The Pittsburgh Tribune-Review interviewed us about our project and some of the attitudes that older adults have about home monitoring technologies. Check it out here:
http://www.pittsburghlive.com/x/pittsburghtrib/lifestyles/family/s_696645.html
Tuesday, August 31, 2010
Saturday, August 28, 2010
Early Detection. Then What?
This past Spring, the outlook for the treatment of Alzheimer's disease was judged by a panel of very smart people to be rather grim. There is little concrete evidence that any particular treatment, lifestyle, or behavior can prevent, delay, or improve the symptoms of Alzheimer's disease for people who eventually get it. This article discusses that there is only "weak" support for drug therapies and keeping mentally, socially, and physically fit for preventing Alzheimer's disease.
http://www.nytimes.com/2010/08/29/health/research/29prevent.html
http://www.nytimes.com/2010/08/29/health/research/29prevent.html
http://consensus.nih.gov/2010/alzstatement.htm
Editorial:
This article brings into light one of the concerns held by many skeptics of critics of early detection. Essentially, their objection is that we cannot do anything to prevent the disease if we find out we are either genetically or chemically predisposed to it, so why go to the expense and scare people about it? I have had a number of very intelligent people come up to me with this concern. I think it is a very valid concern. It is true, there is very little that medical science can do to prevent Alzheimer's and its symptoms, despite new possibilities for early detection. However, there are at least two potential benefits for early detection: emotional adjustment and reducing costs.
Early detection can help with coping with Alzheimer's disease, the effective management of the disease once it begins to take its toll. Coping applies both to the person with AD and their care network including their family caregivers and doctors. Early diagnosis can prevent accidents that can endanger the individual's life. Early diagnosis can also prevent sense of panic when confronted with a sudden diagnosis of Alzheimer's that was discussed in a journal article by (Woods et al., 2003). Families have to scramble to provide adequate care for their loved one. Early diagnosis gives the family more time to adjust emotionally, adult children to adjust their work schedules to provide care and routines to be learned and established to ensure safety. Early detection gives people time to emotionally and relationally adjust to the changes that occur with Alzheimer's disease. In effect, early detection buys people time.
The cost of Alzheimer's disease extends beyond the medical costs of treating the person with AD. The disease indirectly results in lost productivity of caregivers, many of them family caregivers, who have to miss work as a result of having to provide care for their loved one. In 1998, it was estimated that $29.1 billion of productivity was lost due to the disease, with a per-patient cost estimate of $47,000 annually for unpaid caregiving (Leifler 2003).
Editorial:
This article brings into light one of the concerns held by many skeptics of critics of early detection. Essentially, their objection is that we cannot do anything to prevent the disease if we find out we are either genetically or chemically predisposed to it, so why go to the expense and scare people about it? I have had a number of very intelligent people come up to me with this concern. I think it is a very valid concern. It is true, there is very little that medical science can do to prevent Alzheimer's and its symptoms, despite new possibilities for early detection. However, there are at least two potential benefits for early detection: emotional adjustment and reducing costs.
Early detection can help with coping with Alzheimer's disease, the effective management of the disease once it begins to take its toll. Coping applies both to the person with AD and their care network including their family caregivers and doctors. Early diagnosis can prevent accidents that can endanger the individual's life. Early diagnosis can also prevent sense of panic when confronted with a sudden diagnosis of Alzheimer's that was discussed in a journal article by (Woods et al., 2003). Families have to scramble to provide adequate care for their loved one. Early diagnosis gives the family more time to adjust emotionally, adult children to adjust their work schedules to provide care and routines to be learned and established to ensure safety. Early detection gives people time to emotionally and relationally adjust to the changes that occur with Alzheimer's disease. In effect, early detection buys people time.
The cost of Alzheimer's disease extends beyond the medical costs of treating the person with AD. The disease indirectly results in lost productivity of caregivers, many of them family caregivers, who have to miss work as a result of having to provide care for their loved one. In 1998, it was estimated that $29.1 billion of productivity was lost due to the disease, with a per-patient cost estimate of $47,000 annually for unpaid caregiving (Leifler 2003).
