Technology marches forwards with no signs of halting. When the elderly people who reside in America’s assisted living communities were children, the television hadn’t been invented yet, jet planes crossing the ocean, let alone space travel, were but science fiction fantasies, and people wrote with typewriters and did math with a slide rule. Today, advanced technology is ubiquitous, and that includes in senior communities. Assisted living communities are increasingly utilizing high-tech systems to monitor the safety of their residents. Bryce Porter, Senior Living Manager at Care Innovations was quoted in a Senior Housing News article noting that currently about 15-20% of facilities use sensor technologies to monitor residents, but that he expects this to increase to above 65% in the coming years.
“The Big Brother Model of Assisted Living”
A recent article in the Atlantic by author and scholar, Michael L. Millenson outlined these technologies and discussed their implications in terms of privacy. The article itself was an interesting and fairly well balanced discussion of these technologies, but the title itself, “The Big Brother Model of Assisted Living“, was an example of flagrant media sensationalism. In George Orwell’s well known novel 1984 , from which the term “Big Brother” comes, the purpose of the surveillance is control, while in assisted living communities the purpose of these technologies is purely and indisputably for the safety of the senior (and to a lesser degree, for financial reasons).
Fortunately Mellison drops the 1984 analogy after the title of his article and proceeds to ask fair questions:
- Do they cross the line in terms of privacy?
- Do these technologies work?
How Do These Technologies Work?
Many companies make these systems, but essentially they work like this: Sensors are placed in the senior’s apartment that monitor and track routine movement and activity. When the senior greatly varies from their normal activity in a way that’s concerning (for example spending much more time than usual in the bathroom or failing to turn on any lights) an alert can be sent to facility staff to check on the senior. WellAware System, QuietCare, Lowe’s Iris are examples of systems that work on this principle. GrandCare, and Stealth Health are similar systems that include the added ability to monitor vital signs and detect falls.
Unlike the devices in 1984 these technologies generally do not use cameras or microphones to monitor residents, and monitoring is typically done by computers rather than humans. It is understandable that these technologies might strike some as unsettling, but the benign purpose of the technologies, combined with the fact they they don’t allow some out-of-state controller to watch your grandma undress or listen in on her conversations should help put most people’s mind at ease. Furthermore, the technology that we’re discussing is now has been relatively commonplace in assisted living communities for several years, and is used a a chief selling point, so it doesn’t appear to actually frighten residents and their families.
Another indication that these technologies do not scare the dickens out of seniors was revealed when more than 1,600 seniors recently volunteered to participate in a University of Minnesota study on the efficacy of these devices, and willingly had them installed in their homes.
If this data were somehow leaked or accessed by hackers, I wouldn’t be overly concerned as it’s not particarly sensitive information. Why would I care if some hacker in Croatia was able to find out how many minutes my grandmother spent into the living room as opposed to the bedroom, or what time she used the microwave. But more seriously, privacy is a legitimate concern. Residents and their families should have concrete assurances about the integrity and security of the data collected.
Do These Technologies Work?
The Atlantic article as another legitimate questions, which is, “Do these technologies work?” The answer seems to be they only work so long as long as their are people acting on the alerts that these technologies provide. Without human oversight these technologies are worthless. The Atlantic article quoted Jacci Nickell of Good Samaritan, a Lutheran non-profit senior care provider that has developed its own monitoring program for seniors, ” “Unless you gather, integrate, and interpret that data in a meaningful way to the client and to their formal and informal caregivers, a sensor hanging on a wall isn’t going to help anyone,” she says. “It’s what you do with that data, and how you optimize well-being.”
Good Samaritan uploaded this video to YouTube, telling one success story involving this monitoring technology. This story demonstrates it’s not the technology alone that made the difference, but the fact that people were there to analyze and act on the data that they were seeing:
Of course it’s possible that these technologies might on occassion fail to recognize a problem, but in assisted living communities they are meant as a supplement to normal and regular welfare checks and supervision, so these technologies seem to provide much to be gained and little to lose as long as communities do not recklessly attempt to replace staff en masse with monitoring systems (which no one has proposed).
A Personal Perspective
My grandmother lives in an assisted living community, and they don’t have these devices set up in their resident’s apartments, but I don’t believe that my grandmother or any of family members would object whatsoever if they were to be installed. My grandmother’s apartment has a pull cord emergency response system, but if she were to fall somewhere where she couldn’t get to the cord, or have an emergency that made her unconscious, what could be done? It’s completely possible that it could be hours before anyone found her. If one of these systems were present in her apartment, it could assure that she gets help right away.
What are you thoughts about these technologies? Would you object to a system like this in you or your or loved ones assisted living apartment? Does this technology give you the heebie jeebies or would you adopt it wholeheartedly? We welcome your comments below.