June 2018: Evolving IoT Tech Enables Aging in Place
The IoT will support aging adults’ desire to spend their golden years at home.
By the year 2035, U.S. Census Bureau reports citizens 65 and older will outnumber those under the age of 18 for the first time in U.S. history; and as a result, the IoT (Internet of Things) will be instrumental for many aging adults that will require care. To accommodate the needs and desires of these valued adults, the healthcare space will need to rethink how it delivers care. Technology and the IoT will play an important role in providing care whenever, wherever, and however it is needed most.
Rodney Harrell, director of Livability Thought Leadership for the AARP Public Policy Institute, says as America rapidly ages, technology will create opportunities to meet the needs of the nation’s changing population. “Our communities and homes were not often built with the needs of older adults in mind, so we need to work to overcome that and plan for the future,” Harrell says. “As tech companies continue to advance, deep learning, cellphones, wearables, sensors, and other technologies will continue to develop. This creates opportunities to address the gaps and make up for the fact that our homes and communities don’t work for everyone.”
By the time the 2030s roll around, the U.S. can expect a different sort of population than exists today. Census Bureau data suggests that by 2030, baby boomers will be 65 or older, expanding the size of the retirement-age population to one in every five U.S. residents. What’s more, by 2035, the Census Bureau’s number suggests aging adults, approximately 78 million, versus 76 million under the age of 18, prefer living at home to uprooting themselves to an assisted-living facility. Along with this projected demographic shift will come new challenges for the U.S. healthcare system.
One of Harrell’s passions is advocating for age-friendly, livable communities that make it possible for adults to age in place, if they choose to do so. Technology has the potential to act as a great equalizer, creating opportunities for older adults with varying degrees of independence and financial means to live the way they want to live, while also making it easier for family members, doctors, and caregivers to provide proactive care. Harrell is quick to point out that not all adults of retirement age are “frail elders.” Rather, he says there is a wide range of people who want to age in their homes, and technology holds the potential to make this possible.
“Devices that respond to those who have limitations and those who don’t are the ones that best meet needs,” Harrell says. In the home, tools to detect and even prevent events like falls, collect biometric data that can provide insight into a person’s health, monitor her activity and leverage machine learning and AI (artificial intelligence) to detect changes in mood and/or behavior, and fight social isolation are just a few of the ways the IoT can help adults age in place safely and happily.
Solutions for Aging in Place
Dina Katabi, MIT professor and leader of the NETMIT (Networks at MIT) research group at MIT’s CSAIL (Computer Science and Artificial Intelligence Laboratory), says in light of estimates that suggest up to 90% of seniors prefer to stay in their homes as they age, U.S. society must consider the implications for aging individuals, their families, caregivers, hospitals, insurance providers, and society in general. For instance, the industry must be asking questions like: How can we help aging individuals live safely in their homes as their health and mobility declines? How can we give family members the peace of mind that their loved ones are safe and give them enough information to act in case of emergency, while still respecting older adults’ desire for independence? How can healthcare providers identify higher-risk individuals so they can proactively provide them with care?
In this era of #MeToo, it’s a great time to celebrate women who never hold back—and who fearlessly imagine, create, develop, discover, and lead. The 2018 Connected World Women of M2M or as we now refer IoT (Internet of Things) award winners epitomize women’s strength, smarts, charisma, dedication, and staying power.
They have led companies worldwide into new IoT realms with their cutting-edge research, advocacy of cooperative cultures, and dedication to empowering young women who will follow their lead.
Technology can help fill in the blanks. “Connected devices and data provide an immense opportunity to expand the way we provide healthcare to older populations—all the way from clinical research to ongoing care to emergency interventions,” Katabi says. On the clinical research front, Katabi says a major issue with way treatments are designed today is they primarily target metrics that can only be measured in a clinic, and clinic visits can only offer a limited view into a patient’s life. “Non-intrusive sensors that can measure the impact of treatment … while patients are in their natural surroundings at home can change the way clinical research is done,” Katabi explains. “It can provide researchers a window into a rich and continuous data set that they did not have access to before, which could potentially significantly reduce the durations of trials and bring treatments to patients faster.”
