Gadgets for Growing Old at Home

By Jane Gross
A medical monitoring system for the elderly by Intel.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.

Comments are no longer being accepted.

Eleanor Feldman Barbera, PhD January 13, 2009 · 9:42 am

In my view as a nursing home psychologist, the single most independence-enhancing piece of technology is the motorized wheelchair. Ironically, it’s not covered by insurance once you’re in a nursing home because, theoretically, the nursing home staff are there to push you around. But those residents who are lucky enough to have one from when they were home are the most independent people in the facility, and it’s reflected in their mental health. I imagine it’s the same for those in the community.

If I have the resources when I’m older, I plan to buy a motorized wheelchair and a lifetime service and replacement plan, whether or not I need a motorized wheelchair at the time. It can be donated after I’m gone. As a matter of fact, it would be nice to see a donation bank of electric wheelchairs and other technology, so they could be passed on to those in need. Also, I hope someone invents a rubber telephone because they’re always being knocked onto the floor and breaking. Adding boomerang technology would be good too!

Eleanor Feldman Barbera, PhD
//mybetternursinghome.blogspot.com/

From Jane: Apologies for horning in on John’s post, but I have a question. As a nursing home resident, my mother had a motorized wheelchair, which she unfortunately was only able to use very briefly, that my brother and I purchased for her and after her death donated to the home. At the time of the purchase, we were advised that she might — repeat might — qualify for reimbursement since she could no longer push a regular chair, even though there was staff to push her around (your lovely and, I imagine, unintended pun). My mother’s social worker knew my brother and I could pay for the chair, would likely be exasperated by the time and effort fighting with Medicare and might lose the battle anyway, thus she suggested we consider avoiding the fight, as we did. But for the sake of others who don’t have the option of shelling out thousands of dollars, is it 100 percent clear that such chairs are not covered in a nursing home setting? Waiting to be pushed by a staff member, especially at times of day when there are lines of people waiting for such help, is yet one more annoyance for the very old. During the short time my mother was able to use the motorized chair it was a huge quality-of-life improvement, so the fight would be worthwhile unless the answer was a guaranteed “No.”

Jared Glover January 13, 2009 · 10:50 am

Wheelchairs are great for those who can no longer walk, but for most people walkers are actually more mobility-enhancing, since they keep people on their feet and moving around for longer.

A few years ago, we developed a robotic walker at Carnegie Mellon University that could park itself and return to the user when not in use, and could provide navigational assistance to older adults who struggle with spatial memory and navigation. User studies were very positive, but I always wondered how receptive older adults would be once these types of assistive technologies became available on the market. It will be very interesting to find out in the coming years.

MARK KLEIN, M.D. January 13, 2009 · 10:53 am

A heart failure treatment algorithm linked to transmitted daily weights could result in a significant decrease in morbidity, mortality and health care costs.

Catherine January 13, 2009 · 11:17 am

My parents were middle-aged when I was born, acted middle-aged all the while I knew them, (never retiring), became acutely ill in their seventies, checked into a hospital and died prompty. I wish I could do the same for my children. As someone once said, growing old is not for the faint of heart. All these wonderful technologies are depressing.

Michael Flessas January 13, 2009 · 11:38 am

THE principle health care technology developers for the elderly need to keep this in mind:

Ethically speaking, shorten the distance between points A and B where time is also considered as distance to reduce systemic waste and enhance quality of life.

Walter Wacht January 13, 2009 · 11:52 am

I am a seventy seven year old widower living alone (and with no desire to change that status).

After viewing my fellow travelers in a number of airport terminals, I claim the title of “Oldest Person Passing Through.”

I will drag myself from room to room before surrendering to a scooter and do not fear death enough to drape myself with the devices deemed necessary by (and for the profit of ) those claiming interest in my well being.

As for those seeming to require the external assists, may they enjoy them.

Zino January 13, 2009 · 12:20 pm

Keep ’em moving! Sitting around will kill us all.

One idea, inspired by a NYT blog from yesterday on what uses could be found for abandoned or under-used exurban subdivisions: Convert them to elderburbs. Some of those McMansions are large enough to house several folks, including live-in caregivers.

The relatively sylvan environments are good for safe outdoor walks and sunning in quiet ease. And by concentrating so many into a single area, outside support for “home” visits by doctors and physical therapists would be more cost-effective.

Add in some facility for high-functioning oldsters to perform child-care for the community and there’d be a big benefit for everyone, along with some means for work-share folks to help keep the costs down.

Cristopher A. January 13, 2009 · 12:23 pm

Most gadgets for the elderly will come from Japan. I live here and there so many high tech stuff for elderly that is truly amazing but well over 25% of japanese are over 65 years old then no surprise.

susan January 13, 2009 · 12:36 pm

Technology is wonderful as it links many of us to so many information sources and enables us to communicate easily. My 89-year-old mother is technologically inept. She is constantly turning off her answering machine without any idea of how she did it. She cannot navigate her alarm clock after countless instruction sessions. Forget about her digital kitchen timer. I wonder if BBs, who were introduced to technology at a much earlier age, will be the true beneficiaries of this technology for the elderly. I hope that is true.

