Multiroom Audio Benefits Residents with Alzheimer’s

Sadly for patients and loved ones alike, Alzheimer’s sufferers may be trapped in the now, unable to recognize family members or summon memories.

But music has been known to bring Alzheimer’s patients out of their reverie, reminding them of people and experiences gone by.

“We believe it can help to revive memories,” says Rob Garrett, principal of Cypress Springs Residence, an Alzheimer’s facility in Tulsa, Okla. (A second residence is under construction in Oklahoma City.) “For some of the residents, music was a big part of their lives.”

That is why Garrett and his team insisted on a multiroom audio system for Cypress Springs, settling on a PC-based solution from CasaTunes. The facility has two CasaTunes servers, seven XLe expansion boxes that deliver music to as many as 12 rooms each, and eight 12-channel amps.

CasaTunes CEO David Krinker says the system serves about 100 listening areas, including bedrooms of the 66 residents.

The system pipes music from two sources: Internet radio and Companion Radio, a satellite-based service specially created for residents and staff of senior living facilities.

Residents don’t operate the audio system by themselves, Garrett explains: “We don’t want to give them things that will frustrate them.” Instead, CasaTunes is controlled from a centralized location via a PC interface.

There is one caregiver per seven or eight residents, according to Garrett, so the staff knows each patient intimately. “We know that Mr. Smith likes jazz. It may help to calm him down or go to sleep.”

Across the facility, music also can serve as a trigger to signify meal time, bed time, or other activities. “They can often relate better to music than they can with words,” says Krinker.

Research shows that recalling sounds evokes memories of youth, increases self esteem, and puts dementia patients in a better mood. “Some of them go down the hall, and they’re whistling or humming,” he says. “They’re happy.”
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From the country that brought the world George Orwell’s Nineteen Eighty-Four comes a new, friendlier kind of Big Brother. This one is here to help people with memory loss live on their own longer. Engineers at the Bath Institute of Medical Engineering (BIME), at Bath University in England have designed and tested an integrated system that not only monitors people’s actions, but can speak to them, contact help, turn off appliances and faucets, and even e-mail family and caretakers.

“The whole objective is to enable people to stay at home as long as they can,” says Bruce Carey-Smith, a BIME design engineer. The system reports the wealth of information it collects—from potential problems to successful interventions—to health care providers. “It’s about supporting—not about replacing—the role of care staff,” Carey-Smith says.

He says the system has been installed in the assisted-living residences of two U.K. dementia patients about a year ago—and both trials report good results.

In addition to reminding people to switch off potentially dangerous appliances (and actually shutting them off and contacting help if need be), the system is designed to help people avoid other hazards, such as nighttime wandering and incontinence issues. The system, for instance, senses when someone gets out of bed in the middle of the night and automatically turns on the bathroom light to help them find their way. Or, if the bed senses a prolonged nocturnal absence, the system will play voice recordings that gently remind people that, “it’s awfully late, perhaps you should be getting back to bed,” says Carey-Smith.

Of course, a disembodied voice in the middle of the night could be enough to confuse anyone, let alone someone who suffers from diagnosed disorientation. “It was actually found,” says Carey-Smith, “that as long as people could see where the voice was coming from, they accepted it, and it was okay.” To minimize confusion, he recommends that family members or friends record messages so that users won’t be rattled by strange voices nudging them to turn off the lights or oven.

Aspects of the system, such as a bedside light that glows when a user gets out of bed and an automatic stove shutoff, are already available as independent units. But customizable systems tailored to an individual’s special needs are still being perfected. The project’s lead scientist, Roger Orpwood, I said in a statement that the systems could be available to the public as early as 2014. The estimated price tag for equipment and installation, according to Carey-Smith: £10,000 to £15,000 ($14,044 to $21,066).

The technology is on display today at the Olympia Conference Center in London as part of the Engineering and Physical Sciences Research Council “Pioneers ’09″ event. Now if they could just develop a voice prompt to remind us to reread Nineteen Eighty-Four and all the other classics we’ve been putting off in favor of Big Brother reruns.

Sensors monitor older people at home – CNN.com.

Columbia, South Carolina (CNN) — The sensors know when Charlton Hall Jr. wakes up to go to the bathroom. They know how much time he spends in bed. They watch him do jigsaw puzzles in the den. They tattle when he opens the refrigerator.

Sound like a Big Brother nightmare?

Not for Hall. The 74-year-old finds comfort in monitored living.

“It’s a wonderful system for helping older people to stay independent as long as possible,” he said, sitting in the living room of his 7,500-square-foot house, a sensor watching him from an elaborate bookshelf. “They know where I am — all the time.”

Sensor networks, which made their debut in hospitals and assisted living centers, have been creeping into the homes of some older Americans in recent years.

