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Using Tech Sensors in Homes of Seniors: A National Study

A seven million dollar, four-year study funded by the Department of Veterans and the National Institutes of Health is being executed to accumulate information about senior living behaviors at home. The goal of the study is to monitor and detect health changes in older adults allowing them to live safer and longer in their own homes. The meta-data gathered from the sensors is then distilled using algorithms and artificial intelligence to look for patterns and draw conclusions. This data analysis will enable researchers to observe the inter-relations of various activity patterns and predict the onset of new medical problems.

The study, known as Collaborative Aging Research Using Technology (CART), was developed by a team of gerontologists, clinicians, engineers, computer and data scientists, as well as end-users. Sensors are alert to the presence of the at-home senior, collect real-time data, are unobtrusive, and do not hinder daily life. The platform is open-ended, accommodating new data systems or devices that may be developed in the future. All study participants consent to the use of the data collected. The data is ultimately de-identified and stored on participating universities’ advanced computer centers and are available to the research community.

Sensors track mobility, such as movement between rooms and walking speed. Engagement in social behaviors like phone calls, emails, social media, and outings are monitored. Sleeping patterns and physiologic functions like BMI and pulse are also monitored, as are sleeping patterns. Changes in a senior’s activity norms, like computer use or driving habits, can be early signs of cognitive decline. Changes in their gait and movement may identify frailty issues. Real-time information provides a more objective measure of ongoing health than patient-based recall in a doctor’s office, trying to describe something that happened weeks ago. Lead researcher Dr. Jeffrey Kaye states, “The technologies that we install are designed to detect changes that are basic to people’s daily function and their ability to stay independent.” Dr. Kaye further comments, “With this more objective and much more frequent data, you can determine the true trajectory of change over a short amount of time with fewer people.”

Specifically, CART uses wall and ceiling sensors that can track the amount of time someone spends in a room as well as movement between those rooms and walking speed. Outside door sensors monitor the number of times a study participant leaves their home by tracking the doors openings and closings. A digital scale not only measures weight but body composition and heart rate. A digital pillbox measures adherence to medication regimes through tracking the opening and closing of the pillbox lid. Many participants are excited to get an upgrade to their old watch in the form of a digital wristband that measures daily activities, steps taken, and sleep patterns. Driving sensors installed in participants’ vehicles track how often and for how long the senior is driving. A sleep sensor is fitted underneath the participant’s mattress and can monitor when someone falls asleep as well as moments of restlessness, and time spent in light, deep and REM cycles of sleep. Computer use is audited via an installed software program following a participant’s logins, app usage, and time spent on the device. All of these sensors create an array of information to be studied by CART researchers without using overly intrusive cameras or keylogging.

The Wall Street Journal (WSJ) reports the technology for CART participant homes currently number 50, with a projected 250 homes to be outfitted. Participants include a group of low-income seniors near Portland, the second group in rural Oregon and Washington comprised of veterans, a mostly African-American Chicago based group, and finally a group in Miami who primarily speak Spanish. This study is being closely watched by a group known as Aging in Place Technology Watch. Founder and principal analyst Laurie Orlov feels a system like CART can present a better opportunity to manage patients sent home from the hospital but still require some form of medical and daily living monitoring. Because CART looks for behavioral change that is predictive of an adverse event, it is superior to other monitoring systems that reactively alert observers that someone has fallen.

CART’s mission is the creation of a national research infrastructure using new and evolving technologies as well as meta-data to study aging in place. Detecting subtle, but meaningful, changes in a diverse group of older adults’ shifts in daily living habits provides information to assess and aid healthy, independent aging. The cost of care projections for the growing US aging population is more than 1 trillion dollars by 2050. Medicare and Medicaid programs are the primary payers of health care for those Americans aged 65 or more. Creating safe and successful living scenarios for the elderly in non-institutional settings is one of the few ways to reduce spending while expanding services to a broader population through technology. A system like CART can potentially detect the onset of medical issues that require intervention by a medical professional or caregiver for those seniors opting to age at home.

