Assistive technologies

At a glance…

Technology is available now to assist maintaining the physical, mental, and psychological health of disabled and older adults, provide unobtrusive monitoring, and assist with activities of daily living.

The 2009 American Association of Homes and Services for the Aging (AAHSA) Annual Meeting & Exposition last November had many vendors with real, imaginative, and sound technology products to assist maintaining the physical, mental, and psychological health of disabled and older adults, provide unobtrusive monitoring, and assist with activities of daily living.

These technologies can be used now to help residents of nursing homes, assisted living facilities, community-based programs, and independent living settings to retain their independence longer. Families will experience increased confidence in the care their senior is experiencing, be able to monitor their health status, and interact with them more readily through video conferencing and even playing interactive games remotely. The peace of mind is priceless.

Discussions with the vendors and scientists showing the products were encouraging-there is much more to come. This article presents only an overview of the products currently available that were demonstrated in the AAHSA Idea House, a structure built to showcase new technology for aging in place. Other products were available on the vendor floor, and many more are available on the Center for Aging Services Technologies (CAST) Web site (see sidebar).

Medication management

Most seniors are taking several medications throughout the day. Simple daily boxes with medication times are helpful. Weekly sets of daily boxes can be prefilled by a family member or visiting nurse so the senior only has to remember to take the medicine. However, remembering to take medications on time is difficult for everyone. There are now excellent and affordable solutions-devices that can be preloaded by the family, visiting nurse, or even commercial pharmacies in some areas that notify the senior when the dose is due, dispense the dose on demand, and record the time. If the dose is not requested, the device can notify a responsible person by telephone or Internet so there can be a follow-up. Medical issues (often emergency), secondary to poor adherence to a medical regimen, can be eliminated.

Emergency notification

Several vendors supply pendants or wristwatches that communicate with a telephone-connected controller. When the device is activated by pressing the button (or in some cases, by position changes indicating a fall), the device calls predetermined numbers. The vendors have call centers that can take preauthorized actions such as calling 911 or notifying a family member. Several vendors are planning cellular telephone versions equipped with GPS to allow monitoring outside of the home. There currently are cell phones, designed for seniors, with large displays and buttons. These systems can provide easy-use operator support that works if the person is conscious. A fall-detecting phone is planned by at least one vendor.

Wellness monitoring

WellAWARE demonstrated a rather complete monitoring system designed for independent living in the AAHSA Idea House. All monitors are connected wirelessly with a data manager that monitors sensors and communicates events through the Internet. The reports the system generates can identify emergent conditions and help improve the efficiency of healthcare delivery. Changes in sleep and activity patterns are early indicators of developing medical problems.

The system can monitor a number of sensors:

• Bed sensor-monitors sleep patterns, pulse, and respiration

• Impact sensor-detects falls

• Heat and motion sensor-in several rooms to monitor activity

• Door and threshold-to help secure access by providing a better view of who is requesting entry.

• Pendant-for emergency notification

Other companies displayed additional sensors for the kitchen and bathroom to monitor stove, shower, and toilet use.

The Home for Life Solutions demonstrated systems to monitor potential flood situations in the bathroom and kitchen, an enuresis sensor, wireless emergency pull cord, and cooking sensors that turned off appliances and notified the call center.

CAST is a premier source

The premier source for information about assistive technologies is the Center for Aging Services Technologies (CAST.) There are more than 400 agencies and companies in coalition to develop and bring products to help seniors live more independent and rewarding lives. The CAST Web site is: https://www.agingtech.org. It is also available through the AASHA Web site: https://www.aasha.org/cast.aspx. Please visit it and share it with other providers and families.

Interactive technologies

Several vendors demonstrated interactive technologies to keep seniors engaged with their families, improve and support memory, and slow cognitive decline. Large touch-sensitive screens make use by nontechnology-enabled seniors and those with movement disorders easier. The costs are declining rapidly.

Some systems are specifically designed for monitoring and improving cognitive function. Dakim and It’s Never 2 Late have therapeutic systems tailored for nursing home residents. Social networking can be adapted for families with large, touch-sensitive screens, and inexpensive Web cameras to keep families in touch over any distance.

The Nintendo Wii was demonstrated at the Idea House. The gaming system is being used in many settings to improve physical function and balance, as well as social networking. When connected to the Internet, the system can support interaction between friends and family. The system has been used in senior centers to set up competition and encourage increased physical function. More “games” appropriate for seniors are under development for this affordable device. Who says exercise can’t be fun!

Robots

Not mainstream yet, but several robotic technologies are available (or soon will be.) Paro Robots demonstrated a robotic baby seal. It can become a companion to seniors with reduced cognitive function without the issues of real animals. The seal responds to touch, words, and light.

More ambitious is the Cyberdyne Robot Suit based on Hybrid Assistive Limb®-not the HAL of 2001! The suit is worn on the lower body and responds to neuro signals from skin sensors that trigger assistive movements by the motor unit. With further development the system shows promise of helping people with many diseases live more normal lives.

Safety, quality of life

These and all technologies must be used with safety in mind. The assistive technologies can supplement caregivers, but not replace them. Using appropriate technology can support independence and give caregivers peace of mind. Most importantly, seniors can maintain their quality of life longer at their highest achievable level.

Appropriate use of these and other technologies can reduce risk for seniors, improve their independence, and become a profitable product line for providers. The systems need setup, maintenance, and periodic instruction to achieve maximum benefit. The benefits of increased independence, longer time in lower levels of care, and better quality of life can be achieved at a reasonable expense. The future is bright for additional innovative solutions to help improve the quality of life for seniors.

David M. Oatway, RN, MPH, is a long-term care IT consultant based in Key West, Florida. He has been the Chair of the HIMSS Post-Acute Care Special Interest Group, Vice Chair of the American Association of Nurse Assessment Coordinators (AANAC), and a member of the American Health Information Management Association (AHIMA.) He developed one of the first clinical MDS systems (CHAMP). He is the database manager of the STRIVE national nursing home time study which developed the RUG IV Medicare PPS.

To send your comments to the editor, please e-mail mhrehocik@iadvanceseniorcare.com.

Long-Term Living 2010 March;59(3):46-49