JustCare

Tag: Sensors

  • Robots can help older adults age in place

    Robots can help older adults age in place

    Millions of older adults are living in isolation, with no one to care for them, and millions more depend on family, friends and other voluntary caregivers for their health and safety. Few older adults can afford to pay the exorbitant cost of home care workers who can help them remain in their community and avoid nursing home care. Robots are emerging as a resource that could permit more older adults to age in place.

    Jennifer Kingson reports for Axios on the presence of many more robots in our lives. Better artificial intelligence and lower costs have enabled the creation of robots that can do what you might never have imagined. Soon they will be able to prepare food in a kitchen and tend bar. Already, robots can vacuum your home, mow your lawn, deliver your food and, more generally, assist older adults.

    Robots can help improve the lives of older adults in a variety of ways. Older adults  can enjoy the companionship of robot dogs, that don’t need to be walked or fed.  Check out this one, for example, from Sony. Older adults can also rely on robots to get help for them if they fall.

    This all said, robots are still pricey, and there’s little good information telling you which ones are worth the price tag and which are duds. So, you might want to hold off on that purchase for now. In the meantime, sensors are lower cost and can also be extremely helpful for older adults.

    Sensors can perform vital functions to allow older adults to age in place, while feeling secure; they allow caregivers to check in remotely and ensure they are safe. Motion sensors will tell you how long someone is sleeping at night, whether someone has locked the front door and how frequently a person is getting food from the fridge or using the restroom. You can know when someone’s daily activities change significantly.  A body sensor will allow you to know if someone you care for falls.

    What’s in store down the road? Robot healthcare workers are on the horizon. They can do all kinds of housekeeping and provide social companionship, friendship! Yes, robots can be entertaining, telling jokes, singing and can have deep personal conversations.

    Here’s more from Just Care:

  • Ingestible sensors could help treat digestive diseases

    Ingestible sensors could help treat digestive diseases

    Sensors appear to be the “it” new technology for monitoring people’s health. And, not only can you find ones that attach to a bed or an abdomen, you can find ingestible sensors. Casey Ross reports for Stat News on the latest ingestible sensors, which attach to a person’s digestive tract to identify and treat a range of conditions, from indigestion and colon cancer to Crohn’s disease.

    The tech entrepreneurs developing these ingestible sensors have all sorts of health goals. One team wants to collect data about people’s mechanical and electrical changes when they eat. Based on this data, they plan to advise patients on what to eat.

    The sensors could track exactly what you’re eating and your daily calorie intake. The data could be processed and sent to your health care providers and to you. Your mobile phone could give you all the details. You could avoid trips to the doctor and hospital.

    Around 70 million Americans have digestive diseases any given year, including GERD, ulcerative colitis, gallstones and irritable bowel syndrome. Their health outcomes could improve dramatically, And, the sensors could save the health care system billions of dollars.

    Most intriguingly, some sensors are 3D-printable. One such sensor being developed can take the temperature of a pig’s gut and relay the temperature as it changes over the course of several weeks.

    Sensors have been around a long time. As early as the 1980’s, sensors in pills were able to take photos of the digestive system. But, the data collected was not immediately accessible. Now, the data collected can be transmitted immediately through a wireless signal.

    Today’s sensors are quite sophisticated. One electronic sensor being developed uses “genetically engineered” bacteria. Small molecules in the body can pass through the sensor’s skin. And, the sensor collects data on how much light the bacteria produces. It may ultimately be able to replace an endoscopy, detecting bleeding in the gut. It could identify gastric ulcers and other diseases. It may indicate cancer. Inflammation sensors may be able to detect irritable bowel syndrome and other bowel diseases.

    The goal now is to shrink the size of these ingestible sensors down from 1.5 inches. They should be easier to swallow and inexpensive to manufacture.

