The Use of Robotics in Long-term care Facilities: A Step Into the Future?

 

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Robot and Frank (Click for Movie Trailor)

The use of robotics and other AI Technology in Long Term Care is a highly debated topic, and there are fair arguments both for and against. Their use, however, seeks to solve a  grave concern in the field.  The number of adults 65+ by 2050 is expected to rise to 88 million. At such large numbers, resources are essential to the ability to provide and care for our older populations.

The greatest resource is the caregivers themselves, and currently, there is a significant shortage in the United States. Recruitment of employees is hampered by negative stereotypes of nursing homes and the often deeply emotional realities of caring for someone at the end of their life.

The most common reason people choose to work in long-term care is that they had a good relationship with an older adult (commonly a grandparent) at some point in their lives. The lack of senior caregivers will become a national endemic if the issue is not addressed.

There are several different types of robotics for senior care, but the most commonly used are robotic caregivers, social robots, and teleconferencing robots.  Their use has grown increasingly more popular over the years and can now be found in Japan, throughout Europe, and the US.  As the number of older adults increases, their use could be the solution we are looking for.  But can a robot actually replace the human connection and socialization we as humans need?

The Pros and Cons of Robotics in LTC

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Robotic Caregivers

Designed and developed in Japan, the Robobear is a transfer and lift machine for people who have difficulties getting up and moving on their own.  Traditionally, this is a job for Certified Nursing Assistants who assist in lifting and transferring individuals from the bed to their wheelchair or from the wheelchair to the bathroom.

Nowadays, there are Hoyer lifts and sit to stand lifts which help take some of the strenuous burdens off of the caregiver, but they are still in the room and able to talk or calm a resident during the transfer process.

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The Robobear (as pictured above) is designed to make this process a bit less scary and jarring for seniors. However, the idea that a cute smiling bear is more inviting and more receptive to seniors is a bit unfounded, but it does offer a friendly alternative to the more sterile machine options on the market today. In their use, we should keep in mind the potential for confusion they may cause our residents with dementia or Alzheimer’s.

Prototypes of humanoid robots are still being developed.  And one day we may find that robots that look like humans could replace our caregiving staff.  Although this still seems like an idea of science fiction, Carebots are already developed and on the market and their use is specifically targeted to assist the elderly.

Social Robots

Social robots are developed to simulate real pets.  Most common are dog and cat robots as seen in the video below.  The company Hasbro’s found that their children’s toys were being used by a growing number of seniors and decided to create a line especially for older adults living in nursing homes.

 

These “pets” act and respond just as a real cat or dog would.  The cats will purr and vibrate while being pet and meow in response to being held.  Since pets aren’t allowed in many long-term care settings, this type of companionship is a welcome replacement.  And especially for those living with Dementia or Alzheimer’s can offer a sense of comfort and purpose.

Hasbro is not the first to unroll a line of robotic pet companions.  Japan has a line that was established in 2003, which was purposefully designed as a therapeutic intervention for seniors.  Unfortunately, this line is a bit pricey and not as easily obtained whereas Hasbro’s Lifelike pets are much more reasonable at about $100.00.

Robotic Conferencing

The Cruciferous Vegetable Amplification episode of the Big Bang Theory parodies the idea of sending a virtual self out into the world through video conferencing. Funny or extreme as the concept of this was, this type of technology is available and for the medical field has great potential to allow physicians to be two places at once.

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Image Source: CBS Network

One such technology is the GiraffPlus, already on the market and providing In-Home help care to the elderly throughout Europe.  The GiraffPlus is a vacuum cleaner, monitoring system, environment evaluator, and a telehealth conduit for seniors living in their home.

As the number of older adults remain in their home, these types of technologies make aging in place a sustainable living option even as care needs change. Alternatively, however, does the lack of a personal visit to the doctors or the now “traditional” form of health care offer something more than a teleconference can offer? Particularly to a more vulnerable population for isolation.