We help seniors and their families create legal plans that cover long term care and how to pay for it. If you would like to talk about your particular situation, please don’t hesitate to reach out. Please contact our Ruston, LA office by calling us at (318) 255-1760 or schedule an appointment to discuss how we can help.

Ten Organizations Providing Resources for Independent Seniors

Tech-savvy baby boomers heavily comprise America’s aging population. By 2030 all boomers will have hit 65 years of age, accounting for 18 percent of the US population. This demographic is driving significant and lasting challenges as 10,000 baby boomers turn 65 every day. Aging in place is a significant trend of the boomer population as regulatory and policy changes create new incentives supporting the independent living movement. The coronavirus pandemic is also accelerating the desire for aging in place because of retirement communities and senior living facility restrictions and risks, particularly during the COVID-19 pandemic. If you are older and already living independently or are planning to do so, Aging In Place provides a list of ten resources that can help you do so safely and successfully.

The National Council on Aging (NCOA), founded in 1950, is an association whose stated mission is to “improve the lives of millions of older adults, especially those who are struggling” via their vision to help create “a just and carrying society in which each of us, as we age, lives with dignity, purpose, and security.” As a trusted organization and respected national leader, NCOA works directly with governments, businesses, and nonprofit organizations to provide community services and programs. When trying to identify senior programs that address healthy aging and financial services, NCOA is a great place to start.

The American Association of Retired Persons (AARP), founded in 1958, has over 38 million members and a stated mission “to empower people to choose how they live as they age. The nonprofit, nonpartisan organization focuses on helping people ages 50 or more. The website is full of topical information such as specific news and products geared to seniors, senior discounts, and healthy living. For lower-income seniors and near seniors, the AARP Foundation acts as an affiliated charity to help provide affordable housing, steady income, nutritious food, and social integration. A team of legal advocates, volunteers, and organizations works together to create effective solutions for struggling older adults.

For the provision and coordination of all the types of care a senior (55 or more) living at home might require, contact the Programs of All-Inclusive Care for the Elderly (National PACE® Association).  If an older adult needs rehabilitation, medical or personal care, medications, transportation, or social interaction, they can contact PACE via their website or call 800-MEDICARE; TTY 877-486-2048. Qualifying for PACE requires state certification that nursing home care is a requirement and live in a PACE service area. There are more than 230 PACE centers in 31 states.

The US Administration on Aging (AoA) provides a free national service known as Eldercare Locator. Together with the National Association of Area Agencies on Aging (n4a) initiative, you can receive help finding local resources for home repair and modification, transportation, caregiving services, even legal and financial support. You can contact Eldercare Locator via their website or by calling 800-677-1116. If you are a senior 60 years old or more, the network of more than 620 organizations providing services to n4a offers valuable information on a wide range of topics. The organizations can provide home-delivered or group meals and nutrition counseling, respite care and caregiver training, referrals to administrators in assistance programs, insurance counseling, coordination for shared, non-medical transportation, and family assistance to complete complex applications for programs like respite care, some veteran’s programs, and Medicaid.

The National Institute on Aging (NIA) is under the National Institute on Health (NIH). It conducts research on aging and the well being and health of older individuals. The NIA provides important information about the nature of aging and the aging process. It also provides data about diseases and conditions associated with getting older. The NIA also has a program known as Go4Life, a tool supplying seniors with at home beginning exercise and physical activity routines. Go4Life helps adults who are 50 or more to incorporate physical activity and exercise into their daily lives via videos, information, and tips. Another government program through the US Department of Health and Human Services (HHS) is Health Finder. This service provides links to self-help groups, health-related websites, support, and more.

Meals on Wheels, the well-known meal program, operates in nearly every American community through the more than 5,000 independently-run local programs. Community programs are needs and resource-based, but all provide seniors with healthy, nourishing meals delivered to their homes.

