My house is the most special place in the world to me. I have lived here for 33 years – 27 with my husband Tom and 6 with my dogs after Tom passed away in 2015. Many wonderful memories have been created during my years here, including my move into a new career field, Tom’s return home after a long hospitalization stay, our kids’ graduations from college and law school, their marriages, and the births of my wonderful grandchildren. Many of the newer plantings in my yard grew out of the hours I spent gardening during Covid, which was my saving grace during that difficult period. I am glad every day that I can remain here but do understand that successful aging in place takes take work, planning and a lot of good luck. However, do I have to lose my privacy to remain safe?
The Centers for Disease Control and Prevention (CDC), notes that by 2030 older adults will make up approximately 20 percent of the US population. The dramatic growth of our country’s senior population, many who have complex, chronic conditions, brings challenges for the medical, technological and home health care communities, one being keeping seniors in their homes as long as safely feasible.
A survey done at Georgetown University’s McDonough School or Business showed that 96 percent of its senior respondents said it’s very important to be as independent as possible as they age. Seniors’ need for maintaining independence is crucial to their overall well-being and health. According to AARP, 90 percent of older adults nationwide want to remain in their homes, but US Census data suggests that many homes may not be able to accommodate the needs of aging homeowners. If seniors can remain in the comfort of their homes and avoid the need for assisted living and nursing facilities, it can save them, their families and our health care system millions of dollars.
Fortunately, recent innovations in technology are finding solutions that can provide help and support to seniors and their caregivers. Today’s technologies can help keep seniors safe and connected, provide support for them and their caregivers across the health care continuum and allow many seniors to remain safely independent in their own homes.
Medical alert systems have been available for years. These devices allow seniors to connect with help in case of a fall or sudden illness. The older models, generally pendants, were often cumbersome, and seniors felt that wearing them made them appear older, which resulted in them ending up in nightstand drawers. Now today’s alert system devices are very wearable and considered “cool” by people of all ages. The Apple and Fitbit Watches provide fall detection protection, information about your daily exercise and fitness routines, nutrition, sleep habits, and various heart functions. I have had my Apple Watch for 3 years and am uncomfortable if I do not have it on. Walking my two dogs is one of my favorite activities because I now have the security of knowing I can quickly contact help if needed.
Today an amazing array of new technologies gives seniors and their families more confidence in their ability to live alone and remain in their homes safely without having to make the decision to move into a nursing facility. There are devices to track medication use, Alzheimer’s wandering, activity or inactivity in the house, and real time health information. Heather Kelly in the Washington Post (article requires subscription) notes that smart home technology has long been used by caretakers to monitor seniors. Cameras you can watch from anywhere are among the most common, but there are also sensors to detect movement and falls, medication reminders, monitoring devices for climate controls and power outlets as well as voice-activated screens and speakers. It is now possible to see if a relative has fallen or to let them know they left the stove on.
Amazon Astro is a new $1000 robot outfitted with cameras and microphones that can act like a companion or a sentinel roaming around your home to see what is going on. Some experts say that a small robot could be a tripping hazard for people with limited vision. Who has the control is critical when setting up a connected home for a senior. Apple’s Health has a sharing feature set up completely on the user’s device and only updates the caregiver when there is an important change in the senior’s health and activity levels.
Health care professionals are now using innovations in telehealth and other emerging models of care across the health continuum that allow them to effectively transition patients from hospitals back to their homes. Home monitoring is one of the technologies that allows medical professionals to monitor and care for elderly patients remotely, helping to deliver integrated, high-quality care in the comfort of their homes. These data telehealth solutions also help clinicians predict when a patient may experience a medical event, ideally prompting a proactive intervention or adjustment to the care plan to prevent the need for hospital readmission.
Ms Kelly says that on the surface the benefits of home and health monitoring technology seem to provide the best of all worlds for seniors. Some experts on aging, however, note that many of these devices grew out of security and surveillance systems and can take privacy and control away from older people who are less likely to understand and manage the technology themselves. Technology in itself is not the problem, but it is critical that it be designed and used with the senior in mind; if not, it can become a one-way surveillance system which can even lead to neglect.
Florence Macauley, the founder of Age Wise Home and a specialist who updates living spaces for the elderly, the disabled and people experiencing dementia, says the most important thing is to make sure the seniors know that they are in charge – not the technology. Most tech that is brought into homes is not at the request of the one being watched, which can make the senior feel more helpless not more independent. She said sometimes families can use the technology as a replacement for in-person caretaking. One client told her that he was deeply hurt that his kids merely watch him on the camera but seldom come to visit even though they live close by.
Aging experts say it is important for families to recognize that being there for someone virtually is not the same as being there physically. A recent study done at the University of California, San Francisco, reports that an in-person support system can be the difference between a long hospital or nursing home stay and recovering at home. This study said that simply having a friend or family member be able to help them in person overnight or for a few days lowered the chance of a lengthy hospital stay.
There are many things currently on the market and more in development that may make the difference in my and other seniors being able to remain safely in their homes with a little help from technology. It is obvious, however, that this help may come with the loss of some privacy and control for the person being helped or monitored.
Ms Kelly’s Washington Post story describes the feelings of Susan Spring, a healthy, retired 78-year-old who lives on her own in Schenectady NY. She says she would not object if one of her sons wanted a camera in her home to check in on her. “I think it would be a lot of fun,” said Spring. “But I’d like something where, if they were tuning in, I’d know it and say, “Hi.”
No one can make a decision like this until they are actually faced with the situation, but I believe I would be more than willing to exchange a little privacy for the added security that technological advances could provide. The person being monitored needs to have control over which areas in the home are being monitored and who has access to the monitoring system. This system only works well when the senior has a trusted family member, friend or representative who will be responsible for all monitoring devices.
It certainly appears that remaining in our homes longer for seniors like me can be facilitated through our increasing advances in technology. If we think this option would work for us, it is very important that we research what is available, the costs involved, our own feelings about privacy, and the people in our lives with whom we could comfortably share our lives.