Sunday, November 4, 2007

Getting grandpa wired

By Linda Marsa
Published: October 12 2007

Although Carol Roberts’s 77-year-old mother is active and mentally sharp, she suffers from a seizure disorder that requires close monitoring. Many people in her position would move in with family or into an assisted living facility. “But she didn’t want to lose her independence”, Roberts says.

Luckily, there is an alternative: the GrandCare System, which uses strategically placed sensors to record motion in key spots of the older woman’s home, such as the bathroom, kitchen, entryway and bedroom. Roberts can then check the information on her personal computer, keeping tabs on her mother around the clock.

“This way, she can live in her own space and I don’t worry,” she says.

The system, which costs $2,395 plus $49 a month, is just one of many innovative technologies developed in recent years to help a new generation of seniors. These range from remote-controlled lighting and floor sensors to more elaborate set-ups integrating webcams and videoconferencing systems with the internet. Scientists at universities and corporate research labs are meanwhile experimenting with the next wave of gadgets to track whether seniors are taking their medicine, to help with simple household tasks, such as cooking, and to detect mobility problems and medical emergencies.

The goal is to enable the elderly to live safely and independently at home for longer. For their adult children, the point is peace of mind.

The movement even has a name: “ageing in place”. And it is gathering momentum thanks to some important demographic trends. Over the next two decades the ranks of the “oldest old”, those aged 85 and up, are expected to balloon and, in 2011, the oldest members of the baby boom generation will turn 65. This advancing age wave will place an enormous burden on healthcare systems at a time when there are growing shortages of doctors, nurses and careworkers. Assisted living and skilled nursing facilities can’t be built fast enough to accommodate everyone and, even if they could, the costs would be astronomical.

“Corporations and government policy makers realise that as the boomers age, the costs won’t be sustainable if we continue to do business the way we’re doing it right now,” says Majd Alwan, director of the Center for Ageing Services Technologies in Washington, DC.

He and other observers think the solution is to create an entirely new paradigm of care, making it possible for seniors to remain in familiar surroundings until they die. “There is an intrinsic value to the home, where the individual has a sense of accomplishment and a level of comfort that they will never replicate by moving,” says Peter Bell, executive director of the US’s National Ageing in Place Council.

New technology is paving the way and we’ve come a long way from the electronic pendants with panic buttons the elderly can press in case of an emergency. Home automation, from specialist companies such as UK-based ABB, is one area of growth. “To date, the technology has mainly been associated with high-end audio-visual systems but, for the elderly or those with disabilities, smart controls offer massive benefits,” says ABB’s Gareth Rowlands. Tasks such as running bath water to the right temperature can be controlled via voice memos or remote “clickers” and dangerous scenarios, such as water over-flowing from a bath or sink, can be prevented with alarms.

There are also several monitoring and videoconferencing systems now on the market, including not only GrandCare but also AttentiveCare, AT&T’s Remote Monitor, Quiet Care and Home Guardian. Costs are reasonable, ranging from about $200 for a no-frills sensor network to about $2,000 for more complex systems. Because these products have come on the market within the past two years, their use isn’t widespread. “But they should become more popular, especially as the systems become more integrated,” Alwan says.

Deirdre and Steve Downham are early adopters, having installed an AtteniveCare system in the home of her 87-year-old mother, Olga Zaffos. A webcam hooked up to a PC with a flat panel television monitor in Zaffos’s living room transmits images through a broadband internet connection to a dedicated computer set up in her daughter and son-in-law’s nearby home. They can tell when she’s accidentally left the front door open and, whenever she wants to chat, she simply sits down in front of the camera. The computer is set up to flash reminders about taking medication and to receive messages, including family photos, the arrival of which is signalled by a distinctive ring recognisable even to people suffering from severe dementia.

“I check on her several times a day just to make sure she’s okay,” Steve Downham says.

The system, which costs $200 to set up, plus $600-$800 for off-the-shelf equipment and $60 for the monthly subscription, was devised by three brothers after their mother, who lived hundreds of miles away, was diagnosed with Alzheimer’s disease. The family stepped up in-home care as her condition deteriorated but the monitoring and videoconferencing system allowed her to continue living on the family farm in rural Arkansas until she died of cancer in 2003 at age 86.

“I had coffee with her every morning and got her day started,” says Ken Nixon, one of the brothers and now chief executive of the Oklahoma City-based Caregiver Technologies, which makes AttentiveCare. “It made such a difference in my life and in the life of my mom because it kept her engaged and made her feel valuable.”

Remote Monitor ($199 for a starter kit, plus $9.95 a month) also uses webcams to watch over various rooms as well as motion sensors that register when certain doors open. It can even turn house lights on and off and check if someone left a coffee pot on the stove.

Quiet Care ($199 for a basic package, plus $99.95 a month for monitoring) uses five to 10 sensors positioned throughout the home – near the bedroom door, bathroom, refrigerator door or family room – to track movement. The results are input into a computer programme that maps behaviour patterns. If there is any change in daily habits, such as when a person gets out of bed or how much time he or she spends in the kitchen or bathroom, the system will send out an alarm.

And Home Guardian, developed at the University of Virginia and set to be released next year, works in a similar way, analysing footstep patterns to detect problems. Inside a book-sized box, which sits on the floor, is a sensor that measures tiny vibrations, a microprocessor that learns a person’s normal walking habits and a software programme that can spot changes. If a person falls, or begins limping or shuffling, both possible symptoms of Parkinson’s disease or arthritis, the device fires off an electronic message to a PC, which is then transmitted to a monitoring service or the caregiver.

The systems aren’t foolproof: experts worry that they can provide a false sense of security. There are privacy concerns too. “Some seniors have used a hanky to cover the camera,” Alwan says.

Still, he and others think they are better than the alternatives. “Privacy is relative and most feel it’s an acceptable price to pay to avoid being institutionalised.”

Researchers are now hard at work on even more high-tech tools to help the elderly at home. From the Aware House laboratory at the Georgia Institute of Technology, there is the Digital Family Portrait, a monitoring system that keeps family members informed about their elderly relative’s activities, health status and possible problems by creating a “visualisation” of the person’s day as they move through the house. Dude’s Magic Box is meanwhile designed to help seniors keep in contact with their grandchildren. Youngsters put an item, such as a pet hamster, in the box, where a photo is taken. Dude, a cartoon character, pops up on the screen and asks if he should send the picture, then transmits the image to a computer screen at grandma or grandpa’s home. “Both of these devices are designed to make the senior who is living alone feel less isolated and reassure their children that they’re okay,” says Elizabeth D. Mynatt, a computer scientist at Georgia Tech.

Intel’s Health Research and Innovation Group is also working on new devices, such as “presence lamps”, which are set up in the homes of seniors and caregivers and light up when either person is home. “It comforts people to know that someone is around if they need help,” says lab director Eric Dishman. Another gadget, dubbed “caller ID on steroids”, is a computer plugged into a telephone, which holds information about the key people in an elderly person’s social network; when they call, a name pops up on-screen, along with a photo and a word or two to say who they are, helping jog the memories of those with dementia. “This gives people enough confidence to answer the phone and engage in a conversation,” Dishman says.

While all the new technologies are still in their infancy, they are important first steps toward coping effectively with an aging population. “The overall thrust is to increase the quality of life and of care that seniors receive in their home and ease the burdens on their families and on society in general,” Alwan says.

This is an edited version of an article that first appeared in the Los Angeles Times

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