The spirit of independence meets the spirit of invention

Marty Martin keeps close track of his 92-year-old mom's health.

He knows when she gets up, when she fixes breakfast, whether she has taken her medicine -- even the temperature inside her Sarasota home.

He does it not from down the hall, but from more than 500 miles away.

Each morning, Martin logs on to his personal computer in his suburban Atlanta home, visiting a Web site that details his mother's daily activity. Motion sensors, strategically mounted around her home, constantly feed information to a computer program that analyzes the data and detects abnormal variations in her routine.

If his mother misses her medication or meals, Martin can phone with a gentle inquiry. If she were to fall in the bathroom, unable to get out, he would receive an emergency cell phone and e-mail alert.

Distributed nationally by a Sarasota firm, the technology lets Martin's mother, Christine, continue living independently while helping her family look after her -- despite their long-distance separation.

"It's amazing," said Martin, 71. "I think it's a great system."

On the market for about three years, the home health monitoring system, called QuietCare, is among the rapidly emerging technologies that could revolutionize aging in America over the next several years.

From "smart" canes that can help people maintain their balance to talking medicine cabinets and cell phones that can check blood sugar levels, academics and private companies are working on an array of products that could make life easier -- and safer -- for older people and their caregivers.

Many of the products are still in the research and testing phase, and few studies have been conducted to measure the value of the new equipment.

But analysts argue that the potential for age-related technology is both vast and real. Some equipment, like the QuietCare system, is already available for use in homes and long-term care facilities.

Within a few years, the combined research efforts at many of the country's top universities and tech companies such as Intel, Philips and Honeywell could snowball, leading to rapid breakthroughs and more practical use.

"The future, I think, is very bright," Jeffrey Kaye, professor of neurology and biomedical engineering at the Oregon Health and Science University, said at a national aging conference earlier this year. "Technology appears to start slowly, but it has an exponential development curve. This technology is not going to be stoppable, in a way."

Privacy issues

Martin says it has already changed the way his family cares for his mother.

After his father's death last year, Martin said he urged his mom to move in with her 86-year-old sister, who also lives in Sarasota. Both, however, preferred to remain independent.

Christine also wanted to avoid a long-term care facility.

But Martin worried about what would happen if she fell while alone at home, a real threat to the mobility and even survival for elders. And he wanted to make sure she kept up with her medicines.

"I wanted some way, with me living in Atlanta, to know if there's a problem in the house," he said.

A friend who had heard about QuietCare recommended the monitoring system. He had it installed last year.

"I was a little skeptical in the beginning," he said, questioning whether the monitoring could deliver as promised.

And his mom expressed concern about her privacy -- a concern shared by others about household monitoring.

"If you're a senior citizen, the last thing you want is your kids spying on you," said John Kintz, a health care and safety consultant for Telemetry Systems Inc., or TSI, the Sarasota company distributing the QuietCare systems.

But, Kintz added, "There are no microphones, no cameras."

The system is designed not to send an alert for normal events -- say a long bath. Information compiled on activities is available only to family members or others approved by the resident.

Many older people accept the loss of some privacy in exchange for continued independence.

Increasingly, calls for the service, said TSI vice president Lee Lanier, "are from the elders, saying, 'Here's a system that allows me to stay home safely longer.'"

Martin checks how active his mom is each day, whether she's been to her medicine dispenser, when she leaves her bedroom, the time and length of bathroom visits and other actions. On a password protected Web site, he gets a quick overview of his mom's status through color-coded dots, with green for normal, yellow for caution and red for a potential problem.

With another click, he can see when she visited the medicine dispenser and similar detailed breakdowns on other activities. If there are any questions, he can contact his mother or ask family members who live in Sarasota or Tampa to check on her.

"I tell everybody I know that has an elderly parent living alone that they should have one of these," Martin said.

His mother's privacy concerns have evaporated, Martin said.

"The system looks like it's still working good," he remarked on one of his visits to her house.

"I don't pay any attention to it," she responded.

Early warning

QuietCare was initially marketed through a home security business. But last year, the manufacturer signed TSI, a telecommunications firm started in 1989. The company also works in home security and electrical cable work but has increasingly focused on the health care business.

