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The COVID-19 pandemic has amplified systemic gaps in patient safety, including social frailty for vulnerable populations such as older adults (Briguglio et al., 2020). Public health measures, such as prolonged and frequent lockdowns, restricted access to visitors and support networks and in extreme cases led to confinement within a single room, The negative impact of these restrictions has focused new attention on social frailty, which has hitherto been a somewhat neglected patient safety issue. Since social frailty is a multifaceted construct, it needs to be considered in a variety of settings and from a range of disciplinary perspectives. This practitioner-led panel consisting of an internist, a human factors engineer, an occupational therapist, and an implementation scientist, examines the impact of the pandemic on social interaction, and social frailty amongst older people in three different settings (hospital, long term care home, community). Through a set of case studies, the panelists provided applied experiences and perspectives on the impact of the pandemic on patient safety and on social frailty in particular. The panel covered theory, and real-world application of human factors principles. The question of how to design safety into the healthcare system were also explored. In this paper we review the problem of social frailty, list some brief case studies and discuss possible intervention strategies.

Loss of cognitive potential is one of the greatest impediments to human wellbeing and productivity. Our healthcare system does a poor job of managing cognitive development and cognitive decline because it measures cognitive status relatively infrequently and in the limited times when cognitive measures are taken, the instruments used tend to be blunt. In the panel that we presented at HCS 2021 we examined the potential for cognitive assessment games to provide more frequent cognitive assessment. We reported on the use of a cognitive assessment game to screen for delirium risk in emergency patients, and the development of a suite of assessment games that can assess executive functions and other cognitive abilities in both young and old. We conclude with a discussion of knowledge translation and implementation science strategies for incorporating game-based cognitive assessment into healthcare practice.

Older adults living in long-term care facilities typically receive insufficient exercise and have long periods of the day when they are not doing anything other than sitting or lying down, watching television, or ruminating (Wilkinson et al., 2017). We developed an intervention called the Experiential Centivizer, which provides residents with opportunities to use a driving simulator, watch world travel videos, and engage in exercise. We assessed the impact of the intervention on residents of a long-term care home in Fredericton, NB, Canada. In this paper, we report on the results observed and highlight the lessons learned from implementing a technological intervention within a long-term care setting. Practical and research recommendations are also discussed to facilitate future intervention implementation in long-term care.

In our aging societies, slowing and managing cognitive decline has become a significant challenge for older people, caregivers, andhealthcare providers. In the past decade, there has been an explosion in productsaimed at providing cognitive interventions for the elderly in response to the growing market need. In thispaper, we present a framework for thinking about cognitive interventions, and a product typology based onthe level of technology used and the amount of tangibility/physical interactivity that products have. Weshow how current products fit within the proposed product typology framework. We also note shortfallsthat exist in validating products in terms of their claimed cognitive interventions, and in regions of theproduct technology space that deal withproducts that have low technology and low physical interactivity.

Treatment of dementia has, until recently, largely been based on medical models that address the immediate biological needs, but often fail to meet the individualized needs of the person, including social and psychological needs. Recently, Montessori approaches have been used to validate the whole person and to provide engaging alternatives to the responsive behaviors that arise from unmet needs. In this population, sedentary lifestyle is a particularly severe problem, and there is an urgent need for more physical exercise. Given not only the known benefits of exercise, but also the difficulty of providing traditional methods of physiotherapy in the volume required, automated methods for motivating, and rewarding physical exercise are needed. The research reported in this paper focuses on the development of technologies for aging well through increased cognitive and physical activity among people with dementia. Our goal is to develop solutions for some of the issues faced by long-term care environments by creating engaging and rewarding activities that are available to people with dementia on a 24x7 basis. We have developed units called Centivizers (for “in-centivizing” behavior) that show promise in improving or maintaining physical and cognitive status in dementia by providing people with rewarding, and always-on, opportunities for engaging experiences that motivate physical exercise and cognitive activity.

Many people living with dementia are under-stimulated and socially isolated. While there has been an increase in activities and programming based on recreational therapy and music therapy, such programs can cover only a fraction of the day for people with dementia and are resource demanding to execute. The result is that many people with dementia, who are institutionalized, are staying most of the day either in their rooms, sitting in communal areas, or wandering the hallways. A related problem is that people with dementia often have difficulty with social interactions and may become anxious or aggressive around people they do not recognize, or in situations they do not understand. Resulting responsive behaviours (e.g., hitting, screaming) may lead to overmedication and poor quality of life. Ambient Activity Technology (AAT) is a wall-mounted interactive tool designed for people with dementia. The AAT unit is available in the environment for easy access, and have been designed to augment existing programming and activities by providing self-accessed, engaging and personalized interactions at any time (24-hours per day, 7 days/week). AATs have been designed to reduce distress, in residents and caregivers, by substituting responsive behaviours and purposelessness with active and meaningful activities, distractions, and appropriate interventions. This paper describes the motivation behind the design and development of the AAT. The paper ends with a description of our summative evaluation research, which is currently in progress at several long-term care facilities in Ontario, Canada.

Current cognitive testing methods in the elderly rely on clinical assessments, which are time consuming, costly, and require highly trained staff (Kueider, Parisi, Gross, & Rebok, 2012). We are developing a serious game with the goal of improving the ergonomics of cognition assessment. Instead of pencil and paper, or a computer, we are using touch-based tablets in order to provide a highly mobile and usable form of cognitive assessment. We are currently conducting usability studies on elderly adults in different healthcare environments to evaluate the technology. This paper presents work on customizing the game for use by elderly adults in a hospital emergency department (ED) and it will discuss some of the results obtained thus far, focusing on the usability of the game for this clinical population. In addition to usability results we will also report on the validity of the game in terms of how well it agrees with existing methods of cognitive assessment that are used in the ED.