Wednesday, August 4, 2010
In the News: Early Detection of Cognitive Decline With Biomarkers
In the past few weeks, there has been a flurry of news coverage of the potential of finding biomarkers as the earliest signs of Alzheimer's disease. As a result, the Alzheimer's Association is considering changing the diagnostic guidelines for the disease to not only include the common behavioral symptoms but also the less fuzzy, perhaps more objective evidence of biomarkers.
http://www.nytimes.com/2010/08/05/health/05alzheimers.html
Editorial:
This news story shows that the Alzheimer's Association, drug companies, and the overall clinical community are interested in early detection of the disease. Of course, a big question is what to do once we have an "early" diagnosis of the disease. That's up for debate, but at least drug companies are banking on their drugs to slow the progression of the disease or at least treat its primary symptoms. And critics of the early detection approach make the case that scaring people who may not even exhibit symptoms may be premature and reckless. Nonetheless, early detection gives people time to adjust, including caregivers to make themselves available should they need to provide care. And certainly knowing too late, perhaps after an accident or a safety related issue, seems like something to be avoided. Stepping momentarily into the reality of people who exhibit the AD biomarker, we can envision how smart sensors in the home can keep track of when the disease is actually starting to manifest itself in changes in behaviors and functional abilities, beyond simply showing as splotches on an PET scan. This provides opportunities for people to monitor their own abilities as the disease, which they know is lurking within, begins to take its toll.
http://www.nytimes.com/2010/08/05/health/05alzheimers.html
Editorial:
This news story shows that the Alzheimer's Association, drug companies, and the overall clinical community are interested in early detection of the disease. Of course, a big question is what to do once we have an "early" diagnosis of the disease. That's up for debate, but at least drug companies are banking on their drugs to slow the progression of the disease or at least treat its primary symptoms. And critics of the early detection approach make the case that scaring people who may not even exhibit symptoms may be premature and reckless. Nonetheless, early detection gives people time to adjust, including caregivers to make themselves available should they need to provide care. And certainly knowing too late, perhaps after an accident or a safety related issue, seems like something to be avoided. Stepping momentarily into the reality of people who exhibit the AD biomarker, we can envision how smart sensors in the home can keep track of when the disease is actually starting to manifest itself in changes in behaviors and functional abilities, beyond simply showing as splotches on an PET scan. This provides opportunities for people to monitor their own abilities as the disease, which they know is lurking within, begins to take its toll.
Thursday, July 29, 2010
In the News: Sharing with Remote Caregivers
The following article from the New York Times discusses a few cases of monitoring technologies from emerging companies like GrandCare and QuietCare that can monitor the activities of older adults and relay that information to relatives or caregivers who may live far away.
http://www.nytimes.com/2010/07/29/garden/29parents.html
Editorial:
This article makes it clear that the once imagined reality of these systems is actually quite real. By no means have these systems gained widespread use or adoption, but they certainly are being used by individuals who find value in it. The set up costs of these systems are still quite prohibitive but still future reality of these systems embedded in newly built homes may not be as far away as many may think. Another theme that comes up in this article is the idea of privacy. Elders do not feel watched if the system is both unobtrusive and it provides value directly to them or indirectly to them through their caregiver or relative. Nonetheless, it is still interesting to see how these systems change the dynamic between the elder who is watched and the adult child who is doing the watching.
http://www.nytimes.com/2010/07/29/garden/29parents.html
Editorial:
This article makes it clear that the once imagined reality of these systems is actually quite real. By no means have these systems gained widespread use or adoption, but they certainly are being used by individuals who find value in it. The set up costs of these systems are still quite prohibitive but still future reality of these systems embedded in newly built homes may not be as far away as many may think. Another theme that comes up in this article is the idea of privacy. Elders do not feel watched if the system is both unobtrusive and it provides value directly to them or indirectly to them through their caregiver or relative. Nonetheless, it is still interesting to see how these systems change the dynamic between the elder who is watched and the adult child who is doing the watching.
