Prime Time: A New Look At Aging

Technology for Caregivers

Again, another short post meant to help those of you who are looking out for a senior. The Family Caregiver Alliance (found here) has a good section on how to find and choose the right tools to help make your life, as well as the life of the person you're caring for, a lot easier. Click here to go to their section on Assistive Technology.

Lifted from their website: "The area of assistive technology has grown tremendously in recent years, and many manufacturers now provide a wide range of products and devices. It can be confusing, however, to determine which products might be right for your loved one. Here are a few basic tips to help you in this task:

• Focus on the actual tasks your loved one wants or needs to do when choosing devices. While this might seem obvious, it’s easy to get drawn into buying a product that looks good but doesn’t really address your loved one’s needs.
• Generally, it is best to pick the simplest product available to meet the need. Simpler devices are often easier to use, less expensive, and easier to repair and maintain than more complex devices. For example, if someone does not have difficulty remembering to take their medications, but gets confused about which pills to take at which times, a weekly pill organizer that can be filled by a caregiver would solve the problem. Purchasing an automated pill dispenser with alarms to remind the person to take medications would be more complicated than necessary and would certainly be more expensive than the simpler pill organizer.
• Ask experts that provide care to your loved one, like rehabilitation specialists or physical and occupational therapists, about which type of technology might be best.
• Ask other people with disabilities what products they have found to be helpful.
• Ask to use the device on a trial basis to see if it is truly going to meet your loved one’s needs.
• Ultimately, your loved one’s opinion about a certain piece of AT is the most important. The device needs to be comfortable, attractive, and simple to use.

Worries about aging

Insurance companies get rich because we don't understand risk--we take the bad end of most bets.

As an example, what do you think your risks are of getting Alzheimer's disease? 10%? 20%? According to Assistive Technology and Aging, the risk for someone between the ages of 60 and 64 is 1%. If you're between 65 and 74, that creeps up to 3%. Alzheimer's becomes a significant risk only for those over age 85, most likely because you've survived the other risks that got the person next to you in line.

The average age at diagnosis for all cancer is 69. In fact, according to the National Cancer Institute, growing old is the first risk listed. But up to 70% of all cancers are related to decisions we make about what we eat, smoke, drink, and how we behave. So you are not condemned to passively waiting for a death sentence. And for most cancers, adopting better habits has benefits even if you have waited a very long time to see the light--and that even goes for smoking.

Technology is improving in the treatment of all conditions, and it is improving quick enough to possibly help you and me. 

But the biggest risk factor of all, and not ever mentioned by insurance companies, is the quality of healthcare you receive. That's what they're fighting about in Washington right now. 

Where to get the stuff you need to live a better life

Sometimes a short post is better--I don't want to get in the way of information that can help seniors live a better life.

Abledata is a website that can point you to specific machines, tools and resources that can help you. To visit their website, click here or go to www.abledata.com. That's all for this post.

Quitting 5 minutes before the miracle

What constitutes a fulfilling life at the end of our normal lifespan? What are you willing to give up and what is core?

As a technology commentator I get a preview of what the future holds from companies, scientists and academics. And I have this abiding fear that I will shuffle off this mortal coil the day before a cure is announced for whatever actually does me in. I don't want to be the last man to die from Alzheimer's Disease, for example. On the other hand, I don't want to exist with it for 10 years while I wait...

So for me, the bare minimum is being able to think. To be in my right mind, accept information, analyse it and make a decision. Again, strictly for me, a lot of what's left is negotiable. I love watching movies, and sight is important to me. On the other hand, I've seen a lot of movies, most of them awful, and I can't remember the last time I was surprised by one. So... maybe, maybe not. I might live just fine listening to Talking Books and learning Braille. Lots of people do. (Besides, technologists are working hard on bringing sight to the unsighted. I expect to see rapid progress on this in my lifetime.) It's negotiable.

I try and jog three or four times a week, and it's been a part of my life since I was 12. Could I live happily without the use of my legs? Well... I'm not getting any faster at jogging, and running shoes are getting pretty expensive. It's great feeling in good shape, but I'm getting the nagging minor injuries that come with age more frequently. And again, science is working hard on this and is making notable progress. So, it's negotiable.

