mart homes are slowly becoming a reality. Adjusting the temperature of your home remotely is now common. I have a car with web connection. I can tell how much power I have. I can also turn on the heating and set the temperature. I can always arrive to a warm car. We can see from miles away who is ringing our doorbell. The “internet of things” means once dumb appliances are becoming smart.

Smart Homes and Older People

The attraction of many of the current smart home services is independent of age. Everyone wants a remote vacuum cleaner. Perhaps older people do not care that they can control their home heating remotely. It depends on their lifestyle. There are emerging “smart home” services that are targeted at older and frailer people.

Simple Alexa assistants are valuable because of their voice activation. Even that is a help to a frail person who may not be as good with buttons and keys. Especially in the dark when voice activated lights can be important. The next generation of assistants are being equipped with AI. They can learn your lifestyle pattern. They can learn your favourite music and podcasts. They know your appointments and remind you of your plans. They are attractive to everyone. For the old they can offer added value. They have been shown to become companions. To be a welcome voice first thing in the morning. The latest versions will warn carers of an unexpected change in routine.

Safety in the home becomes of increasingly importance. Smart stoves are available that can monitor your cooking. A gas ring or electric hob left on for too long without a pan will be turned off. Food left in the oven for too long can be a fire risk. The smart oven knows this and turns it off. They are useful for everyone who is forgetful.

Falls are the second most common cause of accidental death. One in four older people will have a fall but not tell anyone about it. In the US, falls account for between 10% and 15% of all emergency department visits. Frail older people will often carry a fall warning button they can press if the worst happens. It will automatically call a family member or carer. Of course, they only work if they are worn. Starkey a US manufacturer has developed a range of hearing aids. They are “smart” and can detect a fall. More than that they are programmed with three telephone numbers. They will call in sequence, until they get a response.

Smart watches offer the same functionality, as long as they are in range of a smart phone. The Apple watch is registered with the FDA as a medical device. It can detect a fall. The watch can also detect certain types of cardiac events. Such devices offer more than emergency help. They have been shown to reduce anxiety, depression and perceived isolation.

Activity and fitness improve wellbeing and health. Smart solution prototypes have been developed to encourage older people to exercise. Fitness bands and smart watches have been used with smartphone apps. We have moved on from “10,000 steps per day”. Smartwatches offer the potential to provide biofeedback no matter how old you are.

Incremental Sensors.

One step up in sophistication are the devices using incremental sensors added to the home. Movements in bed can be sensed using a pad inserted above the mattress. Increased sleeplessness or trips to the bathroom can be flagged to a carer. A weekly visit to an older person can therefore be informed with accurate information. This in turn can trigger a “My back is hurting but I did not want to bother you..” response.

The BBC has reported experiments with motion sensors in frail households. Some are using the same sensors employed in prototype autonomous cars. At a more pragmatic level there are start-ups repurposing sensors from burglar alarm systems. All are designed to detect movement or the absence of it. All can provide a safety net to frail individuals of all ages.

Telemedicine

The COVID 19 pandemic changed the nature of medicine. In the absence of personal contact, primary care physicians were forced into telemedicine. Whether that was via a phone or Zoom call. The reassurance of “talking to a doctor” is something valued by everyone. For older people with reduced mobility, it is an essential.

A smart home and telemedicine offers a whole new vision of care. The home “tells” the carer there is an issue using sensors. The carer can escalate to a doctor, The doctor can make a house call but on Zoom