Can a robot console the way a human can?

Seven million Americans over the age of 65 suffer from depression. This number will continue to increase over the next several years, but without enough caregivers, it’s hard to care for the emotional and physical needs of our older adults.

And as many movie and TV representations show us, although some robotics are advanced with many capabilities true human connection is not one of them. Although robotics have become increasingly popular throughout Europe, Japan, and the US one French non-profit the Society of Saint-Vincent-De-Paul
 created a short clip that portrays the ill-effects this lack of human console can have on an individual.

 

The Future of Long Term Care

Technology has been incorporated in nearly every field so it is no surprise that we would find a way to advance our caregiving methods. Personally, I am still on the fence when it comes to robotics specifically and maybe only sold on the cute toy kittens and a bit weary of a giant smiling bear capable of lifting a person.

As a field, we still have an opportunity to invest in real live humans to fulfill our caregiving needs.  In an earlier post, Addressing Our Caregiver Shortage through Intergenerational Programs: Introducing our Youth to Seniors Living in Long-Term Care I discuss the importance of intergenerational interventions now so that our youth will grow up wanting to care for their elders.

I would love to know what you think about the use of robotics in Long Term Care?  Is it cool, weird, innovative?  Leave your thoughts in the comment section below!!

3 Things to Consider as you Devise a Plan to Age in Place

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Designing a Plan to Age in Place

The desire to stay in our homes as we age is more popular now than ever. However, there is a growing segment of our population that are being lost by systems due to no longer having access to transportation, a lack of family support, a recent loss of a spouse, or a recent decline in cognition.

Typically the most substantial issues found for this population while aging in place are; falls, lack of accessible transportation, and isolation. These are mostly non-medical matters, which makes it difficult to fully rely on the health care system to meet their largest needs.

The 65 and older community is the largest population receiving health services. But, even if a person is admitted to the hospital with a fall injury, this encounter with the system does not necessarily replace the carpet the person tripped on.

To sustainably age, in place, we should plan for in-home supports, identify resources in our community, and educate ourselves on what to look out for within our home.

Identifying Resources

Our neighbors, family, friends are our primary supports system.  Having conversations about how we would like to age in place, making a point to outline important aspects of our daily routine, and even creating an action plan in cases of an emergency should be priority conversations with those closest to us.

Having this type of support system and educating them on what signs to look for (i.e. mail piling up or overgrown grass) can help ensure we are checked in on at the first evidence of trouble.

We might not always have family or neighbors to count on, and in this case, it is also important to do a bit of research to see what type of resources are available to us in our community.

Partners in Care  in Maryland is a great organization who for over twenty years has supported older adults remaining in the homes they love and keeping them meaningfully engaged in their communities.  Finding a care team like theirs in our community is an excellent way of ensuring reliable transportation, that we receive general repairs when we need them, and even more importantly we can always count on them to brighten our days with a simple conversation.

A Safe and Secure Home Checklist

AGIS- Assist Guide Information Services provides us with an excellent tool to assess our homes safety and security.  The checklist ranges from the General living area to our personal safety as we navigate through our homes.

General Living Areas Yes No Action Taken
Is there adequate lighting throughout the house?
Are there night lights where needed?
Is home well ventilated?
Are all doorways accessible and easy to operate?

Assuring that the physical layout of our homes and the items within are placed in a way that creates a safe and secure living environment for our aging needs is critical to the ability to continue to live in our homes. This type of prevention could also decrease the risk of falls and subsequently trips to the emergency room.

Preparation is key

The aging process, at times, can be unpredictable and of course we cannot always anticipate for all of our future needs. However, we can create a plan and identify how and where we would like to spend our better years.  Spending time to research resources in our communities, having conversations with those closest to us, and assessing our homes ability to meet our future needs are all places we can begin the planning process towards our ability to age where we want.

 

 

How can we plan for the future? Designing for Older Adults, Livable Communities, and Aging in Place.