I guess the same is true for hearing (I have already compromised mine due to extended proximity to a chainsaw engine), taste (also compromised--too many cigarettes and too much coffee). But so much progress is being made on hearing that I think any loss will be recuperated in my lifetime. I expect to end my days hearing better than I did as a child, due to technology. So it's negotiable.

Functioning brain. Access to a library. Access to modern healthcare. Family and friends not too far away. A little bit of independence. Surprising how little one needs, when you think about it.

A satisfying life for seniors

I don't think there's much doubt that technology can help us live longer and healthier lives. If that isn't true, a lot of big companies are wasting an awful lot of money. The technology curve has certainly worked so far--adding about 3 years of life per decade to what we can expect, and improving the health of the aging on almost every metric we use.

But can technology help us be happier as we get older? Not much point in living to 100 if you're miserable the whole time. (Centenarian to journalist: "I don't drink, I don't smoke, and I don't fool around and I've lived to be 100!" Journalist to centenarian: "Why?")

The keys to being happy appear to be: Feeling loved, feeling connected and feeling useful. It seems obvious that those inventing new technology tools are trying to help us stay connected--I honestly think a winning slogan for the next decade will be "Just disconnect!" as we're experiencing a bit of an overload in ways of staying in touch... And as Silver Survers multiply in numbers, email, cellphones and other devices will keep us ever-more connected (Can there be too much of a good thing?)

Those same tools can help us stay productive. We can become bloggers, like Ted and myself, we can be more effective citizens and neighbors, we can continue to work or pursue a hobby in greater depth, even continue learning, which is another great way of staying alive.

But can technology help us be happy? If so, I don't think it will be the same technologies we're looking at now. 

I thing one major source of unhappiness for seniors is isolation. We want independent living, don't get me wrong. But we also (I think) need human, face-to-face contact, a touch on the hand, the sound of another person around us. You just don't get that from a TV screen or computer monitor. 

So I think the technology we will have to invest in for a happier life as seniors will be bigger and more material. I think living spaces will need to be redesigned to meet our emotional needs as well as our physical needs. It's great to have ramps and walk-in bathtubs. It will be greater when our living centers also have well-designed common areas and spaces that work to bring people together when they want. Not to mention giving them something to do. Not to mention funneling them back into the community rather than walling them off from it.

There is legislation in many cities that prohibits adult entertainment within a certain proximity to schools. I think equivalent legislation could mandate the proximity of senior centers to schools just as effectively.

The technology that will help us stay a part of this world will not lie in new materials, better wiring or even vastly improved architecture. It will be better community planning, residential codes and traffic design. These areas are changing rapidly due to computer technology. But they've all got a ways to go. 

So if you want to help build a more satisfying life for yourself, hie thee down to City Hall and get involved with zoning and planning issues. Your kids don't have the time. Make these managers buckle down and build a community. 

And get a little cranky--it's expected. In fact, it's part of your job description.

How technology can help with Alzheimer's disease

While we're waiting for Part 2 of Ted's story, let's see what technology has to offer regarding Alzheimer's Disease.

The first technology patent for dealing with Alzheimer's was filed in 1976, and it has been followed by more than 67,000 patents since then. A lot of time and attention is paid to this issue. More general research into the nature of prions (when prions malfunction it is thought to be either a cause or an effect of Alzheimer's) is also intense and ongoing. But it hasn't resulted in a cure, a vaccine or even too much in the way of effective therapies. One could come forward any moment, and I hope it does.

But existing technology can help both patients and caregivers:

"Innovative uses of high technology offer many exciting possibilities for earlier diagnosis, better care and improved quality of life for people with Alzheimer's and their family members", stated Maria Carrillo, PhD, director of Medical and Scientific Relations at the Alzheimer's Association. "We now are discovering ways to use available advanced technologies to save health care costs, ease caregiver stress, and help people with Alzheimer's live better, safer, more fulfilling lives."

"Most of the methods for diagnosis, treatment and care for Alzheimer's are based on techniques developed decades ago", stated Jeffrey Kaye, MD, chair of the Alzheimer's Association's Working Group on Technology (WGT). "We need to facilitate technology-based research and application in Alzheimer's, and bring the field up to date."

According to Dr. Kaye, who is professor of neurology and biomedical engineering at the Oregon Health and Science University (OHSU) School of Medicine in Portland, and director of the Oregon Center for Aging and Technology, a wide array of new technologies and methods for assessing and treating patients and helping families is emerging that take advantage of rapid developments in communications and monitoring technologies, such as biosensors and bodily diagnostics, activity sensors and behavioural diagnostics, displays, robotics and assistive devices.