In terms of ongoing care, sensors can provide physicians with fine-grained and objective measures of patients’ health outside of clinic visits—a huge improvement from patients’ self-reporting, which doctors rely on today. “Sensors can also go a step further in improving the kind of care doctors are able to provide,” Katabi adds.
“Many severe aggravations in a variety of diseases—muscular degeneration, breathing disorders, etc.—are usually preceded by a gradual decline in function over a period of days or weeks. For instance, breathing might gradually become shallower and more rapid, walking speed might slowly reduce, and so on. Monitoring and detecting these early indicators through in-home monitoring will allow doctors to intervene when they see a high risk of exacerbation (and) before severe adverse health events occur.”
The ability to facilitate proactive intervention is perhaps the IoT’s greatest promise for healthcare and, in particular, aging in place. Katabi points out that proactive care can help individuals avoid the spiral into increasingly bad health and potential hospital admission that often starts with avoidable initial illnesses. As a result, IoT solutions could contribute to a decrease in the overall cost of healthcare.
Alla Kammerdiner, assistant professor in the Dept. of Industrial Engineering at New Mexico State University, says falls are a huge public health problem, and for people older than 65, one fall could have life-changing consequences that result in a loss of independence. “Technologies like robotics, wearables, novel sensors, connected devices, and the IoT have a great potential at addressing these challenges,” Kammerdiner says. “Just imagine an older person who lives in a fear of falling. While the technologies, which are currently in use, can help detect a fall and summon help, the emerging technologies will prevent a fall.”
Kammerdiner’s own research seeks to integrate inputs from multiple sensors worn on the body to identify different risky situations as they unfold and before a fall happens. “The sooner we detect a possible loss of balance and the better we are at characterizing or predicting the type of balance loss that is experienced, the more useful this knowledge would be for averting a potentially life-changing fall,” she explains.
Wearables and other sensors can act as a caretaker’s eyes and ears to observe what is going on in an older individual’s home at any time, but it’s what is done with this information that can make the data particularly valuable. For instance, AI could discern the precise moment when help is needed and intervene by calling for help. Someday, household robots could even help with tasks and help prevent falls and other accidents.
“Cognitive assistance is another big application of IoT technologies,” Kammerdiner adds. “Aging as well as medication can affect memory, reaction time, and overall cognitive capacity. The IoT can become a virtual ‘helpful roommate or caregiver’ for elderly people living alone in their homes. (Cognitive-assistance tech) could possibly detect mood or detect potential risk or notice a change in a behavior with sensors and use actuators to engage devices or robots, doing something as simple as turning on a light to help you see or a favorite song to change your mood or as life-saving as calling for help.”
“Our communities and homes were not often built with the needs of older adults in mind, so we need to work to overcome that and plan for the future.” – Rodney Harrell, AARP Public Policy Institute
PTC Lifts the Covers
Out with the old and in with the new. PTC CEO Jim Heppelmann might not agree, but that is pretty much what he is saying about the IoT (Internet of Things) these days and maybe even about some of his less than active partners.
Questioning of the Efficacy of Health App
To wrap up the month-long focus of aging in place and healthcare, let’s take a closer look health apps. More specifically, let me pose a couple of key questions. First, do they really work?
AI and Robotics Reinvent Healthcare
For this column, I think it’s essential to take a deeper look at how AI (artificial intelligence) and robotics will impact healthcare and aging-in-place technologies could improve patient outcomes.
Aging in Place Means Staying Connected
More Americans are showing an overwhelming preference for aging in place and the good news is that the IoT (Internet of Things) and mobile technology is playing a key role.
Healthcare, IoT, and Global Health
Healthcare and agriculture are two essential industries that have a direct impact on global health. Simply, without healthy crops, we can’t feed and nourish ourselves.
