GeroTechnology: An Introduction
As settings for long-term care become increasingly
diversified, it is projected that there will be an increased reliance on family
caregivers and technology within one’s home setting, especially during health
status changes requiring extended care services. A relatively new field, GeroTechnology (or GeronTechnology)
engages technology companies, engineering and architectural firms, private
entrepreneurial enterprises, research universities, governmental
representatives, and members of the aging network – all working together to
provide services that people need, when they need them, in the place they call
HOME (Leading Age, 2016). Rather than
having to bear the expense of a nursing home, technology is being built into
housing and products to improve person-environment congruence for older adults
experiencing health status changes
As our senior population doubles over the next two decades,
we face a daunting mission: increasing
the quality of care for a record number of elders while also striving to reduce
the nation’s health care economic woes.
Many professionals argue that if we are to deliver quality care now and
in the future, we must embrace the philosophy of a wellness revolution. In other words, we will need to apply
American innovation to wellness technologies that enable prevention, early
detection, increased compliance, and new modes of remote caregiving and family support (Eldercare, 2015).
Home Care Technology and Aging-in-Place
By its very definition, home care helps people age-in-place. In addition, home care technology provides
essential tools to individuals on a widespread, cost-effective scale. Telehealth
or remote monitoring, an all-inclusive term, encompasses a range of
high-tech applications that involve caring for patients remotely. For example:
·
Monitoring an individual’s heart rate while that
person is working out on a treadmill.
·
Transmitting a patient’s telemetry readings to a
nurse via the Internet.
·
Virtually bringing a health care provider into a
patient’s home via the digital use of a high-resolution camera.
(Hfaging, 2016).
As hospital stays have been shortened and more home care
technology has become available, caregiving at home has come to take on many
aspects of a mini intensive-care unit.
One interesting example is the MEDCOTTAGE
– a mobile, modular medical home designed to be temporarily placed on a
caregiver’s property for rehabilitation and extended care. As noted on their Web page, the MEDCOTTAGE is a state-of-the-art
hospital room with remote monitoring so caregivers can provide quality care and
participate directly in their family member’s recovery (MedCottage, 2016).
Enabling Technologies and Chronic Care
Management
A growing body of research indicates that care technologies
can prevent premature institutionalization (and its related costs) while also
giving older adults more control over their own health and living
conditions. The Center for Aging Services Technologies
outlined several platforms that have demonstrated value for older Americans
coping with chronic conditions. Some of
these include the following:
1.
Medication
Optimization
These platforms
address medication non-adherence – a serious problem which is responsible for
33-69% of medication-related hospital admissions and 23% of all nursing home
admissions.
2.
Remembering
to Take Medications
Many older
adults have problems remembering to take their medications as well as
remembering their timing and sequencing.
Medication reminder systems fall into several categories – passive
organizers, commercial medication reminder services via phone or e-mail, and
software for personal data assistance.
3.
Remote
Patient Monitoring
These may
include communication devices as well as weight scales, blood pressure
monitors, assessment algorithms, and “clinician alerts” by remotely located
health care professionals. These are
especially important in rural and medically underserved communities.
4.
Assistive
Technologies and Home Modifications
Videophone
products, for example, offer family caregivers the advantage of being able to
see and hear their relatives. Observing
an elder performing basic tasks, such as sitting down and getting into bed, can
provide important information about strength and balance. Additionally, if an individual has changed or
stopped routine grooming and self-care habits, it will be more apparent via
video.
5.
Remote
Training and Supervision
For family
caregivers who have to learn how to perform long-term care tasks and who also
feel isolated, remote training has become increasingly beneficial, e.g., online
tutorials, coaching sessions, and family support groups.
6.
Cognitive
Fitness: Training and Assessment
Designed for
working with cognitively impaired older adults with chronic illness, some of
the available tools include counseling support instruments, electronic health
records, and point-of-care computers.
7.
Social
Networking and Loneliness: Social
Connectedness
Although not
typically categorized as an illness, loneliness is a problem faced by many
older adults in poor health who may live alone.
