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Friday, July 1, 2016

Smart Living... beyond smart cities (Part 4) : Senior Citizens Care



Steve Jobs so bravely articulated in his remarkable speech to Stanford graduates in 2005 when he put death at the centre-stage. First, he referred to death as "useful", and then he went on to remind his audience about something the young adults were probably reluctant to acknowledge on the day of graduation: that they would all age and die. It is the one universal human experience. And, finally, he claimed that death "is very likely the single best invention of life. It's life's change agent…” This kind of thought process from various philanthropists has led to multiple innovations in the health and wellness industry to leverage the technology to combat the deadly diseases trying to conquer death leading to an increase in life expectancy. According to World Health organization it is projected by 2020 chronic diseases will account for 75% of all deaths worldwide 

This blog post will connect with you emotionally thru the situations we are today living in and provide practical ways to unleash the emerging technology and overcome an area of our mid-life crisis in lieu with Elder / Senior Citizen Care. 

According to the State of Elderly in India report released by the non-profit organization Helpage India by 2021, the elderly in the country will number 143 million, the report said. Presently, the elderly in divided into three categories: the young old (60-70) the middle-aged old (70-80) and the oldest old (80 plus). The increase in life expectancy the population of those aged 60+ will increase by 270% and out of this, the oldest old segment, which is the most vulnerable on account of suffering from disabilities, diseases, terminal illness and dementia, is also the largest growing segment of the elderly population, at a rate of 500%. 

The traditional Indian society and the joint family system had in built fault tolerant reliable system for all the family members before the nuclear family concept took over the better parts of it. This is especially true for young ones and elder ones reducing them to a compulsion to be more self-dependent. Most often than not, the elderly people are exposed to emotional, physical and financial insecurity of which the most common challenges faced by the elderly is the need to ensure their medical needs are fulfilled.  Today the elderly are both economically and emotionally dependent on a kids who stay away from the beloved ones as the critical need to financially earn and create their career graph beckons, In a distant city, earning livelihood as a prey to rapid urbanization, competitive lifestyle, growing aspiration for more lifestyle products and an insatiable desire to get ahead keeps then on their toes and rarely gives them opportunity to take care of the beloved ones while they struggle themselves to strike a work-life balance. 
All of these are coming at a dearly social cost. Today, the lack of  time to spend with family members, ever increasing work pressures, deadline driven work environment, targets to accomplish, stressed commuting etc… and we are compromising fast and implicitly thereby losing the emotional bonding with kith and kin and hence the  “Relationships”…..starting with spouse at our doorstep. Some have taken that to be a fad to brag about how critical they are for their employer.  Mothers are busy all day slogging for providing the best support systems at home, kids are into rat race so they don’t get time to bond with grand-parents, grand-parents are killing time with the ibox or web-serials and hence the entire house provides a scenario of a busy corporate house.This creates a void in the elderly senior citizens who are left to deal with life and their issues on their own, turning themselves into introverts lest they disturb the rhythm of other lives around them and create the risk of falling into health black-hole which can prove costly.
Kids of the parents who stay far away, realize their compulsions between how they many a times are incapacitated to maintain the balance which otherwise they would have cherished to. What do the elders so? In cases of urgent need, where do they go? Who do they speak to? But there are many who are blind-sighted to even notice what they are missing? Does it hound them? They shudder when they think it’s just a matter of few more years when they too will qualify to become next batch of senior citizen...!!! 