My mother certainly cannot make the conceptual leap to use even the most basic of technologies (or hear the alert beeps). From observation, it seems that rote memory is what enables her to continue to do things, more than anything else. Designing this technology to be “elderly friendly” will be an interesting challenge, but perhaps the BBs will be better able to use it.

Scott, LA (Scott Riddle) January 13, 2009 · 12:44 pm

I’d like to see automatic shutoffs on stove burners and ovens. These might come present to half an hour on burners and two hours on stoves, but could be reset by the owner. This would save a lot of burned food – and perhaps prevent some fires.
You can find large button remotes and (a few) large button cell phones, but what about a large button keyboad? There’s also a market for large button, large zipper (yet fashionable) clothes.
Someone could sponsor miniconventions of gear for the elderly.

tom dunne January 13, 2009 · 2:30 pm

a magnifying label reader at supermarket shelves

Beth Jackson January 13, 2009 · 4:38 pm

We are using home health monitoring devices to record weight and blood pressure for several of our clients at SeniorBridge. Our goal is to keep people at home safely, and we have found that the device can prevent unnecessary hospitalizations and emergency room visits, and reduce the cost of long-term care. The device also seems to help improve clients’ confidence, independence, and quality of life. But no, it does not replace human contact, and our geriatric care managers work closely with the clients to provide counseling, guidance and care as needed.
Beth Jackson, SeniorBridge

Terry Skudder January 13, 2009 · 7:05 pm

I have an elderly – but very spry and self-sufficient – mother still living in her own residence. Her neighbour is even older, but much less able.
I like the above post about mini-retirement communal homes by refurbishing some McMansions, it seems like a little money could save a lot, especially if newly qualified doctors could be pursuaded (salary/fee supplement?) to share the complex for a few years as GPs gaining experience.
I also like the idea of preset timers on appliances, if someone – deaf – is in the next room, they are unlikely to hear ordinary timer rings, especially if engrossed in a TV program.
Perhaps a phone alert – with vibrating buzz – now that watch phones are getting closer (try Googling same) – could tell the elderly that the stove-top had turned off!

J.T. Christopher January 13, 2009 · 9:07 pm

These devices, especially the turning-off-the-stove bit, are wonderful subsitutes for People near the impaired person who could notice such a dementia. But there is a problem. The information contained in these gadgets (weight? a change, Mister Fatso!, and how is your Cholesterol? We sell Lipitor, see your prescriber Today. Feeling tired–after a high night in Las Vegas?? Do you need Counseling about a Gambling Problem? Dial our toll-free hotline) may soon find its way into something more private than one’s caregiver’s comnputer.Soon there will be Wellness Links. Enter your Password. Check up on Mom. Or just troll around.
It won’t matter. Though youngsters are being warned about what they post on MySpace, etc., in case a future employer or college admissions officer peeks in. But it doesn’t matter to us. Nobody want to hire us, nobody wants us in a college classroom — especially if we need monitoring about night-wandering! (“Bye, Prof!” Oh, never mind, he’s a senile.)
In an institution, where a private nurse is not always at one’s side, such gadgets may replace the hopeless call-button, but for those on the loose, there need to be guidelines as to when to use what. Guidelines of compassion. Sometimes the situation is hopeless: a woman, or –more hopeless!–a man, in the “sandwich generation” who has an attention-deprived infuriated spouse, post-teen-age children who want ..everything, a job, and a parent whose mind is failing. What comes first? There is no perfect answer, but one has to decide what is the decent thing to do. Substitute a machine? Maybe. How much, and why?
It simply will not do to have a machine dial up the information that “Mom” is using the bathroom “excessively”! Can no one see that this is revolting? What do you do, call up “Mom” from cross-country and say, “Mom, you’re peeing too much..” oh, no, She’s “forgotten ” how to deal with the answering machine, ;)
We don’t all have “SeniorBridge”, which sounds great if ya gotta, but what of the millions who don’t have regular people who care, which is The Problem, not the distribution of supervisory gadgets!

Active Senior January 14, 2009 · 7:52 am

Here’s 3 more gadgets which may be handy:
Flashlight
Cell Phone
Loaded pistol.

gilmour1 January 14, 2009 · 9:17 am

To Eleanor Feldman Barbera, PhD

“Also, I hope someone invents a rubber telephone because they’re always being knocked onto the floor and breaking. Adding boomerang technology would be good too!”

Have you looked at the Uniden waterproof phone? It’s rubberized, heavy in the hand (but not too heavy). If you drop it, even in water, it still works. It won’t bounce back, but is durable. It’s about $60 at Walmart and other retailers online.

robinr7 January 14, 2009 · 9:42 am

While I take great pride in being the co-founder of The Silvers Summit at CES, and I’m tickled that John and Jane captured its essence, I can’t help but wonder whether the seniors now will be the last to die of natural causes.

I keep thinking that the next gen (myself included) will be too scared, too impatient, and too tech to bother. I can see myself scheduling “the big day” onto my Outlook calendar and attending my funeral before I go.

What do you think?

