High-Tech Devices Keep Elderly Safe From Afar

By ELIZABETH OLSON
26 may 2008--First thing every morning, Lynn Pitet, of Cody, Wyo., checks her computer to see whether her mother, Helen Trost, has gotten out of bed, taken her medication and whether she is moving around inside her house hundreds of miles away in Minnesota.
Last summer, Mrs. Trost’s husband had a stroke and died, but she wanted to stay in the house, in Mankato, where she had lived for 36 years. She did not want a live-in helper, and she cannot drive. At 88, Mrs. Trost has macular degeneration and takes medications for seizures, memory loss and restless leg syndrome.
“She’s a feisty gal,” Mrs. Pitet said of her mother. “She is fine when she takes her medicines, but, even so, I was terrified of leaving her alone.”
Mrs. Pitet and her sister decided to become part of a small but growing number of people who have installed motion sensors and a remote monitoring system to keep aging relatives safe. Sensors attached to the wall are able to register when Mrs. Trost gets out of bed and whether she stops at her medication dispenser, and to alert her daughters to any deviations from her routine that might indicate an accident or illness. The family is updated by electronic report every morning.
Monitoring systems like these, which go far beyond the emergency response buttons that have been around for years, are not found in many homes yet. Privacy is an issue for some older people, and the basic package can range from $50 up to $85 a month for the motion sensors and remote monitoring system like Mrs. Trost uses. More comprehensive packages can include devices to track blood pressure, weight or respiration.
Experts on aging say the systems will become commonplace as the 76 million baby boomers approach ages when disabilities or conditions like diabetes and failing eyesight jeopardize the ability to live independently. The population of those 65 years and older is almost 40 million today, and the federal Census Bureau says that will more than double, to nearly 87 million, by midcentury.
Right now, there is little federal health care reimbursement for such devices. And private insurance coverage is evolving because the area is new, said Dr. Jeremy Nobel, a professor at the Harvard School of Public Health who co-wrote a study on the feasibility of such technologies. “We are at the beginning stages regarding the availability of such services and before business models are developed,” said Dr. Nobel, a medical doctor. “I expect we’ll see a significant increase in the adoption of such systems in two to five years, and widespread adoption in 10 years.”
The coming wave of aging Americans threatens to swamp the existing stock of retirement communities, assisted living and nursing home facilities — making it impossible to accommodate everyone who will need, or might want, more structured care.
Experts on aging say motion sensors and other high-tech devices will help cover the shortfall, allowing older people to live independently for longer.
The growing number of Alzheimer’s sufferers, which is expected to more than triple from the current four million by 2050, may also spur wider adoption of technologies like motion sensors to alert others to deviations in routine, trackers to assure medications are taken and emergency response buttons.
Technology systems to underpin living independently, or what some call “aging in place,” are still years from being rolled out in a big way, awaiting adequate financing for research and other incentives, like coverage by insurance companies, according to Mr. Nobel’s study, which was released in March by the Center for Aging Services Technologies, a program of the American Association of Homes and Services for the Aging.
But projects are under way around the country to test high-tech gadgets for home use, including wireless sensors and devices to regulate temperature, lights and appliances, and sophisticated medical monitors. And some care providers have begun to equip clients with devices that fit their needs.
NewCourtland Elder Services, a care provider for some 2,000 people in Philadelphia, started a yearlong pilot in 2006 that equipped 33 patients living on their own with remote sensors that tracked changes in their health or living patterns that required early medical intervention, said Kim Brooks, the vice president for housing and services at NewCourtland.
One of the patients is Cleora Coley, 77, a retired pharmacy technician, who is in a wheelchair after losing a leg to diabetes. Two years ago, Ms. Coley moved to a living complex for the elderly because she could not maneuver the stairs in her family home.
In her apartment, she checks her blood pressure with a cuff that automatically sends the reading to a monitoring center, which notifies her and her doctor of any change. Sensors placed in each room keep track of her movements, and she has a button to summon assistance, which she used in April when she fell.
“I’m alone but I know I’m not all by myself,” Mrs. Coley said, adding, “And I really like my independence.”
NewCourtland is starting a trial in cooperation with health insurance companies and home health agencies, installing medical monitoring devices in 1,000 residences over the next six months.
One major roadblock for wider adoption of in-home monitoring has been concern that older people, unused to everyday technologies like the Internet, would resist their use. That was true for Mrs. Trost, who said she was apprehensive about having electronic gadgets around but said she had found that “they are really no bother.” A survey by AARP found that older people were willing to use high-tech devices at home, and to pay about $50 a month.
The privacy issue made John T. Fowlkes, 86, of Raleigh, N.C., hesitate last year when his children wanted to install a motion sensor system.
“What convinced me was that there are no cameras,” said Mr. Fowlkes, a retired postal service distribution clerk who lives by himself in an apartment building for retired people. “I get peace of mind, but no one is looking at me.”
Some exploration into future technologies is being financed by the National Institute on Aging, part of the National Institutes of Health, which has been giving grants to entrepreneurs to develop devices like a video data collection system to analyze an elderly person’s activity level.
But most research dollars have come from private companies like Intel Corporation.
Intel researchers are developing devices like a “memory bracelet” that vibrates at a specified time to remind the wearer of a doctor’s appointment or to take medication. Also in trials are sensor-infused carpets — Eric Dishman, Intel’s director of product research, calls them “magic carpets” — and wearable sensors, which would measure changes in gait, to help avoid falls.
Intel invested $3 million with the Oregon Center for Aging and Technology, which runs what it calls a living laboratory, with 225 volunteers. The project, which also received $7 million from the federal aging institute, uses sensors on walls, doorways and appliances — and computer games — to detect cognitive decline.
“There is going to be a major transformation in health care because of these technologies,” said Dr. Jeffrey Kaye, director of the center, at the Oregon Health and Science University in Portland, who oversees the project. “It’s more a question of when rather than whether.”
Recognizing the commercial potential of technologies for the aging, dozens of companies, including GE Healthcare, IBM and Medtronic, two years ago formed the Continua Health Alliance to develop products to aid older people. Despite the projects, trials and commercial interest, Mr. Dishman said the United States was “missing in action” in aging technologies, compared with Europe.
“There just hasn’t been enough research and development yet to prove these technologies work,” he said. “None of us wants to put a bunch of technology in homes of frail elders unless it does.”
He said the European Union had committed $1.5 billion to developing independent-living technologies.
Last year, Intel partnered with Ireland’s government to open the Technology Research for Independent Living Center, known as Tril, in Dublin, to invent and test independent-living technologies in the households of hundreds of older people.
So far, he said, a dozen other countries and 30 universities have approached Tril for advice and assistance.