Computer Security Service for People with Alzheimer's or other Cognitive Diseases

Project location: Italy, Lazio Region
Project start date: December 2010 - Project end date: September 2011
Project number: 2010-74
Beneficiary: Alzheimer Uniti Roma Onlus

January 4 to april 28 - 2011 

 In order to guarantee a functional and efficient implementation of the project objectives, a formal Working Group was set-up, being composed by: Prof. Dr. Luisa Bartorelli (chairman) and Dr. Alessia Fiandra (Coordinator of Test Patients Group), on Alzheimer Uniti side, and Ing. Luciano De Petris (Project technical Coordinator), Dr. Gina Di Liegro (Welfare policy expert)) and Ing. Alessandro De Rocco (Technical Manager), on SdP side.
The Working Group, as an outcome of various meetings, agreed to the following:
- The pilot project will take place mainly in the city of Rome;
- the analytical details and specifications of the planned trials (feasibility study) are under preparation for their eventual submission to the approval of the Chairman;
- twenty is the number of Alzheimer's patients to be enrolled in the Diogenes pilot trial;
- in accordance with the relevant Representatives of Police and Carabinieri operating in the city of Rome, the type of data (name, surname, address, definition of the free movement area of the patient, digital foto, etc.), the protocols, as well as the type of telematic links, between the SdP Central Control Unit and the Police and Carabinieri Control Centres, are to be identified and formally defined;
- The Working Group will report on the progress of the project, to Dr. Michele Penta, Commissioner for the Italian Ministry of Internal Affairs, chairing the Joint Committee for Missing Persons,.
FEASIBILITY STUDY
The daily activities of an Alzheimer patient were classified among three different hypothesis of life scenarios, each one of them descending from the three typical stages of cognitive regression generated by the pathology.
Three daily life scenarios were identified and for two of them relevant Diogenes procedures, to be further defined, were outlined:
1 The patient is self-sufficient and is still able to manage his daily life; he/she is partially independent but is in need of a light monitoring to prevent a sudden, temporary loss of memory that might cause the loss of direction back to his/her home. A caregiver light control, that can be normally ensured by a relative, would be implemented through Diogenes procedure and a 24 hours presence of the caregiver would not be required;
2 The patient can manage some of his/hers daily life functions, but is in need of continuous supervision of a caregiver, both in his/her private home or in any other temporary or dedicated residence. In this case, the risk being that the patient may, suddenly and without any reason, try to escape, the control of a caregiver must be ensured over the 24hours and the Diogenes procedure is meant to control the presence of the patient within the pre-defined given area;
3 The patient is fully incapable of managing his daily life, can't live without the caregiver support because he/she is bedridden or constrained to stay all day at home or in any other dedicated residence. It was agreed not to include patients at this stage of cognitive regression in the trials of Diogenes Project.

FINAL SCHEDULE OF DIOGENES PROJECT
Preliminary
a) type of service and equipment
The types of services offered therefore are:
• Supervision of a patient partially self-sufficient, who still moves autonomously;
• Supervision of a patient in need of constant monitoring by the Caregiver.
The project will then provide:
• A special device, to be worn as a bracelet, for the continuous tracking of the patient;
• Detailed user's manual of the device and of its operation during the service
time.
b) the Control Centre Unit
The SdP CCU will:
• Introduce all the data of the enrolled patients into the project personalized database root;
• Implement a series of tests on the actual functionality of the connections to the identified links, police and carabinieri;
• Simulate a possible escape of the patient from the given place and test the relevant consequent planned rescue activities;
• Implement, at the given specific times of the day, a periodical monitoring of the functionality of the patient's device, eventually warning the caregiver in charge;
• Continuously compare the position of the patient under monitoring with the limits of the authorized area;
• Periodically, at the given intervals, read the position of the person under monitoring.

Diogenes project cruising activity
First scenario: supervision of a self-sufficient patient
- If the person exceeds the limits of the authorized area, the information and the new position are received by the Control Centre: the accuracy of the information is immediately verified and the caregiver in charge alerted;
- Should the information be correct and should the caregiver be unable to localize the patient, the CCU will identify the new position of the patient and communicate it to the caregiver;
- Shouldn't the caregiver be able to trace the patient, all his relevant data, saved in the CCU database (personal, photography, health data, etc..) would be made available to the linked Centres of the Departments of Public Security, Police and/or Carabinieri, for their prompt intervention.

Second scenario: Supervision of patient in need of constant monitoring
- If the person exceeds the limits of the authorized area, the information and the new position are received by the CCU;
- The CCU automatically checks any possible information error and, in accordance with the agreed pre-defined sequence, reaches the caregiver or any other person or organization in charge of the monitoring of the patient, giving them the new patient position;
- Shouldn't the caregiver be able to trace the patient, all his relevant data saved in the CCU database (personal, photography, health data, etc..) would be made available to the linked Centres of the Departments of Public Security, Police and/or Carabinieri, for their prompt intervention.

Third scenario: Planned moving of the patient outside the authorized area
- The Caregiver informs the CCU of the intention of leaving the authorized area together with the patient;
- The CCU modifies the monitoring parameters and starts shooting the position of the patient at regular intervals;
- Should the patient get out of sight of his/hers caregiver, this latter will notify the CCU which will check and provide the current position of the patient. Should the caregiver be unable to locate his patient, within a given time, i.e. 20 minutes, the linked Centres of the Departments of Public Security, Police and/or Carabinieri, will be alerted for their prompt intervention.

PUBLIC SECURITY AUTHORITIES
The Working Group presented the Diogenes project to the Prefect of Rome, dr. Giuseppe Pecoraro and to the Rome Police Superintendent, dr. Francesco Tagliente, who both showed great interest.
The Operation Room of the Police (113 emergencies) was then instructed to cooperate with SdP CCU for the setting-up of telematic links to eventually ease and speed-up possible rescue operations.
Diogenes Project was also presented the to Colonel M. Mezzavilla, Commander of the roman Department of Carabinieri, and to his colleagues, who all expressed the same interest showed by the Police Superintendent, thus instructing the Carabinieri Operation Room (112 emergencies) to cooperate with SdP CCU for the setting-up of telematic links to eventually ease and speed-up possible rescue operations.

JOINT COMMITTEE FOR MISSING PERSONS.
The Working Group finally introduced to dr. Penta, the Commissioner of the Committee, a detailed description of the methodology and of the technical procedures of the pilot Project. The Commissioner confirmed his extreme interest and assured he will support the pilot project at the national level. According to him, the number of reported missing persons is increasing, at national level, every month, thus augmenting the work of the public security departments. Concerning the disappearing of persons affected by Alzheimer, the Commissioner noted that, due to their poor health conditions and to their general fragility, they can rarely be found alive. Considering that the proposed Diogenes Project might considerably enhance the tracking of missing people, which is the main goal of the Committee, the Commissioner called for all the Departments of Public Security, at national level, to attend a meeting where the Working Group presented the project's aims, the methodology and the applied technology. The Joint Committee expressed great interest for the project, confirming its cooperation in the setting-up of the telematic links among the various Control Centres and SdP CCU. This cooperation will first take place in Rome, for the pilot project, and later at the National level.