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The other day as I was out shopping a woman fell just outside of a department store. The step out front of the store was barely painted, and the store did very little to come to her aid. In conversation with an employee, she admitted that this isn’t the first time an older adult fell outside of their store, on the same step, and that they often drive away without seeking medical attention.

As for the woman, numerous passerby came to her aid, but she was noticeably (and rightfully) in a bit of shock from the event and although numerous attempts were made to have her seek help she ultimately got into her car and drove away.

Neglecting to incorporate age-friendly design can have a domino effect on the life of our older adults. 

Still, days later, I can’t help but think how this situation could have been avoided.

If we created our public spaces with the older adults needs in mind, this woman could have gone home only to worry about the beautiful blouse she neglected to buy. Instead, her independence was called into question as she stood there alone surrounded by so many strangers she murmured, “I will call my children to help.”

Falls have an emotionally scarring impact on all of us. After a tumble, we become more careful and timid while walking or during our regular routines. Although I can’t speak for this women, it is feasible that she will avoid shopping at this store…not for lack of interest in the products but rather out of fear she could fall again.

And let’s face it, falling as an older adult is much different than falling at any other age.

Yes, injuries can be much more severe and recovery time can be much longer but maybe even worse than the physical injuries themselves is the sudden ever cautious and watchful eyes of our loved ones. After a fall, statements like “be careful” when mentioning going out to the store, or, “Are you sure? Why don’t you let me do that for you instead” become a part of each conversation.

Age-friendly designs in the community 

Efficiently designing for older adults requires design thinking because it is crucial that thinking, empathy, and emotion are incorporated into the design. An efficient design will allow an older adult to continue to age independently and make them feel safe and secure in their surroundings.

Making the transition to an age-friendly community can be a process. However, there are relatively small-scale design features a community can implement to get the innovation process started. In the figures below, there are photographs of how small design fixes can offer big improvements.

Sidewalk Ramps

The first picture below depicts a sidewalk ramp slightly elevated from the street. The slight elevation creates a physical constraint for someone in a wheelchair or walking with a walker. As ramps allow us to regain access to the sidewalk, it becomes essential that bumps are removed so that wheelchairs and walkers can move smoothly back onto the sidewalk.

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The next picture demonstrates a level ramp between street and sidewalk.  A smooth ramp provides users with much easier accessibility to the sidewalk and will allow someone to move quickly out of the busy street.

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Creating an Age-friendly sidewalk ramp

Crosswalks 

The picture below shows a faded crosswalk at a busy intersection. The crosswalk is barely visible to drivers and pedestrians alike. A crosswalk is a symbol for the driver to slow down and to allow pedestrians to cross; however, if it is faded and indistinguishable to a driver, it no longer demonstrates a relationship between pedestrians crossing and need to slow down.

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Older adults depend on crosswalks to know when and where they can safely cross the street. Faded walks not only confuse drivers but can also be difficult for seniors attempting to pass.

The picture below, however, is good for both pedestrian and driver. The visible lines allow both parties to distinguish the space as a crosswalk, which provides feedback to the driver to slow down for the pedestrians who are crossing. And the best part is, it only takes a little paint!

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Creating an Age-friendly Crosswalk

 

When we create homes and communities with the older adult in mind, we are simulating an experience for all community members to not only be conscious of the needs of the older adult but also to show that with just a few adjustments, older adults can continue to live independently and contribute to their neighborhoods.

Image Sources:
International Federation on Aging Global Communities. (2013, April). Retrieved August 2016, from http://www.ifa-fiv.org/enews/april-2013/
Brookline Community Aging Network. (n.d.). Brookline Can. Retrieved August 6, 2016, from Pedestrian-friendly sidewalks and crossings: http://www.brooklinecan.org/livable_community.html

 

 

 

In an era of isolation, is aging in place a risk to our health? The key to prevention is through socialization.

