Eldercare in Assisted Living Facilities

Humanity today has made great progress in terms of not only computer and communication technology, but also in terms of biomedical technology. For this reason, many people today live much longer than was the case a century ago, or even as recently as 50 years ago. Unfortunately, the social and financial worlds are ill prepared for the sudden increase of the older population in developed countries. The social and financial systems that have been allocated to the care of older persons today fall sadly short of their functions. Indeed, many elderly people find themselves destitute, lacking the care and attention that they need. This is particularly so in the case of those who can no longer do as much as feed or clean themselves. However, it is also encouraging to note that a large amount of technological attention has been focused upon the assisted living environment. Robotic devices and information systems, for example have been implemented to minimize the probability of neglect and loneliness among elderly, and to increase the effectiveness of assisted living where this is necessary.

Although Cranswick and Dosman (2008, p. 48) focus their discussion on senior citizens in Canada, the problems and statistics they mention are a reality in every developed country, and an increasing number of developing countries, across the world. In all these societies, a central concern is that there are a growing number of senior citizens aged 65 or older who need assistance, support and care to continue living a life of significant quality.

Although it has also been found that friends and family members are willing to provide care to a certain extent, the quality of care when faced with a long-term or fatal illness is best provided by professional persons.

In addition, two more factors that concern the ability of family and friends to care for their elderly counterparts include the increasing number of elderly in the country, and also the fact that there is an increasing number of people who care not only for their elderly relatives, but also for children who still live at home. This is the result of the "baby boomer" generation delaying having children while an increasing number of women have joined the paid workforce. As a result of the social and economic dynamic today, the size of this "sandwich generation" is also likely to grow exponentially. In economic terms, however, the ability of this generation to continue caring for both generations before and after them is likely to become increasingly unviable as prices continue to rise without an increase in salaries. This is where technology becomes a suitable alternative in assisted living setups.

Robotic technology serves not only to improve the quality of life experienced by senior citizens in assisted living setups, it also provides carers with the ability to improve their assistance capabilities. In this regard, Yu, Spenko and Dubowsky (2003, p. 52) suggest a personal aid for mobility and health monitoring, or PAMM. What is particularly beneficial about PAMM is its flexibility; it can be applied both by older citizens who live independently, or by those who care for the elderly. The system provides physical support and guidance for users with limited capabilities, while also monitoring basic vital signs, especially if users have limited cognitive abilities as well. At time of publication, the system had been tested at eldercare facilities to prove the effectiveness of its natural and intuitive human-machine interface.

Because of the increasing numbers of elderly citizens, technological systems to facilitate care have become almost mandatory. Systems such as PAMM, for example, provides a level of care that could mean the difference between extended independent living and an assisted living facility. It could also mean the difference between high-quality care and neglect within assisted living facilities themselves. According to Yu, Spenko, and Dubowsky (2003, p. 53), for example, the challenge within these facilities is to provide not only basic needs such as shelter, meals, and bathing services, but also to provide higher-level care, such as guidance and assistance for those who frequently become disoriented. This is where robotic and information technology could provide a valuable component to assisted living programs. In addition to guidance, medication regulation, health monitoring, and scheduling of everyday activities can make the difference between life and death for residents. Hence, robotic and information technology has become vital, particularly due to stress on the availability of caregivers created by the increasing elderly population.

In a later article, Spenko, Yu, and Dubowsky (2006, p. 344), continue their consideration of the PAMM system, noting that residents who suffer from senile dementia can benefit significantly from robotic technology. According to the authors, residents that suffer from this condition represent 30%-40% of the population in assisted living facilities. Clearly, there are not nearly enough caregivers to provide the nearly constant attention demanded by such sufferers. Hence, a clear and effective solution is technology.

Specifically, Spenko, Yu, and Dubowsky (2006, 345) mention the Care-O-Bot and the NurseBot as particularly useful in this regard. The former provides general caring tasks, such as household work, communication, and entertainment. The NurseBot was initially developed to determine the best technology for human-machine interface methods, speech, and face tracking. The most recent of these, at the time of publication, was the NurseBot known as "Pearl." This machine has the capability of guiding users around an assisted living facility. The Power-Assisted Walking Support System supports users who can no longer get out of bed, walk, or sit down with a great measure of ease.

The authors emphasized that a large amount of research was still needed in terms of robotic technology, to determine the best way in which to provide assistance to elderly, frail, and disabled residents in care homes.

Stanford (2002) suggests that information technology could also provide an important platform of care for elderly residents. The Elite Care facility makes use of various technologies, such as the locator badge or bracelet, which is furnished with a trigger that alarms caregivers when a resident has become disoriented and tries to leave the care facility. Often, residents at the beginning stages of dementia develop episodes of confusion, during which they search for a time and place that might trigger memories that they recognize. When this happens, the trigger helps personnel to locate the confused resident to lead him or her back to the facility. This is a way in which to provide residents with maximum autonomy while still being able to provide them with an acceptable level of care.

In addition, pervasive computing also provides a platform from which residents could receive other forms of care, including the continual monitoring of their health and input/output statistics. In this way, this type of technology allows carers to monitor residents in a non-invasive, and yet effective way. It also allows caregiving personnel to provide care in a more time effective way.

In addition to the locator badge or bracelet, residents' apartments and common living areas are furnished with sensor data streams to remotely obtain information regarding the health and well-being of residents. Locator badges then emit periodic IR pulses to the sensors in each environment to provide the necessary information to caregiving personnel.

Another way in which pervasive computing is used is providing each apartment bed with a weight sensor. These are used to monitor sleeping patterns and alert personnel of irregularities that might indicate a health condition.

Residents even receive networked computers with a touch screen interface in each room, where they can communicate with family and friends. The computers also provide communication capabilities that connect residents with each other and with caregiving staff. Any resident in need of assistance can summon this right away by means of this technology.

Finally, the facility maintains a database for each individual in its care. Information such as weight and blood pressure is regularly monitored and documented. This is then used to provide timely care when this is needed.

Virone et al. (2008, p. 387) also promote information technology in caregiving for its non-invasive ability to continually monitor the health and well-being of assisted living residents. This technology allows monitoring of residents by means of a recorder that monitors residents' daily activities. The authors emphasize the importance of rhythmic behavioral activity for its potential to indicate internal medical conditions within the resident. As mentioned above, early or late bed times could indicate internal difficulties that merit closer monitoring. What is so important about this technology, as already mentioned, is the fact that it is non-invasive, and does not require the constant presence of a caregiver. Monitoring can be done remotely, potential concerns can be foreseen, and residents can experience optimal autonomy.

The advantage of remote and pervasive information technology is the fact that it is more easily integrated in the assisted living setup than robot technology. Because it is still in its infancy, robot technology is somewhat impractical because of its size and movability. There is no such concern with remote or pervasive computers, while caregivers maintain theā€¦