Dementia Care

Vol 5 No 5 October/November 2016

Australian Journal of Dementia Care

allows passive monitoring of the latitude

and longitude of the phone. This means it

can show where the phone is on a map.

This has been used by engineers at

CSIRO’s Australian ehealth Research

Centre and our team of health

researchers at the University of

Queensland to develop a custom

Lifespace app (Liddle

et al

2014).

The app keeps a record of the phone’s

location during a specified period and

calculates lifespace outcomes like daily

distance travelled, percentage of time

spent at home and number of trips into

the community. The user just needs to

carry the phone with them. As GPS is not

effective within buildings, small

bluetooth beacons can be placed within

the home to enable monitoring of the

phone’s position within the home.

Our team now has a study underway

in several Sydney suburbs measuring the

lifespace of people living with dementia

or mild cognitive impairment (MCI).

Users carry the phone for one week and

participate in an interview about their

community mobility experiences and

needs. Family members also participate

in an interview.

Preliminary results are giving insights

into the daily lives of this group, their

experiences of using the technology and

ways in which their current and future

community mobility needs could be met.

Sydney study of lifespace

Fifteen participants (nine men and six

women) to date have provided lifespace

data using the app. These participants

are aged between 81 and 90 years of age,

living either in the community with a

friend or family member (eight

participants), alone (five participants) or

in a low-care facility (two

participants).

Use of the phone app and the

beacons in the home have enabled

us to capture the lifespace in

numbers and visually. We are able to

measure distances travelled,

patterns and locations of activity in

a day and percentage of time spent

at home.

From the data collected so far,

participants spend between 65-99%

of their week at home. Their

lifespaces span between 0.08 and

1.93 sq km during the week. Most

participants do not leave the home

every day, with a range of 0-13 trips

(episodes of going into the

community) recorded over the one-

week period. The furthest distance

travelled in a day ranged from 26m

for one participant to 12.5km for

another.

An example image (translocated

to a different city to protect

anonymity) is below.

The study runs through to the end

of 2016 and as it progresses, the

measured lifespace is being

compared to reported community

mobility experiences and barriers, as

well as participants’ descriptions of

effective supports.

We will also be looking at how

lifespace relates to health and well-being

for people. In doing this, means of

identifying people needing support for

their lifespace, as well as ways of

supporting and enhancing lifespace will

be developed in the expectation that

these clinical interventions can be made

available through health and community

services in future.

Preliminary results from our analysis

of participants’ needs and experiences

appear to support the need for

individualised, meaningful and

multidisciplinary support (eg

occupational therapy, physiotherapy and

psychology) for community mobility.

This may range from support for safe

walking, to managing anxiety and

apathy that might prevent a person being

mobile, to learning about and choosing

the best transport options for chosen

community destinations and activities.

Existing interventions (like those for

driving cessation) may also be indicated.

Community mobility

experiences and needs

The participants in the study were also

interviewed about their community

mobility and needs. They described a

range of things that supported and

encouraged staying mobile including

lifetime habits; pleasant, safe walking

environments; friends and family going

with them; transport options and having

personally important things to do that

DCRC SPEC I AL I SSUE : THE B I G P I CTURE I N DEMENT I A RESEARCH

A heatmap, generated with the Lifespace app, showing lifespace for one of the study

participants over one week. Red areas indicate where they spent the most time. (Note:

heatmap transposed from original location)

This image shows the in-home lifespace

for one of the study participants during

waking hours of one week of monitoring

with the app and beacons. Red areas

indicate where most time is spent