COLUMBIA — Sensors monitor George Hage constantly.
They know how long he sleeps. They know when he wakes up. They know how many times he opens the refrigerator. They record his heart rate.
“I know they are there, but I don’t really feel them. They don’t affect me,” Hage said, sitting at his desk and working on a book about his experiences in World War II. A sensor attached to his chair monitors his health, and several sensors watch his activities from the wall.
The people behind the sensors aren’t spying on Hage — they're monitoring his health. Far from being bothered by the surveillance, he says it makes him feel safer.
Hage, 89, is participating in a study of sensor technology to monitor aging adults at Tiger Place, an intermediate care facility in Columbia designed to allow both independent living and those who need nursing home-level care. The sensors monitor various aspects of Hage's health from afar so that he has more independence.
Marilyn Rantz, executive director of the Aging In Place program at Tiger Place, and Marjorie Skubic, director of the Center for Eldercare and Rehabilitation Technology, have used motion-sensing technology to monitor the health of older adults at Tiger Place since 2005 as part of the state Aging In Place program.
The demand for technology that allows older adults to live independently for longer is growing. The older population will continue to grow for at least the next 18 years. The Administration on Aging in the Department of Health and Human Services projects that the population over the age of 65 will continue to increase to 19 percent of the total population in 2030 from 12.9 percent of the population in 2009.
Of that population, a sizable number are considered independent. In 2010, 37 percent of older women and 19 percent of older men lived alone, according to the Federal Interagency Forum on Aging Related Statistics.
In its first use outside Tiger Place, the system is being installed in a similar facility, Western Home Communities, in Cedar Falls, Iowa, to test its long-distance capabilities. Eventually, Rantz hopes it will be available for use in homes throughout the country.
There are 10 motion sensors called "early illness alert sensors" located in Hage’s apartment. They're in the refrigerator, cabinets, bathroom, bookshelf and even under his chairs. They monitor his daily behavior and routine changes, which can indicate early symptoms of illnesses.
Factoring into the same detection algorithm as the early alert sensors is a sensor in Hage's bed that monitors his heart rate, respiration and bed restlessness. This sensor in particular has been entirely developed at MU, and like the early illness alerts, is being installed at Western Home Communities.
In Hage's apartment, there is also a radar sensor system installed in his rooms that can detect falls by analyzing changes in his walking that may indicate a risk of falling. Radar sensors will not be used at Western Home Communities, but are being tested in some rooms in Tiger Place.
Though Western Home Communities isn't installing radar sensors, it is installing another type of fall-detecting sensor that is being tested at Tiger Place. Microsoft Kinect systems set up to detect falls are collecting data on 10 residents at Tiger Place.
Sensors capable of determining a risk of falling are particularly applicable to monitoring and preserving the independence of older adults. According to the Centers for Disease Control and Prevention, one out of three adults who are 65 or older fall every year, and falls are the leading cause of death from injury for this age group.
The program continues to make improvements even as it expands. For example, the program is testing technology to tell immediately if someone has fallen. Hage's apartment has recently been installed with a radar sensor in his attic that can tell if someone is on the floor.
“At this point, we are not doing an automatic falling detection yet. We are working on that,” Rantz said. “When we're ready for that, we will alert people by beeper if somebody falls.”
Rantz said that there is testing that needs to be done before staff are alerted directly of falls in order to prevent false alarms.
Preserving autonomy; detecting illness
Information from these different types of sensors will be sent back to Columbia and will be analyzed by computers, which is the same process for residents at Tiger Place. Instant alerts are sent to health care providers if the automatic database detects any rapid changes in a resident’s health.
“You don’t have to watch; it is all done with automatic database processing,” Rantz said.
Because the systems allow study from a distance, aging residents are able to maintain some independence when their health problems require them to live in assisted care facilities. The sensors do not intrude on their privacy, either, as even the Microsoft Kinect sensors only create what Rantz refers to as "shadowy figures."
"It creates silhouette images, not pictures and not films, so they don't have to worry about privacy," Rantz said.
Hage said he feels "pretty independent" at Tiger Place. He has been a part of the program since it began in 2005, and said that the sensors have been there for so long that he doesn't worry about them. So far, Hage has not had any illnesses detected by the system. But he said he believes it will help him sometime in the future.
Health problems have been found on other Tiger Place residents participating in the study.
"We've detected lots of health problems and gotten things solved early," Rantz said, noting that early detection is highly beneficial to healing and recovery. Among the diseases that have been detected are congestive heart failure, early indicators of stroke, respiratory complications, pneumonia and urinary tract infections.
Expansion to Iowa and beyond
The expansion to Iowa is being funded by a $300,000 grant awarded in July by the National Science Foundation to allow the researchers to test their system over a greater distance.
Western Home Communities already uses a high-bandwidth fiber cable internet system to run some of its services, and that cable is what made the project's expansion possible.
"Not only do they have the fiber, but they're interested in using it," Rantz said of Western Home Communities. She also called the organization "quite technology savvy," because of the staff's familiarity with the fiber connection.
Rantz hopes the expansion to Iowa is just the start of the growth of the sensor technology. Tiger Place is currently working with a company to license the sensors so they can be sold commercially, and Rantz believes they will be accessibly priced.
She thinks people will seek the technology for themselves and family members."I think it's going to end up in people's private homes and other housing projects all over the country," she said.
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