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When LTC high-tech meets low-tech

I’d like to say upfront that this blog is 100% inspired by this week’s Institutes of Medicine Public Workshop on Fostering Independence and Healthy Aging through Technology, held in Washington, D.C.

During these proceedings, Dr. Geoff Fernie, a professor of surgery at the University of Toronto (and 6+ other relevant departments, including occupational and physical therapy), piqued my mind about how technology and senior living spaces are converging.

Our technology advances have already produced much: We’ve got high-tech sensors under the flooring, in-room monitors for falls management and remote home monitoring... but wait—did we forget to redesign the stairs?

Fernie’s unique engineering view and his team’s research on spaces and obstacles was a mind-opener for me. And it got me thinking about how technology dovetails with building spaces and environmental design.

In elder-spaces, it’s all about prevention, of course—Prevention of healthcare-associated infections, poor hygiene and sores from immobility. “Unfortunately, when we go into an institution in North America, one in 10 of us will come out with something that we didn't have when we went in,” Fernie comments.

In the long-term care field, we talk a lot about technology’s potential to better the lives of senior residents. Sometimes, the technology we cover is still “on the concept table” and not really there in real life. But high-technology doesn’t need to be a sci-fi fantasy—much of it is already here, right now.

We already can put sensors under the flooring, sensors on the bed mattress, and motion detectors in the room. We even have software that can monitor a resident's gait, to predict the potential of a fall before it happens.

Yet, sometimes what we might really need to do is redesign the staircase instead, Fernie suggests. And I think he means that both literally and proverbially.

“A study in the UK involved visiting people in their own homes and asking them what they're worried about mostly of all,” Fernie relates. “It came up with a surprising result at first. It wasn't their healthcare, and it wasn't their finances. It was their stairs.”

Would it help our falls-rate if we simply change the dimensions of our staircases? Dr. Fernie and a UK study say yes: “[The study found] a sixfold decrease in accidents as you increase the depth of the step. Sixfold. By making the step deeper, it is a huge difference,” Fernie says. “If you want low-hanging fruit, let's make all of our steps deeper.”

Could this UK study be a possible hint for the U.S. building codes?

On another subject, maybe we should have stricter mores on hand-washing, to prevent the spread of germs among residents. Yes, that surely sounds logical. But how many spaces are your busy nursing caregivers asked to cross between touching that resident and dutifully washing their hands before touching the next one? Is the literal design of the care space thwarting your care purpose?

These are some of the myriad healthcare environment design-related questions posited by Dr. Fernie during today’s workshop.

To me, it also sounds like the future design of our elder-care spaces needs to have both elders and their daughters in mind—since an overwhelming percentage of family elder-caregivers are daughters, Fernie says.

“The daughters of families have been giving up their careers, and kids in support of their parents have been financially deprived, socially deprived. Spouses have been sick because of the psychological stress and physical stress of caring for someone,” Fernie says. “Technology must focus on caregivers.”

So as we look toward technology to solve our challenges in caregiving and in serving the quality of life that our seniors deserve, we can’t forget the crucial interface between high-technology and low technology—the real interface between the “latest things” and the “daily routine needs.”

Fernie says: “The technology that we focus on is not just information technology. Not just web-based technology, not just artificial intelligence. All of these things are important. But we also have to focus on the nitty-gritty problems that people face.”

Fernie’s parting words serve as a bellwether for all of us, I think: “We must not be seduced into funding and supporting only high-tech, complex research. We [also] have to support research and product development in areas where the technology may hopefully end up—it’s relatively simple but the problem is extremely complex. How do you wash someone's feet and still support them so they don't fall out of the bathtub?” 

And by extension, does your facility’s design support that mission?

Because the path toward mobility independence involves the simple as well as the high-tech.