    Here’s more from Just Care:

  • A Fitbit of sorts for your stomach

    A Fitbit of sorts for your stomach

    StatNews reports on a new implantable sensor in development at MIT labs that allows people to relay information on what their bodies are doing. The developers describe it as “a Fitbit of sorts for your stomach,” which captures how your body responds when you are talking, eating and sleeping, as well as while you are feeling any particular emotion. It also can spot diseases in your gastrointestinal tract without the need for an endoscopy or colonoscopy.

    This health technology device is flexible and can be rolled and place in a dissolvable capsule. To implant the sensor, you simply ingest the capsule.  The capsule travels from your mouth down your GI tract and ends in your stomach. The capsule then dissolves, the sensor is released, opens and sits on your stomach lining. It is a tattoo-like device, which interacts with your biological system and is powered by our bodies through “piezoelectricity.” There is no need for battery replacement.

    The sensor can measure heart rate and breathing rate, among other things. It can hear your heart’s sound waves and your lungs inhaling and exhaling. The theory is that different parts of our bodies are constantly conveying information in a coded form. This device is intended to help decode and translate this information.

    The developers are projecting that this health technology will be available for patients in 10-15 years. Watch this video to see exactly how it works:

    Our bodies talk to us — and these implantable devices can help listen

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  • Hospital care at home

    Hospital care at home

    More hospitals are training their emergency room staff in geriatric care and building geriatric ERs. At the same time, hospitals are increasingly finding ways to provide the kind of inpatient care available in hospital at patients’ homes after an emergency. Essentially, they are bringing the hospital to people’s homes, with support from the Centers for Medicare and Medicaid Services and private foundations.

    The “hospital at home” model relies heavily on technology that once was only available in hospital. Today, testing technology can be transported to people’s homes. In addition, body sensors can track people’s vital signs and transmit their data to doctors at the hospital. And video technology allows patients to have ongoing visual communication with hospital staff from the comfort of their homes.  

    Avoiding a hospital stay can improve people’s health outcomes. The risk of infection from antibiotic-resistant bacteria in hospital can be high. It is also risky to be in a facility filled with sick people who may be contagious. The likelihood of delirium for older patients in hospital is also very high, as they are out of their normal surroundings. My 95-year old father, a former physician, who is otherwise of sound mind, spent one night in a hospital ER and told me the following morning that he could not understand why staff had made him chief of pediatrics.

    Michelle Andrews reports for Kaiser Health News, that Brigham and Women’s Faulkner hospital has established a hospital at home program for patients in stable condition. As an alternative to inpatient care, the hospital transports patients home, where a doctor and nurse are waiting for them. They check the patients’ IVs and affix sensors to the patients’ body. They can tell whether patients sleep well or are up in the middle of the night. And, they can tell when patients no longer need medical oversight.

    The Johns Hopkins Schools of Medicine and Public Health have also developed a hospital at home model for qualified patients with particular conditions to check into their own bed for their hospital care. In this hospital at home model,  patients with certain types of pneumonia, congestive heart failure, chronic obstructive pulmonary disease and cellulitis, who would otherwise have to be hospitalized for treatment may never go to the emergency room. Doctors and nurses provide both diagnostic tests and treatment therapies to patients at home. It is intended to address the risks of treating acutely ill older adults in hospital, where they all too often experience adverse events, such as hospital-acquired infections, as a result of compromised immune systems.

    People in Australia, England and Canada have been benefiting from hospital at home programs for quite some time. But, in the US, insurers apparently have not come up with a model to pay for the services or a new definition of what it means for a patient to be “hospitalized.” 

    One small study found far lower costs for patients who participate in a hospital at home program than patients who are admitted to hospital, with no negative outcomes and similar patient satisfaction. Another study found that hospital readmission rates for hospital at home patients were about half as high as for hospital inpatients. Hospital at home care also makes it easier for family caregivers, who do not need to travel to the hospital to be with the people they love. But, insurers appear to be unwilling to innovate on this front. Right now, the hospital at home program is supported by foundation grants and the federal government.

