How can technology be used to help the caregivers of older adults?

How can technology be used to help the caregivers of older adults?

(Employment and Social Development Canada, 2016)

“The great thing about getting older is that you get a chance to tell the people in your life who matter what they mean to you.”

—Mike Love, American singer

With a growing aging population, the need for caregivers is increasing, and a gap of care is forming with increased need for round the clock care. “Most caregiving work is done by families or close friends”(Segal et al., 2018, p. 410). There are many reasons why caregivers are essential to the care of older adults. If technology can bridge this gap, the role of the caregiver could change.

Caregiver burden with chronic care increases risk for physical illness, depression, and mortality. We must integrate care to prevent negative caregiver outcomes of health decline.

(Cemental, 2019)

I have chosen to focus this module on technology for caregivers, because enhanced interactions using technology can promote engagement and vitality along with positive mental health.


In this module, we will talk about how technology can be integrated into existing care plans, and how it can fill this gap of caregiving within an aging population. We will connect aging theory and peer reviewed and grey literature examples of technology integration to this conversation, to answer the question. “How can technology be used to help the caregivers of older adults?”

Theory

The continuity theory suggests that the maintenance or co-maintenance of roles, relationships and environments is key to successful aging (Wadensten, 2006). According to the continuity theory, older adults with mental illness declines and mental health disorders should be encouraged to keep participating in their normal routines, pastimes and hobbies (Wadensten, 2006). This could hypothetically be effectively achieved with the integration of assistive technology that helps the older adult accomplish role maintenance.

For example, if an older adult is given an app that allows them to contact meals on wheels or an Uber type businesses, roles of planner and provider can be maintained. Another example is seen with the integration of online internet and computer supports. If the older adult is given the means to continue their business online and they have the desire to continue working, they can continue to fill the role of provider.

Amazon Alexa - Wikiwand
(WikiData, 2020)

Alexa

The majority of independent older adults live at home (Segal et al., 2018). They can spend upwards of 80% of their time in their homes (Segal et al., 2018, p. 396). As the majority of seniors prefer to age in place within a familiar community, and in their private dwellings, this will likely continue to be a popular housing option for older adults. (Horgas & Abowd, 2004).

Many services, caregivers and family members are required for successful aging in place (World Health Organization [WHO], 2015, p. 136). Ambient Assisted Living (AAL) – community living with assistive devices and smart home technologies – is now a route to aging in place that we should consider (Woolrych, 2016). Caregivers can create an AAL environment with technologies such as Alexa; an artificial intelligence (AI) assistant. These assistants are voice activated program devices that act as a middleman and connector between devices and an electronic smart home (EasyTech Seniors, 2020).

Alexa is well known assistant example developed by Amazon (EasyTech Seniors, 2020). You can easily buy it online and it can help you as a memory aid, a time management tool, a prompting device, and an overall voice activated smart home remote control (EasyTech Seniors, 2020). This assistive technology can help caregivers and older adults to maintain past roles and routines within the home. Opportunities for successful aging (a goal within the cognitive theory of aging) can be generated, with AT that allows stakeholders to remain independent, to practice past roles, and to complete quintessential routines (Wadensten, 2006)


Alexa can be used in every room of the house to help the older adult with physical, cognitive, and social difficulties. With correctly installed appliance pairings, you can verbally command the kitchen faucet to turn on and off, and even to pour a specific amount of water to maximize food preparations. Alexa can start up self propelling iRobot mops (e.g. iRobot Braava) and vacuums keeping an older adults home safe and clean (which can promote aging in place for those with mobility impairments) (EasyTech Seniors, 2020), and this type of technology can also expand access to additional technology (such as the SimpliSafe Home Security System) that senses “freezing temperatures, smoke, breaking glass and gas leaks” (Hodge, 2019, para. 4). This integrated system is cost effective “because of the resultant reductions in the need for formal care “(WHO, 2015, p. 168), can make maintaining your long-term home simple, and it can help prevent social isolation and loneliness in older adult demographics (EasyTech Seniors, 2020).

Here is a list of several other terrific benefits of an AI home assistant like Alexa.

