The relentless wave of new technology just keeps on rolling along like a tsunami. It’s like a digital revolution that never stops! But there are times when we have to pause and ask, when it comes to caregiving, is a high-tech solution really the best solution, or does it take the place of something more vital, like in-person face-to-face contact?  That’s the dilemma that came to mind as we read this recent article on the excellent website of Kaiser Health News. In it, reporter Sofie Kodner takes a fresh look at some of the recent digital advances in elder care – a topic we’ve covered before here on the AgingOptions blog.

She concludes, just as we do, that digital technology can bring a caregiver greater peace of mind, and perhaps keep an aging loved one safer. But, Kodner cautions, we can’t overlook the biggest drawbacks of digital monitoring devices: they’re intrusive, costly, and potentially impersonal. We’ll review the Kaiser article and let you decide for yourself.

“I Was Losing It,” Says One Distraught Daughter

Kodner begins her article with the all-too common story of a woman named Dian Wurdock. “In the middle of a rainy Michigan night,” Kodner writes, “88-year-old Dian Wurdock walked out the front door of her son’s home in Grand Rapids, barefoot and coatless. Her destination was unknown even to herself.” This particular story has a happy ending—Wurdock’s son was able to locate her before she had gotten far—but it reflects a pervasive fear facing the caregivers of aging adults: that their parent or loved one will get themselves into a dangerous situation, and that the caregiver won’t be there to help.

In Wurdock’s case her dementia behaviors progressed into Alzheimer’s, and with the advance of the disease came more frequent wandering. In response, her daughter installed a motion-sensing alarm system throughout the house, especially the outside doors, that connected to an app on her phone. This gave her daughter a peace of mind that was priceless and helped her to get some sleep.  “I was losing it,” Wurdock’s daughter told Kodner. “I needed to keep her safe, especially at night.”

New Tech Solves an Old Problem: Keeping a Loved One Safe

In some ways there has never been a better time to utilize technology as a caregiver, since new and better options are popping up all the time. Monitoring systems in particular are plentiful, though often expensive: the system Wurdock’s daughter installed cost upwards of $330 for both the hardware and the app.

The use of monitoring systems isn’t an option for everyone. The expense, plus the hassle of installation, is a big consideration, since these systems aren’t usually covered by private or government insurance. But these systems also come with questions of ethics along with the price tag: does a monitoring system make care less personal? And does 24/7 surveillance rob a person of their dignity and privacy?

With Caregivers in Short Supply, Can Tech Bridge the Gap?

Most aging adults prefer to live at home instead of a senior living facility. Technology may be the ticket to this kind of aging-in-place that so many desire, while also alleviating the issue of professional caregivers in short supply.

Thanks to insufficient pay, high rates of burnout, and meager benefits, the availability of paid caregivers barely meets the current demand and will certainly fall short in the years to come, if nothing changes. Enter technology. Instead of the outdated medical alert buttons most people are familiar with, today’s alert systems can now use artificial intelligence to sense emergency situations and make appropriate calls without prompting. The dispensing of medication, kitchen appliances, and doorbell systems can all be automated. And fall detection and GPS monitoring can be accessed through apps on the caregiver’s preferred devices.

Kodner writes that for “the nearly 1 in 5 U.S adults who are caregivers to a family member or friend over age 50, the gadgets have made a hard job just a little easier.”

Don’t Let Digital Monitoring Replace In-Person Attention

Don’t be fooled, however: there are potential downsides to any advance in technology. A recent study in England warned against treating technology like a substitute for real, quality, face-to-face care.

“A participant who had visited his father every weekend began visiting less often after his dad started wearing a fall detector around his wrist,” Kodner writes of the study. “Another participant believed her father was active around the house, as evidenced by activity sensor data. She later realized the app was showing not her father’s movement, but his dog’s. The monitoring system picked up the dog’s movements in the living room and logged it as activity.”

This isn’t meant to say that technology isn’t useful, but it can never be a real replacement for human interaction. As advanced as these monitoring systems can be, they can’t pick up on all the nuances that humans can. Crista Barnett Nelson, executive director of a San Francisco elder care nonprofit, puts it this way: “You can’t tell if someone has soiled their briefs with a camera. You can’t tell if they’re in pain, or if they just need an interaction.”

Monitoring Can Create More Stress, Rob Seniors of Dignity

We all know that we change our behaviors when we know we’re being observed. That’s just human nature. It turns out that aging adults being monitored are also at risk of changing their behaviors when they know they’re being recorded or observed, and it can rob them of their ability to just live naturally.

As an example, Kodner writes about “a woman who stopped her usual practice of falling asleep on the recliner because the technology would falsely alert her family that something was wrong based on inactivity deemed abnormal by the system. Another senior reported rushing in the bathroom for fear an alert would go out if they took too long.” This kind of behavior can undermine the value of technology for elder care. A caregiver’s priority is safety, and while their aging loved one cares about safety as well, they probably care more about their sense of living their life. They value their dignity, their identity, and even their privacy.

The Kaiser article emphasizes that senior adults who are still able to make decisions for themselves should be consulted about what kind of systems will be installed, especially if they are going to be recorded or photographed. For those who find this a concern, monitoring systems are available that do not collect images or audio, but instead just track movements and routines around the house.

For those aging adults who are not able to consent or make their own decisions, however, there is a legal consideration. Kodner advises that caregivers do their research into the legal ramifications unique to their state before installing a system like this.  “People making audio and video recordings must abide by state privacy laws, which typically require the consent of the person being recorded,” Kodner writes. “It’s not as clear, however, if consent is needed to collect the activity data that sensors gather. That falls into a gray area of the law, similar to data collected through internet browsing.”

Cost is a Major Barrier to Many Families

The initial expense of a system is always going to be a consideration for many caregivers, especially since federal programs like Medicaid rarely cover any of the cost for such technology and many aging adults don’t have the advanced internet often required for these systems. However, Kodner notes that these systems may have up-front costs but also can save money in the long run. Aging adults with Alzheimer’s can cause costly damage to the home or to themselves when not monitored, and these systems give caregivers a chance to catch an emergency or accident before it happens.

In the end, the choice to install technology in the home is always going to be a deeply personal one, based on the needs and desires of every unique family and their situation. Weighed against the ethical concerns and the initial cost, the peace of mind monitoring can bring to caregivers is often considered priceless.

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Photo Credit: Olle Svensson (https://creativecommons.org/licenses/by/2.0/)

(originally reported at www.khn.org)