The Race to Develop Technology that Enhances Elder Care

It happens with every generation – we’re born, our parents care for us and nurture us, we grow up, they grow old, and then we switch roles and care for them. Soon it’ll be my turn to be the caregiver to my parents, and I recently got a preview of things to come when my mom fell and busted her ankle. That it wasn’t the classic broken hip was a relief, but even “just” a broken ankle was difficult enough to deal with. I live 40 minutes away from the ‘rents, and while that’s not too bad when the visits are just the weekly dinner at Grammy’s, the time and the miles really start to add up when the visits turn into every other day to make sure Mom’s getting around OK and Dad is eating and sleeping.

I was sorely tempted to hack some kind of solution to give myself a rudimentary telepresence, but I couldn’t think of anything that wouldn’t have either been unacceptably intrusive (think webcams) or difficult to support from an IT perspective. Mom’s pretty handy with the iPad and she Skypes with my brother and his family out in California, but beyond leveraging that I was tapped out for ideas that I could easily deploy and would deliver sufficient value beyond the support burden within the time frame of healing the ankle. Consequently, I spent a lot of time in the car this summer.

This experience got me to thinking about how intergenerational caregiving will change with the rise of pervasive technology. The bad news: we’re still going to get old, and getting old sucks. The good news is, I think technology is going to make things easier for caregivers and elders alike. We have an incredible range of technology experiences among the generations present right now, from my parents who can remember phones without dials and nights spent listening to the radio, to my daughter’s generation that is practically growing up with supercomputers in the palms of their hands. How each generation ages and how it embraces technology as a solution for age-related problems are going to be vastly different.

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Smart Desktop Medicine Organizer

Making Stuff That Matters

The 2015 Hackaday Prize has a “make stuff that matters” theme, and a surprising and encouraging number of entries were related to elder care and aging-in-place issues. Among my favorite entries is the Smart Desktop Medicine Organizer. Basically a home version of the Pyxis system used in hospitals, it’s a cloud-connected dispenser for medicines in pill form that keeps track of when to dole out pills, warns of potential drug interactions, and keeps track of compliance. That would be a boon for the remote caregiver – being able to pull up an app on your phone and see whether Dad has taken his meds today would be handy. And providing organization for increasingly complex regimens of medication would be a benefit to the senior. Since it provides tangible benefits to both the care giver and the senior, I bet this would be among the easier technologies to deploy.

Further out on the intrusiveness spectrum, we’re seeing more and more variations on the old “I’ve fallen and I can’t get up!” devices. Another 2015 Hackaday Prize entry is the Elderly Asset Tracker, a name which admittedly would not market very well. But the idea of a wearable sensor that detects falls using accelerometers and alerts a call list using the cell network rather than a proprietary wireless signal has a lot of potential. I think I’d have a hard time getting my parents to carry something like that, though – it has to be tough on your spirit of independence to be tagged and tracked like that. Maybe rolling the same functionality into a smartphone would lower the barrier to acceptance. After all, the suite of sensors on any modern phone should be capable of detecting a fall and initiating a call for help. Does anyone have elderly relatives that are early smartwatch adopters?

Preventice Cardiac Sensor
Preventice Cardiac Sensor

It seems to me the smartphone is probably going to be the gateway platform to a lot of innovation for seniors and caregivers alike. We’re already seeing wearable cardiac sensors that talk to a smartphone over Bluetooth and monitor a patient in real time. There are also FitBit-like devices that monitor and analyze activity and send alerts when unusual patterns begin to emerge, such as alterations in sleep cycles or changes in gait speed. That not only helps the caregiver know when an emergency occurs, but can also provide early warning for some diseases. And for the aging driver, Automatic’s $99USD dongle for a car’s OBDII port allows you to keep track of almost everything about the vehicle, including where it is if the driver gets lost or confused.

All of these technologies rely on adoption by both the caregiver and, perhaps more importantly, by the senior. That’s where the intergenerational part of this will come into play. To those of us who’ve grown up in a world where privacy is a flexible concept that’s easily circumvented by a few paragraphs of legalese buried on some website’s policy page, we might find pervasive monitoring an easier pill to swallow. We know that the smartphone giveth and it taketh away, and we’ll probably be more eager to adopt some form of monitoring when it’s our turn to begin writing our last chapters. It’s probably going to be a different story for our parents, though, and the increased effort to overcome their reasonable objections, coupled with the difficulty we’ll no doubt incur as we try to support whatever we deploy, might make the whole thing more trouble than it’s worth.

Cashing in on our Elders

The hacking community often focuses on solving immediate problems. I think that the coming demographic deluge of aging Boomers offers not only short-term problems that will need to be fixed but also the potential for capitalizing on larger trends. Estimated spending on elder care in 2016 will be $319 billion in the US alone, and is expected to grow at over 6% per year. That’s a huge pile of money, and laying claim to even a tiny fraction of it could make someone quite wealthy.

