Living at Home

Gadgets for Growing Old at Home
By Jane Gross

Technology giants like Intel offer a growing number of devices, such as this health monitor, intended to help aging family members remain in their homes. (Courtesy Intel Corp.)

My colleague John Leland, writing from the International Consumer Electronics Show in Las Vegas, sent us these musings on the first-ever exhibit there devoted to technology aimed at the elderly, their adult children and their medical providers. He would like to pursue this subject in the future, so if you’ve had some experience, good or bad, with technological innovations intended for seniors, please post below. We welcome the thoughts of all concerned digerati, parents and children, old and not-so-old. — Jane Gross
At the International Consumer Electronics Show in Las Vegas, I stepped onto an ordinary-looking white bathroom scale. The scale sent a signal via Bluetooth to a control box, which read my weight aloud.

It was my first time on the scale. We had no relationship. I was just data. The machine was just a disembodied voice.

Then Mikael Hvid, application manager at Tunstall Healthcare A/S, which makes the box, stepped onto the scale. After telling Mr. Hvid his weight, the voice compared the figure with previous readings.

Then it got inquisitive.
“Are you more tired than usual?” it asked.
Mr. Hvid was. (This was Las Vegas, after all.) He pressed a “yes” button.
“Are you having trouble sleeping at night?” Ditto.
Mr. Hvid’s weight and answers were all harvested by the box’s software, which stood ready to make them available electronically to whomever he gave access: his primary care doctor, family members, perhaps a pulmonologist, maybe the administrators at his assisted living community.

The control box also works with gadgets measuring blood pressure, oxygen level, activity level and other markers of health. If the person on the scale were my mother, I might instruct the box to alert me if her weight rose or fell by a certain amount, or if her answers to questions suggested trouble. Other devices in the exhibition hall tracked whether a user fell, opened a pill bottle, made coffee, used the bathroom excessively at night or wandered out of the home.

In a nutshell, this was the big idea about aging at this year’s C.E.S.: how to use mostly simple technologies to gather information and detect warning signs, thereby allowing older people to remain in their own homes with fewer trips to the doctor’s office and less need for supervision in a skilled nursing facility.

I imagined my mother’s doctors all having a single report that showed how a change in her medication coincided with changes in weight, blood pressure, mood, sleep pattern and gait, then being able to discuss that information with one another, family members and my mother. That would be a big step forward for her and for many like her.

But then I imagined my mother living with a half-dozen electronic boxes beeping for attention and me getting alerts every time one of the measurements was skewed — me, without the medical expertise to sort the blips from the real problems. I’d call her doctor and become ensnared in a voicemail loop that asked if I was more tired than usual and if I was having trouble sleeping at night.

Yes, and heck yes. With technology like this, I might never sleep again.
These devices were unveiled at a day-long program called the Silvers Summit, the first forum at the C.E.S. dedicated to aging. Participants included hospitals, nonprofit groups, retailers, insurers and dozens of entrepreneurs, many of whom got involved after personally experiencing what it is like to care for an elderly relative in decline. Presenters said the technology is aimed not at old people but at their children.

“The fact that we’re in C.E.S. and we’re not just one booth means we’re getting somewhere,” said Eric Dishman, the global director of product research and innovation at the Intel Digital Health Group. “Seven or eight years ago, no one even talked about aging. Something tipped.”
Topics ranged from mental exercise programs for fending off dementia to phones for people with diminished hearing and dexterity. Most of the devices shown were not covered by insurance, and either in prototype or not widely used.

“Our society does not reimburse for prevention,” said David Stern, chief professional officer for Living Independently, which produces a home monitoring system called QuietCare that is used in assisted living communities. “But there’s a recognition now that people need technology and that if you can keep someone living at home, it costs a lot less than having them in a nursing home.”

Mr. Stern could not say how much QuietCare cost because each facility programs different features into it. Another system on display, GrandCare, costs $2,300 for the basic equipment, then $25 to $50 a month for the company to manage the flow of data. With GrandCare, relatives can upload photographs, appointments or messages to a device in an elder’s home that looks like a television with a touchscreen.

Mr. Stern said the home monitoring technology answered competing needs: “An older person in assisted living wants to maximize independence. But the expectations of family members and state regulators are that she is going to be made secure 24/7. How do you do both? Technology is the answer. It’s the only way they can be secure and independent without someone coming in and checking up on them.”

All vendors said their products were not meant to replace human contact with doctors or family members. But technology has unintended consequences. For some older people, the experience of having blood pressure checked can be the only human touch of the day. An automated home device can take the blood pressure and save the health care system hundreds of dollars, but it does not replace a living, breathing visitor or conversation with fellow patients during otherwise annoying doctor visits.

At one of the forum presentations, Dr. Hyung Tai Kim, a vice president of research at Ascension Health, a Catholic hospital system, identified two potential stumbling blocks for the devices. They called for doctors trained to treat patients in person to make judgments based on data gathered remotely. And current insurance programs do not compensate the doctors for these analyses.

Some of these gadgets will prove useful. Many others will become the home treadmills of the future — developed and purchased in good faith, but in practice unused. Mr. Dishman of Intel described a pillbox that alerted users every day at the same time that they needed to take a pill, even if they had already taken it. As a result, people didn’t use it, he said.

“No one wants to be nagged or be embarrassed by something that makes them look like they can’t take care of themselves,” he said. “We switched to one that was more responsive to whether you already took the pill, and we quadrupled compliance.”

“Those little tweaks go a long way,” he added.
The prototypes are now out there. Let the grumbling and tweaking begin.


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January 13, 2009, 8:00 am — Updated: 9:27 am