Aging in place
Smart-home technology offers a way to extend seniors’ independence
As a few plaintive piano notes mark time, the image of an an older man slowly ambling down a hallway appears.
“C’mon, Cookie,” the man says as he turns and waves on a small R2D2-ish robot whirring quietly behind him.
It beamed recently from a flat-screen TV in the living room of a so-called “smart home” in Virginia Beach, a thematic centerpiece used to explain how 50 wifi-enabled, web-connected devices arrayed around the house can offer seniors the option to stay in their own homes longer.
“While you might have an aging parent at home, and you live maybe 300 miles away, there’s technology that can help you stay connected to them without having to feel like you need to put them in an assisted living home or a facility,” said Sarah Buck, a spokeswoman for Cox Communications Virginia, which put together the smart-home event.
The technology is emerging at a time when the aging population around the world is being termed by some a “silver tsunami.” By 2030, one in every five residents in Hampton Roads is projected to be older than 65, mirroring U.S. Census Bureau data for the nation .
A century earlier, people over 65 represented just 5.4 percent of the nation’s population, according to UCLA economist Dora Costa.
The story’s much the same globally. Worldwide, by 2050, people over 65 are projected to outnumber children under 14, according to the World Health Organization.
Nursing care has served as one way to address the needs of the elderly, though it is not cheap and availability is limited.
There are 309 nursing facilities in Virginia, with 34,540 beds, Joanie Latimer, an ombudsman with the Virginia Department for Aging and Rehabilitative Services, wrote in an email. In this area, the annual median cost for a semi-private room is $93,258 and $101,105 for a private room.
Cox says the average American is likely to live to 79 or older and that nearly 90 percent of those over 65 want to stay in their current home . It sees a way forward with a line of products and services that provide “connected independence.”
The idea is that, enabled by a powerful internet connection, a lineup of devices and monitoring apps can give families peace of mind by allowing them to keep tabs remotely.
So what do some of these solutions look like and how much do they cost?
First, you have to have an internet connection powerful and fast enough to run the devices. Cox offers plans at prices that vary by speed – about $40 a month at the low end, quick enough to run a handful of devices. It rises to about $80 at the high end, the package Cox used to run 50 devices at the same time at its smart-home event.
Cox offers “Gigablast” packages to those who want the fastest connection – able to handle 1 billion bits of data per second – at prices ranging from about $120-$130 a month.
The gadgets those connections can link include health-monitoring devices that allow seniors to communicate directly with health-care providers, track blood pressure, weight, dietary habits and day-to-day changes in symptoms.
While not exactly new, sensors such as pendants can notify emergency responders in the case of a fall.
The “smart” devices, some available in stores, others online, also include kitchen appliances such as a crockpot ($123 on eBay) or a “sous vide” ($100 at Williams Sonoma) that enables the preparation of vacuum-sealed foods – both controlled through wifi. You can remotely set start and end times for meals, avoiding hot stove tops or flames that can be a danger.
There’s even a wifi-connected fork (about $25 on eBay) to allow a family member to remotely monitor eating frequency and how fast meals are consumed.
You can buy a wifi-linked vacuum cleaner ($450 at Best Buy), a pill dispenser to monitor use of medications ($73 on Amazon) and a Jibo Family Robot ($850 on eBay).
And don’t forget the pets – robotic companions such as the “Joy for All Golden Pup” ($111 on Amazon) and “Joy for All Tabby Cat” ($100 on Amazon).
“Is the cat on?” a Cox worker asked colleagues when it, at first, didn’t respond on cue. But it did soon enough, meowing and purring just as the dog, wearing a red kerchief, turned its head, opened its mouth and barked.
Alison Jacobson, who was among the presenters at the Cox event, lives in Wilton, Conn., and says she’s an expert of sorts because she has to be: Her husband has multiple sclerosis, her son has intellectual disabilities, her mother is 80 and her aunt is 89 .
They all live under one roof.
“Literally, all of these smart devices were made for me,” she said, describing her home as a sensor-laden maze of devices that allow her to monitor from the road which doors of her home are opening or closing .
From his wheelchair her husband can with a touch of a button lock all the doors of the house, turn down the thermostat and turn off the lights, she said.
“We’re talking about aging in place, but also it’s for anybody with disabilities,” Jacobson added, citing the case of her son. The technology gives her hope that he one day may live on his own with a roommate.
“I can put this in his apartment, look in, make sure he’s getting dressed in the morning,” she said. “I can get texts when he leaves for the day.”
In addition to helping seniors stay in their homes and offering more independence to those with disabilities, smart-home gadgets can also help those at the other end of the age spectrum: infants in cribs.
“We lost 32 babies to unsafe sleep in 2016, just in our region,” said Trish O’Brien, president and CEO of Chesapeake-based Children’s Health Investment Program or CHIP.