Tuesday, July 20, 2010
In the News: Cuts in Home Health Care
From time to time, this blog will link to articles in the news that are relevant to this project. The linked articles may be about the ever-changing landscape of caring for older adults and people with disabilities in the United States. They may relate new developments in technology that bring the vision of embedded assessment of wellness ever closer to a reality. They may talk about new developments in medical or clinical research that discuss the impacts of early detection of declines in cognitive, physical, or functional abilities. The posts will also contain an editorial about how the referenced topic influences the need, design, or feasibility of embedded assessment technologies.
The inaugural article is about how the slumping economy is causing governments to reduce financial support for home care for older adults. These services can range from meals on wheels to in-home health assessments by nurses to personal health assistance for feeding and bathing.
http://www.nytimes.com/2010/07/21/us/21aging.html
Editorial:
Home health care and embedded assessment share at least one overarching goal: helping older adults remain in their own homes by delaying institutionalization. Embedded assessment can be used to distribute limited home care resources to those who may need it the most, and thus the depriving effects of budget cuts can possibly be mitigated slightly. With these programs being cut, monitoring wellness becomes just that much more difficult especially for those individuals who live on their own or are the most fragile. Embedded sensing can be used to monitor and collect information for use by professional carers without requiring costly visits. Of course, the goal of this project is not to eliminate human contact, but in the realities where in-person visits are increasingly becoming rare and expensive, the vision of objective, timely, and ecologically valid data from sensors in people's homes becomes more all the more alluring.
The inaugural article is about how the slumping economy is causing governments to reduce financial support for home care for older adults. These services can range from meals on wheels to in-home health assessments by nurses to personal health assistance for feeding and bathing.
http://www.nytimes.com/2010/07/21/us/21aging.html
Editorial:
Home health care and embedded assessment share at least one overarching goal: helping older adults remain in their own homes by delaying institutionalization. Embedded assessment can be used to distribute limited home care resources to those who may need it the most, and thus the depriving effects of budget cuts can possibly be mitigated slightly. With these programs being cut, monitoring wellness becomes just that much more difficult especially for those individuals who live on their own or are the most fragile. Embedded sensing can be used to monitor and collect information for use by professional carers without requiring costly visits. Of course, the goal of this project is not to eliminate human contact, but in the realities where in-person visits are increasingly becoming rare and expensive, the vision of objective, timely, and ecologically valid data from sensors in people's homes becomes more all the more alluring.
Welcome!
This blog will cover various aspects of the Smart Aging project at the Human-Computer Interaction Institute at Carnegie Mellon.
The goal of this project is to develop and evaluate the potential feasibility, usefulness, and challenges of developing sensing systems that can monitor and track how well (not just how often) older adults perform everyday activities important for independence such as taking medications, preparing a meal, or using the telephone.
With the longitudinal, in-situ, and detailed data collected by sensors embedded in the homes of older adults, older adults, their caregivers, and their doctors can be more aware of changes in functional abilities. This greater awareness can help older adults make the appropriate adaptations to remain independent and age in place.
This research is led by doctoral student Matthew Lee and Professor Anind Dey of the HCI Institute at Carnegie Mellon.
We welcome your contributions to this blog through commenting.
The goal of this project is to develop and evaluate the potential feasibility, usefulness, and challenges of developing sensing systems that can monitor and track how well (not just how often) older adults perform everyday activities important for independence such as taking medications, preparing a meal, or using the telephone.
With the longitudinal, in-situ, and detailed data collected by sensors embedded in the homes of older adults, older adults, their caregivers, and their doctors can be more aware of changes in functional abilities. This greater awareness can help older adults make the appropriate adaptations to remain independent and age in place.
This research is led by doctoral student Matthew Lee and Professor Anind Dey of the HCI Institute at Carnegie Mellon.
We welcome your contributions to this blog through commenting.
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