In a bid to find a solution to this, a quite revolution is brewing across the healthcare industry. While heightened patient awareness has led to demands for better health services, remote care and health monitoring for senior citizens, especially for those sets whose kids are far away but would still like to keep a tab and reach out help if needed. Requirements for remote Treatment of complex chronic conditions, with updated PHRs and statistical parametric records have been demanding smarter healthcare systems which through various connected devices should enable measurement and effective treatment of old-age issues which does not seem too far from reach with the advances in the technology at hand. 
  • In a medical emergency, timely provisioning of help is the essence. Minutes can make the difference between life and death; disability and recovery. By lessening the time it takes to diagnose and treat a patient, smart, connected devices, will lead to fundamental improvements in emergency medical care 
  • Instead of hospitalizing senior citizens a home care option can be extended and alternative for constant physiological monitoring with minimal people intervention using IoT-driven, non-invasive monitoring. This type of solution employs sensors to collect comprehensive physiological information and uses gateways and the cloud to store the information, then send the data wirelessly to caregivers for further analysis and review. It replaces the process of having a health professional come by at regular intervals to check the patient’s vital signs, instead providing a continuous automated flow of information 
  • Smart sensors, which combine a sensor and a microcontroller, make it possible to harness the power of the IoT for healthcare by accurately measuring, monitoring and analysing a variety of health status indicators. These can include basic vital signs such as heart rate and blood pressure, as well as levels of glucose or oxygen saturation in the blood. Smart sensors can even be incorporated into pill bottles and connected to the network to indicate whether a patient has taken a scheduled dose of medication 
  • As per the WHO 2014 statistics every year worldwide there are 32.4 million heart attacks and strokes that lead to 14 million deaths. About 85% of strokes are ischemic, and these patients can be treated within the first 3 to 4.5 hours and 15% of the strokes are hemorrhagic. Patients suffering Ischemic stroke if given tissue plasminogen activator have a very great chance of recovery but the doctor needs to diagnose if the stroke is Ischemic or hemorrhagic which needs a CT Scan. Most of the time today especially with traffic conditions in India is wasted only to get to the hospital. Here is where a use case of connected devices in the ambulance can help reduce time and transmit information while in transit for the care giver to be ready for action when the patient arrives saving the time and increase the chances of survival
  • One of the prominent statistics from the American journal of medical research indicates at least 75% of adults are non-adherent to physician prescribed treatment and medication in one or many ways with respect to medication. The economic impact of non-adherence is estimated to cost $100 billion annually. IoT medication pumps are effective at adequately dosing medications, without the risks of overdose or missed doses that are present when medications are administered manually, also with IoT sensors an alarming mechanism will not only set an indication to elders at home to take medication but also will monitor and give feedback to the care giver 
  • Bio-electronic therapies is just beginning to ramp up and that in the future many conditions could be treated with electrical impulses, leveraging IoT in healthcare with the implants both the provider and the care taker will receive specific feedback on various vital parameters that can be monitored proactively with predictive analytics and set course correction which will add a whole new dimension especially to the senior citizen health care treating aliments like Arthritis, Respiratory conditions, Heart diseases, etc…
  • A trend from the west which will soon catch up in the east in the coming years is the concept of “aging in the place” where the elder citizens especially men wish to stay back independently in their homes, while another trend is commonly seen in senior women is home sharing, where two or more than two women share a home teaming up as senior roommates. Affordable remote monitoring will become popular with digitally savvy millennials increasingly look to sensors and wearable tech to keep track of parents and grandparents. For Example… Sensara is a remote monitoring system and app that uses small, unobtrusive sensors to keep on eye on elderly family members and friends who live on their own 
  • Goode Intelligence forecasts that by 2019 there will be 5.5 billion users of mobile and wearable biometric technology around the globe. Apple is the leading manufacturer of biometric-mobile devices, and HealthKit is said to have an “Emergency Access” feature where medical information can be shared through the “Medical ID” app. Apple has also partnered with EPIC and their MyChart app to capture physical vitals and other patient data, and make this information available to physicians via the HER 
  • GreenPeak Senior Lifestyle System consists of just four sensors and a gateway. One sensor is located in the bedroom, one in the kitchen, one in the bathroom and one on the front door. These sensors track the movement of a senior or disabled resident in the home, and by using ZigBee and a ZigBee gateway, transmits the information into a cloud intelligence app. Within a period of one or two weeks, the cloud intelligence app learns the “normal” behavior and activities of the household. When does the resident awaken, when does he go to the bathroom, when does he make breakfast, when does he usually leave the home and return. Once the normal behavior pattern is learned, if there is a sudden or dramatic change in the anticipated movement, then an alert can be sent to family members or caregivers. 
  • The BodyGuardian Sensor performs cardiac ECG and rhythm monitoring. A body worn sensor allows individuals to remain active and independent while their heart and general health are being monitored. The patient data is wirelessly delivered to the Preventice Care Platform, a cloud-based mHealth platform that collects real-time data from devices and delivers information to physicians 
  • BeClose says it takes less than 15 minutes to set up sensors to monitor a senior’s routine that can be viewed through a web dashboard. Emergency alerts are also provided via email, text message, or phone. Additionally, the system is smart enough to recognize gradual changes or adjusted trends in the senior’s lifestyle. For example, if they are getting out of bed later, or it is taking them longer to get to the kitchen, or if they no longer leave the house, a message can be sent to the family alerting them of this change 
  • Old people have tendency to fall and injure themselves.Active Protective can help them in this area. This smart garment detects a fall before we hit the floor. It uses 3D sensors to determine falls and crashes in progress, and then deploys wearable airbags in textile in order to protect our hips from braking. This might be a good thing to consider when hip fractures are so often in older population. While fall detection is not for everyone, it can be the difference between life and death for those who need it. Falls can result in critical injuries, like those to the head and hips, and are the leading cause of loss of independence for the elderly. The top performers in the Fall Detection sensor are Medical Guardian, LifeCall, and Medical Care Alert 
  • WalkJoy, a wearable aimed at helping people with neuropathy who have trouble maintaining balance and walking. Individuals who suffer from the nerve problem—most of whom are older—lose feeling in their feet and sometimes calves and knees and, as a result, find it difficult to determine where their foot is in space, leading to frequent falls. The device, which fits right below the knee with a Velcro strap, contains a variety of sensors able to detect velocity and the angle of the foot. With that data, the system fires on the heel as it strikes the ground, causing the motor system to revive and sending appropriate messages to the brain 
  • The EverThere has hands-free voice communication, and it can even make a call if the wearer isn’t able to do so herself. Internal GPS allows the care center to determine the user’s location and send an ambulance or call a loved one 
  • Another important fact of life especially in the senior citizen community is of Depression. A survey from Times of India group indicates 21.9% of elderly citizen in India suffer depression. One of the causes for depression clearly stated is loneliness. While antidepressant drugs are administered the IoT coupled with augmented reality and social platforms can being the senior citizens close to their loved ones and also with the community then often interact with. Proactive mood aware wearable’s will trigger messages to their near and dear ones who can act immediately to help the elderly bring back smile and cheer on their faces and avert any kind of mood disorders 
Although earlier generations may not have been raised in such a technologically advanced time, statistics show that a large majority of this demographic understands the need to join the digital revolution. Now more than ever, the elderly are engaging in this sphere more often than healthcare providers seem to recognize. Research suggests that a significant number of senior citizens are engaging digitally, but–for those who aren’t– why not? Most likely, this is due to ignorance or inexperience. As their healthcare provider and YOU probably the most important person in their life, it would be wise, as well as appreciated, if YOU were to take their hand, and pull them into the 21st century by educating them on how to engage in a digital world. 

Smart citizen is what they have made you to live in today’s competitive smart city capable of making smart choices using smart devices … it’s time to look back at our parents and grandparents and gift them smart care … think thru. 


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