1. EMERGING TECHNOLOGIES IN COMMUNITY RESIDENTIAL SERVICES FOR PEOPLE WITH DEVELOPMENTAL DISABILITIES Workshop for Service Providers in North Dakota Sept. 17, 2009, Bismarck Rodney Bell Coleman Institute http://www.cu.edu/ColemanInstitute/ Principal, ASSET Consulting assetcon@easystreet.net

2. 2 Coleman Institute and ASSET Consulting, 2009 Rodney Bell, Moderator Coleman Institute for Cognitive Disabilities, University of Colorado Overview of Emerging Technologies R Bell, Principal, ASSET Consulting, LLC (“Applying Systems, Software, and Engineering Technologies”) Rest Assured Systems Jeff Darling, President, Rest Assured LLC and President, Wabash Center (Lafayette IN) Night Owl Systems Duane Tempel, Night Owl Support Systems, LLC Sr Outreach Specialist, Waisman Center, Univ. of Wisconsin Adopting Technology (Bell) Questions/Discussion (all) Workshop Agenda

3. 3 Coleman Institute and ASSET Consulting, 2009 http://www.ColemanInstitute.org

4. 4 Coleman Institute and ASSET Consulting, 2009 Coleman Institute 2009 Conference Cognitive Disability and Technology in an Age of Uncertainty November 5, 2009, Westminster, CO James K. Galbraith, Ph.D., Lloyd M. Bentsen Jr. Chair and Professor in Government/Business Relations, Lyndon B. Johnson School of Public Affairs, UT at Austin; former Director, Joint Economic Committee, U.S. Congress Tamar Heller, Ph.D., Professor of Human Development and Public Health; Director, RRTC on Aging with Developmental Disabilities, UIC Jay Lundell, Ph.D., Digital Health Group, Intel Corporation Ann Turnbull, Ed.D., Distinguished Professor, UK Beach Center on Disability Rud Turnbull, JD, Distinguished Professor, UK Beach Center on Disability Conference Chair: David Braddock, Ph.D., Associate Vice President, University of Colorado, Professor and Executive Director, coleman Institute for Cognitive Disabilities Special Guests: Bruce Benson, President, University of Colorado System Renee Pietrangelo, CEO, ANCOR

5. 5 Coleman Institute and ASSET Consulting, 2009 Why Use Technology In Residential Care U.S. demand will grow to nearly 700,000 persons in 10 yrs from 533,000 persons currently in residential services Staff turnover in community living settings: 50-70% Emerging residential technologies can address projected demand for long-term care services and reduce the need for tens of thousands of additional staff Technology can monitor and support persons with I/DD in recreation, health promotion, other activities of daily living.

6. 6 Coleman Institute and ASSET Consulting, 2009 How Can Technology Help? Higher Quality of Life  Foster independence, engagement, activities Healthier Residents  Monitor activities & health signs, predict problems, advise staff Safer Homes  Monitor activities, control systems, disable appliances Lower Service Costs  Operating efficiencies, remote monitoring/supervision Supported Caregivers  Record/plan care, relieve tedious/unpleasant tasks, training

7. 7 Coleman Institute and ASSET Consulting, 2009 Wireless, world-wide communication Internet – computers, people, devices Smart Phones, Personal Digital Assistants Global & Local Tracking Robots Technology in the 21st century Microelectronics Neuroscience & Engineering Health Technologies Virtual Reality Home Automation

8. 8 Coleman Institute and ASSET Consulting, 2009 Categories of Technology Supports Machines Robots Tangible computing Virtual reality Personal Devices Memory, prompt aids Body monitors Alternative, Augmented Comm. Smart Phone-based Assisted cognition Location-based info services Reality mining

9. 9 Coleman Institute and ASSET Consulting, 2009 Categories of Technology Supports Computing/Networks Software apps Information systems Web apps Situated Systems Smart Homes Facility systems Urban systems

10. 10 Coleman Institute and ASSET Consulting, 2009 Smart Living - Personal Supports Devices carried on or worn by a person  Smart phone, wearable sensors, connected to external systems Support daily activities, health, and care  Monitoring, Prompt wearer, Alert caregivers  Guidance away from home, for tasks/directions/… Record life history  Support care staff about transitions in care settings  Support consumer with reminders, suggestions, analysis, … Empower social engagement  Augment personal capabilities