Senior veterans who opt to age in place and are enrolled in the VA health care system can use the Guide to Long Term Service and Supports program, which provides resources, information, and guidance about long-term care options. The website reviews the many home and community-based as well as residential care options available to aging veterans. Helpful tools to navigate the available programs can help veterans to age more healthily.

Finally, the National Directory of Home Modification and Repair Resources (homemods) is a useful website when looking for qualified local professionals and services that can modify or renovate your home. Adjustments can be minor such as grab bars, or more intensive, like providing better mobility access for wheelchairs, ensuring a safer and more suitable home environment. The list of providers is routinely updated; however, seniors must be wary of using good judgment and caution when employing these resource options.

Independent living for aging Americans should be an enjoyable, rewarding time of life. Aging in place is becoming particularly attractive to baby boomers who prefer the dignity and quality of life living at home while employing online resources (many of which are available in Spanish) to help them meet the needs of living safely, healthily, and happily.

If you have questions or would like to discuss your particular situation, please don’t hesitate to reach out. Please contact our Ruston, LA office by calling us at (318) 255-1760 or schedule an appointment to discuss how we can help.

An Increase in Elder Abuse During COVID-19

In both long-term care facilities and at home, the elderly population in America are facing increasing incidents of mistreatment and abuse as social isolation during the pandemic which creates more vulnerabilities. Stay-at-home guidelines isolate seniors from the systems that can protect them like medical providers, congregations, extended family, and senior centers. The high rate of coronavirus deaths for those Americans 70 and older increases fear and their dependency on those who might seek to take advantage of them. Sadly, most of these abusers are family members, such as an adult child or spouse, followed by caregivers or staff in a long-term care facility.

Four Common Types of Elder Abuse

The Center for Disease Control and Prevention (CDC) lists four common types of elder abuse: physical, sexual, emotional, psychological, and neglect and financial abuse. Many incidents of elder abuse, neglect, and exploitation are underreported, especially during social isolation. According to a PBS report, Paul Caccamise, the vice president for program at Lifespan, Rochester, NY, says that the stream of calls reporting abuse is lower than usual. Yet, elder abuse has not gone away during the pandemic. Many referrals of abuse to Lifespan come from home care agencies, physicians, or hospitals, reporting suspected signs of abuse. Now that many older Americans are avoiding interactions with doctors and hospitals, the monitoring function is no longer available. Similarly, for those elderly in long-term care facilities, family members are no longer allowed direct access to check on the welfare of their loved ones.

Elder Abuse Issues During Coronavirus

This situation is not exclusive to New York. Across the country, the number of reports of elder abuse is decreasing during the coronavirus pandemic. The Minnesota Elder Justice Center’s executive director Amanda Vickstrom understands that although the quantity of cases is down, the amount of help our elder Americans need is up. About the disparity in case reports versus senior needs, Vickstrom states, “It doesn’t tell me that suddenly we’ve reduced elder abuse. It tells me that people are unable to reach out for help.”

Other support groups for the elderly like the National Clearinghouse on Abuse in Later Life (NCALL) are seeing similar trends. NCALL founder Bonnie Brandl says, “Abusers are using the threat of the virus and the isolation to provide misinformation to people.” Isolated seniors can fall prey to threats of being visited by a caregiver who may have been exposed to the coronavirus or sent to a nursing home where COVID-19 death rates are disproportionately high.

Caregiver promises to keep a senior safe if they hand over checks or other assets during this pandemic is not uncommon as many Americans have lost their jobs or have reduced hours of income and are facing financially tough times. If the senior lives with an abuser, the situation can become desperate as abusers can threaten to hurt or manipulate the senior who, in isolation, has little confidence to seek outside help. The coronavirus pandemic, which already disproportionately impacts older people’s health, makes them more vulnerable to abandonment, neglect, financial, emotional, sexual, and physical abuse.

The increase of seniors’ dependency on their caretakers at home and staff in long-term care facilities can incentivize abusers to target these older adults. Many seniors are targeted as they have resources saved, consistent monthly incomes from investment sources, or Social Security benefits. Desperate for their health and safety, many seniors will turn over their money, hoping that it will be key to their survival. There are also thousands of reports of scam artists offering bogus or nonexistent free home test kits or fake cures, posing as counterfeit charities, or preying on other virus-related fears to gain personal information or money.

