Carried out on 27^th November 2000

Introduction

Sigma is a person who is wheelchair bound with limited upper body mobility and is paralysed from the waist down. Since her brain viral infection, she has found it very difficult to speak clearly and her limited upper mobility means that simple tasks such as controlling her electric wheelchair are highly difficult. She was released from the Brain Injury unit in Dundee and returned home to her anxious husband Chi. The CUSTODIAN team were asked by the Tayside Consortium to design and install a smart house for Sigma and Chi. The installation was completed in October 2000.

The Assessment Process

The first time Guy met Sigma she was in hospital at the Royal Victoria Hospital Brain Injury unit. From previous discussions with staff from the unit, it was elicited that Sigma had a serious infection that was indeterminate but spread throughout her body and everyone thought she would die. Luckily, she continues but the result of the infection had taken a considerable toll on her. She appeared very frail, ataxic and communication was considerably difficult as her voice was very soft and she was expectorating significantly, possibly through a chest infection. It was clear from the initial discussion that Sigma had all her mental faculties and was trapped in a body that she could not, at the time, deal with. Her skills in her wheelchair were also not excellent as she constantly collided with objects due to poor motor control. She was also required to be manually fed, which she conceded to, but obviously felt was not the correct way to live.

Through discussions with staff at the unit, it was agreed that Sigma was an ideal candidate for smart home technology because:

1. She was wheelchair bound for the remainder of her life
2. She had poor upper body co-ordination
3. She was in possession of her full mental faculties
4. Her husband would be unable to cope with her
5. Her husband appear to be unwilling to leave her by herself in the house
6. She wanted independence
7. She wanted to be able to do things

Jeremy (JL) was involved fairly soon after this decision as well as Lorraine (LP) and together with Guy (GD) discussed the possibilities of what could be achieved by the technology. The Engineer/installer of the technology (CDE) was working with GD as part of the project that GD works on and his boss had said that they would like to install a house to demonstrate the utility of the technology. Although it appeared that Sigma and Chi could have any products they desired, this was later proven not to be the case. After a number of other meetings, it was agreed that the installation would go ahead and CDE came to meet with Sigma and Chi at their house with GD in attendance. GD had previously met with Sigma and Chi to discuss the potential for devices, but they were still unclear what was on offer. CDE attempted to explain what he could do and presented a picture that anything they wished for could be done using the technology, but effectively left them confused as they were unsure what options were possible (see www.gdewsbury.ukideas.uk/some.html for more details). Certain key point should be made of this interaction:

CDE could not look Sigma in the eyes at any point

CDE spoke to Chi the whole time

CDE was unable to understand what they needed or even wanted. This client group is not what he is use to dealing with.

Sigma and Chi were more confused when he left than before he arrived, but luckily still positive they wanted the equipment.

GD agreed to design a draft outline of the potential devices that could be installed and with the aid of JL and LP who contributed ideas and based on previous discussions. A draft was sent to JL for approval before consulting with Sigma and Chi. On presentation of the outline draft, Sigma and Chi became quite certain that they wanted most of the draft but also wanted extra security features in place. GD and JL discussed this issue with CDE who was able to offer a potential solution which appear to be acceptable to Sigma and Chi. An electrical contractor and builder were brought in to review the work that would be needed to be undertaken and GD, JL and CDE were in attendance. The structure of the bungalow was excellent as the roofing cavities could be used to house the control boxes although the walls were solid and therefore the wire routings would need some restructuring. Window openers were not possible due to the PVC windows that were installed in the house. After further discussions and numerous emails from all parties the works was undertaken successfully. After three months post completion GD visited Sigma and Chi to evaluate the installation.

The evaluation was conducted at the Sigma and Chi's house. The overall impression given to the evaluator was that the design of the smart home installations had significantly improved the quality of life for the couple.

