Predicting the future is a precarious business but if the cutting-edge research being carried out around the globe is a clue then today’s baby boomers will be spending their dotage in mobile “pods” parked in a relative’s back garden, with a robot to fetch and carry, and a fluffy seal toy which responds to voice and touch for company.
Older people – as the UK charity Age UK refers to the over-65s – and how to house them are issues that have come to the forefront of scientific exploration because the world is undergoing a momentous demographic shift. People are living longer and the result, according to the UN, is that there will be two billion people aged over 60 worldwide by 2050.
Many will not have an extended family to care for them, and the current options of care homes and nursing homes are neither appealing nor able to cope with the sheer numbers involved.
Enter the robot – or at least a spectrum of technology to make independent living easier, safer and even companionable in a weird, techie way.
Ken Dupin, who is based in Virginia, US, first began considering this problem a decade ago, while studying for a PhD in international development. As he travelled around Asia, South America and the Middle East talking to families and older people, he saw at first hand how disparate cultures care for older relatives.
“In many of those places the entire family participated in care, whereas here we have a system of nursing homes and assisted living institutions,” he says. “Nobody really wants to go to these institutions and they are very expensive. I began to think about other options.”
Dupin’s solution is the MEDcottage – or “granny pod” – a mobile home with 288 sq ft of living space. It can be parked in a relative’s backyard (or shuttled between family members), giving both the older person and their family privacy, while ensuring help is close at hand.
The pod is fitted with sensors to monitor for practical problems like water leaks. If a leak is detected, an email or text is sent to a designated family member.
Family members or carers can keep an eye on a MEDcottage dweller via a CCTV system which is positioned to cover an area about 12 inches above floor level. Positioning monitors at this level may seem unusual but the idea is that an occupant’s fall will be noticed while their general activities remain private.
In the first year of operation three MEDcottages have been sold, priced between $40,000 and $100,000-plus, depending on the specification. Another three are on order.
Much of the technology on offer to older people is, like the MEDcottage, available in North America and focused mainly on remotely monitoring health and safety within a sheltered housing environment.
Residents of the Stephen Foster Senior Apartments in Louisville, Kentucky, for example, hold teleconferences with their doctors via their television sets, while an on-site nurse is on hand to carry out any necessary tests.
At Eskaton Village, in Roseville, California, which is home to 115 older people, apartments are fitted with motion sensors which respond to anomalies in residents’ regular routines. If someone appears to be getting up through the night more than usual, for example, staff on site will be alerted to check on them.
But at the cutting-edge, scientists are increasingly interested in how to retrofit homes to allow older people to retain their independence within familiar surroundings.
Dr Thomas Linner, based at the Technische Universität München in Germany, is developing what he describes as a “wonderwall” to assist with everything from monitoring blood pressure to finding lost glasses.
In reality, the wonderwall looks more like a cupboard. It is designed to stand in a hallway, to complete the domestic camouflage, and it comes fitted with a mirror and coat pegs as well as smart technology.
The wonderwall is an ideal home help and, indeed, there may be many able-bodied young people who could do with one. It issues an alert if residents start to leave the house without taking their keys from a built-in holder. In addition, an “indoor positioning system” can help to locate important items like glasses or anything else which tends to trigger the irritating “where-are-my-gloves/keys/boots” panic. The objects in question simply have to be fitted with an identification chip.
Tactfulness is an unexpected dimension of this system. Instead of a raucous alarm, the wonderwall will allow its owner to know about lost items with an inconspicuous signal of the owner’s choice. “The alert can be musical or a light coming on so that other people in the room do not know that the elderly person has forgotten something,” says Linner.
He hopes a version of the wonderwall will be on the market within five years. In future he plans to augment it with a voice-activated mobile robot to carry out chores like turning on lights or carrying shopping.
He has also designed an armchair that acts as a mobile gym – it is fitted with cross-trainer-style levers instead of armrests, and bio sensors that monitor blood pressure.
Another in-home solution is being engineered by Maged N. Kamel Boulos, associate professor of health informatics at Plymouth University, southwest England.