  • It helps you to set up medication reminders. With or without additional medication machine technologies, it can like an alarm, and remind you of your next dose of medication (EasyTech Seniors, 2020).
  • An assistive technology assistant can help you manage your schedule– if there are family get togethers, birthdays, doctors appointments- all of these events can be dialogued verbally to you through in home speakers (EasyTech Seniors, 2020).
  • It can keep track of important lists – you can add items to your grocery list or Christmas wish list (EasyTech Seniors, 2020).
  • It can facilitate the locating of your phone, keys, or wallet. I mentioned a few alternative versions of these Alexa paired gadgets in module 4. Check that module out for more information about assistive devices that are also locator technologies (EasyTech Seniors, 2020).
  • Alert others in emergencies – there are waterproof medical alert buttons, and security systems that can be connected to an AI assistant, which can promptly activate a request for help when a sensor is activated (EasyTech Seniors, 2020).
  • It can help you store your “memories” with digital photo albums and electronic picture frames (EasyTech Seniors, 2020).
  • Work in conjunction with other smart appliances in every room of the home (EasyTech Seniors, 2020).
  • Help you remember your past, using programs like My Life Story. The AI assistant can narrate memories and experiences inputted by family members, friends or the individual to help the older adult recall important life moments (EasyTech Seniors, 2020).
  • It can act like a google search bar and answer your questions. It can be a hands-free way an older adult can search the internet and make full use of todays wealth of online information (EasyTech Seniors, 2020).

These aging-in-place assistants helps caregivers empower seniors to be safe and independent (Hodge, 2019), and this technology can prevent relocation and care giver burden that manifests as worry or fear for loved ones living alone or with a disability (Hodge, 2019).

Apps and Gadgets for Day to day Safety

Caregivers can have an important role in capability enhancement with the use of assistive technology (Horgan, 2020). Assistive technologies increase independence, autonomy, mobility, and range of communication. By extending the abilities of older adults, assistive technologies also extend quality of life and duration of community living (Horgan, 2020).
Examples of capacity improving technologies include medication reminder phone applications and assistive pill distribution equipment that minimize medication errors (e.g. double dosing, missing a dose) and encourage medication adherence. Perceived competence and capacity can be a positive outcome of technology integration (Lindeman et al., 2020).

Technology that addresses safety issues in addition to competency enhancement can also be integrated by caregivers into a care environment. For example, there are technologies that have been developed for other demographics (e.g. bath mats that identify when the water is too hot), that could be integrated into the shower routines of older adults (Bed Bath and Beyond, 2020). Decreased sensitivity to temperature extremes occurs with age and there is increased burn risk for older adults with and without mental illness (Touhy et al., 2014). I believe that reminders and prompts from technology could mitigate burn risk and lessen caregiver responsibility for related caregiving tasks.

Safety studies surrounding technologies that aid the older adult (with or without mental illness) with other daily tasks are also showing promise. Wearable injectors can prevent sugar irregularities and has been associated with dementia and could potentially reduce risk for dementia in at risk older adults; as literature is associating irregularities in blood sugar with dementia onset (Kawamura et al., 2012).

(Unknown, 2020)

Memory issues associated with issues of aging that impair an older adult’s ability to remember to take diabetes medications could also be aided by these devices (Kawamura et al., 2012). The detrimental cognitive effects of hypoglycemia and hyperglycemia can be avoided with this assistive device that maintains sugar levels (Kawamura et al., 2012). I believe that, with AT like this, caregiver burden could be lessened, because the caregiver would not have to check their loved one’s blood sugars, and there would be fewer daily tasks of care.

Caregivers can also have piece of mind when round the clock care is not possible while safety devices that aid in the caregiving task of supervision. For example, the GPS SmartSole Wearable Shoe Tracker is a locator designed for individuals with dementia and caregivers to prolong autonomous living (Horgas & Abowd, 2004). Experiences of wandering can be frightening, and the tracker (that is inserted into the soles of the older adults shoes), can lessen event trauma. The caregiver can better supervise the loved one using a linked phone application that locates the older adult during these experiences.
There are now many phone and digital applications can provide navigation services (for cognitive impairments) on the market. Angel sense is a phone application that learns the users walking and movement patterns within an area. The application allows you to listen in the loved ones surroundings which could help the caregiver identify environments where increased supervision may be necessary (Horgas & Abowd, 2004).

