Health

When looking at elderly patients is a camera

In the middle of a rainy Michigan night, 88-year-old Diane Verdock walked out the front door of her son’s Grand Rapids home, barefoot and without a coat. Her destination was unknown even to herself.

Vurdock was diagnosed with dementia a few years later, which turned out to be Alzheimer’s. Luckily, her son woke up and found her before she got too far down the street. As Alzheimer’s disease progressed, so did her travels, and so did her children’s anxiety.

“I was losing him,” said her daughter, Deb Weathers-Jablonski. “I needed to keep her safe, especially at night.”

Weathers-Jablonski installed a monitoring system with nine motion sensors throughout the house – in her mother’s bedroom, hallway, kitchen, living room, dining room and bathroom, as well as around three doors leading to the street. They connected to an app on her phone that sent activity alerts and provided her mother’s travel log.

“When I went to bed at night, I didn’t have to guess what she was doing,” said Weathers-Jablonski. “I was really able to get some sleep.”

New monitoring technology is helping caregivers to cope with the ongoing challenge of caring for older people with cognitive impairments. Installing an extensive monitoring system can be costly – People Power Co.’s Weathers-Jablonski system. costs $ 299 for hardware and $ 40 per month for using the app. With many companies selling such equipment, including SentryTell and Caregiver Smart Solutions, they are readily available to people who can pay out of pocket.

But this is not an option for everyone. While the technology is in line with President Joe Biden’s plan to spend billions of dollars to help older Americans and people with disabilities live more independently at home, the costs of such systems are not always covered by private insurers and rarely by Medicare or Medicaid.

Monitoring also raises ethical questions about confidentiality and quality of service. However, these systems allow many older people to stay in their homes, which can cost them much less than institutional care. Living at home is what most people preferespecially in light of the damage done to nursing homes by the COVID-19 pandemic.

Technology can help fill the huge gap in home care for the elderly. There are not enough paid people to meet the needs of an aging population, which is expected to more than double in the coming decades. The scarcity is fueled by low wages, meager benefits, and high burnout.

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And for nearly one in five US adults caring for a family member or friend over 50, gadgets have made the hard work a little easier.

Passive surveillance systems replace “I fell and I can’t get up” medical alert buttons. Using artificial intelligence, new devices can automatically detect when something is wrong and make emergency calls without being asked. They can also control pill dispensers and kitchen appliances with motion sensors such as EllieGrid and WallFlower. Some systems include a wearable watch for fall detection, such as the QMedic, or GPS tracking, such as the SmartSole insoles. Others are camcorders that record. People use surveillance systems like Ring inside their homes.

Some carers may be tempted to use technology instead of care, researchers in England have found. recent research… The participant, who visited his father every weekend, became less frequent after his father started wearing a fall sensor on his wrist. Another participant believed her father was active around the house, as evidenced by activity sensor data. Later, she realized that the application showed the movements not of her father, but of his dog. The surveillance system recorded the dog’s movements in the living room and recorded them as activity.

Technology isn’t a substitute for face-to-face communication, said Christa Barnett Nelson, executive director of Senior Advocacy Services, a nonprofit group that helps seniors and their families in the North Bay area outside San Francisco. “You can’t tell if someone got their underpants dirty with a camera. You can’t tell if they are in pain or if they just need interaction, ”she said.

In some cases, the observed people changed their habits in response to technology. Clara Berridge, a professor of social work at the University of Washington who studies the use of technology in elderly care, interviewed a woman who stopped her usual practice of falling asleep in a chair because technology was falsely warning her family that something was wrong. when inactive, which the system considers abnormal. Another senior reported that he rushed to the bathroom for fear that the alarm would go off if they took too long.

Technology is another concern for those being monitored. “The caregiver usually really cares about safety. Older people are often very concerned about security too, but they can also seriously affect privacy, their sense of identity or self-esteem, ”Berridge said.

92-year-old Charles Vergos, who lives in Las Vegas, does not like video cameras in his home and is not interested in wearing gadgets. But he loved the idea that someone would know if something went wrong while he was alone. His niece, who lives in Palo Alto, California, suggested that Vergos install a home sensory system so she could monitor him from afar.

“The first question I asked was, is he filming?” – remembered Vergos. Since there is no video component in the sensors, it was fine with them. “In fact, after they appear in your house for a while, you don’t even think about it,” Vergos said.

The sensors also made talking to his niece more comfortable for him. She knows he enjoys talking on the phone while he is sitting in his office chair, so she will check his activity on her iPad to determine if the time is right to call.

Audio and video filmmakers must comply with state privacy laws, which generally require the consent of the person being recorded. However, it is not clear whether consent is required to collect the activity data that the sensors collect. This falls into a gray area of ​​the law, as does the data collected when you browse the web.

Then the problem arises of how to pay for all this. Medicaid, the state’s federal health care program for low-income people, does include some passive monitoring of home care, but it’s unclear how many states have chosen to pay for such a service.

Some the elderly also do not have access to reliable broadband internet, making much of more sophisticated technology out of reach, ”said Karen Lincoln, founder of Advocates for African American Seniors at the University of Southern California.

Terrain monitoring devices that caregivers bring may be the most compelling reason to use them. Delane Whitehead, who lives in Orange County, California, began taking medication for anxiety about a year after her husband Walt was diagnosed with Alzheimer’s.

Like Weathers-Jablonski, Whitehead sought technology to help, finding peace of mind in the sensors installed in the toilets in her home.

Her husband often flushed too much water, leading to overflowing toilets. Before Whitehead installed the sensors in 2019, Walt caused $ 8,000 in water damage to their bathroom. With the help of sensors, Whitehead received an alert on her phone when the water was too high.

“It really reduced my stress,” she said.

Sophie Codner is the author of the Investigative Journalism Program at the Graduate School of Journalism at the University of California, Berkeley. The IRP has communicated this through a grant from the SCAN Foundation.

Kaiser Health News is the national health policy news service. It is an editorially independent program of the Henry J. Kaiser Family Foundation, not affiliated with Kaiser Permanente.


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