He has created a “smart vest”, designed to be worn under clothing, embedded with sensors to monitor vital signs. If a problem is detected, a distress signal is sent to a central monitoring station staffed by medics who will contact the wearer or a family member. The vest is also fitted with GPS technology which can locate the wearer if they get lost.
All of which leaves two important questions about this gadgetry: will older people be able to get to grips with it, and will such reliance on technology lead to loneliness and isolation?
Stuart Greenbaum, vice-president of Eskaton, the company which runs Eskaton Village, has been pleasantly surprised by the willingness of many residents to tackle new technology – so long as they are offered plenty of sympathetic face-to-face support.
“We have to appreciate that it is going to take older adults a little longer to feel comfortable with this sort of technology,” he says. “Providing technical support by people who are going to be more patient with them, and who will encourage them to make notes so they can remember how to do things, is very important.”
The question of social isolation is more complex, however. A slightly unsettling project by Japan’s National Institute of Advanced Industrial Science and Technology has led to the development of Paro, a “therapeutic robot” disguised as a fluffy toy.
Paro, who looks like a baby seal, is aimed specifically at older people and is covered in sensors which respond to sound and touch.
Studies at a day care centre found that older clients who petted and spoke to the toy experienced benefits in terms of reduced stress, greater motivation and better socialisation with staff and carers.
There has, however, been no significant research into the impact of technology on older people’s emotional wellbeing.
Dr Matthew Norton, social and economic research manager at Age UK, a charity dedicated to helping older people, believes technology does have a role. But he has a proviso.
“It has to be implemented in the correct way, in conjunction with the older person, and it must be introduced as part of a care package,” he says. “Older people are accepting of technology so long as it does not take away things that they value, such as help from social care professionals.
“It can often be the family which pushes the technology on the older person, and they can fear it will mean they do not see them as much.”
Norton points out that if an older person learns to use Skype or online forums, it can increase contact with the outside world.
However, he cautions that it is too soon to tell whether remote or robotic contact can make up for a lack of human contact.
Back in Virginia, Dupin is also considering the emotional welfare of future granny pod residents. He is developing an avatar, provisionally named Sidney, who would appear on a flatscreen TV to chat to the resident.
Sidney would be able to remind them to take their medicine and ask questions such as what they would like to watch on TV or what music they would like to hear.
Having a digital avatar for company sounds rather Brave New World. But in a country where fewer older people can rely on traditional – family – support, Dupin considers Sidney as a best alternative.
“Other cultures see old age as a celebrated time and not a difficult time, which often disappoints me about the United States,” he says. “But it is a hard message to get across in a culture which so worships youth.”
Rising cost of care
Older people in the UK
● Over-65s to increase from 17 per cent of the population in 2010 to 25 per cent in 2050
● Residential care market for over-65s across all sectors (NHS, private and voluntary) was £15.2bn in 2012
● Average yearly cost for a single room in a private residential home is £27,872 (£536 per week). The average yearly cost for a room in a nursing home is £38,376 (£738 per week)
● Care for the over-65s comprises 40 per cent of all NHS spending (£38.24bn)
● 1.5 million people in England have care and support needs not met by the state
Older people in the US
● Over-65s to increase from 13 per cent of the population in 2010 to 22 per cent in 2050
● Residential care market in the US was $190bn in 2010
● Average cost for a single room in an assisted living residence is $41,400 ($796 per week). The average yearly cost for a room in a skilled nursing residence is $83,950 ($1,614 per week)
● Care for the over-65s accounts for 36 per cent of total healthcare spending ($454bn)
● Annual healthcare spend per capita in the US is among the highest in the world, with over-65s spending an average $14,797 per person per year
● The cost of Medicare is set to rise from 3.7 per cent of GDP in 2011 to 5.7 per cent in 2035
Sources: House of Commons Library; Age UK; UN World Population Prospects; US Dept. Health and Human Services; American Elder Care Research; US Census Bureaus: US Social Security Administration
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