1. 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

2. 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.

3. Living Longer

4. Living Longer with Chronic Diseases

5. Living Better?

6. Where’s Home?

7. 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

8. 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!”

9. I have fallen and I can’t get up

10. Crossroad

11. 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

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

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

14. Long Distance Care Giving Family caregiving coordination Communication Relationships Socialization

15. Home Safety Fall prevention Security Lighting

16. “Seniorizing” the Home

17. Pimp My House (Senior Edition)

18. “Aging in Place” Technology http://www.grandcare.com/wp- content/themes/theme1367/videos/html/TodayShow.htmlhttp://www.grandcare.com/wp- content/themes/theme1367/videos/html/TodayShow.html

19. Lifeline Provide quick access to help

20. Alzheimer’s Association Safe Return Demented wanderer Emergency response service

21. 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 http://www.lotsahelpinghands.com/

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

23. 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 http://www.youtube.com/watch?feature=player_embedded&v=Bg0HKGPQHjw

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

25. GrandCare Systems Activity monitoring Digital home monitoring Medication management Multi-media socialization http://www.grandcare.com/wp- content/themes/theme1367/videos/html/Ed_Thelen.html

26. 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

27. Ideal Life Facilitate vital and objective communication between patient and health providers Monitoring –BP, Glucose, weight, Pox Email or text alert caregiver’s smartphone https://www.youtube.com/watch?v=wlLAKLIrBMY&feature=player_embedded

28. 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

29. 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

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

31. Can You Do More Push-Ups than Grandpa?