(Sardis, 2020b)

Wearables

Wearables (e.g. smart watches and activity trackers) are popular technology accessories that can be used to improve the older adult’s and caregiver’s quality of life (Sardis, 2020a). When a wearable is integrated into care, efforts made to document, record, and recall important measurements and times are minimized (Sardis, 2020a). I think this would allow a caregiver to spend more time on duties that enrich both the senior and caregiver’s quality of life with device integration.
Wearables can monitor everything from asthma to heart conditions (Sardis, 2020a). Nowadays, medical alert watches have a built-in medical alert function, and even built in blood pressure cuffs. There are also watches such as the Kardiband which can visually show you an ECG like display (a video image of your hearts rhythm) (Sardis, 2020a). This feature can notify caregivers of a rhythm abnormality, and it can help caregivers effectively communicate with the right health services (e.g. telehealth or emergency services) if a need for formal care arises (Sardis, 2020a).

Telehealth with the connection to wearables information can also complete more through assessments that can lead to better effective treatment plans. This integration could minimize visits to medical facilities and care hours for the caregiver of the older adult (Karunanithi, 2007).
The medical team would also have greater details about vital measurements (blood pressure, sleep habits), and caregivers would not need to be burdened with keeping track of these measurements for medical appointments (Karunanithi, 2007).

Robotics

Caregivers roles are being also filled by artificial intelligence robot caretakers that can assist the older adult outside of the home. The robotic caretakers that assist help through social interaction as opposed to physical interaction are known as Socially assistive robots (SAR). These robots can promotes activities, leads games, exercises, and prevents loneliness (Mucchiani et al., 2020). SAR integration could potentially take the onus off of the informal caregiver related to care provision, however, we must ask the question, “Are robots acceptable replacements for human contact?” SARs have a place within pandemic care, as social isolation develops across populations (Mucchiani et al., 2020). Their uses have run the gamut, from taking a patient’s temperature to assisting with ADLs (however, robots are not people, and the authentic human connection remains absent with SAR integration (Mucchiani et al., 2020). I believe these robots are useful companions but not replacements for human interactions

We will discuss the ethical questions about robots in care more in Module 6.

Finally, robots can be integrated by a caregiver into a care plan, to maintain an older adult’s status of physical functioning (Hutson, 2017). For example, robotic exoskeletons that help prevent falls (by moving extremities to restore balance as fall situations arise) may be on the market within ten years (Hutson, 2017). Outcomes could include improved gait and movement, perceived competence, independence, and capacity may also be improved within the older adult. Robotic exoskeletons may seem like a technology of the future, but prototypes have been in the works for many years.
These devices would change the landscape of long-term care for older adults and caregivers (Turja et al., 2020). Many difficult transfer related tasks could be improved, and caretakers’ physical exertions could be minimized with inclusion of exoskeleton technology in their loved ones lives (Turja et al., 2020). Efforts and physical strain could be reduced with an assistive suit of care (Turja et al., 2020). This invention also addresses potential caretaker positions and tasks that can be limited because of pre-existing physical limitations (e.g. arthritis). These devices follow the continuity theory goal of promoting successful aging through role maintenance (Wadensten, 2006). Older adults with these exoskeleton devices could make support worker jobs safer, and less physically demanding, which would decrease burnout and turnover of important care positions (Hutson, 2017). Here’s a video about one of these devices that will help you visualize why exoskeletons could relieve caregiver burden.

Conclusion

Assistive Technology can be used to help caregivers as a partner in care (Turja et al., 2020). Caregivers can make choices about which technology to include in their plans of care to safeguard an older adult’s (with and without mental health issues) (Sriram et al., 2020). If these technologies are encouraged, positive health and long-term outcomes can be achieved (Sriram et al., 2020) and roles that would be altered because of aging and mental health struggles, may be preserved (Wadensten, 2006). To meet the needs of future care, we must think outside the box and enlist help from technology to better ourselves and our loved ones.

