A look inside the future of caregiving
Imagine having a robot around the house that can lift a frail elder if they fall when you are not around. Now visualize automated dresser drawers that can literally talk and guide a dementia patient through the complex—and often stressful—act of getting dressed in the morning. You are seeing what could very well be the future of caregiving.
Diane F. Mahoney, PhD, Professor of Geriatric Nursing Research at MGH Institute and her team were among the first to study wireless monitoring technologies for caregiving. Frustrated with so-called “alert” bracelets that patients frequently fail to activate, she became interested in high-tech devices that not only monitor patients in the home, but can provide an assist to the harried caregiver. Mahoney’s research is at the bleeding edge of caregiving technology. I spoke with her recently to find out what’s coming next.
Q: Robots in the home? What sparked this concept?
A: I got the idea when I heard that people are falling and not getting up, and they are not pushing the alert button on their alert bracelet or calling for an ambulance. I thought, wouldn’t it be nice if we had some kind of personal lifting device for elders?
Q: Is it feasible?
A: The concept already exists. The military has some neat robotic devices that they use to go into the battlefield and lift downed soldiers and remove them under fire. So I wound up getting involved as a consultant to a couple of robotic companies that are indeed working on devices that can move and lift a person. I am helping companies to develop a product for in-home use, for a future version when the technology becomes affordable.
Q: So, robots in the house? I guess, to appeal to baby boomers, you just put a BMW label on the thing.
A: [Laughs] Right! I’m a baby-boomer and, I’ll tell you, 20 years from now, I’d like a little robot running around the house.
Q: Yes definitely, me too. So, will we start seeing robots soon?
A: iRobot already has the Roomba, a robotic vacuum device, and they are very entrepreneurial. There are also other companies around that are working on components of robotics for in-home use. So in the near future they could merge together, combine developments, and solve potential safety issues. I’m sure these companies will be able to overcome the technology challenges in the next decade. And wouldn’t that just be great?
Q: A lot of your work has focused not just on the patient, but on the caregiver’s need for respite, for just a small break during their 24-hour workday. Can you tell us a little about that?
A: After years spent listening to Alzheimer’s caregivers talk about their needs, one of the themes that kept coming up was, “if only I had 10 minutes to myself, if I could just breathe or go to the restroom without my husband or wife banging on the door!” So I designed an automated telephone call; I called it a respite call. To make it effective, we interviewed the caregiver for their patient’s favorite hobbies, foods, smells, songs, and so forth. The phone call was all computerized, and the caregiver could call in anytime and put their patient on the phone—even at two in the morning when they were being driven crazy. And by calling in and putting in the password the conversation would come up and the voice on the phone would say, “Oh, hello Harry. Oh, it’s so nice to talk with you now. You know, I understand you really like brownies…” And of course, for someone else, it could be chocolate candy.
Q: Would this keep them busy for the magic 10 minutes?
A: Actually I designed it to be 28 minutes long and it was able to repeat once. So we put it out there; I had no idea if this would work or not. Many people don’t let their person with dementia use the phone anymore. But others tried it and it gave people more than their 10-minute break. They got a 28-minute break. Some of them went around twice, for a total of 56 minutes.
Q: I bet caregivers were pleased with that.
A: Yes. One caregiver said to me, “The day is very long. And I need a tool box. And in my tool box I need a whole bunch of things to keep him occupied. This is a very important tool in the box.”
Q: What other tools have you developed?
A: I’m starting another project with a colleague who has been using motion sensor technology for children with autism. We just got funded a few months ago by the Alzheimer’s Association to build what I call DRESS – Development of a Responsive Emotive Sensing System—to help people with dementia get to a state of rest. The project grew out of our observation that, for people with dementia, getting dressed is often a trigger activity for becoming extremely upset. The person gets in the drawer and rummages and gets stuck and keeps on rummaging.
Q: What is the solution?
A: For the prototype we are going to put iPhones on each drawer. So if they get stuck in one drawer too long, the iPhone on the next drawer they should go to will turn green and flash, and if they open it, fine. If they don’t open it, the phone will speak, and actually say “Open this next.” It will continue with verbal cues until they perform the requested activity.
Q: This is not just to help them get dressed, right? Again, this is partly about caregiver respite.
A: Yes, even if we can’t get them fully dressed, the caregiver can use this as a safe activity. We might be able to convert what would have been an annoyance into a distracting respite activity for 20 or 30 minutes. Worst case, the caregiver gets a break; best case, the person actually gets dressed alone.
Q: Either way, sounds like a victory.
A: Certainly! The respite part is central. Caregivers themselves are often so focused on their loved ones that they often don’t take the time to take care of themselves. I’m in this field because I really appreciate the role caregivers play. They make such a vital contribution that sometimes I don’t think our society fully appreciates.
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