Home, smart home

Actor Bette Davis once said, “Getting old ain’t for sissies.”

That adage applies to a growing number of older Canadians for whom simple tasks like walking, shopping, reading, and even remembering to take their pills can become Herculean feats.

It also applies to their children, spouses, friends, and others struggling to care for the people they love in their golden years.

But what if instead of being confined to a nursing home or wheelchair, an older adult with mobility issues could strap on an AI-powered robot suit and go about their day?

It’s not as far-fetched as it sounds: Engineers and clinicians at UBC are helping develop robotic exoskeleton technology that allows people to stay mobile. It’s just one of a brand-new generation of cutting-edge devices that are transforming our relationship with Father Time.

“This is happening now. This is not futuristic,” says Dr. Janice Eng, a professor in the UBC Department of Physical Therapy.

As co-director for the Centre for Aging SMART at Vancouver Coastal Health, Dr. Eng works with engineers and clinicians to develop tech-based solutions that help people maintain their health and independence as they age.

“We’re trying to keep people in their own homes longer, with a higher quality of life,” she says.

For most of us, independence is a top priority as we age. Ninety-six per cent of Canadians over 45 want to age in place, according to a recent survey by the research firm Ipsos. Nine in 10 respondents said they would prefer having an in-home caregiver to moving into an assisted-living facility. Only six per cent, however, reported both having planned for a caregiver and having the economic means to employ them.

For most of us, independence is a top priority as we age. Ninety-six per cent of Canadians over 45 want to age in place, according to a recent survey by the research firm Ipsos.

But the solutions Dr. Eng and her colleagues are developing are meant to make aging in place achievable for anyone. These include clothes lined with biometric sensors that gather long-term data to track the onset of illnesses such as Parkinson’s disease and diabetes.

Dr. Eng is collaborating with UBC professor of engineering Peyman Servati on a smart glove that can monitor grip strength and hand dexterity. It could help track things like the onset of motor-function loss or the recovery process for stroke patients. They are working with Dr. Servati’s local startup, Texavie Technologies, to advance the glove’s development and bring it to market.

Other devices assist with basic day-to-day tasks, such as a pill dispenser that helps people take their medications on time. One project uses Wi-Fi routers to monitor what people are doing in their homes.

“ If you can imagine that your mom is living in the next city, but you had some reassurance that she’s doing okay—that she's got breakfast, and she’s gone for a walk, now she’s back, she hasn’t fallen—that could really mean a lot for you, as a caregiver,” Dr. Eng says.

Many of these technologies are surprisingly far along. The aforementioned robotic exoskeletons are already in use in hospitals. The technology was originally developed by the military to help soldiers lift heavy objects; they use the same stabilization technology in Segway scooters to keep the wearer from falling over. The exoskeletons can help people with partial paralysis stay on their feet—and even see permanent healing.

“We’ve found that even when they remove the device, they are actually able to have better mobility and better walking,” Dr. Eng says. The robotic exoskeletons aren’t cheap—they cost around $80,000 right now, but advances in 3D printing are making them more affordable.

The end goal is to allow anyone to have access to the quality of care at hospitals and assisted-living facilities without leaving their own homes, Dr. Eng says. Unfortunately, a given device’s transition from the hospital to a home setting takes longer than one might think.

“The technology and engineering is one thing, but you also have to design for the human factor,” explains Dr. Calvin Kuo, a professor of biomedical engineering at UBC. Along with Dr. Eng, Dr. Kuo co-leads Care Anywhere, a graduate program sponsored by the Centre for Aging SMART that provides students from various disciplines with hands-on experience applying smart biosensors to promote healthy aging and transform healthcare.

Dr. Kuo knows better than anyone that no design, however ingenious, survives first contact with a user. He uses the example of fall detectors. The technology has come a long way since the heyday of Life Call (with the iconic “Help, I’ve fallen and I can’t get up!” TV ads from the late 1980s). The next generation of fall detectors will use accelerometers in bracelets, pendants, or even one’s smart watch or phone to detect when someone has taken a tumble and automatically call for help.

“The challenge is not so much that the fall detectors work or don’t work. The challenge is how people use it,” Dr. Kuo explains.

“The historical fall detector is a pendant, like a necklace, and it works if you’re wearing it as a pendant, but not everyone does. There are a lot of people who will stick that thing in their pocket and just walk around with it. Same thing with their watch or phone. The fall detection inherently is not bad. The problem is that people are wearing these sensors willy-nilly.”

But Dr. Kuo doesn’t blame the users; he believes it’s up to him and his colleagues to make devices work for people, not vice versa. “That’s step number one: to understand that there’s a lot we can’t control, out in the real world,” he says. “And that’s going to influence how we design a lot of our technologies.”

The problem is worse for older adults with dementia and other neurocognitive decline—and therein lies an entirely different challenge. Physical problems have proven to be the easiest to address, but devices that address mental decline are far more nascent. There have been breakthroughs. For example, one method uses machine learning to track changes in how fast people type on their phones and catch signs of dementia. But these aren’t direct measures of brain activity.

“There are a few wearable technologies that are essentially brain wave measurements, like electroencephalography (EEG), but they’re not very common. I think that is one big gap, at least in the healthy aging space,” says Dr. Kuo.

The robotic exoskeletons use machine learning to track and predict people’s movement patterns. The biometric sensor-laden clothes and accessories use AI algorithms to track subtle trends in someone’s blood pressure, heart rate, dexterity, and sleep.

But there is one major breakthrough that has supercharged basically every aspect of healthy aging tech: artificial intelligence. The robotic exoskeletons use machine learning to track and predict people’s movement patterns. The biometric sensor-laden clothes and accessories use AI algorithms to track subtle trends in someone’s blood pressure, heart rate, dexterity, and sleep.

“Pretty much all the applications we’ve discussed are using AI,” Dr. Eng explains. But when it comes to developing technology for older people, the greatest asset is the younger ones. UBC’s Care Anywhere program, which Dr. Eng helped launch, doesn’t usually produce fully realized inventions. Rather, it equips students from a variety of disciplines to go out in the world and develop innovations that redefine what it means to grow old.

“Our goal is to increase the capacity of students who are going to come out with this training and step into hospital positions, industry positions, and academic roles. Hopefully our program is one small step toward finding solutions to all of these problems,” Dr. Eng says—problems that almost all of us and those we love will face at some point.

Dr. Kuo tells of a recent episode in which his mother-in-law fell and sustained a fracture. He and his wife were on hand, and she was fine in the end, but it could have gone far worse. “If we hadn’t been there, what would have happened? Who would have taken care of her?” he asks. “We saw for ourselves this big need right now for shifting healthcare to the home. For making home healthcare at the quality of Vancouver General Hospital.”

We are closer than ever to achieving that vision, he says.