Summary The United States
is facing a major challenge, as an aging population threatens to
strain our nation’s healthcare system to the breaking point. Already
we're feeling the strain, as Congress struggles to provide
prescription drug benefits for today’s 34 million seniors. The cost
of caring for older adults will escalate sharply in less than a
decade, when 76 million Baby Boomers begin to retire. Unless we
develop a more effective and less costly model of delivering
healthcare services to seniors, the U.S. may soon find itself in the
midst of a public health crisis that could threaten our nation’s
economic well-being.
How can we deliver quality care to a
rapidly growing population of older adults - historically the most
expensive demographic to treat - while reducing the nation's
healthcare costs? We believe the solution must include three
components: an emphasis on prevention rather than treatment; a shift
in the focus of care from expensive clinical settings to the home;
and a shift of some responsibility for care from formal providers to
individuals and their family and friends. This solution can be
enabled by a range of proactive computing technologies in the
digital home. These digital home technologies have the potential to
improve public health and significantly lower the U.S. healthcare
bill while enabling seniors to "age in place," maintaining their
independence and deferring more costly institutional care as long as
possible.
This article highlights Intel’s role in advancing
the digital home technologies and our efforts to help create an
ecosystem of companies, universities and government agencies to
address the challenge of providing quality, affordable healthcare
for older adults. The article also recommends actions that Congress
can take to prepare for the coming age wave.
The U.S. has the potential to improve
the quality of care for its aging population while saving billions
of dollars annually in healthcare costs, through home-based
technologies that focus on prevention and early detection of health
problems; improved compliance with care plans; monitoring of older
adults in their homes, and emergency response in the event of a fall
or other health crisis. Together, these technologies could enable
seniors to age in place in their home environment¹, maintain their
independence, and defer more costly care in emergency rooms and
institutional settings for as long as possible. Intel is investing
in the digital home, proactive computing and other enabling
technologies to help translate this vision into reality.
Intel has made a substantial investment
in R&D to advance the concept of the digital home, in which
computers and consumer electronic (CE) devices throughout the home
are linked together in a wireless network. Once the digital home
infrastructure is in place, any computer or CE device could also be
used to deliver health and wellness applications. Older adults will
be able to access these applications through whatever interfaces are
most familiar to them, from phones to PCs to televisions; they will
not have to learn new technology. The goal is to have a variety of
interfaces distributed throughout the home, within easy reach of the
person needing assistance.
Intel is exploring a variety of
proactive computing applications that could assist the aging in the
digital home environment. As the name suggests, proactive computing
is designed to anticipate people’s needs and take action to meet the
needs on their behalf. The input for proactive computing
applications is real-world data gathered by wireless sensors. Intel
Research Berkeley is developing tiny sensors or "motes" which can be
used to gather both behavioral and biological data for customized
proactive health applications.
The Continuum of
Care
With each
successive move along the continuum of care²
(below)—from living at home through residing in a
24-hour care facility - the cost of caring for older
adults escalates and their quality of life sometimes
declines. Digital home technologies for aging in place
can play a key role in enabling seniors to remain at a
given stage in the continuum of care for as long as
possible before moving to the next level.
Intel’s
Proactive Health lab employs both social scientists who study the
needs of seniors dealing with cognitive decline, cancer, and
cardiovascular disease, and engineers who build home health
technology prototypes to test with real families. Their current
research focuses on helping people with Mild Cognitive Impairment
(MCI) to remember names, faces, and past conversations with their
loved ones. Through connected home technologies - a telephone with a
rich visual display, a PC, and a sensor network that looks for
sudden declines in social contact - the goal is to help people with
MCI to stay socially engaged for as long as possible. The
researchers are also exploring future versions of such "social
systems" which could detect early-stage cognitive decline and
perhaps reduce the estimated $100 billion the U.S. spends annually
to treat illness related to social isolation among seniors.
Researchers at Intel Research Seattle and the University of
Washington have built a prototype that can infer a person's
activities of daily living (ADLs). By placing sensor tags on
everyday objects such as a toothbrush or coffee cup and using tag
readers to track the movement of tags, we can determine, for
example, whether a person has brushed his teeth or taken medication.
The long-range goal is to develop computerized assistants to help
seniors and their caregivers manage ADLs so that seniors'
independence is compromised as little as possible.
Through
the Intel Research Council, which funds university research
worldwide, Intel is supporting dozens of researchers who are testing
new home health and aging-in-place technologies. For example, one
prototype system analyzes sensor data from drawers, medicine
cabinets, pill bottles - wherever medications are stored - and
delivers timely reminders via cell phone, TV, or whatever device is
preferred or nearby. Two other projects: wearable wireless sensor
networks that could alert caregivers to a senior's fall, and sensors
in footwear which could monitor a person's gait for irregularity and
prevent a crippling fall (and a costly hospital stay or premature
move to a care facility). Such proactive intelligent systems could
reduce U.S. healthcare costs by billions of dollars annually.
