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Keeping track of Dad: Technology allows aging Americans to enjoy more independence while families monitor them from miles away
[April 09, 2006]

Keeping track of Dad: Technology allows aging Americans to enjoy more independence while families monitor them from miles away

(Chicago Tribune (KRT) Via Thomson Dialog NewsEdge) Apr. 9--In an assisted living home on the outskirts of Portland, Ore., a retired nuclear engineer who suffers from Alzheimer's disease gets out of bed in the middle of the night. His daughter, a night owl in San Diego who monitors her dad's location, vital signs and activities via a secure Web connection, sees in real time that he has left his room and gone to the nearby kitchen.

"I see Pop's been conducting midnight ice cream raids again," she quips in an e-mail to her siblings the next day.

A couple of hundred miles away, in a test apartment in Seattle, a computer engineer perfects technology he hopes might someday allow people like his aging parents to stay in their homes years longer.

The technology goes something like this: A private home, including most items in it, is wired with unobtrusive sensors that detect every time the items are handled by the resident. The result is a detailed daily log that records what the house's residents are eating, how well they are keeping up with housework and hygiene, and whether they took their medications on time and remembered to turn off the stove.

Earlier this year, the first of America's 79 million Baby Boomers turned 60, and many began confronting the dual challenge of preparing for old age while coping with the realities of their parents' advancing years. Like no generation before, the Boomers, a demographic group long ago indoctrinated to a world of e-mail and BlackBerries, wi-fi and video conferencing, increasingly are turning to cutting-edge technology to help navigate these often choppy and anxiety-inducing waters.

"This isn't cold technology for a cold, heartless society," said Richard Suzman, director of the behavior and social research program at the National Institute on Aging. "It serves a real purpose and shows real promise."

Projects on the bench

Research and innovation--some academic, some commercial but all directed toward the elderly and those who care for and about them--are under way across the country:

Computer engineers at the Georgia Institute of Technology have developed memory-aid systems that allow people to look back on instant digital photos of themselves to help them remember what tasks they have completed that day.

At the University of Washington, researchers are developing a handheld global positioning system device that uses artificial intelligence to predict where a forgetful person is trying to go and help him or her navigate the way there through verbal prompts and directional instructions.

Home builders in Florida are offering smart floors that can sense when an elderly person has fallen and then summon emergency help.

The technology is being tested, designed and marketed to support a burgeoning social movement aimed at allowing people to "age in place"--to grow old inside their homes.

The movement is not solely motivated by research that shows elderly people are happiest and most comfortable at home. It is, in part, a response to the practical reality that by 2030, almost one in five Americans will be 65 or older, and the nation's current nursing home and assisted living facility infrastructure is incapable of housing the largest generation in American history unless people move into these facilities much later in life.

Yet the challenges of allowing people to age in place are myriad: The realities of age make people's health less stable and memories less sharp, and some experts worry that the technology will keep people at home longer than is safe; an increasingly transient world means supportive family members are routinely far away and perhaps not involved enough to monitor the exhaustive personal data such technology produces; and privacy, held dear by senior citizens who bristle at being monitored like children, often must be sacrificed for such technology to work.

A high-tech retirement home

At Oatfield Estates, a peaceful, wooded assisted living facility with a stunning view of Oregon's Mt. Hood, some 68 residents live in six free-standing homes, each containing six private living suites as well as a common kitchen, dining room and social areas.

Though homey and traditionally decorated, Oatfield is high-tech to the hilt. Residents wear small badges that trip a silent sensor as they walk throughout Oatfield's buildings and grounds. Residents' beds take daily weight readings, determine how much time a person spent sleeping and how many times he or she got up at night; the beds instantly alert the staff if a resident categorized as a "fall risk" appears to be getting up so a nurse can rush to help him get safely to his feet. And this information--and more--can be viewed by family members on a secure Web site, assuming the resident has agreed to that.

Barry Jacobson, whose father, Jack, lives at Oatfield, has a small icon labeled "Pop" on his desktop computer at work in Portland. Throughout the day, he clicks on it and sees what his father has been up to: who he dined with at lunch, what his vital signs are, where he is, how quickly nurses responded to any call for help he made, which social activities he participated in.

"It has been so reassuring to be able to check in anytime," Jacobson said. "There is no longer the anxiety that the next phone call is going to be from someone there saying something's wrong with dad."

Other aging-in-place technology under development would go further: Much of it is designed to be installed in people's homes long before they require moving to a facility like Oatfield where there is 24-hour professional care.

