As family ties in the western world weaken, elders age alone. With age come mild conditions that render personal care increasingly difficult. The traditional solutions involve either retirement homes, or having a care provider at home. In addition, systems appear that provide e-care at home.

Retirement homes offer many advantages. They make the lives of elderly people more enjoyable by offering around the clock supervision, expert on-site medical care and individualized help with daily needs. They provide a structured environment, with a daily schedule for normal life, which is especially needed if the care recipient is mentally or physically disabled. The care recipients remain as independent as possible, keeping on with their usual independent life style. Finally, they help the families deal with the logistics of elderly care, without having to disrupt their lives. On the other hand retirement homes can be quite expensive and may not be covered by insurance policies. There are quality issues with the staff being under-qualified or unwilling to work closely with the families. Finally there are acceptance problems from the care recipient side, with the elderly being reluctant to change environment (home, neighborhood and friends), facing strained personal relations in the retirement home and feeling neglected by their families.

Another alternative is to have a person providing care at home, from a few hours to permanently in-home, depending on the conditions of the care recipient. The positive side of this arrangement is that the environment of the care recipient remains mostly unchanged. On the negative side, time is needed to familiarize with the new arrangement, and as always there is the issue of personality matching between the care provider, the care recipient and the family.

e-Care at Home

There is another option for care provision at home: that offered by e-care systems. These are suitable for mild cases and in essence they adapt the home environment to the care recipient’s needs, instead of forcing the care recipient to adapt to a new environment. These systems offer peace of mind to the care recipients and their families by understanding and monitoring habits and warning about or reporting situations that deviate from those habits or are critical.

To do so, e-care systems assess both the physical and the cognitive state of the care recipient. The physical state includes vitals measurements, medication intake via medication-monitoring pill boxes, bed sensors assessing heart rate, quality of sleep and breathing patterns, the state of cabinets and doors, the room presence or absence from home, and the assessment of gait, balance, or even exercise patterns. The cognitive state is assessed via video-conferencing with family, interaction with digital pets, mood recognition, in-home or outdoors wandering detection and cognitive games.

Do all these sound like the solution to elderly care? Well, e-care systems do have their disadvantages. The technology has not yet fully matured: Many such systems are experimental and the associated devices are expensive, since they are not widespread consumer products. Also, one should not underestimate the danger of such systems changing the mindset of the families and the care recipients. Using them can create the illusion that humans are out of the picture. But not! Doctors still need to be visited, and visitors still need to come around for a cup of tea!

The e-Caring Home

What are the ingredients of a successful e-caring home?

First of all, the mental state of the care recipient should be addressed. User immersion is important for that. The care recipient should feel the presence and reassurance of the caring home. Large screens and speakers are utilized by friendly applications displaying the necessary information.

Care recipient interaction with the e-caring home is also very important. For this, touch, gestures and speech are used. Definitely not mouse and keyboard!

Another important aspect is communication. Systems facilitate the traditional person-to-person communication with family, friends and caregivers. But also machine-to-person communication is important. The e-caring home communicates with messages and warnings to the care recipient, as well as with reports and alerts to family and caregivers.

The final important aspect is to hide away the tech. The systems should be designed in ways that package away unfamiliar devices. On the other hand,
the care recipient and the home can be equipped with familiar devices. Here smartphones, smart watches, screens and tablets come into play.

e-Care Systems

There are e-care systems currently in use.

QuietCare Plus features a personal emergency alarm button and sensing for motion and extreme temperature detection. The collected information is sent to a website for checking at any time. QuietCare are also on the lookout for anything out-of-the ordinary.

BeClose places discreet sensors throughout the home to track daily routine.
It sends an e-mail any time there’s a disruption of that routine.

E-Neighbor System detects unusual activity in the home. A shower left running or a fridge that remains unopened for a day could trigger a phone call to the family or a caregiver.

The GrandCare Como reprograms the TV to monitor elderly well-being. It allows family members to send photos and coordinates a calendar with caregivers.

Just Checking utilizes presence and door sensors to provide an up- to-the-minute picture as a care recipient gets on with daily life.

eWALL is a new system now undergoing its first tests with actual users. It offers a holistic approach to care-giving. It senses the home environment, body motion and vitals, body posture, face and voice, as well as position indoors and outdoors. It reasons for activities and forming habits sending alarms and notifications to the care recipient and the caregivers. Finally, it promotes well-being via communication, exercise, cognitive games, goal setting and motivation.

Concluding remarks

Independent aging can be promoted with e-care systems at home. These systems are an alternative to care by human caregivers away or at home. They do not downgrade the importance of the human caregivers, either formal, or the family; they just allow some distance and a sense of independence without sacrificing the feeling of reassurance. They employ home and body sensing for assessment and help. The first systems are out there, while eWALL is on the making!

Aristodemos Pnevmatikakis

Associate professor Athens Information Technology, interested in tracking and identification systems for activity recognition in smart spaces, the hills and the sea.

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