    Here’s more from Just Care:

  • Sensors offer peace of mind to caregivers

    Sensors offer peace of mind to caregivers

    Anyone who is a family caregiver knows how stressful it can be. Is your loved one eating, using the toilet, taking her medications and sleeping well at night are just some of your worries. For caregivers, sensors can offer peace of mind. They also may save you the expense of paid caregivers.

    Ideally, caregivers can spend significant time with their loved ones.  But, many caregivers are juggling caregiving responsibilities with work responsibilities and kid responsibilities. It’s a struggle to know whether the people they love are taking care of themselves. With sensors, you have timely answers to important aspects of their lives, even when you can’t call or visit.

    With motion sensors, you can know how long your mom is sleeping at night, whether she locked the front door and how frequently she is getting food from the fridge or using the restroom. You can know when her daily activities change significantly. Sensors placed in the home can track her activities for you, so you can ensure she is safe. And, she can feel secure that you will know if something goes awry.

    You can check on the people you care for remotely, via computer or smartphone.  A sensor on a pillow will reveal the number of hours a person slept. A sensor on the fridge indicates how many times a person opened it.  A sensor on the toilet flush keeps track of the number of times a person uses the bathroom.  You can even track medication use.

    A body sensor will allow you to know if your loved one falls. And some sensors can help predict whether a person is prone to fall based on the size of the steps they are taking or the speed at which they walk, among other methods.  This can be life-saving information since falls are a frequent cause of hospitalization, disability and even death in older adults.

    Sensors can also help older adults remain independent, by doing basic activities at their request, such as turning on the lights or turning on the air conditioner. Amazon’s Alexa will make a phone call for you or remind you to take your medications or play Man of La Mancha.

    Of course the sensors present both benefits and risks.  On the benefits side, home sensors can help older people age in place and avoid moving into a nursing home.  They also can ease the stress of caregivers who may not be able to visit them or call them as much as they’d like. But, they do impinge on people’s privacy, and they could very well mean that the companies selling these devices are also selling the personal information they are collecting.

    Here’s more from Just Care:

  • Telehealth on the rise

    Telehealth on the rise

    Telehealth or telemedicine–the provision of care through telephone or digitally, including video visits and online care–originally was designed to meet the needs of patients otherwise unable to access care, such as people living in rural areas. But, telehealth is on the rise, increasingly meeting the needs of people who want to avoid leaving work to travel to the doctor and keep their costs down.

    Now, according to a July 2016 article on the State of Telehealth in the New England Journal of Medicine, a large number of institutions offer virtual doctor’s visits at low cost 24 hours a day. For many, it’s a great alternative to waiting 20 days to get a doctor’s appointment and then spending 2 hours traveling and waiting for a 20 minute visit.

    People are now more interested in using telehealth to treat a variety of chronic conditions. Nearly half the U.S. population has one or more chronic conditions, 140 million people.  And, telehealth is moving from the hospital to the home, where it can meet the care needs of frail older adults and people with disabilities for whom leaving home is difficult. Combined with sensors on the patient and in the home, providers can learn a significant amount about a patient.

    Health systems with integrated care, such as Kaiser Permanente, the Veterans Administration and the Department of Defense, are finding that telehealth can promote health at less cost than in-person care. Kaiser predicts that it will provide more telehealth visits than in-person visits this year. In 2014, the VA provided more than 2 million telehealth visits. The Mayo Clinic says it will serve 200 million people remotely by 2020, including many who do not live in the United States.

    The biggest constraint on telehealth is that most insurers are not yet covering the cost of the services. But, telehealth coverage is on the rise. And, 29 states now require commercial insurers to cover telehealth services in the same ways they cover in-person care. Already, Medicaid covers some telehealth services today in 48 states.