Discussion
Control box with ten levels which allows up to one hundred different operations to be undertaken such as the television, video as well as lights lamp, telephone, teletext, radio, CD, tapes and as well as the overhead lights and side lamp, Computer, entryphone and opens front door, and back door. The back door is automatic opens for fifteen seconds and then shuts itself. Stops when it hits me.

The following are excerpts from the conversations with Sigma, Chi and the carer.

Sigma: Yes I am very happy with system. I don't hate anything about it, except I cannot put videos and CDs into machines. It has made me more independent; Chi can leave me here and know that I am okay because of the entryphone and the ability to contact him on his mobile phone.

I am not left alone much, just for an hour at a time. So it (the smart home installation) has given Charles a break and he can leave me for short periods.

Problems encountered with the system:

Sigma was asked to recall and detail any problems that had been encountered with the system not only from a design perspective but also from the installation side of things.

Sigma:
After the initial bother, where it didn't work properly, it now is fine... The smoke alarm kept beeping intermittently, every so often, but after a new battery was fitted, it was okay. The lights also went on and off after sixty seconds which was very annoying. Chi had to go to the control box and override it. [Chi backed this up and referred to the lights being a considerable bother initially, they are remedied now].

The internal doors do not open automatically, and that would be nice [for them to be automated]. Therefore, if they are shut by mistake then I could be able to open them [if they were automated]. Curtains and window are not so important to me, as I can get someone to open/close them for me.

Chi likes the intercom bit (on the control panel) as well the television controls (that Sigma can operate), as it saves him having to do it all the time.

 

Discussion with carer (external agency carer):

The discussion with the carer was very brief to ascertain her views on the system and as a yardstick to compare with other people with similar conditions. The carer is not the usual carer for Sigma, but had been to the house on a number of occasions before. During the conversation, she recalled that she cares for person with a similar set of conditions as Sigma and is amazed at what the system can do. The other client has to rely on his wife for total round the clock care, the wife is unable to leave for anything more than short periods to the neighbours for a cup of tea. He wants to be independent but partner is unable to leave him alone. A smart home installation would improve the quality of their lives substantially.

 

Observations on the house tour:

Sigma was proud to demonstrate the house to the evaluator and through the tour of the house a number of areas were discussed and observations noted.

Accessing the house is difficult as the back door has a slight bump which is difficult for Sigma to negotiate and the door is timed to open for fifteen seconds which makes it impossible for Sigma to go out of the back door herself. Also the severe 90 degree corner on the ramp that makes Sigma scared to attempt coming in or going out alone of the backdoor alone.

There is no access to cooking/kitchen activities as the new kitchen has been designed so that it is too high to be accessed by Sigma. The new cooker cannot be used by Sigma as the knobs are too stiff to be turned by her. Disability solutions are available for both these features but were not used. The washer/drier area, which is off the kitchen, is inaccessible, as the passage is too narrow to allow wheelchair access.

The lights in all rooms can be activated by chair control.

The social services have provided a smart toilet.

Back door opener occasionally does not close fully, as the input can be confused if too many operations are given in too short a time, which is a security issue and causes some bother to both Sigma and Chi. This is possibly due to the use of a cheap door opener that is visible. The standard solution would be to change the door opener, but due to the design of the door, this could be very costly. The door opener was provided by Dundee social services and apparently, this is the standard opener that they use.

Automated taps would be useful to be fitted in the bathroom, as Sigma would be able to use them to wash her hands and face if they had been fitted. Chi was unaware of this until informed. This would act as a rehabilitative feature of the home design although cost prohibited their inclusion.

The floor surfaces are uneven in places and wheels on wheelchair slip, this is especially the case where a Linoleum type flooring is in place. Carpeted areas are better for manoeuvrability.

Sigma's control panel is not useful in the dark, as it does not have illuminated buttons. She had discussed this with the medical and social work teams who have informed her that the battery life for illuminated control units is very short. She is not too distressed but there is a definite consideration for future control panel designs.