A fair number of the Hackaday Prize entries in the elder care space have real potential to be developed into products that can be mass-marketed; you can bet they’re not the only ones walking that path. As with anything in health care, regulatory hoops aplenty will need to be jumped through before the Next Big Thing hits the market and starts turning a profit. A lot of great ideas will fall by the wayside, and the hackers who succeed will be those that have not only a great idea but also what it takes to navigate through the system and deliver their vision. And even for the ideas that don’t hit it big, there’s plenty of room to make a difference and make a living on the margins. If you can come up with that must-have smartphone app that’ll make elder care better, easier or cheaper, a $1.99 price point could end up being very lucrative without becoming a financial burden for those who need it.

It’s going to take a lot of passion and a lot of perseverance to rise our technology to the challenge of hacking elder care for the better. Bringing these ideas to market and building products that stand a chance at making a difference in the lives of caregivers and elders alike is a worthwhile pursuit for many reasons. And who knows – you may end up working on something that will save your own life one day. 

31 thoughts on “The Race to Develop Technology that Enhances Elder Care

  1. Within the U.S., one must be careful not to violate Patient Privacy concerns (HPPA). For instance, Tweeting, “Dad has taken his medication” or similar communication over public venues is a violation. So please keep that in mind when designing/building a system.

        1. Before we start, please enter the phrase you would like tweeted publicly when an event has transpired. Note, this is a public communication that can be seen by anyone. Thank you for completing the pill-o-tweet5000 setup wizard.

          ^ Dialog prompt from the near future

    1. Are you sure you don’t mean HIPPA? The Health Insurance Portability and Accountability Act?

      That doesn’t really apply in the way you think it might if you don’t actually work in the healthcare environment. But I am not an attorney and I would suggest you look in more detail at the specifics with respect to how it applies outside of the doctor / patient environment.

      1. I’m sure your correct in that HIPAA doesn’t apply to private conversations outside healthcare providers. That doesn’t mean that someone would develop common sense Guidelines. Such as not adverting you are or another are going to be alone, when your home will be empty. Many people put a lot of trust in family and friends. Often in complete strangers when the Facebook posts go the Facebook pages of entities they like. I’m pretty open on some forums on the internet, but not on the popular social site. No doubt such guilines have bee created & disseminated, no doubt that are largely ignored

    2. With HIPPA the patient need only to give written consent and the TWITTER posting is covered. However, the entire conversation could be a private TWITTER posting or codified as like CONDITION 1-A with time-stamp. There are other modes of TCP/IP communications other than TWITTER. A private website that use streaming text object could also be used as a 2-way communications medium.

        1. Technically I use HTTP (port 80) to surf the web. However, Twitter requires a logon id, password, and a 140 character limit per message. It’s not easy to structure a Twitter posting with a simple Query string in a JavaScript or HTML command. With ASP’s FSO (Field Streaming Objects) you can send unlimited text characters to a ASP text database with no authentication at all and can be structured in a Query string command. You could have an unlimited private 2-way chat session with no oversight from a webmaster or a constraining chat host program. You can customize it anyway you want only limited to your HTML/JavaScript/ASP (or VBSCRIPT) programming skills. You could have a private secret chat room.

  2. Yes there are lots of opportunities for clever tech to help ease the burden of caring for the elderly.

    On a broader social scale, the single best way to provide better care for the elderly is to give back the free time that the modern work world took away from individuals and families. High-tech tools and institutionalization are not good substitutes for the extended family setting that is still the norm in other societies and cultures.

    One of the big promises made for technical progress was shorter workweeks, so that we’d have more time for family and self-improvement. We need to push harder for this. Unless you think that wired devices and a robot caregiver will be just fine when you’re in need of care.

    1. Well… it’s in the power to take back the free time is in the hands of the families. So many work to consume more than basic needs. Not they have to give up recreational activities, just be smart about it. Doesn’t take a boat like pro fisherman use to be able to catch fish. A camper for weekend and couple of weeks use a year doesn’t have to be like a camper like those who live full time in them have. don’t make living playing golf, you don’t need the equipment that those who do use. My mom still lives in the house her dad bought in 1968, that wasn’t their plan but that’s how life turn out for her. What Dan described is what the extended family is like for him and so many others is these days. No doubt families like the TV Waltons sill exist, but I’m sure it’s still a struggle.

      1. ahahahahaaaaa, lookit this starry-eyed wishful thinking. When you’re 40 and working two part time jobs totaling well over 60 hours just to make ends meet, where’s your shorter work week?

