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Dissertation
Assessing Complexity as an Indicator of Frailty in Older Adult Smart Home Residents
Washington State University
Doctor of Philosophy (PhD), Washington State University
2023
DOI:
https://doi.org/10.7273/000006394
Abstract
Background: In the context of older adults’ health, the idea of complexity consists of two seemingly opposite phenomena. On one hand, health needs become more complex with age and on the other, the body’s systems and processes tend toward less complexity. The theory of complexity and aging suggests that (1) measuring the complexity of the body’s physiological and behavioral signals can illuminate a person’s adaptive capacity, and (2) one’s decreasing complexity is indicative of decreased adaptability and increasing frailty. I hypothesize that if a person’s underlying complexity, and therefore adaptive capacity, could be estimated using continuous unobtrusive environmental sensor-based monitoring it would open opportunities for early identification of incipient frailty, underpinning interventions aimed at maintaining older adults’ ability to age-in-place safely. This dissertation consists of three manuscripts exploring how complexity may be used as a key indicator of older adult health within the context of a long-term sensor-based remote monitoring system. Method: Manuscript 1 is a Principle-Based Concept Analysis of the use of complexity as a concept in gerontological nursing literature. Manuscript 2 reports results of simulations mimicking smart home sensor data to validate measurements of complexity taken from complexity science. Manuscript 3 is an exploratory multiple method case series study using real-world historic sensor-based data and nursing assessment data gathered from community-dwelling smart home residents age 65+ to measure the complexity of their daily activities, describe complexity changes over time, and relate these changes to frailty. Implications for Nursing: This dissertation expands and clarifies the conceptualization of complexity in relation to frailty within a nursing-centered lens. Study findings (1) resulted in tools nurses can use for measuring and interpreting the complexity of sensor data; (2) add clarity on the conceptualization of complexity in gerontological nursing; and, (3) generate important questions for future nurse-driven smart home research.
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Details
- Title
- Assessing Complexity as an Indicator of Frailty in Older Adult Smart Home Residents
- Creators
- Katherine Ann Wuestney
- Contributors
- Roschelle L. Fritz (Advisor)Catherine Van Son (Committee Member)Diane J. Cook (Committee Member)
- Awarding Institution
- Washington State University
- Academic Unit
- College of Nursing
- Theses and Dissertations
- Doctor of Philosophy (PhD), Washington State University
- Publisher
- Washington State University
- Number of pages
- 177
- Identifiers
- 99901087840501842
- Language
- English
- Resource Type
- Dissertation