Innovation in senior care: 'Telecaregivers' help more seniors age at home

Cameras, sensors, and video chat allows caregivers to be hundreds of miles away. But some see shades of 'Big Brother' in this new senior care model.

Ann Hermes/Staff
Research Associate Steven Proulx (through car window) sets up an interactive screen with the lab’s test car in Cambridge, Mass. The VW Beetle records a driver’s eye-tracking and behavior.

Every night at 5 when Edward and Lavinia Fitzgerald tuck into dinner in their Savannah, Ga., kitchen, they have a guest. Denise Cady chats with the Fitzgeralds about their neighbors and swaps jokes about the weather. She has known Edward and Lavinia, both octogenarians, for two years; to them, she’s like a daughter. The twist? They’ve never seen Ms. Cady in person.

Cady is a telecaregiver who checks in on the Fitzgeralds every evening from 800 miles away in Lafayette, Ind. She’s with a senior home care company, and she joins the couple via a computer monitor set up next to the kitchen table. Thanks to two cameras and several motion detectors wired throughout the Fitzgeralds’ ranch house, she can see a lot more than what’s for dinner – such as if Mr. Fitzgerald has left the burner on, how long Mrs. Fitzgerald has been in the bathroom, and how many times the front door has opened and closed.

Though it may sound like “Big Brother” to some, the video-monitoring service provided by ResCare means peace of mind for Colleen Henry, who began taking care of her mother years ago after Mrs. Fitzgerald sustained a brain injury and, more recently, a broken ankle.

“She and my dad have required a lot more care, a lot more of my time,” says Ms. Henry, who lives five miles from her parents and brings them dinner every evening. When Henry learned about ResCare’s monitoring service, she thought of it as “a dream come true, and it has been…. I’m so happy to have another pair of eyes.”

This year, the first of 78 million baby boomers hit retirement age, the beginning of a so-called silver tsunami that will revamp America’s demographic profile. People ages 65 and older will grow from 13 percent of the US population to 20 percent by 2050, according to the US Census Bureau, a greater share of seniors than Florida currently has. Just as important, more of them want to spend their golden years at home, whether for reasons of finances, convenience, or a desire for independence.

Seniors’ rising desire to “age in place” is driving innovation, as researchers, businesses, and policymakers scramble to solve new challenges and cater to a booming elderly population.

Aging issue no longer a projection – ‘it’s here’

“The aging issue is no longer a demographic projection. It’s here,” says Joe Coughlin, director and founder of AgeLab at the Massachusetts Institute of Technology (MIT) in Cambridge. “There’s a market that awaits, policy that demands to be made, and a lifestyle to be invented today – actually yesterday,” he says. “Frankly we’re already 20 years behind.”

Professor Coughlin founded the AgeLab in 1999 to invent ways to improve seniors’ health and quality of life. The lab, housed in MIT’s School of Engineering, frequently looks to places like NASA for inspiration.

Among AgeLab’s equipment is the Aware Car, a red Lincoln MKS wired with cameras, monitors, and sensors that evaluate a driver’s behavior, to improve safety. It’s a test bed for innovations. Nodding off? Cameras and infrared sensors track eyelid movements and direct the driver to pull over and rest. Sensors in the center console also track heart rate, blood pressure, and respiration, and might release a spritz of lavender, adjust the air temperature, or prompt the driver to eat a snack.

“Very soon cars are going to be taking a more active role in your safety,” says Coughlin.

For the home, Coughlin’s team uses the same technology that NASA does to track supplies in a space station to track Mom’s medication and Dad’s eyeglasses. Tiny radio frequency tags can be attached to such items, and adult children can track their location and usage on the Web.

The AgeLab’s Smart Trash Can even tracks the weight and material of disposed items to alert adult kids if something is amiss.

Coughlin says the AgeLab’s technologies represent the future of innovation by going beyond simply reacting to a crisis and addressing more than ailments and emergencies.

“It’s no longer about detecting what’s going on in somebody’s house. Rather, it’s about predicting and being proactive about well-being and motivating behavior to ensure overall wellness,” he says. “Innovation is about where we want to be and how to get there, not simply managing where we are today.”

In Tampa Bay, Fla., developer Keith Collins is designing homes and garages where seniors can park their Aware Cars. Since 2000, he has built more than 2,300 senior-friendly homes in the area. His company, New Millennial Homes, uses a concept called universal design to make homes accessible to a range of people, including seniors and those with physical handicaps.

“To build a home, you have to look at demographics and what is a person’s need,” says Mr. Collins, who spent time in a wheelchair after serving during the Vietnam War. Many of his clients simply want to maintain their daily routines – at home, on their own terms, he says.

His homes feature flat entries, wide doorways, low counters, and accessible front-controls on appliances for those in wheelchairs. Large, bright numbers on thermostats ensure readability, and large, low wall switches are easier to control. Some features, like rollout cabinet shelves and stove-top pot-filler faucets, now come standard in high-end homes. But with starting prices as low as $95,000, Collins’s homes are anything but.

“We want to keep people in their homes longer and do it affordably,” he says.

But Collins’s homes aren’t widely available across the country, and many AgeLab gizmos have yet to hit the market. So for folks like the Fitzgeralds, the most practical services are home-monitoring systems that repurpose existing technology.

Tracking Grandma remotely

Take Adaptive Home. The start-­up elder-care monitoring company uses sensors to track a senior’s movement around his or her home. Tech­nicians place about a dozen motion detectors around a client’s home to give adult children a detailed summary of a parent’s day. Sensors placed under a mat beside a bed indicate when Mom gets up in the morning. Additional sensors track when she’s opened the fridge or taken various foods or medications. The sensors are programmed to feed information to a secure website for adult children to check.

The Fitzgeralds use ResCare’s remote telecare service, called RestAssured, to enable their daughter to keep tabs on them. Video cameras, audio systems, and a few motion sensors placed around the Fitzgeralds’ house and some 300 other homes record the residents’ daily routines for telecaregivers and adult children to track remotely from a secure website. If something is amiss, caregivers and family members are alerted immediately. In fact, the cameras are so sensitive that a telecaregiver with ResCare once zoomed in on a frying pan and told her charges to cook the eggs and sausage longer because they didn’t look done, says Nel Taylor, a spokeswoman for ResCare.

“[Children] feel such guilt when parents live so far away,” says Ms. Taylor. “This is the first step to help people stay where they want to be and help children care for them.”

But for many, there’s a fine line between convenient and creepy.

“It’s like Big Brother is watching you,” says Nancy Schlossberg, a professor emeritus of the University of Maryland who wrote “Revitalizing Retirement: Reshaping Your Identity, Relationships, and Purpose.” “It’s not that I’m opposed to technology, but what worries me is whether it diminishes older people.”

Too often, Dr. Schlossberg says, adult children impose decisions on their aging parents, many of whom aren’t comfortable with technology to begin with. “[Seniors] have got to be part of the decision,” she says, suggesting children introduce new technology in stages.

Back in Savannah at the Fitz­geralds’ house, Mrs. Fitzgerald, who seems to be always laughing and in a sunny mood, insists she loves the telecare service her daughter had installed two years ago. “I love it, because it’s just for me,” she says. “It keeps me out of trouble.”

For her daughter’s part, the decision to install cameras and sensors to track her parents wasn’t difficult.

“I just felt relief, that someone’s going to help me,” she says. Her father can go to mass in the morning or run to the grocery store, something he couldn’t do before the telecare system. “I don’t know what we would do without the camera system,” she says. “Me and my dad have a life now.”

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