Explore evidence-based technologies to help consumers be more proactive in managing their health and wellness needs at home, work, and play.
Helping the Elderly Age Gracefully at Home
Carl’s ailment started as a touch of forgetfulness, nothing more. Old age? Perhaps. But when friends' names, simple tasks, and life events began to slip from his memory, profound dismay gripped him. Doctors recently diagnosed the 79-year-old retired woodworker with early stage Alzheimer’s disease. How can technology help Carl and the millions like him who suffer from dementia? Intel is pioneering the effort to find out—seeking to understand how proactive and pervasive computing can help prevent disease, foster independence, and improve quality of life.
A bright blue pill box rests near a television remote on Carl’s kitchen table. Carl takes about eight types of medication at different times during the day. His plastic pill box has compartments, each with a lid that flips open to help Carl keep track of what medications he’s taken, but sometimes he forgets.
Carl’s wife, Thelma, often has to remind Carl to take all of his medications on time. She also has to help him remember what day of the week it is. And when Carl is downstairs tooling around in his woodworking shop, Thelma has to remind Carl to come upstairs and eat.
One recent day, as the first winter snow fell outdoors and lightly blanketed the ground, Thelma answered a knock at the door. She welcomed Intel’s Eric Dishman and his team of researchers into her small home in New York. The team brushed off the frosty air and stepped into the warm suburban house as the door swung closed behind them.
Imagination: the Key to Ubiquitous Computing
Imagine. That’s what this team of ethnographic researchers do when they visit Carl and Thelma and families like them. Dishman glances about the room. His mind races with possibilities. He imagines sensors everywhere—the whole home a canvas for new computing technologies. He imagines smart pill boxes that can track usage, smart furniture that can recognize and record human activity, and smart appliances that make use of ordinary devices in Carl’s home like the television and clock radio that prompt Carl to remember routine tasks and to guide him in daily activities like popping a meal into the microwave.
As manager of Intel’s Proactive Health Research Project, Dishman explores the ways in which ubiquitous computing can support the health and wellness needs of people in their everyday lives in their homes. Together with clinical psychologist Margaret Morris, software engineer Brad Needham and the larger People and Practices Research team of which they are a part, the Proactive Health team envisions and develops proactive systems that can anticipate a patient’s needs and improve the quality of life for both patient and caregiver. In addition to the core team, Intel Research Seattle, Intel Research Berkeley, and the Intel Research Council are part of the broader virtual team of people making this vision a reality.
“We have the largest group of elders alive on the planet in human history,” Dishman explains. ”By the end of the decade, it is estimated that one in three households in the United States will have at least one family member dealing with cognitive decline. We need to consider how computing can evolve to meet their needs. And tomorrow’s elders will be different than today’s. For instance, baby boomers accustomed to the PC and the Internet will expect applications and services to enhance their retirement years.”
Social Stigma and High-Cost of Memory Loss
At the onset of his disease, neither Carl, nor his wife acknowledged the disorder. For many households, denial of Alzheimer’s is common; for Carl and Thelma, the “A” word was taboo. Today Thelma provides round-the-clock care for her husband while she tries to hide the saga of Carl’s declining memory from their small clutch of friends. Dementia is one of the most costly diseases to treat in terms of lost productivity to culture and long-term care costs, so health plans are looking for ways to keep people well at home. Dishman believes that dementia and other healthcare needs will drive demand for computing.
Launched in April of 2002, Intel’s Proactive Health Research Project is a multi-year effort focused on home health and wellness. Through research and innovation, the goal of the project is to ensure that Intel® silicon will power the products of the growing home healthcare market.
The project consists of three phases. During this first phase, the team of research scientists study the needs of those in physical and cognitive decline. The second phase will address the needs of those with common chronic conditions like cancer and cardiovascular disease. The final phase focuses holistically on wellness, including nutrition, physical fitness, and mental health.
Carl descends the stairs to his woodworking shop in the basement while upstairs, Morris bends an ear to Thelma’s whispered frustrations. Carl forgets things every single day. And then he forgets that he forgets. So he doesn’t realize that the disease is a problem. He really can’t be left alone for very long. He can’t drive anymore. Thelma wonders how much longer Carl can continue to safely use the five screaming saws in his wood shop. And she worries.
Aging-in-Place: Advanced Smart-Home Systems
In collaboration with Intel Research Seattle, the Proactive Health team is building an advanced smart-home system to help those like Carl and Thelma deal with Alzheimer’s. Researchers are integrating four main technology areas into a prototyping environment to be tested in the homes of patients: sensor networks, home networks, activity tracking, and ambient displays. The researchers wonder about developing a better pill-tracking system for Carl’s medications, about sensor networks to help his adult children look in on things from far away, and about computer-based coaches that help Carl keep his mind fresh.
In the basement, Carl crafts a small woodworking project. He carefully measures pieces of wood, cuts dowels, and glues together small spindles to make a little ladder for his daughter—a request she had for Christmas. In the cold winter months when the frosty temperatures prevent him from enjoying his daily two-mile walk, Carl retreats to his wood shop. Thelma good-naturedly refers to his shop as ”Carl’s Dungeon.”
Carl's woodworking shop
Five large electric saws cast their shadows on the workspace, but it isn’t a dungeon that the research team finds when they venture into the basement. Instead, they come face to face with Carl’s passion for living. In a basement filled with wood projects, massive wooden chests, and tools galore, Carl eagerly describes his love for woodworking and shows the team his projects and tools. “Our aging-in-place technologies clearly have to solve day-to-day assistance problems, but the larger issues related to helping people maintain social engagements, enjoy a sense of purpose, and experience a better quality of life are even more important,” Morris says.
Dishman and his team cast a parting sidelong glance at the small wooden ladder lying on the workbench as they wrap up their visit. The carefully crafted ladder reminds them that the researchers’ greatest challenge is not technology, but imagination.
How can computing help to give Carl and others like him motivation to keep on living? The Proactive Health Team is determined to find out, day-by-day, visit-by-visit, one rung at a time.
Proactive Health Research Technologies:
Sensor Network
A sensor network senses the location of people and objects in the home. The network uses a combination of motion sensors, cameras, contact switches, magnetic switches, and Radio Frequency Identification (RFID) tags. RFID uses electronic tags to store identification data and a wireless transmitter gun to capture it. Built upon Intel Research Berkeley’s mote technology, the network enables multiple sensors to be wirelessly networked together around the home.
Home Network
A home network allows a household to interact not only through multiple, distributed touch points, including traditional PCs, PDAs, and tablets, but also through televisions, clock radios, and telephones. This is particularly important for Alzheimer’s patients who often forget how to use the newest technologies like PCs. These people must rely upon more familiar interfaces of older technologies such as phones or television sets to get reminders and prompts from the system. Most important, the system can deliver a reminder to a person on any familiar, proximate device.
Activity Tracking
An activity tracking system using dynamic Bayesian networks and other artificial intelligence (AI) technologies is used to translate all of the raw sensor network data into meaningful trending information about what activities people are doing in the home. Intel is working with researchers at Oregon Health & Science University, the University of Washington, and the University of Michigan, which are funded through the Intel Research Council, to develop these sophisticated AI technologies. The new technologies may well be able to detect the onset of Alzheimer’s years before it is traditionally diagnosed. They will do this through an analysis of simple daily tasks like teeth brushing or meal preparation.
Ambient Display
The research team is experimenting with ambient display technologies that allow distant family members—like Carl’s son who lives in California—to check in on their aging parents. For example, smart photo frames can show a person at-a-glance that “all systems are normal at Mom’s house,” and presence lamps turn on to let a person know that a loved one has gotten home safely.