Digitally Yours,
Katie

References

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Bed Bath and Beyond. (2020). Dreambaby heat alert anti-slip bath mat with too-hot indicator. https://www.bedbathandbeyond.com/store/product/dreambaby-reg-heat-alert-anti-slip-bath-mat-with-too-hot-indicator/1044983758

Cemental, M. (2019). Taking care of America’s seniors: The importance of homecare [Infographic]. Caring Senior Service. https://www.caringseniorservice.com/blog/infographic-taking-care-of-americas-seniors-the-importance-of-homecare

EasyTech Seniors. (2020). How can Alexa help seniors with memory loss? EasyTech Seniors. https://easytechseniors.com/how-can-amazon-alexa-help-seniors-to-deal-with-memory-loss/

Employment and Social Development Canada. (2016). How To Be The Best Caregiver Possible | Tricks and tips [Video]. YouTube.
https://www.youtube.com/watch?v=GzM47tzwXiU

Hodge, R. (2019). These aging-in-place apps empower seniors to be safe, save money and get medical care. Cnet. https://www.cnet.com/news/these-aging-in-place-apps-empower-seniors-to-be-safe-save-money-and-get-medical-care/

Horgan, S. (2020). Module 4: Models of mental health care [PowerPoint slides]. Queen’s University. Aging & Mental Health OnQ: https://onq.queensu.ca/d2l/le/content/435736/viewContent/2512943/View

Horgas, A., & Abowd, G. (2004). The Impact of Technology on Living Environments for Older Adults. https://www.ncbi.nlm.nih.gov/books/NBK97336/https://www.ncbi.nlm.nih.gov/books/BK97336/

Hutson, M. (2017). This robotic exoskeleton could help prevent falls in the elderly. Science Magazine. http://www.sciencemag.org/news/2017/05/robotic-exoskeleton-could-help-prevent-falls-elderly/

Kawamura, T., Umemura, T., & Hotta, N. (2012). Cognitive impairment in diabetic patients: Can diabetic control prevent cognitive decline?. Journal of diabetes investigation, 3(5), 413–423. https://doi.org/10.1111/j.2040-1124.2012.00234.x

Karunanithi, M. (2007). Monitoring technology for the elderly patient. Expert Review of Medical Devices, 4, 267-77. https://doi.org/10.1586/17434440.4.2.267

Lindeman, D. A., Kim, K. K., Gladstone, C., & Apesoa-Varano, E. C. (2020). Technology and caregiving: Emerging interventions and directions for research, The Gerontologist, 60(1), S41–S49, https://doi.org/10.1093/geront/gnz178

Mucchiani, C., Cacchione, P., Mead, R., Johnson, M. J., & Yim, M. (2020). Deployment of socially assistive robots for elder care amidst the COVID-19 pandemic. J International Conference on Intelligent Robots and Systems. http://ras.papercept.net/images/temp/IROS/files/3628.pdf

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Sardis, B. (2020b). Kardiband [image] Tech for aging: Aging in place technology for dummies. https://techforaging.com/healthcare-wearable-technology-elderly/

Segal, D., Qualls, S., & Smyer, M. (2018). Aging and mental health (3rd ed.). Wiley-Blackwell

Sriram, V., Jenkinson, C., & Peters, M. (2020). Carers’ experience of using assistive technology for dementia care at home: a qualitative study. BMJ Open. 1-4. doi:10.1136/ bmjopen-2019-034460

Touhy, T. A., Jett, K. F., & Ebersole, P. (2014). Ebersole and Hess’ gerontological nursing & healthy aging. (4th ed.). Elsevier/Mosby.

Turja, T., Saurio, R., Katila, J., Hennala, L., Pekkarinen, S., & Melkas, H. (2020). Intention to use exoskeletons in geriatric care work: Need for ergonomic and social design. https://doi.org/10.1177/1064804620961577

Unknown. (2020). Figure 2 [image]. Wearable drug delivery devices: An Attractive Proposal. Drug Development and Delivery. https://drug-dev.com/wearable-injectors-bd-wearable-drug-delivery-devices-an-attractive-proposal/

Wadensten, B. (2006). An analysis of psychosocial theories of ageing and their relevance to practical gerontological nursing in Sweden. Scandinavian Journal of Caring Sciences, 20(3). 347-354. https://doi.org/10.1111/j.1471-6712.2006.00414

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Woolrych, R. (2016). Ageing and technology: Creating environments to support an ageing. Gerontechnology, 15(2), 65-97 https://doi.org/10.4017/gt.2016.15.2.005.00

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