Home Technology Trends for the Future:
Pro-Active Monitoring and Prevention
Dan Stone
dstone@assuredindependence.com / (425) 417-5373
Opening Thoughts- Improve Aging in Place
WE ALL KNOW THAT

A huge percentage of the US population is getting old and will need long term help

Falling down is the biggest threat to this population

The healthcare system cannot sustain the current care delivery method into the future

We need to help our healthcare and home care workers become more efficient, lower costs and
prevent unnecessary hospitalizations
Opening Thoughts- Improve Aging In Place
THE TREND
 In the next 20 years, Americans age 65 and older will
represent 20% of the U.S. population
(Genworth)
 If you are 65 or older you have a 70% chance of
needing long term care at some point
(Genworth)
Opening Thoughts- Improve Aging In Place
THE RISK
 Fall risk is the number one threat to seniors “Aging In Place” (CDC)
 1 in 3 seniors over 65 fall every year (Hornbrook et al. 1994; Hausdorf 2001)
 2.2 million nonfatal fall injuries among older adults were treated
in ER’s (National Conference of States Legislatures)
 When injured, the average time it takes to be found is 15 hours (Active
Care)
 1 in 5 Medicare patients were readmitted within a month of
discharge (USA Today)
 Labor is by far the largest category of expense in health care (New
England Journal of Medicine)
 Unlike virtually all other sectors of the U.S. economy, health care
has experienced no gains over the past 20 years in labor
productivity (Robert Kocher, M.D., and Nikhil R. Sahni, B.S, New England Journal of Medicine)
Opening Thoughts- Improve Aging In Place
THE COST
 The average cost for a Home Health Aide/CCNA $168 per day &
LPN services is $432 per day (Genworth)
 Falls among older adults cost the U.S. health care system over
$28.2 billion in 2010 (Northwestern Mutual)
 Average hospital stay is 8 days / $9,985 (Active Care)
 The current model of healthcare delivery is simply not sustainable
(US Social Security Advisory Board)
 Noncompliance costs up to $250 - $300 billion / yr in ER
readmissions
(Fierce Healthcare)
.
How Do We?
Improve care for seniors with chronic conditions at home
Improve safety of seniors with chronic conditions at home
Maximize dollars spent for care at home
 Proactively monitor activities (Activates of Daily Living) when a patient is
alone
Identify when ADL’s are not being achieved
Identify when more care is needed
Improve response times to emergencies
In Home Monitoring Technologies Can Help
Identify activity patterns within a home
Detect changes in activity patterns when a senior is home alone
Alerts caregivers of abnormal activity when a senior is home alone
Helps caregivers identify problems before emergencies occur
Based on The Spectrum of ADL’s
Basic ADL’s
Instrumental ADL’s
Feeding
Bathing
Toileting
Transferring
Dressing
Continence
Housework
Shopping – Groceries/Clothing
Transportation
Telephone Use or Other Communication
Taking Medications
Meal Preparation & Cleanup
Manage Finances
Monitoring to Promote Independence and Safety?
General Activity
Specific Activity
Exact Activity
General Household Activity
Medication Reminders
Sleeping and Wake Up Patterns
Digital Photo Frame
Email and Text Messaging
Weight
Blood Pressure & Glucose
Two Way Emergency Voice (speaker phone)
Movement (or lack of) Throughout Home
Kitchen Usage
Medication Retrieval
Frequency of Bathroom Visits
Failure to Return From Bathroom Visits
Changes in Specific Patterns
Home Temperature
Stove and Oven Sensing
Wandering Outside
Door and Window Openings
Breathing & Respiration
Heart Rate
Pressure Sore Prevention
Proven Results
HUNTER NURSING - GE / INTEL STUDY (Australia, 2010)
28 % reduction in hospitalizations for seniors at home with chronic conditions
38 % reduction of time in hospital
Nurse efficiency went from 8.8 patients to 50 patients
Cost of around $1000 per person
KORNOWSKI, ZEELI, AVERBUCH & FINKELSTEIN (Israel, 1995)
Total hospitalization rate dropped from 3.2 admissions / yr to 1.2 admissions / yr
Total length of stay decreased from 26 days per year to 6 days per year
Cardiovascular admissions declined from 2.9 per yr to 0.8 admissions per yr
Cardiovascular length of stay decreased from 23 days per year to 4 days per yr
Significant functional status improvement in elderly patients with CHF
OTHER STUDIES THAT LOOK AT HOME MONITORING TECHNOLOGIES
Humana CHF Study
Leading Age CAST Study
How The Systems Work