Women Wearing Colorful Bathing Caps
Women Wearing Colorful Bathing Caps — Image by © Royalty-Free/Corbis

Why we need to incorporate the community into our definition of aging in place.

So much of our lives involve being with or being around other people.   Almost all of us will engage with others on a daily basis whether it is with our families, our friends, or our community at the grocery stores.  Socializing becomes almost second nature, and often we don’t have to think about it or plan for it, we are just able.

But what happens when it’s no longer just as simple as hopping in the car and going? When once simple tasks become obstacles? It may not be until our body begins to change that we even notice how many steps we have to go up and down just to get out our front door. Or how cumbersome and tiring are going to the grocery store and carrying all of those bags can be.

We live in an active and yet independent society.  We are engaged as long as we initiate, and are independent as long as we can actively participate. And it isn’t until we are no longer able to go to the grocery store, or drive over to a friend’s house that we may even realize how vulnerable we all really can be.

We all feel the need to be apart of the community, which is why it is so important that we incorporate community into our definition of aging in place. We want to live in our homes even as we are no longer able to independently able to do so by ourselves. We may have in-home care providers to talk to while they provide care, but we are all more than just a medical routine. Just as accessible as in-home care has become means there is a need to make socializing just as available to those who can no longer go out and actively pursue it themselves.

Older adults living alone at home are at the greatest risk of social isolation

Socializing as a primary need for seniors is not a new concept. Long-term care facilities have incorporated social wellbeing in residents care for years. And for good reason!  Isolation has several known negative impacts on both health and cognitive functions and will even increase our risk of mortality.

The Campaign to end loneliness reports:

Loneliness and physical health

  • The effect of loneliness and isolation on mortality exceeds the impact of well-known risk factors such as obesity and has a similar influence as cigarette smoking (Holt-Lunstad, 2010)
  • Loneliness increases the risk of high blood pressure (Hawkley et al, 2010)
  • Lonely individuals are also at higher risk of the onset of disability (Lund et al, 2010)

Loneliness and mental health

  • Loneliness puts individuals at greater risk of cognitive decline (James et al, 2011)
  • One study concludes lonely people have a 64% increased chance of developing clinical dementia (Holwerda et al, 2012)
  • Lonely individuals are more prone to depression (Cacioppo et al, 2006) (Green et al, 1992)
  • Loneliness and low social interaction are predictive of suicide in older age (O’Connell et al, 2004)

Such severe consequences deserve our attention!  We should plan for our future welfare just as we plan for our medical needs.

For more on the dangers of social isolation read: 8 dangers of loneliness social isolation is deadlier than obesity

Planning for socialization as we plan for our future

Establishing routines with friends and family is one of the most important actions we can take in preventing our isolation.  And if we are no longer able to hop in the car and go we can trust that we have a reliable support system by our side.

Staying in our community and joining clubs/social groups are two great ways to start isolation prevention after retirement.  We may have led active lifestyles before retirement, but never are we more able to invest the time and attention to our friends than after retirement. Always a great place to start is at our local senior center.  They will often have calendars of events and a variety of groups to suit any interest.  Or go online!  Websites like www.meetup.com offer a variety of meetup topic groups that pop up all over the country and world!

As previously mentioned, advocates like AARP are working tiredly to bring our communities up to par as age-friendly.  But, we have control in this too, and if we want to age in place, we should do everything in our power to provide ourselves with the happiest and healthiest aging experience.

Stay tuned for more on the vital role our transportation systems play in our ability to age in our home and community!

 

 

Aging in place. Why we should plan for our future housing needs.

 

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In the first post of this series, why is everyone talking about aging in place? We defined aging in place as the ability to live in our home and our community as we age.

In recent years, the demand to age in place has created a booming market for in-home care services. There are a variety of care services available to consumers ranging from need base to hospice care. As we make the decision to age in place, it is feasible that we may require some if not all of these services over time.