As research indicates, they have a very different experience of aging
than those with family and social supports.
In such cases,
technology can help elders feel more connected to those outside their
homes. As just mentioned, videophones
can be a tremendous asset. In addition,
computer networks, such as the Internet, offer many opportunities for
communicating with others. Some services
are designed specifically for people aged 65+.
They may offer social activities as well as host a variety of online
discussion and enrichment topics, such as book clubs and virtual travel
excursions.
8.
Social Media
Most
health experts agree that the future of medicine will incorporate social media
– Internet-based tools used for sharing and discussing information. Such social media might include social
networking sites, news and bookmarking, blogs, video sharing, photo sharing,
and virtual reality.
For example, according to nation-wide
survey findings of The Pew Social Research Center, once someone is online, living with a chronic
disease is associated with a greater likelihood of accessing user-generated
health content, such as blog posts, hospital and physician reviews, and
podcasts. In general, it seems that
older adults believe that others with the same condition are more likely to
understand, be supportive, and offer wise advice (Pew Research Center, 2010).
An aging population and a growing
number of individuals living with chronic conditions mean, in turn, an
increased reliance upon family caregivers to provide front-line health care.
Recent national reports indicate that these caregivers are becoming health
information specialists – thanks to the internet, used in researching health
conditions and treatments. (Pew Research
Center, 2013).
Health Technologies in Nursing Facility
Settings
While this
discussion has primarily focused on home-based care, I also want to add a
few comments about those technologies
that are being implemented within nursing home settings.
·
Advanced
Total Quality Systems – integrate several basic components such as nurse
calls, wandering management, fall prevention, resident tracking, resident
assessment, and electronic medication administration.
·
Advanced
Bedding Systems – have embedded sensors for monitoring vital signs and
sleep quality.
·
Comprehensive,
Interoperable Electronic Health Records (EHRs) – allow security in sharing
health information across various settings.
As noted by many nursing home administrators, resistance to
change remains one of the biggest obstacles to technology integration within a
facility’s environment. Having a long
history of being manual and paper-based, it will require a cultural shift to a
technology base. Education and communication are essential in addressing this
challenge (Eldercare, 2015).
The Future of GeroTechnology
While it is clear that future cohorts of older adults will
have more options in health care, much will depend upon their financial
resources. It seems clear that consumers who do not have adequate income will
have fewer choices in the type or quality of services received. It must also be recognized that use of these
technologies (low-tech and high-tech) assumes a level of health literacy, as
well as a willingness to embrace the required new learning. Others caution us to be mindful of potential
negatives, such as patients’ privacy / confidentiality issues and
dissemination/access to personal information.
Most agree that those health technologies that connect
elders (in a long-term care facility or home) and their respective families
will continue to experience increased demand.
However, among the challenges we face will be the ability to make these
innovations seamless, easy to use, respectful, and affordable.
Resources
Health Technologies & Elder Care
- Center for Aging Services
Technologies of Leading Age (2016). http://www.leadingage.org/cast
- Eldercare (2015). Assistive
Technology, Eldercare: Connecting
you to Community Services.
- Georgia Institute of
Technology. Human Factors &
Aging Laboratory (2016).
- MedCottage (2016). http://www.medcottage.com
- Pew Social Research
Center. Internet and American Life Project (2013). Family
Caregivers are Wired for Health. http://www.pewinternet.org/report/2013/familycaregivers.aspx.
- Pew Social Research
Center. Internet and American Life Project (2010). Chronic
Disease and the Internet. http://www.pewinternet.org/Reports/2010/Chronic-Disease.aspx
- The American Elder Care
Research Organization (2014). Technologies
to reduce care costs and allow safe aging at home. Paying for Senior Care.
Blog Author: Dr. Donnelle Eargle deargle@sjcme.edu
With a background in geriatric
rehabilitation psychology, Dr. Eargle teaches gerontology-related courses at
Saint Joseph’s College. Standish, Maine.
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