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Monitors Hold Promise for Easing Families' Worries Over the Elderly
One of the toughest challenges families face is trying to care for a frail, aged family member from afar. Millions of long-distance family caregivers lack the most basic information. They can't observe their loved one's daily routine. They can't see signals of failing health, such as weight loss. They worry that early warning signals of a decline will go unseen and skid into a medical crisis. Technology holds promise in easing the problems. In the second of two columns on high-tech elder care, my brother, Dave Shellenbarger, and I look at the potential of technology to help remote caregivers. With Dave, founder of a computer hardware and software concern, playing the role of caregiver from his Michigan home, and me playing the role of an aged relative, we tested one of the best examples of applied technology in U.S. long-term care -- Oatfield Estates, an assisted-living facility in Milwaukie, Ore. Electronic monitoring isn't for everyone. Some old people would no doubt feel uncomfortable with it, and some family caregivers would lack the necessary patience. Nevertheless, we found e-gear like that at Oatfield can serve as eyes and legs for a remote caregiver, creating a nearly omniscient perspective on an old person's day for those who care to look. A record of life routines. A thousand words can be worth more than a picture. Though Oatfield has few videocameras, its online database yields an even clearer picture of a resident's day. Transponders worn by residents and sensors on building walls yield location records of where each resident has been, with whom and for how long. Alert logs record calls for help and staff response times. Beds sit upon "load cells" that track weight and bedtime behavior, charting flat lines for deep sleep, zig-zags for restlessness and ups and downs when -- you guessed it -- the resident lies down and gets up.
With Oatfield's permission and a password, Dave gains database access. (Residents' privacy is well-protected here.) There, he monitors me during a 24-hour stay as a resident. My location records allow him to see that I moved among many rooms and spent time with others. Rather than relying on staffers, "many caregivers would find this moment-by-moment account very useful," says Dave, who has experience as the lead caregiver to our late father, and in helping his wife Kathie care for her father and stepmother. A basis for cooperation. One of the most promising aspects of technology is its potential to get everyone involved in an old person's care -- family, nurses, aides and doctors -- on the same page. Though this vision is far from fruition, a glimmer of its potential appears at Oatfield. Computer access enables Dave to play a more active role. When he sees the temperature in my room is 79 degrees, he considers asking staffers to turn on air conditioning. "Are you too warm?" he asks by phone. I assure him I'm OK. He finds it reassuring that when I wander too close to campus boundaries, I'm intercepted by staffers in only three minutes. "Score one for technology," he says. After staffers raised questions about whether a resident, an Alzheimer's victim, was getting up more at night after moving from one suite to another, family members consulted his sleep chart. Seeing that his patterns were unchanged, they stopped worrying, says Evelyn Bloom, the resident's daughter. Keeping aging minds active. Oatfield's technology has a big impact on old people with the will to exploit the freedom it affords. Personal computers sit in nearly every room, and resident Carlos Beeck, a retired engineer, logs on often to read newspapers online. Mr. Beeck calls Oatfield "enlightened" in comparison with a nursing home where he had lived with his late wife. His son Kellyn Beeck says the computer is "nothing less than a lifeline for his mind"; Oatfield's technology, the younger Mr. Beeck adds, enables an open, homelike atmosphere that benefits his dad. After one couple in their 90s moved in, the husband became "campus photographer," seeking shots with such enthusiasm that he wore out the pads on his walker, says Oatfield co-owner Bill Reed. After the couple died, family members told him their quality of life was better in the last six months than it had been in their own home. Dave's wish list: On the whole, Dave says Oatfield's technology has great promise. He would like access to staff comments about me and related medical records. As more doctors computerize records, it will be easier to share data, says Kenneth Brummel-Smith, chairman of the American Geriatrics Society and a member of the advisory board of Elite Care, Oatfield's parent company. More streamlined database access would be helpful. So far, downloads are slow and the technology seems "bulky," Dave says. Access requires at least a cable modem or DSL line, he adds; a standard modem would be too slow. Also, don't expect to find an Oatfield lookalike in your neighborhood. Its model is still just that -- "an example for others to follow," says Joseph Coughlin, head of the Massachusetts Institute of Technology's Age Lab. Fees at Oatfield, which is higher-quality and better-equipped for end-of-life care than most comparable facilities, are $3,600 a month -- more than the average assisted-living facility in its region, but less than a nursing home. As technology is integrated more deeply, Mr. Reed says, he hopes to cut costs -- a move that would surely gain broad attention. FAIR USE NOTICE: This page contains copyrighted material the use of which has not been specifically authorized by the copyright owner. Global Action on Aging distributes this material without profit to those who have expressed a prior interest in receiving the included information for research and educational purposes. We believe this constitutes a fair use of any such copyrighted material as provided for in 17 U.S.C § 107. If you wish to use copyrighted material from this site for purposes of your own that go beyond fair use, you must obtain permission from the copyright owner.
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