Home Care Systems for the Management of Patients With Mental Disorders: The “ALADDIN” Experience

Introduction

Chronic illnesses impose a great burden on the lives of citizens worldwide. In modern health-care, decentralization, dehospitalization and self management of diseases at home are crucial factors for improving the every-day life of chronic patients and the people close to them. Telemedicine and Home Care systems have been developed, making significant advances in healthcare by decentralizing it, offering innovative services to patients and doctors, and making medical practice more efficient and cost-effective in a variety of medical disciplines. However, people in general tend to dislike monitoring of their daily activities, so the challenge for modern home care solutions is to implement systems that provide clinicians with adequate and concise information on their patients’ health status while at the same time be as unobtrusive as possible and easy to use. Moreover, such systems must ensure that they produce high impact warnings on the patient’s status, only when these warnings are truly necessary, in order to relieve clinicians from unnecessary workload and become a real tool for decision making and efficient patient follow-up. Cost considerations are also very important and must be taken into account when designing homecare systems in order to produce solutions that are affordable by the users. Finally, open issues also exist with regard to strategic design aspects and care guidelines. For example, the implementation of fully automated systems vs solutions that allow an increased level of self-involvement to the disease management process is an open question as regards the benefits to the users.

Due consideration of the above aspects is necessary when developing home care systems for chronic patients, but can become more demanding and difficult when it comes to older patients with mental disorders (Archer, Keshavjee, Demers, & Lee, 2014). The development of home care systems for this patient group has not advanced as much as those for other chronic patients, even though mental disorders induce a significant burden on the lives of people all over the world, and they are directly associated with increased costs for national healthcare systems. Moreover, special attention is required for the informal carers of patients with mental disorders, as they run the risk of developing depression symptoms themselves and often face social withdrawal and heavy additional private costs (Tremont & Davis, 2014).