Sensors and devices placed throughout house
Sensors monitor motion, pressure & temp
Devices monitor BP, glucose, weight
Monitor activities associated with ADL’s
Can be changed as needs change
Wireless- No Construction Required
How The Systems Work
Sensors passively monitor activity
Devices measure & log condition
Information sent to secure web server
How The Systems Work
Caregivers are granted access to server
Two methods of retrieving information
View activity patterns on web dashboard
Email & text alerts for abnormal activity
Real time and historical activity patterns
Any internet device
Automatic alerts are customizable
Alerts can be adjusted according to need
Sample Configuration – Lower Acuity
Stove / Sink
Sensor
Eating / Meal Preparation
Contact sensor on pantry, microwave, fridge
Cabinet
Sensor
Occupancy sensor in kitchen
Thermal sensors on stove
Humidity sensor above sink
BP & Glucose device in living space
What does this mean?
Activities associated with meal preparation
Results of proper (or improper) meal prep
Fridge
Microwave
Sensor
Weight
BP/Glucose
Sample Configuration- Higher Acuity
Chair / Bed
Sensor
Mobility / Transfers/ Wandering
Occupancy sensors in each room
Pressure sensors on furniture
Doorway sensors
What does this mean?
Activities associated with mobility
Wandering
Lack of movement / Potential fall
Decreased mobility
Activities associated with toileting
Door
Sensor
Occupancy
Sensor
Monthly Cost Comparison
In Home Monitoring-
In Home Care-
$4,719*
Bathing Assistance
Toileting Assistance
Mobility Assistance
Medication Reminders
Light Housekeeping
Laundry
Meal Preparation
Shopping / Errands
Grooming / Hygiene Assistance
Companionship
* Based on Genworth Cost of Care 2011 (Mass)
$85 - $425
Panic Button
Medication Reminders
Two Way Emergency Voice
Email and Text Messaging
General Household Activity Monitoring
Sleeping and Wake Up Pattern Monitoring
Weight, Blood Pressure & Glucose Monitor
Movement (or lack of) Throughout Home
Kitchen Usage Monitoring
Medication Retrieval Monitoring
Frequency of Bathroom Visits Monitoring
Changes in Specific Patterns
Home Temperature Monitoring
Stove and Oven Sensing Monitoring
Wandering Outside Monitoring
Door and Window Opening Monitoring
PERS-
$45 - $65
Panic Button
Two Way Emergency Voice
Med MindersMedication Reminder
Brings balance to home care
Maximize home care dollars
Gives peace of mind to family
Increase independence
No change in daily living
Provides 24/7 peace of mind
Proactively ID’s problems
$35 - $45
Reactive to problems
Provides less value to home care
No impact hours for care
Does not increase independence
Maximize Home Care Dollars
Home Health Aid
$ 4,719*
(44 hrs / week)
Bathing Assistance
Toileting Assistance
Mobility Assistance
Medication Reminders
Light Housekeeping
Laundry
Meal Preparation
Shopping / Errands
Grooming / Hygiene Assistance
Companionship
Reduce home care hours slightly
Increase monitoring
Overall home care cost reduction
Increase independence and safety for senior
Provide 24/7 peace of mind for family
Maximize home care dollars
Bathing Assistance
Toileting Assistance
Mobility Assistance
Medication Reminders
Light Housekeeping
Laundry
Meal Preparation
Shopping / Errands
Grooming / Hygiene Assistance
Companionship
Panic Button
Medication Reminders
Two Way Emergency Voice
Email and Text Messaging
General Household Activity Monitoring
Sleeping and Wake Up Pattern Monitoring
Digital Photo Frame
Weight Monitoring
Blood Pressure & Glucose Monitoring
Movement (or lack of) Throughout Home
Kitchen Usage Monitoring
Medication Retrieval Monitoring
Frequency of Bathroom Visits Monitoring
Changes in Specific Patterns
Door and Window Opening Monitoring
Home Health Aid + Monitoring
$ 3,753
$ 250
$ 4,003
(35 hrs / week)
(monitoring)
(15% cost reduction)
* Based on Genworth Cost of Care 2011 (Mass)
Who will this help & What are the challenges?
END USER
Individual who is at risk of harm to self or others
An individual who wants to live independently
An individual who is adverse to interacting with technology
An individual who is not interested in changing daily living routines yet
needs assistance
An individual who will have an increased quality of life by leveraging these
products
Individual who understand the products and is willing to allow caregivers
to use them
Individual who has another person acting on their behalf & understand
the products
Home Care Partnership Benefits
LIVE DEMONSTRATION