Since last fall, TSI has been creating a network of dealers to sell, install and service the systems. TSI also controls billing.

Living Independently, the manufacturer, handles the computer server in Illinois that analyzes the data regularly relayed from the home monitors. Emergency situations are monitored by people based in New York, who can contact caregivers by e-mail, pagers or text messages to cell phones.

The service costs $400 for installation and activation, and $149.95 a month. The cost also includes a two-way radio emergency alert device.

Call center personnel can contact the home directly to check on residents to avoid a false alarm.

Typically, infrared motion sensors are installed in the refrigerator, to detect meal preparation, in the kitchen, inside and outside the bathroom, in the bedroom and in other activity areas. Most homes have six, but some have as many as a dozen.

After installation, the computer monitors routines for 10 days, to establish a baseline of activity.

About 3,000 of the systems are in use nationwide. Many are in assisted living facilities, helping workers there monitor residents' activity.

TSI vice president Lanier said he can foresee a time when the monitoring system and other technologies are routine features as families balance caregiving with jobs and raising children.

"Families are trying to take care of their own needs and Mom or Dad," he said.

Besides aiming to keep older people in their homes longer, much technological research is devoted to early diagnosis of potential health problems, before they become more serious, and costly.

Kaye, who directs the Layton Aging and Alzheimer's Disease Center in Oregon, says the current health care system for older people is "not very informative."

Visits to the doctor are brief, and data on their condition shallow. More continuous information, such as regular home blood pressure and glucose readings, could help treat chronic heart conditions or diabetes.

QuietCare's monitors might provide such data. For example, more frequent bathroom visits could be an early indicator of a urinary tract infection, and prompt a family member to suggest a doctor visit that could prevent bigger problems.

"If I ask my mom in Indiana how she's doing, she may say, 'Everything's great; everything's peachy,'" Kintz said. "But now the (adult) children can look at the report and say, 'Everything is going good.' Or, if they see a change, they might say, 'Now we need to plan a visit,' or 'We need to get to the doctor.'"

Saving money

The home sensor system is not for everyone. It only works with people who live alone, so that any motion can be traced to the single occupant. And while it can be deployed in assisted living facilities, it is not considered suitable for nursing homes, where the residents are more infirm.

There have not yet been academic studies to verify whether QuietCare and more emerging technologies actually delay institutionalization, one of the primary justifications for their development.

But such examinations are likely, said Kaye, as more products enter the market. He and other researchers are testing similar home sensors to see whether they detect changes that would be early warning signs for Alzheimer's disease.

Phones that could pick up early tremors, watches that remind cognitively impaired people to take their medicine, video face recognition systems that could trigger automatic door locks to prevent Alzheimer's residents from wandering off and other devices are also being developed.

Once evidence is available that the technology works, insurers and the government will likely agree to pay, which will make their use more common. The Center for Aging Services Technologies, a group of more than 400 tech firms, health organizations, researchers and government officials, started in 2003 to push for more rapid progress.

Majd Alway, the organization's director, said products will have to do more than wow consumers with technological wizardry. Technology's impact on aging "depends on many issues, he said, "including how well designed the products are and how good they are.

"Do they work? Do they make a difference? Do they deliver value, improve the quality of life of the individual, reduce informal caregivers' burden and strain and health care costs or improve the efficiency of health care providers?"

The QuietCare system is still early in that evaluation. Four states have approved it for reimbursement under Medicaid; Florida is not among them.

Kaye noted that one of the major reasons older people have to move into long-term care facilities -- at a cost of tens of thousands of dollars per person annually -- is trouble managing their medication because of memory loss and confusion. If the sensors help adult children ensure that their parents take their medication, they could potentially delay the need for long-term care for months or even years.

"You don't have to delay long to save people money," Kaye said, noting that one year of nursing home care in Oregon costs $50,000.

Martin said he has not faced any emergencies with his mother. He said there have been a few times when he has called to remind her to take her medication or learned she has not been moving around much because of leg pain.

Now, his aunt is having the system installed.

"I can't sing its praises high enough," Martin said.

 

Last modified: July 22. 2007 4:57AM