High-Tech Monitoring Is All the Rage

Push by seniors housing operators to maximize efficiencies, reduce ER visits and engage residents leads to steady flow of innovative products.

By Eric Taub

Here are the magic words that every tech startup longs to hear: “We trialed the product for six months and we were so impressed that we became a paying customer.”

Unfortunately, those words rarely come. Technology startups often have a short shelf life. With the need to spend large amounts of capital to create cutting-edge features, and faced with a host of competitors, many great ideas are developed, demonstrated through an impressive online presence, and then never see the light of day, leaving behind artistically beautiful websites, tombstones to what could have been.

The problem is no different, and perhaps even more acute, for technologies targeting seniors. With a limited population from which to draw, a reluctance of many senior living communities to try new things, and an often-inadequate technical infrastructure that would even allow a community to implement high-tech products, commercial success is that much more difficult.

Still, startups keep on coming up with some compelling ideas for senior-oriented monitoring products and technologies that promise a strong value-add to senior living communities by reducing emergency room (ER) visits, improving socialization and adding record-keeping efficiencies. Some new entrants have launched while others are on the cusp of doing so. 

Fall detection devices reduce ER visits

As is well known in the senior care industry, falls are a major cause of injury, social isolation and death among the elderly. Personal emergency response systems (PERS) allow users to signal when they’ve fallen, but not all seniors prone to falls have such a device or always remember how and when to use it.

SafelyYou has automated the fall detection process by using cameras installed in an elderly resident’s apartment that, with artificial intelligence software, can detect a fall and immediately notify a caregiver of its occurrence.

Not only does this minimize the amount of time an elderly person is left before he or she is discovered, but the video record allows caregivers to analyze the reason for the fall and take preventive action to stop them in the future.

To mitigate privacy concerns, cameras are not installed in bathrooms. And all video — except for an actual fall event — is automatically erased within minutes of recording. The video itself is stored locally, not on Safely You’s server.

The technology detects 94 percent of falls and results in a 50 percent reduction in the time a resident spends on the ground, reducing trauma, disorientation and injury, according to Shirley Nickels, Safely You’s chief operating officer.

One operator that has adopted the Safely You system is Carlton Senior Living, a California chain of 11 communities with 1,500 residents. “We used it for six months in a trial and we were so impressed with it that we became a paying customer,” said Alli Groves, Carlton’s director of clinical operations.

Deployed only in its memory care units, where falls are most likely and residents may not remember why they fell, Safely You has reduced ER visits by 60 percent. That’s because caregivers can respond to a fall quickly and determine via video if the individual actually was hurt.

Knowing how a resident fell allows caregivers to take proactive measures to ensure that that is less likely in the future. For example, one Carlton resident appeared to have fallen out of bed. In actuality, as the video showed, she had fallen off her walker as she tried to climb on it. The community exchanged her walker, which had a seat, for one with just two wheels and no seat.

Families have been given peace of mind (87 percent agree to use the service) and have reduced their ER costs. One family saw its resident’s trips to the ER cut from 16 annually to two. And Carlton is saving money as well. Its liability insurance premium was lowered by 10 percent due to the ER visit reductions, says Groves.

Another product, Stay Smart Care, eschews cameras and microphones, and instead keeps track of residents via in-room sensors, blood pressure cuffs and weight scales. A typical residence will have six sensors to detect falls and activity. 

The system learns a resident’s regular movements and then can detect anomalies. If a fall is thought to have occurred, the resident is asked to push a button if he or she is not hurt. After 30 seconds with no reply, the resident will receive a call from the center. 

A regular call-in service can be added to Stay Smart Care, with a trained nurse contacting the resident at fixed intervals. Each month, a report on the individual’s health and well-being is sent to the physician. In addition, apps can be added to an Amazon Alexa-powered device that allow the user to state his or her health status and then have that information automatically sent to a caregiver. 

Stay Smart Care is testing the service with six senior communities in California, Florida and Illinois, according to Mark Feinberg, the company’s CEO. Basic monitoring with no live nurse communication is priced at $79 per installation. The nurse check-in feature costs an additional $199 to $349 per month, depending on whether the nurse contacts the resident once, twice or four times per month. 

Social isolation is a significant concern for otherwise healthy seniors. And while the elderly often forget how to complete tasks that once were regarded as elementary when younger, the ability to speak and ask questions is not forgotten.

Meet the WellBe

One of the simplest solutions to improve elderly social engagement is Amazon’s Alexa voice technology. Several add-on apps, known as “skills,” have been developed that specifically appeal to the elderly.  

For example, the Ask My Buddy skill will alert designated caregivers in the event of an emergency. The user says “Alexa, ask my buddy for help,” and Alexa will contact a designated caregiver via text, e-mail, or voice message.

Several developers have created medication reminders that are given by saying “Alexa, remind me to take my medicine at 9 a.m. every day.” Individual alerts for each drug and time can also be created.

Trading on the popularity of the Alexa, HandsFree Health expects to come to market at the end of this year with WellBe, a HIPAA-compliant voice-activated product.

The tabletop WellBe is activated by saying “OK WellBe,” followed by a question. Users can ask it such general health questions as the symptoms of food allergies, drug interactions, stroke symptoms, Medicare benefits, and receive answers from the Healthwise database.

Caregivers can input reminders for users to take their medications, check vitals, upcoming social classes, medical appointments and other information. A throbbing Ring of Light alerts the user that a message is waiting. 

To hear a message, the user says, “OK WellBe, what are my reminders?” If several people are using the same device, a differently colored ring distinguishes the messages.