11. 11 Coleman Institute and ASSET Consulting, 2009 Smart Phones The future of personal computing  Web, software apps, GPS, wireless  Hi-Res camera, video, microphone  Analyze speech, sounds, images  Recognize gestures and movement  Sense RFID and objects  Open and customizable Context-based Personal Supports  Monitor/relay health signs  Log life activities  Prompt task performance  Give reminders, directions, information Need Simple User Interfaces

12. 12 Coleman Institute and ASSET Consulting, 2009 Wearable Physiological/Activity Monitoring Body Sensor Systems  Vitals, breathing, temperature, …  Activity, position, falling, …  Context, location, …  Medical devices, body area network  Need unobtrusive, passive devices

13. 13 Coleman Institute and ASSET Consulting, 2009 Transportation/Urban Guide

14. 14 Coleman Institute and ASSET Consulting, 2009 Smart Care – Staff Supports Real-time, web-based information systems  Alerts/reports about resident health and behaviour  Case management: assess needs, plan care  Assure medication administration  Train and prompt staff in care services  Automatically document care services  Help manage operations and care practice Future  Predict problem behaviors, health issues  Integration Care planning and service monitoring Of disparate care systems With solutions for smart home, smart living

15. 15 Coleman Institute and ASSET Consulting, 2009 Service Planning and Delivery CappsDATA ( www.cappsdata.com)  Computer-Aided Person to Person Services. Design, Administration, Tracking, and Analysis  Task modeling, Kiosk-based  Alternatives for People with Autism, Inc Brooklyn Park MN (www.afpwa.org) Service Planning  Program planning, scheduling, communication, training and data collection Service Delivery  Data capture at point of service, reporting and analysis

16. 16 Coleman Institute and ASSET Consulting, 2009 Medication Administration Specify meds Procedures Schedule Outcomes Reports Customize Web-based Imagine! MedSupport

17. 17 Coleman Institute and ASSET Consulting, 2009 Smart Homes – Residential Supports Systems built into the facility  Sensors, tracking, controls, networks, databases, software Supports Smart Care and Living  Monitor activities/health of residents and care staff  Programmable control of buildings/systems (e.g, person location) Foster independence, engagement  Monitor Activities of Daily Living and Care services  Analyze/report variations and trends  Alerts to intervene; Calls for assistance  Soon, cognitive prompts, predict health issues & problem behavior Smart building  Convenience, comport, and safety of consumers  Efficient systems and utilities

18. 18 Coleman Institute and ASSET Consulting, 2009 What Smart Homes Can Do Provide a constantly monitored environment so the individual is safe (activity monitoring/remote sensing). Automate specific tasks that an individual is unable to perform (turning lights on or off). Provide a safe and secure environment (alerting the user of potentially dangerous activities). Alert caregivers should the occupant be in trouble (through linking to the local community alarm system). Enable and empower the user (by assisting them in daily tasks). Facilitate the rehabilitation of individuals (by giving prompts that could be auditory and/or visual). Source: Smart House Social Care, UK www.smartthinking.ukideas.com/Smarthoussocialcare.html

19. 19 Coleman Institute and ASSET Consulting, 2009 Smart Home Definition A Smart home can detect signs of and determine, estimate, or predict residents’ activities, cognition, or health and provide or use this information on residents’ behalf

20. 20 Coleman Institute and ASSET Consulting, 2009 Smart Home Technology Precursors & Related Tech Home automation, Security systems, Electronic home, Remote monitoring, Green houses Sense activity, vitals, house, etc Resident Models of care, resident, house Fuse sensor, input data Family & Providers Capture info about resident Predict activity, health, needs … House Control house Prompt resident Inform carers

21. 21 Coleman Institute and ASSET Consulting, 2009 Smart Home Products, Services, and Research SystemProvider/developPurposeFunctionsStatus Rest AssuredResCare and Wabash Center TelecareMonitor risk, communicate with resident, security, respond Service Night Owl Sound Response Dane Cty, NOSS, U of Wisconsin Overnight watchMonitor risk, respondService SmartHomesImagine! (internal) Assisted Care & Living, Costs ECT CARE, MedSupport, assistive tech, green building Operating CARECurotek (Elite Care Tech ) Assisted living for seniors Monitor activity & health Support facility care Product 7 sites QuietCareGE and Living Independently Independent senior at home Monitor key ADLs Raise warning/alert Service WellAWAREU. of Virginia MARC Independent Living Monitoring ADLs & sleep Monitor quality of life Service GatorTech SmartHouse U. of FloridaAssistive Environment Smart facilities … Tracking R&D Aware HomeGeorgia TechIndependent Living Memory aids, home assist Social communication R&D Benefits: Independence, Improve Quality of Life/Health, Reduce Costs