Supporting Aging Adults
Henrik Christensen, director of the Contextual Robotics Institute, and a professor of computer science and engineering at UC San Diego, says one of the biggest challenges facing healthcare today is providing adequate support to people throughout their lifetimes, especially since most U.S. citizens would like to live in their local environments for as long as possible. “We have 10,000 people turning 65 every day in the U.S.,” Christensen says. “Our mobility and our mental functions are reduced with age, and it is essential to consider how technology can be utilized to compensate for such reductions in function.”
However, the use of IoT and smart devices can enable 24/7 monitoring of a person’s health, including how long he slept, whether he took his medication and turned off the stove after using it, and even whether he is making healthy food choices. Off-the-shelf sensing systems can already monitor blood pressure, brain activity, movement patterns throughout a home, and other parameters that support aging in place, and, in the future, this data will be relied upon to determine what’s normal for an individual and signal changes that could indicate changes, such as the need for more support or a move to institutional care.
Rachel Walker, an assistant professor in the College of Nursing at the University of Massachusetts Amherst, says an aging population will create healthcare delivery challenges, but connected devices, data, and IoT-enabled technologies will help us meet these challenges by addressing issues such as loneliness, perhaps connecting persons who may be socially or geographically isolated to each other, and providing access to resources and information. The IoT will also enable predictive algorithms for healthcare decisionmaking and early identification of potential healthcare issues that could be prevented and/or better managed through early identification and intervention. Importantly, Walker says the IoT can also open doors for the self-management of chronic conditions and day-to-day health.
However, Walker says the industry must do more to ensure that information gathered via these systems flows both ways. “Individuals should have access to and control over their information and the ability to interpret what that information means for them in ways that promote autonomy and dignity, not diminish personal agency,” she says. In fact, one of the central concerns Walker and other scientists and inventors at her university have is finding ways to leverage technology in a way that levels the playing field.
“How do we generate solutions that move us closer to health equity, as opposed to exacerbating existing health disparities by widening the gaps between those who have access to these new technologies and those who do not and (between) the persons who get included in the design and innovation process and those who do not get a voice,” Walker asks. It will also be important going forward to keep the big picture in mind. Does a tech solution address the root issues associated with aging in place? If not, the industry must re-evaluate how it is using its resources.
New Mexico State University’s Kammerdiner says more research and development is needed before a society that’s fully equipped to allow aging in place becomes a reality. Importantly, individuals must be able to trust the technologies to keep their personal data safe, which is only possible if there are legal safeguards to protect users’ privacy.
MIT’s Katabi says a key challenge will be bridging technological capabilities and medical and clinical needs, which will require collaboration. On the technology side, experts must work to ensure sensing and monitoring technologies capture precisely defined metrics of medical and clinical interest for an aging population. On the medical side, experts must expand the view from the metrics currently used in the clinic to the wider possible variety of measurements possible with continuous, in-home monitoring.
Look Who’s Talking
Dr. Jennifer Schneider, chief medical officer, Livongo, joined Peggy Smedley to talk about family, technology, and being a Women of M2M/IoT. She shares how she is very blessed with an incredible family and grew up with an older brother and younger brother—and it never occurred to her that girls were any different than boys. She also gives advice and explains how the IoT (Internet of Things) can help propel us forward, almost without us even knowing.
Further, the current FDA approval processes for devices and medical endpoints take several years, often disrupting the rapid cycle of innovation. However, Katabi says the FDA is working to change this reality. With continued innovation in the tech realm, changes in regulation to support user privacy and data security, and a continuous rethinking of prevailing paradigms and how they can be improved upon to support the big picture, aging in place will become less of a dream for the aging U.S. population and more of a reality.
“These are exciting times in the worlds of technology and healthcare,” Katabi says. “We have a real opportunity to make a significant leap in the way we understand how patients progress with age, how medications and treatments can help their quality of life, and how we can empower our senior citizens to live with dignity and independence during their golden years.”
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Agriculture and Healthcare
Peggy says agriculture and healthcare have some things in common—including the fact they both have a direct impact on global health. Peggy says accuracy is important in both, as medical errors can cost human life. She also explains that technology is being used to improve accuracy and reduce errors, and data analytics are also important in both fields.