The systems — which can monitor a host of things, from motion in particular rooms to whether a person has taken his or her medicine — collect information about a person’s daily habits and condition, and then relay that in real-time to doctors or family members.

If Hall opens an exterior door at night, for example, an alert goes out to his doctor, a monitoring company and two of his closest friends, since he doesn’t have family nearby.

“They want to know if I’ve fallen, and where I am,” he said, noting that he’s fallen several times in recent years and also has a chronic heart condition and diabetes.

Hall’s monitoring network, made by a company called GrandCare Systems, features motion-sensors in every room as well as sensors on every exterior door. A sensor beneath the mattress pad on his bed tells health care professionals if he’s sleeping regularly.

All of this connects wirelessly with vital sign monitors, which send his doctor daily reports about his blood-sugar levels, blood pressure and weight. He can see charts about how he’s doing on a touch-screen monitor that sits on a desk in his home office.

This type of set-up may only be the beginning.

University researchers are testing robots that help take care of older people, keep them company — and even give them sponge baths. Meanwhile, some younger people have taken to collecting information on their own, often going to extremes to document exercise routines, caffeine intake and the like and posting the data online.

Jeff Kaye, director of the Oregon Center for Aging & Technology, said this monitored-all-the-time life will become the norm for older people in the United States within five years, and will be common for people of all ages soon after.

His lab has been conducting research on the benefits of monitoring people all the time, and they have early indications that doctors may be able to spot early Alzheimer’s, dementia and indicators a person is susceptible to falls by monitoring their daily lives.

While the technology is basically ready to go now, he said, researchers haven’t had enough time to figure out how these systems will work most effectively. Crunching the data can be challenging, and the number of things we can monitor needs to be increased for these systems to provide more valuable info.

“The temperature you sleep at, the particulate matter in the air, the ambient light your body experiences … drastically can change your physiology, and we are barely aware of it,” he said.

The idea of monitoring older people is catching on slowly, and there are several reasons for this.

Part of the hold-up is a lack of research. While tech researchers and health care experts have a general sense that more monitoring must be a good thing for spotting health trends and preventing accidents, there’s little formal research to prove this.

Companies that make these systems are also scarce.

Only a few boutique companies in the United States sell these types of monitoring systems for home use, experts said in interviews, although Intel and GE are set to announce a partnership such systems in January, GE Healthcare’s Jim Pursley said.

Some complain that the monitoring systems are too expensive for many people.

Hall’s system in Columbia, South Carolina, cost $5,500 to install, he said. Others pay monthly fees for monitoring services, kind of like a cable TV payment model.

Bob Jennings, who lives 45 minutes down the road from Hall in Orangeburg, South Carolina, said he pays $300 to $400 per month for a system to monitor his parents’ home, which is about a mile down the street from his house.

That’s cheaper than a nursing home, and it brings him peace of mind, he said.

There are also ethical issues with monitoring people as they age.

Jennings, 49, said he made a pact with his dad to let him stay in his house — which he’s lived in for more than 40 years — as long as possible. Jennings didn’t feel safe about that arrangement without placing a network of monitors in the home.

Bob Jennings’ dad, Robert Jennings, now 86, didn’t take to the idea kindly.

“I don’t need that damn thing,” Bob Jennings recalls his dad saying.

But if it meant he could stay in his house, he would agree to it.

The younger Jennings said the system has proven useful.

Until recently, Robert Jennings lived in his large house with his wife, who has Alzheimer’s and has since moved to an assisted living center. Before she moved to the center, Bob Jennings worried his mother would become disoriented and wander out of the house. He used a GrandCare network of sensors to track her and notify him if she broke from normal routine.

If she was out of bed for more than 10 minutes in the middle of the night, for example, he would get a call. And if she opened a door to the backyard, where there’s a swimming pool, he would get a call on his mobile phone, work phone and home phone.

One night he got that call, and rushed to the house to find his mother fiddling with a latch that kept her out of the backyard.

“She could have walked right out there and fell in the swimming pool,” he said.

Jennings said his dad has been able to stay in the home at least two years longer than he otherwise would have because of the monitoring system.

But it’s not clear Robert Jennings understands the system.

His son had the sensors installed while his dad was out of the house so that he wouldn’t worry. The 86-year-old users a touch-screen monitor that controls the system from the kitchen mostly to look at photos of his family members. Pictures of granddaughters in cheerleader outfits and his grandson on hunting trips flash across the screen while he eats breakfast.

The AARP supports these monitoring systems as a way for people to “age in place,” but the group says adult children should have serious conversations with their parents about why they’re interested in a monitoring system and the possible benefits.

“Conversations should be taking place early and often,” said Elinor Ginzler, AARP’s senior vice president for livable communities.

Lee Tien, senior staff attorney with the Electronic Frontier Foundation, a group that advocates for privacy online, said rules need to be developed to ensure the personal data from these monitoring systems is protected.