22. 22 Coleman Institute and ASSET Consulting, 2009 WellAWARE Systems: In-Home Monitoring Low-cost, unobtrusive, passive sensors  For individual living spaces, elders Monitor health, activities, systems Alerts, trends, analysis Supports interventions, care planning Data management over Internet Feedback reports  for resident, caregivers, service provider Developed by U of Virginia MARC Others: QuietCare/GE, HealthSense, HomeFree, Vigil

23. 23 Coleman Institute and ASSET Consulting, 2009 WellAWARE Systems

24. 24 Coleman Institute and ASSET Consulting, 2009 Imagine! Charles SmartHome

25. 25 Coleman Institute and ASSET Consulting, 2009 Charles Smarthome Technology for Consumers Family Portals  monitor relative’s daily activities, health, care, environment  communicate by sharing files and pictures Adapted Web Browsers & Email Programs Journaling captures history of care, activities, health Specialized Keyboards and Communication Devices Automatic, accessible & safe appliances/systems Environment Control

26. 26 Coleman Institute and ASSET Consulting, 2009 Charles Smarthome Technology for Staff MedSupport  Medication administration prompting and records  from Imagine! Hands-free communication/paging Monitoring- cameras, sensors, PERS Document consumers life history (Life-logging) Employee training & time tracking, web-based CARE System  CuroTek (aka Elite Care Technologies)

27. 27 Coleman Institute and ASSET Consulting, 2009 CARE System - Curotek (Elite Care Tech) Locate/track residents and staff Assistance calls, programmable alerts Get help from anywhere on campus Track and report call response System raises alerts for risky situation Bio-sensors Bed load cells, motion sensors Early warning for health problems Smart building Responds to person movement CareKey Door Entry; prompts Disable appliances Intranet Information System For staff, residents, families Care incidents, planning, logs Community activities Time Card, employee records Reporting, analysis, decision support Elite Care Residential Care Facilities Holistic care model for active engagement Open building design for social interaction Technology for residents, family and staff Evolutionary technology development 9 yrs, 7 facilities (2 internal, 5 customers )

28. Elite CARE Copyright 2001 Animation Future Staff enters type of service on PDA Calls and Events Residents call for help: Badge button, pull cord, PC Event (resident movement) Definable: bed, threshold, Alerts appear/sound on Nurse station (or PDA) Records who, when, where Control building appliance CARE system

29. Elite CARE Resident approaches room Badge detected, door unlocks Green light, if it’s their door CARE system Smart House Assist resident Unlock their doors Disable unsafe appliance Turn lights on/off Prompt activity (future) Programmed for event Turn on bathroom light if resident arises at night Copyright 2001

30. 30 Coleman Institute and ASSET Consulting, 2009 Family Portal Caregiver Dashboard

31. 31 Coleman Institute and ASSET Consulting, 2009 Implementing Smart Homes Business case for meeting needs (cost, quality of life/care) Financial & organizational feasibility, more than technical Adopt and adapt mainstream technology Involve staff and consumers from concept thru trials Co-evolve solutions with cultural & organizational change Address ethical concerns (e.g., privacy, rights, …) Do It Yourself  Elite Care, Wabash Center, AfPwA, Imagine!, Sound Response

32. 32 Coleman Institute and ASSET Consulting, 2009 Opportunities – emerging technologies Action  Technology awareness, get started  Assess your needs, tolerance for risk, technology maturity  Pilot technology solutions: assess benefits, impact, cost  Change care practices to utilize and benefit from technology  Adopt early, iterate, learn from experience Implications for Service Providers 2000 2005 2010 2015 Residential monitoring, alerts Care information systems … on web Care staff support Personal Assistants … life history Predictive modeling … Cognitive assistance

33. 33 Coleman Institute and ASSET Consulting, 2009 Technology Maturation

34. 34 Coleman Institute and ASSET Consulting, 2009 Technology Implications for North Dakota N. Dakota Issues  Safety, medication, care incidents, planning Support small residential settings  Monitoring and alerts  Family portals  Safer, controlled environments Support/complement care staff  Care planning and documentation  Medication administration  Remote monitoring/supervision Improve consumers’ quality of life  More independent, healthy  More active in the community