Sensor networks are powerful new tools that can assist with
caregiving across the continuum of care. They could be used to
monitor the safety of an older adult in the home, allowing a family
caregiver to take a nap or a break and ultimately, prevent burnout.
The digital home network could be accessed through the Internet,
enabling adult children to check in remotely to assess the
well-being of an aging parent far away. Wireless sensors and mobile
computing devices in skilled nursing facilities could automatically
capture diagnostic and behavioral data, thus freeing an
over-burdened nursing staff to spend more quality time with
residents, reducing data entry errors, and providing real-time
feedback to facility managers about the health of their residents,
staff, and their overall facility.
Successfully preparing for the coming
age wave is a major challenge that requires a collective effort.
Intel is helping to create an ecosystem of companies, universities
and government agencies to address the challenge. Intel actively
participates in the Digital Home Working Group and provides
resources for developing the digital home solutions through the
Intel Developer Network. In collaboration with the American
Association of Homes and Services for the Aging (AAHSA), Intel
helped to launch the Center for Aging Services Technologies (CAST),
to drive awareness and advance technologies for aging services. We
also joined the Alzheimer’s Association in the ETAC (Everyday
Technologies for Alzheimer's Care) consortium, which is funding
university grants to research home health technology for older
adults experiencing cognitive decline, and their caregivers.
A variety of
technologies in the digital home will enable older
adults to age in place, improving the quality of their
lives and reducing healthcare costs by deferring
expensive institutional care. Existing telemedicine
technologies can access data from the digital home
network, enabling virtual exams in the home. Proactive
computing technologies under research at Intel and
elsewhere will reduce costs further by enabling the
aging to be proactive about caring for themselves. A
network of sensors throughout the digital home will
track and monitor health status and activities of older
adults, providing input for proactive applications that
will offer a variety of assistance, from reminders to
take medications to help in completing cooking tasks and
accessing social support. Seniors will access the
network using a variety of familiar interfaces, such as
telephones and televisions; they will not need to learn
new technology to receive assistance. Such proactive
systems will also enable adult children to assess the
health and well-being of their aging parents remotely
through private, secure Internet connections and will
provide on-site caregivers with the social support they
need to avoid burnout—a common problem among caregivers
of older adults.
The participation of the federal
government is essential if we as a nation are to prepare effectively
to meet the needs of an aging society. Intel urges government
leaders to establish a special commission to focus the spotlight on
aging services and illuminate how technology can help the nation
provide for its graying population.
The age wave will place
a major burden on our economy. Unless we are prepared, workforce
productivity could decline sharply within a decade as a growing
number of employees continually miss work to deal with eldercare
emergencies. In addition, Western Europe and portions of Asia are
already innovating new healthcare paradigms and usage models.
Congress must address the liability concerns and reimbursement
issues that are inhibiting American innovation in this arena.
Without the commitment of Congress, U.S.-based companies could be
left behind in what will become one of the largest technology
markets to emerge over the next 30 years.
Digital home technologies can play a
key role in helping to meet the challenge of caring for an aging
population. The digital home electronics that will be part of
people’s everyday lives for other purposes, such as entertainment
and communication, can also be used to deliver health and wellness
applications, allowing older adults to age in place and reducing
U.S. healthcare costs, which have soared to more than $1.5 trillion
annually.
Intel is contributing to the development of the
digital home technologies for aging in place, through R&D
investments, funding of university research, participation in
organizations and consortia, and by catalyzing industry, university
and government players to join in a collective effort to meet the
challenge. The involvement of the federal government - through
funding research and breaking down obstacles to innovation - will be
essential to success. By being proactive today, we can avert a
public health crisis tomorrow.
For more information about
Intel's role in advancing the digital home technologies for an aging
society please visit the following sites:
¹For some
older adults, "home" may be an independent living apartment or
assisted care facility. The digital home concept can be implemented
in a variety of care environments. ²The American Association of Homes and Services for
the Aging de.nes "continuum of care" as a complete range of housing,
health care and supportive services for older adults. These include,
but are not limited to, senior housing, assisted living, skilled
nursing, and home and community- based services, such as home health
care, adult day services, transportation, meals, and other programs.
Few aging-services organizations provide every type of service, but
many retirement communities and other organized systems of care do
provide multiple levels of service for older adults and may be
called continuums of care.
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