Unfortunately planning only for our medical needs is not enough

According to the U.S. Department of Health and Human Services senior policy analyst James Toews, many of us enter long-term care prematurely due to our homes inefficiency to meet our physical needs.

Health care often dominates the aging conversation. And while we should always invest and plan for our future medical attention and needs it is just as important (if not more) to plan for our homes ability to adapt to our changing needs.

Planning for our future housing needs

Home is a highly personal decision, and ultimately we want to find a home that best suits our needs and lifestyles. But what if we are already living in the home we want to stay?

Then we should create a space that will ensure our ability to grow and age there. Luckily there are ways we can adapt our homes to suit our changing needs and many in the home renovation industry have already started adopting principals of universal design in their projects.  

Where should we start in a home remodel? 

The main bedroom, the bathroom, and the kitchen are great places to start when you begin considering an aging in place remodel.

For example, in a double story home, the master bedroom is typically found on the upper level. Moving the bedroom to the first floor saves us from having to climb all of those stairs. Bathrooms are safest with non-slip flooring and no step in showers. And kitchens have too many high and low places.  Lowering cabinets and raising appliances can save us the strain of reaching and bending for those out of reach items. 

Aging in place on a budget

Understandably, we can not all afford a full scale remodel on our homes. But there are several cost-effective ways we can make our homes more age-friendly:

  1. Install grab rails in the bathrooms
  2. bring high shelf items down to lower levels
  3. resecure loose carpeting
  4. add more lighting throughout the home
  5. add more seating areas around the home 

For more on in-home remodeling ideas or other senior living alternatives, read 5 Senior Living Alternatives: Finding a Home that Fits your Lifestyle.

 

 

Why Is Everyone Talking About Aging In Place?

Leading experts in the field – AARP, the CDC, and the National Institute on Aging – have all told us that 90% of people have expressed the desire to age in place. This high percentage may not be a total surprise. As discussed in a previous post, the comforts of the home are important to all of us. But, what does it mean to age in place? And how does it work for our oldest of adults?

In the coming weeks, I will explore the variety of needs and services available in a community.  Each week will focus on 1 of 4 topics medical care, the interior and affordability of a home, access to transportation, and the importance of recreational activities and community involvement.

But, before we do it is important to discuss what is aging in place and why people are choosing it!

What is Aging in Place?

In a broad sense, it means the ability to stay in our homes as we age.  When we take a deeper look at the needs of older adults, however, this definition must be expanded. For instance, things like access to reliable transportation, the physical layout of our homes, and the ability to easily receive medical care and go to the grocery store must be considered. Access to these types of resources within our community becomes critical to the sustainability to age in place. With this in mind, the meaning of aging in place changes to the ability to stay in both our homes and communities as we age.

And, we aren’t in this alone!

Thankfully, organizations like AARP have already started the process of raising awareness to local and state governments to plan and invest in the infrastructure that would promote an age-friendly community. And as they move the effort forward on a policy level there are still things that we can and should do to ensure our own ability to stay in our homes and communities.

Why Choose to Age in Place?

The Unwanted Mess and Stress of Moving

There are so many things that can change as we age and sometimes these changes can happen all at once.  Adding a big move to the mix can be both stressful and unwelcomed.

Save that Hard Earned Cash

Long term care facilities aren’t cheap! The entrance fee alone can be the price of a home.  Budgeting for services on a needs base may be a more economically friendly way for consumers!

Savor the Memories

Arguably, we spend a lifetime in our homes.  There we can be surrounded by all of the wonderful memories we have collected over the years.

It’s Familiar and Friendly

Not only do we already know the layout of our homes like the back of our hands, but we also probably know many of our neighbors! Who better to call when we are in a grind then our next door neighbors.

Stay tuned next week as we continue the conversation on Aging in Place by focusing on access to in-home care!

Are you aging in place?

I would love to hear your ideas on how you are already aging in place or how you plan to do so in the future!