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Using mHealth to Help Seniors Age in Place

A University of Missouri project is finding that embedded sensors and other care coordination tools can help seniors live longer and better lives

- A smart home project launched by the University of Missouri has found that seniors who have access to care coordination tools double their chances of living independently. And if they’re using sensors, those chances are doubled again.

Marilyn Rantz, Curators Professor Emerita and the MU Sinclair School of Nursing and the project’s leader, says the study proves that seniors who use mHealth tools and platforms – from communications tools to embedded sensors that measure vital signs, sleep patterns and even the potential for falls – can live independently longer, and with better health outcomes.

The key, she says, is detecting a change in health status instantly, while it’s still subtle, before it becomes a full-blown health issue or emergency. Catch those problems, and a senior has a much better chance of living longer and better. With almost 90 percent of seniors expressing a desire to stay at home for as long as possible, according to a 2010 AARP study, the potential for this technology is enormous.

“If you can get head of the symptoms, you can fix the problem when it’s much smaller and avoid the hospital” or the long-term health problems, she says. “If you can pick up subtle changes and address them early on, you’re so much better off.”

Rantz, who has been leading MU’s aging in place initiatives for more than a decade, says the university’s independent living community, called TigerPlace, was fitted with an array of technology that includes bed and motion sensors. Sophisticated algorithms sift through the data coming in from the sensors to detect changes in sleep patterns, vital signs, even gait, which helps researchers determine if a resident is in danger of falling.

A recently-concluded five-year project, detailed in the November issue of Nursing Outlook, determined that seniors who live with sensors in their homes had an average length of stay in an independent living community of 4.3 years, compared to 2.6 years for seniors who live without the sensors (but who do have access to MU’s care coordination program, which includes healthcare and social workers).

The national average for a senior living in an independent community is 1.8 years.

“The sensors also enhance decision-making for the care coordinators,” Rantz said in literature detailing the study. “The sensors help the nurse or the social worker focus on alerts to potential health problems. The alerts can also indicate potential depression, increasing confusion and/or other problems the person may be experiencing. With the sensors, the nurses get a head’s up several days or weeks before the health condition becomes serious – before people will even detect it themselves and complain about it. It’s all about early detection.”

Rantz said the program is now testing the sensors in other settings, ranging from a 100-year-old senior housing center in Cedar Falls, Iowa (“Refitting that was a hoot,” she said) to smaller facilities in Kansas City. They’re even enlisting local seniors to embed the sensors in their own homes.

“It doesn’t take long; they forget the sensors are even there,” she says.

Most of the sensors used are off-the-shelf models adapted for use by the university, Rantz says, while the team has five patents either granted or pending for the algorithms. They’ve looked at other technology, from motion sensing to imaging to radar, and have taken a look at wearables but are waiting for better, more advanced models to come out.

“We’re always looking around,” she says, noting that one MU alumnus has launched a commercial venture – Foresite Health Monitoring – that will be marketing some of the program’s achievements in fall detecting to hospitals. “We’ve tested lots of things. We play with a lot of different technologies to get the ones that can be built in a robust way and an efficient way.”

Rantz is an unabashed advocate of using mHealth to help seniors live independently, having lost her mother to a fall-related injury and another family member who was trapped in her own home for a few days before being discovered. She says the technology not only enables friends, family members and care teams to keep track of seniors and detect health issue in advance; it also gives the seniors themselves some comfort.

She says she’s most surprised at how much information the sensors can detect – and what researchers, using ever-more-advanced analytics, can find in that data.

“I’m surprised at how diagnosis-agnostic this technology has become,” she says. “Health status can be measured in many, many, many ways. (The technology) has been more robust than I ever thought it would be.”

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