application 
  2. Telenoid rental service
  3. Correspondence course for nursing staff (multiple short video contents + reading materials + videophone + attendance record)
  4. Delivery demonstration (on-site using video phone Demo experience)