WellBe will integrate with a proprietary smartwatch, which will incorporate fall detection technology. The company says that WellBe will eventually add a weight scale and blood pressure monitor. Data from the device would automatically be uploaded to a physician’s online portal.

HandsFree hopes to sell WellBe to assisted living communities, thanks to its ability to incorporate tasks that will improve staff efficiencies, such as the eventual ability to use WellBe to report burned out lightbulbs, a non-working TV, and other repair issues within the residence.

The device will be sold for a one-time price. Customers will also be charged for a yearly subscription to WellBe at a “very cost competitive” price, but HandsFree declined to offer specifics. 

WellBe will soon be joined by Aloe Care, another sensor-based monitoring system that is positioned to help reduce social isolation among the elderly. The product consists of a hub, which connects to various room sensors that monitor falls, temperature, air quality and movement. 

Artificial intelligence (AI) technology helps Aloe Care learn an individual’s patterns, and then to alert assigned caregivers via a smartphone app when those patterns are not followed. Users can contact caregivers through a verbal prompt, and caregivers can also initiate a check-in to ensure that the elder user is doing well, emotionally and physically. 

Lifepod combats isolation

Eschewing HandsFree’s approach of requiring a user to wake up a voice-centric device, Lifepod has created what it calls the first “pro-active voice,” an AI-powered caregiving service. 

Unlike HandsFree’s WellBe, Lifepod reaches out to the user without prompting, checking in daily to find out how well users slept, if they’re feeling well, whether they’ve taken their medications, and other questions that can be programmed into the Lifepod service by an adult caregiver, whether that’s a relative or a staff member in a residence.

Using Google’s voice technology, answers are recorded and caregivers alerted if those responses have been programmed as warnings. If Lifepod doesn’t understand the user’s response, the device asks the user to simply answer “yes” or “no.”

The user can also trigger Lifepod. For example, if the user falls, saying “Hello Lifepod” can be followed by a request for help.

The company has contracted with iHome, a well-known supplier of smart home audio accessories, to supply the Lifepod device. Plans call for Lifepod to integrate with a smart scale. 

Specifically, the company will be conducting a study in conjunction with the American Heart Association to determine whether pro-active voice reminders can aid in helping those suffering from congestive heart failure to regularly weigh themselves. Doing so can guard against excessive fluid buildup, which otherwise could result in a disruptive and costly ER visit.

Room sensors will detect motion. Movement patterns will be discerned using AI, and when that movement deviates from the norm, an alert will be sent to the caregiver.

Lifepod will be available this fall, one year after the original target date for the launch.

Wingate Healthcare has been testing Lifepod in Haverhill and Needham, Massachusetts, two of its 12 communities that offer assisted and independent living in Massachusetts, New York and Rhode Island. (Wingate operates 39 communities overall.) The institution has now signed a contract to extend the product’s offering at those two communities plus more sites. 

 “We needed to see if there was value to the product before we signed up,” says Michael Spearin, Wingate’s senior vice president of sales and marketing. “We wanted to see an improvement in health, wellness, and reduced hospital visits.”

Lifepod will not be offered to Wingate’s memory care residents due to concerns the company has that the disconnected voice queries could confuse and agitate residents. 

Wingate chose Lifepod because it was interested in a product that would help decrease social isolation. It liked the idea that it could proactively reach out to the user and provide reminders about upcoming appointments, classes and health checkups.

“Our biggest challenge is getting a resident to admit that he or she needs help and support,” says Spearin. He recounts the story of one resident who said she didn’t need any assistance, but while watching a Lifepod demonstration showcasing its medication reminder feature she remembered that she failed to take her medication.

Wingate is charging its residents $35 per month for the service; it pays Lifepod $30 per month, plus $75 for the iHome hardware.

While Wingate considered other competing products, it decided that Lifepod’s proactive voice feature gave it an important advantage. Unlike a standard Alexa-powered device, the user does not have to first “wake up” a Lifepod device by saying a particular phrase.

“There’s a huge benefit not to require a wake word,” according to Spearin. “That’s the biggest challenge for regular Amazon Alexa-type devices.” 

Tough competitive landscape

Which of these products, if any, will succeed is unknown.  And they must compete against other products from established companies. For example, Withings, a long-time maker of Bluetooth-
connected health monitoring devices, has recently introduced its $250 BPM Core.

In 90 seconds Core measures blood pressure, atrial fibrillation, and the presence of valvular heart disease. Data is automatically downloaded to Withings’ app and the information can be sent via email to a physician. 

Apple’s Watch Series 4 also can check for atrial fibrillation, as well as heart rate and irregular heartbeat. 

In addition, the Watch’s fall detection technology will automatically alert a caregiver if the user does not dismiss the notification.

Philips has introduced its Philips Care app for users of its Lifeline service. The app allows caregivers to set up a circle of friends, decide who should be notified in the event of an emergency, track the user’s emergency calls and discuss the user’s health with those within the circle of friends and family.

In addition, its latest fall detection product, GoSafe 2, can track the location of an individual using five different locator technologies. Once a fall is detected, emergency help can be dispatched even if the user does not push the pendant’s button for assistance.

Barriers to adoption

Underlying structural changes at senior living residences still need to take place. “The big issue for senior living communities is the availability of tech resources and a fear of risk-taking, plus the requirement to do the basics around WiFi, electronic health records, fall detection and wellness,” says Laurie Orlov, founder of the website Aging in Place Technology Watch (www.ageinplacetech.com).

When asked if these are the same problems that weighed on the industry a year ago, Orlov had a simple answer: “Yes.” n