Innovative home monitoring service aims to improve care for patients with dementia
(Image: Thomas Angus, Imperial College London)
Imperial College Healthcare NHS Trust has launched a new NHS service for people living with dementia, offering remote, at-home monitoring that provides specialist support. It is hoped the service can lead to more appropriate interventions and earlier treatments for some of the most vulnerable people living in the community.
MinderCare uses a network of sensors installed in the home to send data back to a dedicated team of doctors, nurses and other clinical specialists. This team use the information to better understand how the person is managing their daily routine, provide tailored advice and identify early signs of changing health and care needs which may help reduce unnecessary hospital admissions.
This new service provides access to a cutting-edge technology system, informed by over 10 years of NHS research and underpinned by clinical care and support, including infrastructure support from the NIHR Imperial Biomedical Research Centre. The MinderCare service model has been developed by researchers at the UK Dementia Research Institute (UK DRI) Care Research & Technology Centre at Imperial College London and is led by Professor David Sharp, in partnership with clinical teams at Imperial College Healthcare NHS Trust and Surrey and Borders Partnership NHS Foundation Trust. MinderCare has been funded and supported by the not-for-profit medical research charity, LifeArc who are dedicated to bringing the benefits of research closer to direct patient care.
MinderCare aims to enhance the quality of life for people living with dementia and their families, by offering medical teams access to data that could help maintain independence for longer for many by identifying areas they may need more support with. This can also provide much-needed reassurance for families and friends.
The person with dementia is provided with a network of smart home devices which are connected via the internet and installed in their home. It includes door, appliance and movement sensors, which can capture trends in movement around the home and during basic household tasks, such as making a cup of tea. There is also a bed mat, which sits under the mattress, tracking sleep disturbances, detecting movement and measuring breathing and heart rates. None of the devices record sound or video, maintaining the individual’s privacy, and they have a discreet design to avoid interfering with daily life.
Data is reviewed every day by the MinderCare monitoring team, which has been sent from the individual’s home system directly to the Minder platform – a dedicated and secure digital research platform which analyses information from the various devices to provide detailed insight. This integrated data helps the monitoring team identify any trends or patterns that might indicate a health and care need so that it can be escalated quickly for further review and intervention if required.
For example, disrupted sleep and night-time restlessness are common issues for people with dementia. These challenges can be improved with careful medication management. The bed mat sensor can be used to track the response to medication through changes in night-time activity, heart rate, and respiration. This valuable data can then be used manage medication and ensure the right dosage.
Respiratory infections and urine infections, which are more common in older adults, can lead to severe health complications in patients with dementia, who may not easily recognise the early signs and symptoms. MinderCare's sensors can detect subtle changes that may indicate an infection, such as changes in heart or respiratory rates. This allows for earlier intervention and faster recovery. The system can also identify unusual habits of movement, such as leaving the house in the middle of the night or a lack of activity during the day.
For some people, changes in routine and exits from the home at unusual times may highlight an immediate concern but this may also mark a period of more gradual increasing risk, especially for people living alone with dementia. The team can respond to these changes, view the pattern of activity over time and use the data to update care plans and ensure they suit the person’s needs.
Prof. David Sharp said: "We need to develop new ways to care for people living with dementia. New technologies can support our existing dementia services to provide more responsive and personalised care. MinderCare is an exciting partnership between the UK Dementia Research Institute and Imperial College NHS Healthcare Trust that trials a radically new way of dementia care that is anchored in the hospital but reaching out into peoples homes, with the aim of delivering cost-effective care that improves quality of life and reduces hospital admissions."
Edith's story
Edith, 83, was diagnosed with dementia a couple of years ago and lives with her son Lee, 54, in West London. Edith’s care is overseen by specialists at Charing Cross Hospital and she’s been using the MinderCare service for the past four months.
Edith said: “It’s reassuring to know that the hospital team are looking out for me at home, especially when Lee isn’t here.
“I’ve had a couple of falls in the last two years and some trouble with my breathing. So I’ve had to spend quite a bit of time in the hospital. The nurses suggested trying these sensors to help me at home – so they can make sure I’m doing OK.
“It took a bit of getting used to – the sensors on the wall flash sometimes and I needed to adjust the mat under my mattress. But I don’t really notice them too much now.”
Lee said: “I’m grateful that she’s able to live at home, with a bit of extra support with me. But I can’t see always everything that’s going on and I get worried that something could happen while I’m out of the house, at work or something.
“So, I was interested when the specialist nurses supporting mum mentioned a new home monitoring service and asked if we wanted to give it a go. It took about half an hour for the team to set it up at home, putting sensors on the door, walls and under Mum’s mattress. It was slightly odd at first, but not disruptive and we’re completely used to it now.
“It’s given me more peace of mind. I know that mum is in good hands and, with the extra monitoring, hope we'll be able to pick up any issues early and adjust her care accordingly."
The new NHS service is run by nurse consultant and dementia specialist Jo James, who has been part of the academic collaboration with the NHS from the outset. Jo and her team support patients living with dementia. She says the new system will be life-changing for families: “MinderCare promises to address the gaps between services that people living with dementia often experience. The MinderCare service model has been designed to provide continuity of care and personalised support for people that we know struggle to navigate health and care services on their own. The technology allows us to do this remotely for more people that we could otherwise reach. The AI enabled risk notifications and data insight provide the prompts and context for the clinical team to make timely contact with a specific focus - and of course patients and their families are also able to contact the team directly when they feel the need for advice, support or reassurance from a specialists in dementia care.”
The MinderCare team are based in the North West London Virtual Hospital at St Charles Hospital, where they are part of a wider team who provide remote monitoring and virtual ward services across North West London. Jan Amade Cassimo, is a specialist dementia nurse from the Trust who has been seconded to support the MinderCare service. She has assessed over 60 patients and continues to receive new referrals every day: “We have been very encouraged by the response so far. Referrals have come from GPs, geriatricians, case managers and other healthcare professions in the community, as well as hospital teams who have identified people going home with some anxiety about how they will manage. We have been able to offer a point of contact for many patients and their families already.”
The new NHS service will aim to enrol 100 patients by September 2025, as part of a study establishing the feasibility of continuing and expanding the service within North West London.
Commenting on the research behind the new NHS service, Professor Ramin Nilforooshan, Consultant Psychiatrist at Surrey and Borders Partnership NHS Foundation Trust and Chief Investigator for the Minder study, said: “At SABP, we are incredibly proud that our award-winning Technology Integrated Health Management research, and subsequent collaboration with the UK DRI on the Minder study, form the foundations of service developments such as MinderCare. We remain committed to transforming dementia care through innovative technologies that enable earlier interventions, enhances continuity of care, and promotes better quality of life for patients and those who support them.”
Research at Imperial College Healthcare is supported by the NIHR Imperial Biomedical Research Centre, a translational research partnership between the Trust and Imperial College London, which was awarded £95m in 2022 to continue developing new experimental treatments and diagnostics for patients.
For more information about the MinderCare smart home monitoring service, you can contact the team directly at imperial.mindercare@nhs.net.
