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Aging in Place technologies -- a qualified endorsement in the NY Times

For those of you in and around this industry, this is very cool. Today's NY Times has a lengthy front page feature by John Leland called "Sensors Help to Keep the Elderly Safe, and Living Independently at Home." Give it a read. It includes mention of HealthSense eNeighbor™, Meridian Health, Quiet Care, Jitterbug -- and a number of seniors who are happy to be alive and still living on their own. These vendors hopefully all get a boost from such broad-based publicity (with photos and device explanations.)

But several issues bubble out of the quotes from healthcare experts -- I think these need some thought -- and perhaps some pushback:

"Until they're launched on a wide-scale basis, you just don't know." Dr. Brent Ridge (Mount Sinai School of Medicine) when asked about sensor-based home monitoring tech like New Courtland was using observed: "On an individual basis we've demonstrated that they can be very effective, but on a wide-scale basis...physicians might say: I'm already overstretched, I don't have time for all this data."

My take: Not sure why we're worrying about the doctor. The data doesn't have to be processed or sent in volume to a doctor; rather, unexpected behavior can be detected from home monitoring sensors and only that information (alert) is sent to a designated call responder, who could be a nurse, a nurse's aide on duty in an assisted living facility, a home care agency, an alarm company staffed by EMT's, or a call chain of nearby family members.

"It somehow absolves kin of the responsibility." Dr. Stuti Dang of Miami Veterans Affairs Healthcare System, said that one unforseen consequence was that "the daughter doesn't have to call every day because she knows that something is wrong with her father, she would receive an alert. This is good for the patient, but there needs to be personal responsibiltiy."

My take: This one is very interesting in the context of many statistics on job time loss (and cost to companies) due to one out of four in the US involved in caregiving.  Having assistance in monitoring parents so that a daughter doesn't have to call every day about her father -- this is a good thing!  If her father needs more company or a chance to talk with his daughter (or even a cell phone of his own), that's a completely separate issue.

"But until there is more research -- and reimbursement --...impact remains unknown." It's not that we need new technologies, says Dr. Jeffrey Kaye of Oregon Health and Science University. We need to use what we have more creatively. It's all cool, but is it going to be helpful?" 

My take: First of all, the technology that exists today is not 'all cool' or 'enough'. Certainly more of what exists should be deployed when so many elderly people don't want and cannot afford to move. As for all cool? I think even those in this industry will acknowledge that the state of the art for design and cost has yet to be achieved.

Innovation is not done. It is not yet common knowledge among those with aging parents that sensor technologies are possible, let alone, standard in a home -- placed there as a matter of course to help baby boomers and seniors remain safe, even if and when they suffer from chronic diseases or disabilities.

Netting it out: We are at a point where home monitoring technologies are available to consumers and if they help even one elderly person avoid a debilitating accident and remain longer in a home they love, maybe that's validation enough.



I liked your take on this article. I had bittersweet feelings after reading. I am happy that information on technology is being shared and in the NY Times no less. However, I felt the negatives outshine the positives in the article and your counter points are very valid.

The opinion of doctors, while interesting, is certainly not going to make or break the course. This can be a question of whether or not a senior can remain independent at home and be technologically enabled by a son/daughter/family member. Many times, a doctor will not be involved whatsoever in this process.

As far as anything 'working', I think we are in the process of proving this! Technologies out there DO work, but people need to continue to use them as we solidify and better the technologies.

This is not a new process.

The same thing happened when computers first became available, cell phones, any new technologies.

I always like the old saying - don't solve new problems with old solutions!

We'll get there!!!

Great site -- I'm a former caregiver and amateur geek (never do seem to catch up), so the technology of care is always of interest.

This was a comment I posted to New York Times about the article you've cited, as well as on my own blog, http://www.elderland.net. Though eldercare technology was a real savior to me over my decade of caregiving, I cringe when I see people (elders and caregivers) insisting that some new technology can substitute for personal interaction with elders. Sensors and computer recording of data are only as effective as the capability of the sender to use and maintain them and all require that a human being respond at the other end.

Mr. Hayduk, for instance, performs his own health assessment every morning. Does he weigh himself with exactly the same clothes on every day? How accurate is his scale? In assessing fluid retention, a difference of 1-3 pounds can trigger changes in medications. Is he capable of communicating the status of his breathing and the swelling of his ankles accurately? I’m sure the police were not amused that he forgot to wait for the call from his nurse. I suspect it wouldn’t have gotten a chuckle out of his family caregiver either, if he has one. It wasn't mentioned.

All the technology Ms. Branch had didn’t prevent her from falling. Three times. Where did she go after the firefighters broke down her door? Straight to the emergency room, I’ll wager.

“This system’s invaluable to me, not only physically, but psychologically,” Mr. Hayduk said. “I don’t want to be in assisted living. That’s for people in wheelchairs and walkers.”

This is a fairly typical misconception shared by many seniors and their families. 'Out of home straight to dreary, smelly nursing home. Assisted living is a gold mine for private investors, at the expense of unsuspecting seniors.' When I first began to care for my own parents, I, too, was fearful of the “institutions.” But in the decade since then, the quality of housing alternatives for seniors has improved exponentially. Some are, admittedly, breathtakingly expensive, and this is an issue we are all going to have to deal with. But many offer advantages for senior health and well being that can make up for the expense. Each of the people profiled could be socializing, learning, exercising, dancing, laughing, with others of similar capabilities instead of sitting, as they all were, alone, in their “independence.”

Aging in place is one of many options. But people like Mrs. Branch need to be a bit more realistic about its benefits.

Agreed! I think that aging in place technologies (including home monitoring) are supposed to be supporting seniors inside assisted living facilities (and CCRCs) as well or better than in their own homes -- in fact may be more easily marketed to ALFs then to seniors. And monitoring can (perhaps) address the most dangerous aspect of ALFs -- the closed door to protect privacy -- that also hides great risk.

 It is worrisome that today's ALF costs and difficulty in selling homes to pay for them may keep people mentally declining and lonelier longer than they would be in an ALF. Both my mother and mother-in-law were fortunate to be in ALFs that offered more social life than actual assistance or intervention.  But painting, singing, dancing, eating with others -- wonderful.



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