Steven January 14, 2009 · 10:09 am

To M.D. Mark Klein:
You are right. It could save a lot of costs when used in the right system. I learned of them that this Tunstall Telehealth monitor can receive and transfer even 12lead ECG vital parameter too via bluetooth. Even COPD, Asthma and diabetes can be monitored and the vital signs can be forwarded encrypted as XML file via the phone or GSM line over the internet to the care provider. Amazing. Danish engineering.

Barbara Marquardt January 14, 2009 · 11:23 am

Now, at 69, I cannot envision a time when I would appreciate being electronically monitored and nagged, by either the devices or my children. As for doctors I have seen, they barely are familiar with what’s on my written record and have no time or interest in anything beyond writing quick prescriptions. Although for comfort I happily use things like a seat-lift and raised toilet seat, when it comes to others’ help, humans can’t be replaced. I would love to see some kind of volunteer network established that connects seniors who live near each other, so that they can call and visit and help out each other on a regular basis, providing socialization as well as monitoring. I have proposed this idea to organizations like RSVP and the Obama volunteer initiatives, but nobody even responds.

Andre January 14, 2009 · 4:29 pm

While we may have to wait for some of these new gadgets, there are some already out there to make life easier for the elderly. When I was doing holiday shopping, I ran across an article on Silver Planet that listed multiple sites that sold gagets for seniors. They included “the Loc8tor, a homing device that helps you find those things that always seem to disappear (keys, checkbooks, etc.); the ClarityLife C900, a sound-amplified mobile phone that doubles as an emergency response device; and a subscription to BookSwim, the book equivalent to Netflix..” These are highlighted in replly to some other comments. All of links can be found at //www.silverplanet.com/lifestyles/some-gift-ideas-holidays/39360. There was also an article on robots being study to assist caregivers in Norway!

Joy Loverde January 14, 2009 · 4:30 pm

Do you know about Presto and how fabulously it keeps people connected who are choosing to stay home, yet fear technology? I love this easy-to-use product, and so do the people I know who are using it.

Check it out! //www.presto.com

Joy Loverde
//www.elderindustry.com
Author of The Complete Eldercare Planner (Random House).

Taffy Todd January 14, 2009 · 8:17 pm

What gets me is the price for some of these things. Not only do some of the “health” gadgets cost over $1000 but then they want $25 – $50 a month to use it. Perhaps some have the money for things like that, but I sure don’t., and I am sure I am not alone.

I fell very badly two years ago and would love to have Lifeline but there is no way I could pay for that either. I am not quite 65, that comes in May, but I am disabled by a chronic disease. If you can’t get Medicare to help you out (and I doubt they’d pop for some of these new expensive machines) then you just have to live with the risks and problems of not having items that might help you a lot, or even save your life.

I do appreciate a lot of the suggestions from other commenters. I will look in to whether I can get an electric wheelchair — that would really free me. I have 94 year old mother who lives alone, in a lovely apartment in my small town, walks well, but uses a cane, drives locally, and continues to write daily — she was a journalist and fiction writer, I’d love to live that long, but not with the limitations I have now. A lot of help is needed to guide those of us who are not in assisted living or any other controlled environment.

Karen January 14, 2009 · 8:21 pm

I found several advanced gadgets of a more technically advanced (and luxury nature) at a company called Elderluxe //www.elderluxe.com

They also had a concierge and giftwrapped items for free!

Nancy Hatch January 15, 2009 · 11:10 am

Our insurance company gave my husband, who has high blood pressure, a scale to check his weight twice daily to assess fluid retention. The scale was hooked up by computer to a nurse-manned center that assessed the weights, especially rapid weight fluctions–a signal of fluid retention.

If the weight was out of line with his PCP’s protocol, a nurse called my husband to advise him to take a medication, such as a fluid pill prescribed by the PCP, and to confirm he was taking his HBP medications correctly, and cheer him on.

The result was that, by using the computerized scale and working with trained nurses and an MD’s protocol, my husband’s HBP was quickly brought under control. It gave the PCP valuable info in managing the HBP. It saved money in doctor and hospital visits for us and the ins. co.. It improved his health and quality of life.

We recommend this kind of care. It would be especially helpful for individuals who are mainly housebound, or live in areas underserved by health care providers, esp. doctors . It would be ideal for public health programs. And a terrific, cost-saving benefit to insurance companies.

N Hatch,

Eleanor Feldman Barbera, PhD January 15, 2009 · 12:35 pm

Jane, in response to your question about my original post (#1), I checked with a rehab director I know and he also said that motorized wheelchairs are not covered by insurance for those in nursing homes. I personally have only known of one case where someone was able to obtain a motorized chair. This was a man who had cerebral palsy. He was in his seventies, placed in the nursing home, and could no longer wheel himself around as he had when he was younger. He started the paperwork for a motorized wheelchair when I was working at the facility and when I returned for a visit several years later, I was pleased to see him zipping around the place. He said the fight to get it had taken a couple of years. Perhaps there are other rehab staff who know more about this situation and can add to the discussion.

Eleanor Feldman Barbera, PhD
//mybetternursinghome.blogspot.com