The magazine of the Melbourne PC User Group
Wired From Head To Toe
Monika Merkes
 monika@melbpc.org.au

Picture this: A residential care complex for older people wired from top to bottom to monitor the residents' health and well-being. Each bed has sensors that can detect a resident's weight as well as how much a sleeping person tosses and turns. Infrared motion sensors switch lights on and off and detect whether a person has left a bed and not returned. Electric panels are in the wall behind the toilets for the future installation of toilet sensors that will detect a person's pulse and body temperature and whether he or she is dehydrated. Residents wear tracking badges that also serve as electronic room keys and help buttons. A high-bandwidth fibre optic system conveys the information to a central database which is monitored by staff members. Residents' rooms have touch-screen computer stations for email and Internet access. Residents can view and track their own medical information and make it available on the Web for family members. The computer also reminds people to take their medication.
 
A future scenario? No, such a service is available in Milwaukie, Oregon in the U.S. The New York Times reported that this wired retirement home opened in October 2000 and has been slow to fill up, which may have something to do with the cost: $3,250 a month for a single person and $3,650 for a couple. 

Technology for "smart" homes is currently being developed that could be installed to monitor the occupants' health or provide memory aids. These smart homes could help older people to avoid or postpone institutional care. The range of devices includes:

  • Sensors that detect sound or vibration and monitor and analyse the pace at which someone climbs the stairs or moves between rooms. If a pattern changes, the system could alert friends or family.
  • Memory aids that prompt a person to take medication or finish a task.
  • Small radio-frequency tags worn by people in the house that track movement. The signals are picked up by antennas hidden, for example, behind the living room chair. The monitoring system can then provide a digital portrait of the occupant's level of activity to relatives.
  • Wearable computers, contained in special lightweight vests, that use an infrared system of tags and detectors to identify places, people and objects, and to provide medication reminders. The information can be displayed on a tiny monitor that is part of a pair of eyeglasses.
  • Sensor arrays worn by people that are capable of measuring factors such as temperature, respiration, electrocardiogram and skin blood flow.
These monitoring systems raise issues of privacy. Do people want to trade some privacy for an increased sense of security? There are also concerns about how much this new technology will cost, and how easy it will be to use. It is unclear whose responsibility it should be to collect and analyse the data, and take the appropriate action if help is needed: the family or a health service provider such as the person's GP. Further, if people's data are stored in a central system and accessed by multiple providers, informed consent has to be obtained.
 
A report from the UK found that 15% of home visits by a medical practitioner and 14-16% of home nursing visits could be replaced with telecare. A U.S. study suggested that 46% of all activities carried out by on-site nursing could be replaced by telenursing. Telecare is expected to be particularly cost-effective for chronic conditions.
 
Will there still be human interaction? Or will older people of the future be limited to contact with robots like PaPeRo (short for partner-type personal robot)? PaPeRo has been developed by NEC and is capable of recognising 650 phrases, speaking more than 3,000 and able to recognise people's faces. This robot can also provide access to the Internet, remotely operate TVs and other electrical appliances, play video messages and interact with its owner by dancing or playing games. It is 38.5 cm high, weighs five kilos, and has a battery lasting up to three hours. NEC anticipates PaPeRo to support older people and provide emergency communications and home security. 

Sources:

Adams D (2001) Personal robots - coming soon to a home near you? The Age, 23 March.
Berck J (2001) The wired retirement home. New York Times, 5 April.
Celler BG, Lovell NH and Chan DKY (1999) The potential impact of home telecare on clinical practice. Medical Journal of Australia, 171: 518-521.
Eisenberg A (2001) A 'smart' home to avoid the nursing home. New York Times, 5 April.

Reprinted from the June 2001 issue of PC Update, the magazine of Melbourne PC User Group, Australia

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