The Eastern Virginia area – including Norfolk, which had the highest numbers – had the highest rate statewide for such deaths, which are preventable and occur when infants are left in unsafe positions or when they’re brought into bed with adults who accidentally suffocate them.
O’Brien and Jessica Gipson, who runs a regional campaign called “Sleeptight,” showed how a device called an “Owlet” – a kind of open-toe sock strapped over an infant’s foot that monitors pulse and oxygen levels and communicates by wifi with a base station – can alert caretakers through a phone app if the readings drop below normal .
This kind of monitoring technology has taken off.
“The revenue of the global smart homes market in 2014 was at $20.38 billion and it is projected to grow to $58.68 billion by 2020,” according to the Swiss-based journal Sensors, which follows the science of sensors and biosensors.
It adds, though, that the market is “in a state of stagnation.” Why? It cites a number of factors, from cost to the complexity of the systems, “which require multiple networking devices and software applications to implement and control the smart homes.”
Colin Milner is the founder and CEO of the Vancouver-based International Council on Active Aging, which operates in 47 countries and serves as a kind of resource center for an array of senior-living communities.
“We’ve seen some communities pull the smart-home technology because it was more of an aggravation,” he said. “… We have to be careful in these initial phases.”
Tools – including smart-home devices – are only useful if you know how to use them, he added, citing the example of Apple’s Siri.
Technology becomes more mainstream when you don’t have to think about it, when it’s built into your clothing, for example. “It becomes invisible,” he noted. “That’s where I think we’re going with all of this.”
In Hampton Roads, Steven Morrison, a professor at the School of Physical Therapy and Athletic Training at Old Dominion University, suggests that the smart-home movement is OK, as far as it goes.
“It doesn’t deliver everything that it possibly could,” he said, citing the example of fall monitoring, which he has researched. “To me, the falls are the biggest thing. One in three people over the age of 65 fall.”
While devices can detect when someone falls, they merely record the event and call for help. They don’t prevent the fall. “You’re not improving their risk,” he said.
The smart-home concept, if taken too far, can also create problems, he added.
“The downside to it I see is that if you automate the house so much that you decrease their activity so they do less – so they don’t get up to turn the lights on, they actually use their ‘Clapper’ or whatever or their smart phone – that can be problematic if you’re decreasing their activity,” Morrison said. “That can actually be worse for them long-term.You want to keep them active.”
Diane Cook, a professor in the School of Electrical Engineering and Computer Science at Washington State University, does research that includes robotics and “smart environments.”
“Yes, technologies can address some of those issues,” she said of smart-homes’ ability to give seniors more independence. “Right now, they can’t address them all.”
Cook cites fall-monitoring technology as having made the most progress and adds that devices dispensing medicines – while not entirely foolproof – are becoming more marketable.
She works a lot with people in cognitive decline, somewhere between health and dementia. What smart technology can do is prolong the time that a person dealing with such issues can hold on to some measure of independence, Cook said.
Yet, once an individual needs help getting dressed, using the bathroom and eating, the situation changes.
“That’s a little more advanced than what technology can robustly handle at this point,” she noted, while adding that it can still provide months to even years of being able to live more independently.
“We’ll take it,” she said. “I would take it.”
In the closing seconds of the Rance Howard video, he sums up his case.
“I don’t want to be in a nursing home,” he says. “The quickest way to lose your independence is to go where you don’t have any independence. That’s the truth.”
Steve Zollos is CEO of Norfolk-based Senior Services of Southeastern Virginia, a not-for-profit organization that he describes as a kind of personalized, one-stop-shop for seniors and caregivers in the community. Nursing homes, he says, have come a long way from where they were decades ago.
His agency, though, still aims to help people avoid that option.
“Our emphasis is on giving people the opportunity to stay in their homes as long as possible, because that’s where they desire to be,” he said.
People wind up having to leave their homes often because “they have a propensity to leave the stove on or they can’t keep track of things the way they used to, and now a caregiver has to try and monitor that and keep track of it.”
Technology now provides resources to seniors and their caregivers to enable them to work around such issues.
“I can have my mom at home while I’m working and feel like I can monitor what’s going on,” he said. “I can actually monitor what’s going on and I have a comfort level now that Mom’s OK.”
Technology alone, though, can’t be the ultimate answer.
“Even with the technologies, there will always be a need for the personal care and the personal touch,” he noted. “I like the perspective that health care starts at the kitchen table and it ends at the kitchen table.”
Those who experience chronic health episodes and hospitalization want to get in and out of the hospital and get through any needed rehabilitation as soon as possible because they’re driven by one goal, Zollos said: “to get back to the kitchen table where life really happens for us.”