University of Florida Rehabilitation Engineering Research Center on Technology for Successful Aging

1. Funded by National Institute on Disability and Rehabilitation Research University of Florida Rehabilitation Engineering Research Center on Technology for Successful Aging

2. The University at Buffalo RERC-Aging (91 – 01) Supported by the National Institute on Disability and Rehabilitation Research of the USDE

3. Consumer Assessments Study How do frail elders cope in face of impairment / disability / pain?

4. In-Home Interviews of Frail Elderly • 2849 interviews over 10 years in Western New York and North Florida

5. R1: Consumer Assessments Study • Explored functional needs of frail elders - over time (10 years) with focus on AT and Home Modifications • Provided direction for other RERC-Aging Research, Development, and Dissemination Projects • Participants serve as “sample pool” for other studies and projects – Continues today with • Concept testing, usability testing, prototype testing for industry • Focused research studies with additional grant funding • Led to present study: Needs and Barriers to Home Monitoring and Communications Technology

6. Consumer Assessments Study: Data Collected • Demographics • Health status • Functional status • Psychosocial status • Services received • Quality of life • Caregiver survey (if person has family caregiver) • Ownership, use, satisfaction, problems with AT • Home / neighborhood environment & modifications

7. Who does the CAS Sample Represent?

8. Summary Device Ownership, Use, and Satisfaction

9. Consumer Assessments Study: Findings Of all impairment groups, elders with cognitive impairments use the fewest number of assistive devices, with a mean of 5.8 devices per person (Mann et al., 1992).

10. Assistive Technology Use by Elders with Dementia

12. Subject Attrition and Reasons

13. Subjects with Alzheimer's: Chronic Diseases at Year 1

14. Changes in Functional Status, Physical Disability and Pain (n=7)

15. Use of Assistive Devices (n=7)

16. The Caregivers (n=7) • Mean age: 69.4 years (SD=6.2) • None employed

17. The Caregivers

18. Case 1 - Mrs. Grella (slide 1) • MMSE Years 1, 2, 3 - -19, 0, 0 • FIM Years 1, 2, 3 - - 81, 18, 18 • SIP Years 1, 2, 3 - - 13.6, 42.1, 44.2

19. Case 2 - Mrs Grella (slide 2) Devices Year 1, All used, satisfied with 1. Lock system - key required to exit 3. Watch with date 4. Hand written schedules 2. Towel bar and soap dish used as grab bars 5. Locking thermostat cover

20. Case 2 - Mrs. Grella (slide 3) Devices Year 2, Changes in Year 1 Devices • uses none of the year one devices, now non-ambulatory Devices Year 2, Additions • Incontinent briefs and pads, urinal • Over bed table • Hospital bed with double side rails • Hoyer Lift

21. Case 2 - Mrs. Nichols (slide 1) • MMSE Years 1, 2, 4 - -17, 21, 9 • FIM Years 1, 2, 4 - - 88, 73,29

22. Case 3 - Mrs. Nichols (slide 2) Year 1 Devices • Magnifiers • Calendar for orientation to date • Notes around home for reminders

23. Case 3 - Mrs. Nichols (slide 3) Year 2 Devices • No changes in Year 1 devices • Grab bar added in tub

24. Case 3 - Mrs. Nichols (slide 4) Year 4 Devices • Not using Year 1 Devices • Spouse added: wheelchair, wheelchair restraint, walker, bath chair, hospital bed, incontinence pads

25. Summary - Alzheimers Subjects • High attrition, most to Nursing Homes • Those followed for two years (3 interviews) • Decline in mental and functional status • Increase in physical disability • Increase in #s of ADs owned • Little change in #s of ADs used • Major change in types of devices used

26. Summary - Caregivers • Increase in hours spent caregiving • Increase in assistance and other resources • More depression • Burden dropped Year 2, increased Year 3

27. How are we addressing these problems?

28. Technology for Successful Aging University of Florida Rehabilitation Engineering Research Center on Technology for Successful Aging Funded by National Institute on Disability and Rehabilitation Research

29. Smart Phone Smart Phone – Carry Anywhere Assistant Smart Home At Home

30. Why Cell Phones? • Elders are accustomed to using phones – it is one of their most important technology devices • Most portable and mobile device • Better chances for acceptability as compared to other computing devices • Smart Phone evolution: • Voice • Computer and IP data network on board • Platform standardization  enabling third party application developers

31. Code reader (Smart ID, RFID,…) Wider Screen Back-lit & Contrasting colors Full-day Back Battery Wider Vertical Key Spacing Larger fonts Back-lit Audio-feedback Wider Phone Keypad Wider Horizontal Key Spacing Smart Phones

32. Smart Phone Smart Phone – Carry Anywhere Assistant Grocery Stores On the road Restaurants Doctor Office . . . . . . Parking Lots Other Smart Spaces … and Away

33. Emerging Mobile & Wearable Subscriber Identification Module (SIM)

34. Global Satellite dik © Suburban Urban In-Building Pico-Cell Micro-Cell Macro-Cell In-Room (BlueTooth) Wireless Networks

35. Automatically refill prescription Check if laundry is done Sense and see visitors/strangers at front door Turn on/off lights (and visually inspect) other rooms. Check locks on doors and windows Monitor of kitchen: oven and stove on/off; temp. Call in for help and Assistance Order groceries with dietary restrictions Call in a nurse Other Services

36. Honeywell Partnership • Leverage of Smart Home technology: The Independent LifeStyle Assistant (ILSA) Program • Plans for future collaboration on joint applications that uses Smart Phones and ILSA • Testing in the homes of elders beginning October, 2002 (next month).

37. Cognitive Assistance • U. of Wisconsin – focus on mild impairment • U. of Florida – focus on moderate impairment • Addressing interface questions

38. Partnership with Veterans Health Administration • Tele-homecare demonstration • Low ADL Monitoring Project (LAMP) Spinning off applications from RERC to Veterans in VISN-8

39. Issues Relating to Older Drivers • Testing • Remediation • Florida ‘leading the nation’ in older drivers

40. Policy • Promoting home based services versus institutional • Reimbursement for independence tools and services • Models that promote independence

41. International Conference on Aging, Disability, and Independence December 4-6, 2003 Washington, DC

42. THE END rerc.ufl.edu THank You