Identifying memory and movement changes that are early signs of Alzheimer's may allow elders and their families to be pro-active about seeking diagnosis, initiating therapies and planning for the life changes that accompany the disease. Tamara Hayes, PhD, of OHSU, and colleagues focused their research on using unobtrusive technologies to monitor those changes in the home in a study called "A Novel Marker of Mild Cognitive Impairment" and funded by NIA/NIH.

Small motion sensors were used to continuously measure walking speed and overall activity in the home of seven healthy seniors and seven with mild cognitive impairment (MCI) for up to 60 consecutive weeks. The volunteers were not required to do anything except go about their daily business. Walking speed was estimated using sensors along a hall in each home.

The researchers found that the MCI participants had longer walking times than the healthy elderly group. Furthermore, the elders with MCI had more variability in their activity during the day, as compared to the healthy elders. These results are consistent with clinic-based studies of motor changes preceding dementia. However, unlike clinic-based studies in which the differences were identified using measures taken over many years, these differences were detectable in the home using unobtrusive assessment techniques after only four weeks of monitoring.

"Continuous assessment of key thinking, memory and movement skills provides an opportunity to identify early signs of impairment", Dr. Hayes stated. "This study provides the first indication of how continuous, unobtrusive monitoring may be used to assess clinically relevant motor behaviours that relate to cognitive change."

Maintaining cognitive performance is a key factor influencing elders' ability to live independently with a high quality of life. Taking advantage of growing use of computers by seniors, Holly Jimison, PhD, and colleagues from OHSU and Spry Learning Company have developed computer games that can monitor cognitive performance on a routine basis at home.

Glenn Smith, PhD, and colleagues from the Mayo Clinic-Rochester, Minnesota, observed that 30 to 40 percent of people with Alzheimer's are living alone at the time they are diagnosed. Dementia can impair a person's ability to properly take their medicine - known as "compliance" - and this issue regularly plays an important part in the decision to move patients to a residential care setting.

Dr. Smith's team investigated whether interactive video monitoring for persons with mild dementia who live alone, or who spend a significant amount of their day alone, could improve their ability to take medicine correctly and improve their mood in a study called "Telehealth Home Monitoring of Solitary Persons with Mild Dementia", funded by the Mayo Foundation, Minnesota Department of Human Services.

The researchers used two-way interactive video technology to provide virtual supervision of 12 patients with mild dementia. They contacted the participants each time they were to take their medications or have their meals. During the two-year study, more than 4000 contacts were made. Once per month, an independent evaluator went into the home to assess whether the patient had taken the appropriate amount of medication. The scientists compared their findings with 12 other participants who received no video monitoring.

In the video-monitored group, people took their medication correctly 81 percent of the time compared to 66 percent in the control group. Comparison of compliance from beginning of monitoring to the end of the programme revealed that video-monitored participants' compliance remained stable while unmonitored patients' compliance fell 12 percentage points, which is consistent with expectations for people with dementia.

Roundup of interesting technology developments Part 2

We send you off to your weekend fun with more information about technology for seniors:

"GeckoSystems Intl. Corp.  announced today that they expect pent-up demand for their cost effective, home based eldercare personal robots. This new type of modern eldercare will postpone, if not eliminate, many elderly persons from having to endure the loneliness and loss of independence when living in nursing homes, and other assisted living facilities. Their families can now better manage the difficult decisions regarding independence they allow their now dependent aged parent while minimizing the concern and risk the adult caregiving child is willing to assume to enable an acceptable level of independence for their now dependent parent. GeckoSystems is a dynamic leader in the emerging Mobile Service Robot industry revolutionizing their development and usage with "Mobile Robot Solutions for Safety, Security and Service™."

"For the last several years, the US eldercare crisis is commonly portrayed as 'not happening' until the baby boomers reach the age of great reliance on their children and younger family members. The truth of the matter, since the US is the only country in the top ten of the world's industrialized nations without national healthcare, is that we really don't have solid statistics for our true 'bottom line' annual US eldercare costs. Many middle class baby boomers are presently suffering significant financial, time and emotional pressures attempting to care for their surviving WWII and Korean War era parents," observed Martin Spencer, President/CEO, GeckoSystems.