How to Help Elderly in Isolation

If you have a senior family member who is socially isolated due to COVID-19, it is crucial to stay engaged with them to prevent their mistreatment. There are programs available that help those who face isolation to stay connected. AARP has a program that provides weekly phone checks provided by vetted volunteers who can spot trouble signs. There are other nonprofits that check to see that seniors have proper resources during the pandemic such as food and medication. Volunteers will also address the emotional needs seniors have during isolation. For many seniors, it will be the only conversation they will have that day. Check with your community and see how you can best protect your senior during the social isolation and vulnerable times of the COVID-19 pandemic.

If you have questions or would like to discuss your particular situation with us, please don’t hesitate to reach out. Please contact our Ruston, LA office by calling us at (318) 255-1760 or schedule an appointment to discuss how we can help.

Understanding Veterans, Home Health Care, and Technology

In the quest to provide cost-effective, quality in-home care for veterans, the Department of Veterans Affairs (VA) has been surprising trailblazers. Although the agency has long been mired in controversies surrounding its programs, particularly arbitrary caregiver dismissals, the home health services sector of the VA has long been touted as an overall success story. As Thomas Edes, director of comprehensive geriatrics and palliative care programs for the VA puts it “We’re working in this environment of challenging budget constraints, and at the same time, we’re a very mission-driven organization. Put those together and what happens? That really pushes us to innovate.”

The VA Innovations

This innovation has seen home-based primary care for veterans quadruple since 2000, and all VA medical centers throughout the US now have a palliative care program as well. The VA Medical Foster Home program care has expanded from a pilot to a national program, recognized in at least 45 states and providing veterans housing as well as in-home care. These success stories are great news for veterans and a must for the Veterans Administration in part because the median age of a veteran is now 64 and the US aging veteran population is growing even faster than the senior civilian population.

It is not just the “new-comer” seniors straining the VA health care system. Nationwide the 85 plus population is on track to increase 70% from 2000 to 2020 according to the US Department of Health and Human Services. The overall unsustainability of the US health care system has forced the hand of the VA, and there is no more cost-effective way than through subsidized, at home family and community-centered health care and technology to meet veterans’ care needs.

The Official Blog of the U.S. Department of Veterans Affairs reports that Telehealth is revolutionizing veteran care and providing high-quality treatment for them. The VA Video on Demand is delivering convenient, accessible health care particularly to those 24 plus percent of veterans who live in rural and remote access locations. Telehealth is also important for those veterans who are disabled. Although a veteran might live in a city they might be unable to get themselves to a medical center for an appointment

Technology Trends for Veterans

Assisted living technologies for veterans include assistive mobility equipment – an ever-expanding category including wheelchairs, all-terrain vehicles, exoskeletons, and in-home ceiling track mobility systems. Each of these continue to be refined and specialized to meet the individual veteran’s needs. The Veterans Administration awards grants to develop technology to assist veterans and service members in modifying their homes. Adapted computer access and electronic aids to daily living and environment control units (personal assistants) provide customized interactive abilities for veterans.

Electronic cognitive devices help veterans who struggle with activities of daily living (ADL). These devices include personal digital assistants (PDAs), smartphones, pocket personal computers (pocket PCs) and other handheld devices, global positioning systems (GPS), reminder watches, pagers with reminder features, and digital voice recorders. The use of these devices helps a veteran stay on schedule with medications as well as stay connected with family, friends, and their medical monitoring community. Those veterans with Post Traumatic Stress Disorder (PTSD) are further helped with their ADLs when robots with artificial intelligence (AI) are introduced into their environment. These AI “tech bots” are capable of reading human facial expressions and can identify when a veteran is feeling particularly stressed, isolated, angry, or depressed. The robot can upload the information to the veteran’s caregivers thus alerting them to the need for human intervention. Wearable sensors can also alert a caregiver or medical professional when vital signs are outside of a normal, healthy range.

