The September 2011 AARP Bulletin has full-page ads for two brands of neck pendants used to protect against falls: you just press a button, which sends a call to an emergency center that can dispatch someone to your home. These ads have been around for years, but they don’t signal any new innovations to help older adults stay mobile and live independently at home. But Majd Alwan is an optimist. “From a technology standpoint, we’ve come a long way from ‘I’ve fallen and I can’t get up,’ ” says Alwan, vice president for the Center for Aging Services Technologies at LeadingAge, a trade association for nonprofit assisted living facilities and nursing homes.
There are promising products now slowly entering the commercial market, including a better pendant that measures gait, steadiness and mobility. Its built-in gyroscope is able to sense when your gait becomes erratic, and signals a computer (and eventually your doctor), warning that you are having difficulty walking. Pendants usually come free as part of a monthly service contract, which might cost $25 to $35 per month; the newer gait-measuring version may run $10 more.
Other product development involves sensors that can be installed on your bed, toilet seat, refrigerator door and medicine cabinet. If you get out of bed frequently at night and use the bathroom repeatedly, the computer will alert your doctor to check for a urinary tract infection. If the refrigerator hasn’t been opened all day, maybe you are at risk for starvation or dehydration. If you don’t go into the medicine cabinet, maybe you skipped your necessary medications.
Sensor prices vary depending upon vendor and system complexity, says Alwan. They start at around $200 to $300 and increase to $2,500 to $3,500. The monthly monitoring fee begins at approximately $40 and goes up to around $150. Several firms deal in this technology, marketing to developers of assisted living apartment facilities and nursing home owners.
Neither Medicare nor Medicaid will pay for these products yet because they are not treatments or services, but are categorized as long-term and supportive care. But the ACA’s Center for Medicare and Medicaid Innovation is supposed to encourage use of such technology and other moneysaving approaches.
Alwan says the long-term savings for taxpayers could be promising if the technology becomes widespread among individual users, not just institutions. The technology alerts doctors, nurses and caregivers about activity and behavior patterns. If needed intervention arrives quickly, more people could possibly avert long spells of illness that lead to nursing home stays—where care costs $70,000 a year.
Farther down the product development road are “live shirts,” garments that measure blood pressure, respiration, body temperature and other vital signs, and signal a constant data flow; a version already exists for pro athletes. At this year’s National Football League scouting session, Under Armour unveiled its special shirt. “The sensors collect stats (heart rate, acceleration, max horsepower and more) and transmit the information [via] Bluetooth to a PC,” according to the September 2011 issue of Men’s Journal.
As 8,000 people daily turn 65 and enroll in Medicare, these escalating numbers demand that we fulfill the promise of technology: we need to do better. The fastest growing, most vulnerable population comprises those who are ages 85 and older, a group at risk for a 40 percent chance of having Alzheimer’s disease and other dementias, and a 40 percent chance of ending up in a nursing home.
Who will care for these elders? The U.S. Department of Labor says much of the caregiving will be done by workers in the economy’s fastest growing labor categories: home health aides and aides working in nursing homes. If current demand continues, by 2018 the ranks will swell to a staggering 461,000 in-home aides, and 376,000 nursing home aides. This is an enormous call for workers who are woefully underpaid, with a median annual income of about $20,000—half the average income of a U.S. worker.
If we can’t get workers to fill these arduous jobs, our aging population will be in a nightmare of pain and suffering. Once, there was a dream that robots would be the great labor-saving device in nursing homes, lifting people in and out of beds, a chore that causes back strain and other injuries. The Japanese were pioneers in robotics, but have pulled back, said Alwan, not only because the devices needed humans to monitor them, but also because nursing home residents didn’t like them.
The Star Wars vision of friendly, compassionate talking robots may never materialize in the real world of long-term care. And the kind word, the reassuring pat on the shoulder and a smile may be irreplaceable for frail, dependent elders. Technology can help, but we’ll always crave the human touch.
Freelance writer and editor Bob Rosenblatt is Senior Fellow at the National Academy of Social Insurance, a Washington, D.C., think tank dealing with Medicare and Social Security. He was a Washington correspondent for the Los Angeles Times for 27 years. Send him your comments, questions and column topic suggestions at email@example.com.
Editor’s Note: This article appears in the November/December 2011 issue of Aging Today, ASA’s bi-monthly newspaper covering issues in aging research, practice and policy nationwide. ASA members receive Aging Today as a member benefit; non-members may purchase subscriptions at our online store.
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