Not coincidentally, Gecko estimates the market for multi-tasking eldercare robots to reach $80 billion by 2013... I love the profit motive and hope they get rich helping seniors...

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And maybe tekkies will turn all seniors into die-hard video gamers: "WHEN Pip Carter and the team at St Andrew’s in Ballina developed a new interactive technology at the nursing home, they were only thinking of the benefits if would give to residents who aren’t able to leave their beds.

But the system, in which a video camera and other technology similar including an Xbox is used to relay events like church services and activites like bingo – with the residents being also able to join in by phone – has gained interest internationally."

"“Imagine the feeling of being a resident bed-bound and not being able to become involved in activities being carried out throughout the facility or being able to be part of church services which meet your spiritual needs in the later years of your life,” he wrote in the abstract submitted to the conference organisers.

“Advanced technology in care and assisted living will address many issues of isolation and inclusiveness and feeling part of a community again.”

He said technology in the past 50 years has become a fundamental part of our lifestyle.

“It is essential that organisations grow and develop new technologies for the very purpose of allowing people to once again feel alive and make life worth living,” he wrote.

He said he believed St Andrew’s is the first home of its size to use this kind of technology, which had a set-up cost of about $4000."

Roundup of interesting technology developments

One of the drugs used in suppressing immune reactions associated with transplants has proven to have another use--extending lifespan in mice. As noted in Discover,  "Laboratory mice who were given an immunosuppresant drug called rapamycin lived between 9 and 14 percent longer than mice who didn’t take the drug, according to a study in Nature. The drug, which was developed from bacteria found in Easter Island’s dirt, is the first pharmacological agent shown to enhance longevity in a mammal [Technology Review]. Even more remarkable, the mice weren’t given the drug until late middle age, showing rapamycin had effects even when taken later in life."

This contest in June passed unnoticed--entrepreneurs competed for a $10,000 prize for new products and services to help seniors: "The aging "have unmet needs that might be passed over by inventors," said Ruley Peh co-founder of the company that is based at Stanford University. "We're bringing technology to places and people where we think we can make a difference."

"Startups that target the aging are getting better, said Mary Furlong, a consultant and Santa Clara University business professor who started the competition - called the Silicon Valley Boomer Venture Summit - five years ago. Data about aging are improving, too.

Yet most businesses are still slow to the market, preferring instead to chase youth even though many Boomers try to defy their inevitable physical deterioration by living active lives."

"Other finalists for this year's $10,000 prize included companies that have improved hearing aids, chemotherapy, abdominal surgery and treatment for infections.

There were also five finalists for a $1,000 elevator-pitch prize, several revolving around technology to help seniors stay in touch with family, cut costs or find the best health care when they retire to foreign countries.

The winner, Live at Home Longer, has technology to help seniors stay independent."

How could technology help senior theater?

Using what is commonly called Web 2.0 tools (which are free or very low cost ways for non-professionals to communicate with each other), what could we build to help further the senior theater movement Ted wrote about directly below?

A weblog such as this one could keep tabs on what's going on.

New video cameras could record productions and even rehearsals, and post them on the Internet, using a site such as YouTube.

The Internet makes searching for government grants much easier--but where it might help even more is by sharing the results of those searches, again using a weblog.

A 'marketplace' where venues and theater groups could get in touch with each other is another natural for the Internet.

And of course, email lists can be used to remind prospective audience members of what's going on.

Ted and I could be persuaded to help...

A prime time for seniors

If you or someone you love is over the age of 74, there is enough going on to keep you all very busy. New technology is rolling out and being tried. New clinical trials are occurring frequently to deal with a variety of serious diseases. Governments the world over are trying to find new wasy of accommodating the growing number of seniors.

Seniors (and their caretakers) who are pragmatic, pay attention to details and who understand that in times of great change there are winners and losers, will make sure their needs are met.

Seniors (and their caretakers) who believe the system will come to them in an inclusive movement to help them are liable to be disappointed--and disadvantaged. That strategy was probably correct--and more moral--during the past 50 years. But now it is time to claim what is yours by right.

In most cases, this will not mean you are taking something away from another deserving senior. It will mean you are getting what otherwise will not be used at all.

This difference in attitude may be more important that any of the technology toys I keep throwing in front of you. So get out there and get what you need.