    2. Ken N – As much as we want to say we love our parents, more time with them and less money from work is not going to happen. Corporations certainly don’t want to loose money over this issue either. CEO’s and executives just get mom and dad a nanny. Do you really want to have Friday’s off to sit with mom and/or dad all day? Especially with senile dementia or Alzheimers in the mix? It’s all well and good you feel this way but most young Americans don’t want to do that. Either a visiting nurse, assisted living, or technology. Camping and fishing with dad once a month is very cool but not every weekend. Some really want to spend more time with their immediate family (wife and kids). In some foreign countries, parents living with you is mandatory. Do they ever look happy about it? Spend about a week with your parents or grandparents, especially the cantankerous type. Tell us about your experience then.

      1. Hi Mom Hi Dad. Thanks for raising us and all. Getting old sux amirite?, Here’s a hacked Dash button and a Lego Mindstorms robot to take care of your every need. Ciao.

        (O brave new world, That has such people in ’t!)

    3. Ken, I don’t think of this type of tech as minimizing a burden on caretakers. I would argue that (even though our parents love spending time with us) they don’t want to loose their freedom. Technology like this can lead to a future where the aging population can live more independent for longer, ultimately improving their quality of life. No one likes getting their diaper changed (being treated like a child is some ways) and anything we can do to prolong a happy productive life is a plus in my book.

  3. Problem is the FDA and HPPA force tech to not advance fast in the world of healthcare.

    in europe we already have constant glucose monitoring and a lot of other very cool devices that are not available here because of really really stupid laws that have more to do with protecting businesses than people.

    1. Sure.. Replace merchant in the Gettysburg Address to get the true nature of the USA government. Our Constitution addressed commerce before it addresses rights mentioned in Declaration of Independence & prerevolution pamphlets circulated.

    2. Our US laws are not “stupid”. They are just overly careful.

      A constant glucose monitor would hve to be FDA approved as it involves invasive procedures which could harm a human if not done properly. The FDA does not care that Europe is doing it carefully. They have the mandate to prove it’s safe in USA. HIPPA is not an issue here in USA. It helps protect our privacy. If we give our written consent anyone we choose can monitor our health stats remotely.

      However, FDA has an unhealthy alliance with Big PHARMA (large pharmaceutical companies like Eli Lily and many others). It appears that Big PHARMA uses their LOBBYING powers in US Congress (Washington DC) to help “steer” things in their favor and FDA has to obey Congress. No new medical gadget can be sold without FDA approval. And unfortunately indirectly without Big PHARMA’s tacit approval too.

      For instance, You Europeans can use Vigabatrin (an anti-epilepsy drug) to combat cocaine, nicotine, and alcohol addiction. We just recently got FDA approval but not without decades of fighting with them. Now it’s the same fight with them over Topamax. These two GABA receptor drugs could ostensibly end COKE HEADS in America! That also means end crack heads. That alone would cut down crime extensively as they are usually the perpetrators of crime, Might have even helped a recent coke head ex-President of ours too.

      So yes we are crippled by self-serving Corporate LOBBYISTS here in America but not stupid laws.

  4. The future will not lie in elder care. The future will lie in protecting our children and teenagers from diseases, because in the end they will pay our retirement pension. A pill dispenser will not save any life. A pill dispenser will just be one of many peripherals of a bunch of much more advanced machines. One of these machine will be a medicine synthesizer.

    1. M. Bindhammer – I’m afraid to say that empirically in USA that that is just not happening. Many elders are being abandoned to live in danger at home on their own or forced into elder care facilities. The costs are usually on the federal government via Social Security, Medicare, and Medicaid. The former payment method is being financially stressed by this phenomena.

      In places like Japan, France, China, Russia, etc it is a REQUIREMENT for adult children to take in their parents in and care for them. Of course additional elder care is paid for by their far superior to USA’s Socialized Medicine in those countries. Costa Rica being the best place to grow old.

      The children NEVER pay our pensions. That is our employer’s and government’s job. Our children’s future paying their taxes is a whole other issue for the IRS and states. Not sure we are teaching our children the right family values in USA today. They seem to be like weeds in a garden. Only the most attentive parents are doing it right and they are few judging from the crime in all economic cultural groups in USA.

      You’re right in that actuarially insurance companies agree that elder care doesn’t have a long-term future. However, our children, and us baby-boomers, are fast approaching senior citizenship. Most retailers view 55 years of age as seniors now. It seems there will always (for now at least) be a future need for elder care options as we all grow old and die.

      A medicine synthesizer would scare the heck out of me. With all of the pharmaceutical mistakes, intrinsic side effects, and big PHARMA political corruption I would not trust a medicine synthesizer to make drugs for me. Technology is wonderful but the down-sides are many. Did you know there are criminal-medical-hackers out there looking for ways to remotely disrupt pacemakers, impact automatic hospital pharmaceutical dispensers, etc? Humans are very inventive but they can be very sociopathic too.

