Radio technology gives independence to elderly

Wouldn't it be great if there was a way that elderly people with dementia or long-term conditions could maintain their independence and continue living in their home without someone looking over their shoulder 24 hours a day?

Technology developed at the Bath Institute of Medical Engineering (BIME) in the School for Health at the University of Bath in Britain claims to have made this possible. It has been developed over several years in consultation with people with dementia and their carers.

The technology has made possible an autonomous home that can help the resident live there independently in a way that wasn't possible before.

The system uses sensors that can wirelessly 'talk' to devices, such as the cooker, taps and light switches, in response to the behaviour of the resident. By monitoring movement within the home, the system can respond to many different situations without having to contact care staff, often just using simple voice prompts that can be recorded by family members.

Autonomous homes require three extra features:

• Sensors that can monitor the resident's behaviour and interaction with their environment;
• Support technologies such as taps that turn themselves off and voice prompters that can all imitate the support provided by carers;
• A communication system, known as a 'bus', to link the sensors with the support equipment, and to include the inevitable computing ability.

"This kind of technology has been around for quite some time for large buildings such as airports and big hotels to maintain autonomous control of their environments. We are adapting it to provide support for our users, and developing specialist support equipment that can automatically be brought into play," Prof Roger Orpwood, director of BIME said.

"One of the beauties of this technology is its inherent flexibility."

System installation and configuration

The installation of the system is configured according to the needs of the user. After it is activated it can be adjusted to suit changing needs and the carer's improved understanding of their needs from all the sensor data. When there is a new resident, the configurations are modified and the setting up and adapting is repeated.

Examples of how the system works include:

• If the occupants are detected opening the front door at an inappropriate time, they would be given a prompt to let them know the time and encourage them to go back to bed. If they continued to go out, care staff would be alerted.
• If the occupants got out of bed at night, the bedroom lights would gently fade up.
• If the occupants got back into bed and left the lights on, the lights would fade off after a couple of minutes. Residents could turn the lights on and off themselves at any point.
• If the occupants moved around the house when it was dark, appropriate room lights would be turned on.
• If taps were accidentally left on they would be turned off.
• If the cooker was left on occupants would be prompted to turn it off. This would be done twice but if they didn't respond, or if smoke was detected near the cooker, it would be turned off and care staff alerted.
• While the cooker hot plates were still hot, even if the cooker had been turned off, a small warning sign would be illuminated saying 'Cooker Hot'.

One advantage of the system is that it provides a very quick response and gives residents a greater feeling of control and independence because it doesn't rely on people coming in from outside to resolve problems. This means that outside help is only called in for real emergencies.

"The really smart thing about the wireless technology we have used in this flat is that we can take the elements that clients find particularly useful in the smart home and install them in their own home," Orpwood said.

"The whole installation is quite unique because it is designed to empower the resident rather than rely on outside help to deal with problems. The idea is that residents will stay in the smart home for a short period of around three months, before returning to their own home."

"Smart technology doesn't just monitor people to make sure they stay safe, it also has the potential to preserve the dignity and independence of people with dementia who want to continue living in their own homes," Councillor John Kiely, Executive Member for Housing and Adult Community Care at Bristol City Council, added.

How much will it cost?

"This is a difficult question to answer because it requires putting monetary values on things like quality of life and independence. However, comparing the cost of the technologies we are exploring to other means of providing care, then there are big savings to be made," Orpwood said.

"Our system as a prototype cost us about £9000 (AU$23,000) to install. This is quite expensive but would come down considerably if the system was rolled out commercially. It was the first time the installer had done this so was time consuming and expensive. Future costs should come down to at least half this."

Orpwood notes that the costs were for full-blown installations, and many users would probably need just a subset of the equipment that was installed, depending on their abilities.

"The interesting comparison though is with the cost of nursing homes. In Britain, these are around the £25,000 (AU$62,000) per year mark. So if someone can be enabled to stay in their own home for around an extra four months through using the technology, even our expensive prototype installation has paid for itself," Orpwood said.

According to Orpwood, the biggest barrier to the technology being rolled out on a much larger scale is the way that current care practices can be adapted to include it. There is a lot of infrastructure needed to make it work; for example, appropriate assessments from knowledgeable OTs, technical support networks, and care plans that can take on board the new technology and can be modified according to how users get on.

"To persuade authorities to embrace all these changes requires good evidence that the technology can make a real difference, not just to costs but importantly to people's wellbeing and independence. Providing this evidence is really our task at the moment," Orpwood said.

The flat has been set up as a two-year pilot to assess how the technology helps give people more independence and control, reducing the risk of users being readmitted to hospital or going into long-term care.