Disabled Veteran Opportunities

The VA will provide a payment to disabled veterans toward the purchase of a car or other transportation and additionally will pay for adaptive equipment, repair, reinstallation or replacement of necessary equipment due to disability. If a veteran has lost the use of at least one foot, hand, or has a permanent impairment to their vision or severe burn injuries or immobile joints that their limit mobility, the VA will help to fund the adaptation of the vehicle to make it fully operational to the veteran.

While the latest technology brings benefits to all seniors opting to age in place, the veteran community is especially helped. Many veterans would like the luxury of aging without combat or noncombat injury so inherent to military service. Some of the aging in place obstacles they must overcome are extreme, commensurate with the injuries (psychological and physical) they have endured. Navigating the benefits that are available to a senior veteran is complicated if you are not well versed in the process. Getting enrolled in the correct program and receiving benefits can also be a lengthy process, so it is best to seek help before wasting valuable time.

If you have questions or would like to discuss your particular situation, please don’t hesitate to contact our office by calling us at (318) 255-1760 and schedule an appointment.

 

The Top Trends for Senior Living

As the silver tsunami of baby boomers continues to enter the senior living and care organizations markets, the general response has been uncertainty as to how to meet changing and varied senior needs while maintaining profitability.  Health Dimensions Group (HDG ) has released its list for 2020 entitled “Top Trends in Aging Services: Preparing for Historic Changes.” Owners and operators of senior living facilities must become responsive and make changes that are swift and diverse.

New Senior Housing Projects

Actuaries used to define senior housing construction projections and schedules are based on population data that are five or more years out. These metrics attempt to address occupancy and growth challenges as senior living occupancy rates fluctuated between the 86 – 88 percent mark for 2019 according to new data from the National Investment Center for Seniors Housing & Care (NIC). The third quarter of 2019 set a record for the highest demand of net new senior housing units while the construction data indicates a slowdown is near. The population projections of 2015 are not in accord with the latest senior housing demand. More cost-effective construction options and the repurposing of existing real estate is becoming a necessity to offset occupancy pressures and saturated markets.

Alternative Living Care Options

For lower-income seniors, alternative living care models, including the Program of All-Inclusive Care for the Elderly (PACE), integrate Medicare and Medicaid financing; provide a comprehensive service delivery system. This coordination of care is an effort to defer or avoid seniors moving into a long-term care fee-for-service facility. Implementing this program and other, less costly models of care can help to address lower-income senior housing issues. These models will continue to leverage technology to drive innovation and efficiencies, as well as address workforce shortages.

Middle-Income Seniors

The most challenging market segment for senior living is that of middle-income seniors. Those seniors without sufficient resources for long-term care but who are also not in a position to qualify for Medicaid seem to face some of the most significant issues as it relates to housing and healthcare costs. According to McKnight’s Senior Living, investors and operators focus on the upper end of income distribution as their preferred targeted residents while leaving state and local programs to provide for low-income seniors. This scenario leaves a large portion of middle-income seniors whose living needs are not adequately being addressed.

Technology for Seniors

Applied digital technologies are changing the senior living sector, and the race to seize substantial market share in the active adult and under-addressed middle-class needs has not gone unnoticed by tech behemoths like Apple and Amazon. Alexis Ohanian, the co-founder of Reddit, who runs a venture capital firm, is predicting that a significant change is imminent for senior living. New startups, heavy on innovation and technology, will bring major disruption to existing senior living models and facilities very soon.

Investments in Senior Living Facilities

Existing operators and investors of aging senior living facilities are increasing investment in a wide range of offerings and services to remain operationally sound and competitive. One service strategy is to partner with home health agencies that provide therapy under Medicare Part B while a senior resident ages in place. Another is to create more public spaces within facilities. The creation of roof-top restaurants and park spaces on the property can increase senior socialization alleviating depression, which is a contributing factor to downward health spirals for seniors. Smartwatch technology that acts as a smart key for residents as well as a movement and health monitor reduces the number of daily interactions with staff and provides a way for loved ones to monitor their spouse or parent remotely. Creating more job flexibility for staff and dramatically increasing wages for hourly positions is a necessity to recruit and retain competent staff in a tight labor force.