  5. Dan Maloney – I like your challenge. I am presently working on some HaD .io systems-integration projects that deal with elder care. theme at https://hackaday.io/sonofthunderboanerges. None of them specially deal with actual hardware builds only integrating existing systems. One in particular deals with Alzheimer Mitigation of short-term memory loss problems. Another is a non-verbal communications method called Luddite Mitigation. I am thinking of posting a visual acuity enhancer I call VISOR after the Star Trek glasses Geordi La Forge character wears in The Next Generation. And the initial project is a Skype based remote medical diagnostics system called DOCTORS WITHOUT DOCTORS.

    I think your situation could be mitigated with SKYPE on a smartphone. Not only could the smartphone detect falls, critical vibration, excessive heat, and be connected to a medical monitoring Bluetooth smartwatch but Skype uses video conferencing and can be set to AUTO-ANSWER. The Smartphone could be either left in it’s recharging cradle aimed at parent’s main living area so you could dial in periodically and listen in and view but you could have mom or dad pick it up and walk around with it. It would automatically be in speakerphone mode so they would not need to hold it to their ear.

    The system could be aimed at dad’s daily pill box setup so you could view if he is up to date with the days of the week. He could be asked to aim the phone at that daily pillbox for you. You could monitor his vital signs via a remote medical diagnostics website just as long as he wears his smartwatch. The watch monitors hear rate, respiration (with a chest strap), horizontal attitude (falls), and responsiveness green button (i.e. “Dad press your I’m OK button please”). There could even be a red PANIC button on it too.

    You may soon need to hire a daily visiting nurse (VN) to pay visits to them and make sure they are eating well and are safe. The VN could also make sure pillboxes are prepped accordingly, secure the smartwatches on their wrists, and have their individual smartphones charged up. At some point it will get worse and you or VN will have to be there quite frequently. The only other option is to send them to an assisted living center. Or they can move in with you.Trust me it won’t be fun for your spouse nor you for that matter when Alzheimer’s raises it’ ugly head.It can stress out even the most patient person in the world. It’s like entering the Twilight Zone EVERY DAY! And when they stubbornly refuse to cooperate with you… it becomes your own private hell.

    Yes this may SEEM intrusive. But you must not be aware of the evils of senile dementia and Alzheimers. At first your parents will welcome this technological “intrusion” as your effort to help them survive life. They need your personal attention and this is a way for you to virtualize it. But that’s only today. One day they may resent it and try to disable things they forget to understand. You may need to build your systems to withstand tampering. You may find the smartwatch in the wastebasket or the toilet. Ex-convicts have to wear them around their ankles and they can NOT be tampered with.

    One other function you’ll like about smartphones is the automatic Geo-location function. There are apps that track a smartphone’s movement on a Google map even without GPS (uses cell phone tower triangulation). This will be a Godsend when dad goes walkabout wandering the streets at night 12 AM! The police will try and look for him but this app will pinpoint him immediately as long as the smartphone is strapped to his body some how (in a belt snap holster or neck lanyard with camera peeking outward). You can say to him on Skype: “Dad where are you!” Dad: “I dunno son!” You: “That’s OK dad I can see you’re on the corner of Main and Vine. I’m coming to get you now, Stay put! Let me see your face please… OK leave your phone on I’ll talk to you while I drive there.” Dad: “Oh OK son I will…”

    Technology today is great! 30 years ago this would be the stuff of James Bond! :-)

  6. As a son tasked with the care of my elderly live-alone mother (and not too far from old age myself), I can get behind any tech that ease that care, and privacy be damned if it gets in the way. After all, she used to change my diapers.

    For now I get along with an old laptop which says out loud which pills to take and when to take them (using just a text-to-speech freeware and Windows task scheduler), and keep repeating the remainder until my mother comes to the pill organizer and clicks a button on the laptop, which is right beside it.
    That laptop also have a simple webcam setup that covers relevant zones of her home, for live web monitoring and motion detection capture with the images being saved to a shared Dropbox folder, so I don’t need to have her on screen at all times to know that she has been up and moving about.

  7. Very much appreciate this article. Just helped my mom pass and saw the need for all this firsthand.

    Can I get recommendations for folks to follow on Twitter who are specifically working at the intersection of aging and tech innovation? My favorite is @josephcoughlin who heads the MIT AgeLab. I also work with LGBT elders so anyone who is working to advance the specific needs of diverse elder populations like ours or others, I’d also love to follow on Twitter. Thanks!

  8. They are people, and they do not want to wear anything special. That’s why the best tool for them, is the Amazon Echo.
    If they fell on the ground, they will only have to call for help.

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