Inside a cozy demonstration apartment in Seattle, researchers for Intel work on a system that monitors a person's movements far more precisely than the technology at Oatfield does.

For Intel's technology to work, the resident must wear a special bracelet. Most household items--a gallon of milk, a teapot, cups, the refrigerator door--are tagged with small, inexpensive sensors that recognize when the resident touches them while wearing the bracelet.

The system then uses artificial intelligence to determine what is happening: If the resident runs water, picks up a spoon, touches a kettle and opens the cabinet where cups are stored, the apartment's computer system concludes that tea has just been made and logs that on a database that social workers or children can track.

"I think of my own parents, who live in India," said Intel researcher Matthai Philipose. "Something like this could allow them to stay home longer while at the same time allowing me here in Seattle to monitor that they are safe and well while they do that."

The National Institute on Aging, a branch of the National Institutes of Health whose mission since 1974 has been to improve the health and well-being of older Americans through research, has seen such promise in some of the emerging technology that it called for proposals from small businesses for more aging-in-place inventions.

There are risks

Yet the agency's Suzman is cautious in his optimism. He points out that some elderly people simply have too many physical and cognitive ailments to live alone, and he wonders if technology could become the crutch that encourages people reticent to push an unwilling parent into a nursing home to allow them to stay home too long.

"By and large the evidence already shows that people often keep family members in their homes longer than is truly safe or healthy," he said.

Indeed, some of the technology is so futuristic that one can be lulled into thinking it can do virtually everything.

Royal Philips Electronics, a Dutch company, has begun marketing the TeleStation, an information hub that collects data from medical testing devices set up in the user's home. It transmits blood-sugar readings and a list of other vital signs to the patient's doctors. Doctors then can send electronic questions to the patient about symptoms, medication side effects, diet and pain.

The patients' responses are beamed back, allowing the doctor to determine if an office visit is needed.

Welcome to the Aware Home

On the campus of Georgia Tech, a sprawling, video camera-filled structure known as the Aware Home tests aging-in-place technology. One invention is the digital family portrait. Like the pictures in the Harry Potter books and movies, in which images move around inside frames as though alive, the digital family portrait is designed to hang on the wall of the elderly person's family's home and display a changing image of the person that reflects what he has been doing in his own home.

Inside the Aware Home, Wendy Rogers, a psychology professor and co-director of Georgia Tech's Human Factors and Aging Lab, is asked to be something of a devil's advocate.

Rogers studies whether today's elderly, those who have struggled to program their VCRs or have never used the Internet, will embrace the technology. Even more, she asks them if they are more troubled than intrigued by it.

"Computer engineers often ask, 'What can technology do?'" Rogers said. "I'm charged with coming in to ask, 'What should it do?'"

Clearly the biggest worry associated with much of this technology is the loss of privacy. Philipose, the researcher at the Seattle test apartment, said early demonstrations of the technology revealed that many seniors are very concerned about who would have access to such detailed information about their daily lives. Some insist that they would remove the bracelet--the device necessary to trigger the sensors on objects they touch--when they want privacy. He told the story of one person who said she ate chocolate cake for breakfast and would do whatever necessary to hide that from her children.

Exercising privacy right

At Oatfield Estates, one resident knows well how intrusive technology can sometimes feel. Though Lester "Ray" Croft prefaces his story by calling his daughter a "lovely sweetie," he describes how one of his children went too far with the family portal and her monitoring of his ever-increasing weight.

"I had to fire her from being able to look in on me," he said. "Oh, I wasn't too popular over that for a while."

Yet the technology can be tweaked to deal with some privacy concerns. The video cameras in the Aware Home, for example, can be programmed to recognize and record only specific events--falls, for example, or medication consumption. And many seniors say they would take comfort in knowing there is the safety net of having someone keep a close eye on them.

"What we are finding is that, by and large, older adults seem willing to trade some measure of privacy in order to have the comfort of staying home," Rogers said.

Barry Jacobson, who on Thursday afternoon had just finished checking on his father via Oatfield's family portal, put it like this:

"In 20 or 30 years I'm going to want to know that my family is there watching out for me. At some point it's not about privacy but about being connected."

Jacobson's father, who has midstage Alzheimer's at age 82, does not fully realize the technology his children are using to monitor his health and care. But Jacobson suspects his dad, who spent so many years as a nuclear engineer and who had an e-mail account until just a few years ago, would approve of it all.

"The motto of engineers is: 'I can improve your life. Just ask me,'" the obviously doting son said. "He would be impressed with what engineers have accomplished on this."

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