While many of the baby boomers are still below the average age of residents that live in traditional senior communities, demographics point to the fact that the senior living industry will soon be under more pressure than ever to provide for a diverse and increasingly particular population. Market sector opportunities in middle-income senior living will drive innovation as competition increases, and companies vie for market share. These opportunities to realize new solutions will positively affect the entire senior income spectrum for housing.

We help seniors come up with comprehensive plans to address the aging process and the challenges that come with it. We welcome the opportunity to talk with you about your particular needs.

Contact our office by calling us at (318) 255-1760 and schedule an appointment to discuss how we can help you.

Should You Remove Your Loved One from Their Nursing Home?

Uncertainty can breed fear, particularly when it comes to caring options for a loved one currently in a nursing home during the COVID-19 pandemic. Facing the questions like how long this health crisis will last and will there be secondary, or even more waves of infection, give pause to those with loved ones in these vulnerable nursing home environments. Whether it is your mother, father, or spouse, you are considering moving; there is no right or wrong answer, only choices because all decisions come from a place of love. It is never wrong to try to help those you love to be better protected. Here are some things to consider about changing your loved one’s residence during this pandemic.

The truth is that bringing a cherished family member home is a complicated decision because it is both emotional and fraught with unknown consequences that have real-life ramifications about life and death. If you were to move your spouse or parent home, are you and is your home environment suited to caring for them? If they are on Medicaid, will they allow your loved one to be released and then reinstated in the future? Will there be room in the facility at the time when they need to return? Does your community provide services that can help you provide care? Does the job that you would do at home meet the same level of care as professionals in a nursing home? Will there be a lapse in medications or other necessities during the transition phase?

Before making plans to remove your spouse or parent from a nursing home during the COVID-19 pandemic, the American Association for Retired Persons (AARP) suggests you ask yourself these questions to help you make a sound decision based on your loved one’s wellbeing.

  • What are the benefits versus the risks of moving your loved one out of the facility?
  • What does your spouse or parent want?
  • Can you meet the caregiving needs of your loved one in your home environment? (this includes any specialized medical care, medication management, meals, bathroom and hygiene assistance, and time to engage your loved one in activities)
  • In bringing them to your home, are they still at risk of COVID-19 exposure?
  • How will you prioritize care if someone in your home becomes infected?
  • Can you currently do window or virtual visits with your loved one in the nursing home to decrease the problems associated with social isolation?
  • Will the facility readmit your spouse or parent if you change your mind?
  • Are there still valid reasons for having your loved one in a long-term care facility?
  • Does their current living facility have adequate staff and procedures to handle the issues associated with this pandemic?
  • Will your caregiving in the home match that of the professionals in a nursing home?
  • Do you have the time to dedicate to your loved one’s proper care?

Answering these questions should reveal whether you are leading with your heart or your head while considering moving your loved one out of their current care facility.

AARP’s position on moving your loved one into your home during the COVID-19 pandemic is in agreement with the experts at the Centers for Disease Control and Prevention (CDC). The CDC reports there is no one size fits all solution to this question, and each family must pursue their decisions based on recommendations from their health care providers and their unique circumstances.

Before discussing the option of moving your parent or spouse out of a nursing home, it is advisable to pose these questions with in-home family members as well as your loved one’s health care providers. In times of uncertainty, it is best to logically think through at home living scenarios both short and long term, as well as review the variety of steps the CDC has put in place for long term care facilities with regards to protecting residents and staff during the COVID-19 pandemic. The caregiving your loved one needs will be the best for them if you take the time to make an informed decision.

If you have questions or would like to discuss your particular situation, don’t hesitate to reach out. Please contact our office by calling us at (318) 255-1760.