Traditional methods of diagnosis fail to demonstrate the transition from being healthy, energetic, and independent to being sick and frail for elderly persons. Approaches that will provide objective and continuous assessments of an individual’s function that can be applied to community dwelling persons are needed. Continuous monitoring of health status of the community dwelling elders may effectively prevent potential social psychological and medical crises by automatically triggering an appropriate and timely response from health care systems.  The continuous monitoring system might have large potential economic implications to contain the increasing cost of providing health care services to the aged.

     Remote monitoring has been found to be a very cost-effect way of monitoring the health conditions of the elderly as well as identifying high-risk groups within the community. The purpose of this group project is to establish a remote monitoring system for community dwelling elders. In this group project, instruments for assessing different aspects of well-being of elders will be finalized, predictors for excessive medical care resources utilization will be identified, monitoring protocols will be developed, a client registration system and remote monitoring devices will be established. In this group project, we will also develop theoretical models integrating laboratory and social/behavior sciences to explain the medical resources utilization, including the number of hospitalizations, emergency room visits, out-patient clinic visits, nursing home and home nursing utilization, of community dwelling elders in Taiwan. At the same time, a cohort database of community dwelling elders can then be established. By doing so, not only the incidence of diseases can be followed, this database can also served as a control for many clinical studies.

     In this program project, in order to gain a holistic understanding of the phenomena, there will be three sub-projects, and each one will focus on the effect of a particular aspect of well-being and its effect on medical resources utilization for the elderly living in the community.  First two projects will focus on physical aspects of the well-being: Project A will deal with the circulation system and physical fitness; Project B will deal with the nutritional status and physiological indicators. Project C will deal with psychological well-being, quality of life, and environmental quality.     These three sub-projects are an integral part of this program, and there will be strong interaction among them. The core facility will be built to facilitate the group project.

     In the first 6 months, a pilot study will be conducted which will include the development and testing of the psychometric properties of measures, and the modification of the feasibility of the research process, and the instruments will be transformed into computer form as well. After the first 6 months, an investigation of the effect of the well-being of the elderly living within the community upon medical resources utilization will be conducted. Longitudinal follow-ups every 6 months for the next 2 years will also be conducted. In the last 6 months, the instruments will be computerized.