“When data is being held by a third party, that also means it’s susceptible to being subpoenaed by your insurance company or accessible perhaps by your employer or law enforcement or the IRS,” he said. “Everyone can make up their own idea of who they wouldn’t want to know all the things that the 24-7 record of the movement inside your home — connected with monitoring devices — would tell you.”

Robert Jennings said he wants to do whatever he can to stay in his home.

“It’s where I spent most of my time with my wife and raised my children,” he said. Nearly every inch of available wall space in the home is covered with portraits of family members and pets.

Hall is a rare case in that he chose to install a system to monitor himself. Without it, he said, he would have to leave his home, which is stuffed full of beloved items he’s collected over the years — from porcelain birds to Chinese furniture and nude statues.

A tiny dog named Precious tails him everywhere he goes in the house.

But Hall likes knowing someone else is watching, too.

“It is the most secure feeling,” he said.

BATON ROUGE, La., Nov. 9, 2010 /PRNewswire via COMTEX/ — When faced with managing the care of an aging or ill family member, a new survey shows that Americans want to keep their loved ones close to home. According to a national telephone poll conducted by Harris Interactive for Amedisys, a leading provider of home care and hospice services (AMED 27.90, +0.22, +0.79%) , 74 percent of Americans would prefer having a terminally ill family member taken care of at home with the care of a trained health aide, rather than in a traditional nursing home or other care facility. In comparison, only 10 percent would prefer a nursing home and six percent would choose an outpatient center. The poll also found that when considering care for an elderly family member recuperating from surgery, half (51 percent) would prefer home health care over any other facility.

The survey was conducted as part of Amedisys’ Annual Home Care Matters Initiative around National Home Care and Hospice Month, a national month of recognition across the industry, which takes place each November.

The poll results show that Americans have a preference for home care for themselves, as well. If faced with chronic medical care, terminal illness or surgery recuperation, the overwhelming majority of Americans would prefer home health care versus off-site care at a nursing home, rehabilitation or outpatient center. The poll found that 65 percent of respondents would prefer home health care for themselves while recuperating from surgery, while 75 percent would prefer it for themselves if they were in the final stage of a terminal illness.

Home health care is identified as a valuable resource for families

Survey respondents said they are already providing some sort of care for their loved ones: one-in-five poll respondents (19 percent) reported that they are coordinating or assisting with home care for a spouse or elderly family member, and according to the Robert Wood Johnson Foundation, 43 percent of those providing care are 50 years of age or older, and 61 percent of family caregivers are women.

According to the AARP Public Policy Institute, the annual economic value of these types of unpaid care giving activities is an astounding $354 billion.

“Home health care assists these familial caregivers in being more effective in managing a loved one’s illness which provides a significant cost and family stress relief benefit,” says Michael Fleming, MD, Chief Medical Officer of Amedisys. “The home health industry can help produce better health outcomes for patients if more people, doctors included, were better educated about health care at home options.”

And, the number of family members caring for sick loved ones is expected to grow: more than one-third (34 percent) of respondents to the Harris poll anticipate that they will have to do so within the next five years. Not surprisingly, respondents felt that home health care is a critical part of the continuum of care. Eighty-eight percent of those polled felt that home health care could be considered a valuable resource for themselves, their family members and future generations.

Home care plays a critical role in managing the age tsunami

According to 2008 figures, approximately 7.6 million Americans receive care at home for a variety of conditions. Recent studies show that the average home care patient has changed considerably during the past few years, with an increase in patients requiring major rehabilitation needs. In fact, a 2007 report from the Centers for Disease Control showed that 80 percent of older adults had at least one chronic condition and two-thirds of all health care costs are spent on chronic disease management. With the graying of the American population – and the clear preference for care at home – the demand for home care and hospice is only expected to grow.

“As the population ages, home health and hospice care is going to become increasingly important as an alternative to hospital or nursing home care. And it’s a service that Americans clearly want,” said Amedisys Chief Executive Officer William Borne. “Over the next ten years, home health care has the potential to save $31 billion dollars in Medicare costs. As we progress into the role of chronic care management, the home health and hospice industry has an important role to play in the future of health care.”

Other survey findings:

Currently, 25 percent of those polled provide some type of financial support to an elderly family member, and 38 percent anticipate having to do so within the next five years.

Regionally, those in the South (43 percent), the West (44 percent), and Northeast (38 percent) are more likely than those in the Midwest (26 percent) to provide financial support within the next five years.

Half (49 percent) of Americans would be angry and an additional one-third (33 percent) would be disappointed if home health care was not an available care option to them.

The Harris Poll National Quorum(R) was conducted by telephone within the United States between August 4 -8, 2010 among 1,006 adults (aged 18 and over). Figures for age, sex, race/ethnicity, education, region, number of adults in the household, and number of phone lines in the household were weighted where necessary to bring them into line with their actual proportions in the population.