Innovations in Home Care for the Elde rly Robert P. Chen, MD MBA Co-Director, CentraState Geriatric Fellowship Program CentraState Family Medicine Residency Program Department of Family Medicine Robert Wood Johnson Medical School at Rutgers

Abstract American are living longer but with “no less” disabilities. Most elderly desire the option to “aging in place”, but the cost of additional care is increasingly expensive. There is a need for better home care in terms of health care, long distance caregiving, and home safety. Technology that automate and integrate care can help maintain independence as well as function and perhaps even reduce health care costs.

Living Longer

Living Longer with Chronic Diseases

Living Better?

Where’s Home?

Current Trends Living longer (chronological age) Living with “no less” disabilities (physiological age) More desire the option of “aging in place” Cost of additional care is increasingly expensive

95% of Americans 75 and older say they want to stay in their homes indefinitely “IF I ever need to go to a nursing home, kill me first!”

I have fallen and I can’t get up

Crossroad

Re-define “Home” Shelter and Protection –Physical comfort Comfort and Self-Expression –Emotional comfort Safety –Compensate for normal changes in perception, physical abilities and judgment which makes elderly more prone to accidents

Re-define “Caregiving” Family (Sandwich Generation) Technology –Automation –Integration

Health Care Remote Monitoring Medication Reminders Daily Medical Testing Remote Medical Consultation Medical Care Coordination

Long Distance Care Giving Family caregiving coordination Communication Relationships Socialization

Home Safety Fall prevention Security Lighting

“Seniorizing” the Home

Pimp My House (Senior Edition)

“Aging in Place” Technology content/themes/theme1367/videos/html/TodayShow.htmlhttp:// content/themes/theme1367/videos/html/TodayShow.html

Lifeline Provide quick access to help

Alzheimer’s Association Safe Return Demented wanderer Emergency response service

Lotsa Helping Hands Caregivers set up a member-only community to coordinate care and track tasks that need to be accomplished Incorporate social media and caregiving

ResCare HomeCare Constant in-home monitoring Operator assistance Family can access at real time

GreatCall: Jitterbug cellphone Smartphone Health & medical apps and services –Urgent care app for healthcare advice –Medication / task reminders, Brain games & My World 5Start Urgent Response –Emergency response / 911, GPS locator, Personal profile

Safe-T-element Set of cover plates installed over each stove Limits burner temperature to 700 F (1291)

GrandCare Systems Activity monitoring Digital home monitoring Medication management Multi-media socialization content/themes/theme1367/videos/html/Ed_Thelen.html

SafetyChoice Centralized monitoring station –Personal emergency response system –Bedside pressure mats –Door & window sensors –Smoke & carbon monoxide detectors –TabSafe medication dispensing solution –Portable GPS-based PERS systems Out of home monitoring

Ideal Life Facilitate vital and objective communication between patient and health providers Monitoring –BP, Glucose, weight, Pox or text alert caregiver’s smartphone

ADT Companion Service Personal emergency response system In-home monitoring Wearable device connected to a base up to 300 feet away Linked with ADT home security system

Effectiveness Maintaining Independence? –Yes when used appropriately Reducing Home Care Costs? –Unlikely in the short term Reduce Health Care Costs? –It should but more research needed

Conclusion Seniors expect to live longer and better Technology can help aging in place

Can You Do More Push-Ups than Grandpa?