    Medicare is behind on telehealth services, limiting coverage to areas where it is hard to see a doctor, as we reported here on Just Care. And, digital doctor visits present a bit of a challenge for older adults since only 58 percent of them are online. Moreover, state licensing restrictions limit the out-of-state care doctors can provide. But, there is a bill in Congress, the Tele-Med Act of 2015, which would give providers the right to treat Medicare patients in any state.

    According to Bloomberg BNA, the National Business Group on Health (NBGH) projects that, in 2017, 9 out of 10 large employers will offer employees telehealth services. NBGH further predicts that virtually all large employers, 97 percent, will offer telehealth services within four years.

    Large companies still don’t have a good sense of whether telehealth is bringing down their care costs. In fact, just four years ago, only 7 percent of these companies offered telehealth to their employees. But, they now believe it is a valuable benefit that promotes employee satisfaction. It can save people time and money. And, many insurers are now offering the service.

    Telehealth has its limitations. It puts less of a premium on the doctor-patient relationship–what the doctor can learn from looking a patient in the eye and conducting a physical examination as well as the trust that can be built–than in-person care. Continuity of care is easily lost, with fragmented care taking its place. And, lack of integration in the delivery of telehealth care could lead to conflicting treatments and poor outcomes. There are also privacy concerns.

    On the flip side, telehealth can lead to greater equity in the delivery of health care, reducing racial, gender and age disparities and well as disparities in treatment between people in rural areas and people in urban areas.

    Here’s more from Just Care:

  • New White House report recommends ways to help older people remain independent

    New White House report recommends ways to help older people remain independent

    A March 2016 report by the President’s Council of Advisors on Science and Technology, PCAST, recommends ways to help older adults remain independent, improving their ability to live in their homes and their communities longer. PCAST focuses on technologies and policies that foster independence, purpose, and engagement for older Americans. The report takes into account the need for social connectivity and physical and emotional well-being.

    The population is aging. In 2014, 46 million Americans were over 65, some 15 percent of the population. People are living longer. They are living with fewer functional limitations as they age. More than four in ten older adults report excellent or very good health status. And, one study found that almost nine in ten would like to remain in their homes as long as possible. While older adults are in better health than ever before, two out of three have multiple chronic conditions. Support services can be invaluable to them, yet many are unaffordable.

    PCAST looks at four changes many people experience as they age with the aim of recommending support services to make it easier for older adults to age in place: hearing loss, increasing social isolation, physical change and cognitive change. A report issued in March 2015 focuses on hearing loss. This report focuses on the other three changes and emphasizes their interrelationship. For example, if a person is unable to leave home, the person is more likely to be socially isolated, and the person’s social isolation can affect her mental health.

    PCAST offers 12 ways to promote independence and aging in place for older adults through technology. Here are five of the recommendations:

    1. Federal policy that promotes affordable internet access and training for older adults. Broadband access is key for social connectivity. It can help older adults be aware of local resources, volunteer opportunities and jobs. Broadband access also allows for telehealth and easy communication with caregivers.
    2. Sensors that monitor behaviors and activities of older adults also could add tremendous value, allowing caregivers to know whether an older person is safe at home. Of course, privacy and security issues need to be fully understood.
    3. The federal government should encourage banks and other financial institutions to improve ways to monitor and protect older adults from financial scams. PCAST states that “Financial exploitation of older adults is massively underreported.” The Consumer Financial Protection Bureau offers tips for people to protect themselves and the people they love.
    4. Federal agencies should promote the setting of minimum design standards for homes and products, which recognize people’s declining mobility as they age. Housing should have accommodations that make it easier for people to remain in their homes even if they have difficulty moving around. New technologies should be used to design and create lighter, more durable and more comfortable wheelchairs. And, packaging of foods and medical supplies should be designed so that older adults do not have to struggle to open them.
    5. Federal government needs to explore changes to its Medicare and Medicaid coverage policies that allow people to receive services at home, in particular telemedicine services.

    PCAST notes that there is no evidence that digital games of any sort promote memory or cognitive well-being. And, the federal government should be protecting older adults from spending money on these products.

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