By Laura McCaffrey
Carleton University, Bruyère Research Institute, and Best Buy Health have joined forces on timely and practical research investigating at-home wellness monitoring systems.
The goal? To test and optimize an in-home sensor system that will allow Canadians to age in place with independence, delay institutionalization in long-term care facilities, and take pressure off the health care system by enabling at-home triaging and recovery.
Researchers at Carleton and Bruyère, with support from AGE-WELL, have been investigating sensor-based smart technologies to monitor the health of older adults for years.
Dr. Frank Knoefel, co-principal investigator and physician at Bruyère, recognized a gap in the healthcare industry some 15 years ago.
“Most people want to stay at home for as long as possible. That’s an almost universal sentiment amongst older adults,” explains Knoefel. “But as our population continues to age, there will be real challenges to maintain the number of home care personnel required to provide the kind of support that older adults will need to continue to live independently. This is where technology comes in.”
As an alternative to wearable emergency alert pendants for health monitoring, which are not always effective (especially when they are not worn), Dr. Knoefel and his colleague Dr. Rafik Goubran, co-principal investigator, professor and vice-president (Research and International) at Carleton, began to explore the use of non-intrusive, ambient—or non-wearable—sensors in the home.
Sensors installed throughout individuals’ homes collect health-related data, which is then transmitted to the cloud and analyzed to assess the individuals’ overall daily functioning and well-being. Through this research, Goubran and Knoefel are seeking to determine the effectiveness of different types of sensors at measuring specific clinical parameters like gait, sleep and eating patterns.
Goubran explains: “There are many ways to measure the same health indicator. Gait, for example, can be measured using video and other visual sensors, infrared, and pressure sensitive mats under floorboards. By using sensors, we can track a person’s gait over time and see changes, like slower-than-usual walking or swaying, which may indicate a health concern.”
This multi-year, cutting-edge research has been carried out in close collaboration with a myriad of industry partners, including sensor manufacturers, telecommunications companies and data analytics specialists.
In a recent study, the researchers worked with multiple sensor manufacturers and retailers—including Best Buy Health—to observe sleep using pressure sensitive mats. These mats, which go under the mattress and can detect presence and movement, can provide valuable information about sleep duration and quality—an important health indicator—as well as potential early detection of certain health conditions.
“Using pressure sensitive mats, we get data about bed occupancy, bed exit characterization, tossing and turning, and breathing rate, among other things,” explains Goubran. “If an individual is suddenly exiting the bed much more frequently throughout the night, that could indicate a bladder or prostate issue. If someone’s breathing patterns change during the night, it could indicate a health condition such as sleep apnea.”
Interestingly, serious and hard-to-diagnose conditions like congestive heart failure (CHF) may be detectible using pressure sensitive mats, says Goubran. “Individuals with CHF experience pooling of fluid in their extremities while standing because their hearts are not strong enough to pump blood throughout the body. In an individual with this condition, we would expect to see more weight in their legs when they get into bed, with the weight redistributing throughout the body as the night progresses.”
The research team has now partnered with Best Buy Health, which is focusing on smart home wellness monitoring as a means to help improve outcomes for aging Canadians and other vulnerable populations.
The research project will aim to better understand Assured Living, Best Buy Health’s at-home, sensor-based wellness monitoring system. The team will deploy sensors strategically throughout volunteers’ homes to measure activities of daily living (ADL)—such as eating, bathing, dressing, mobility, and so forth—in order to detect changes in the functioning of older adults.
Specifically, the team will assess how the system can be tailored to support specific segments of the population—like individuals with particular medical conditions—and test the relative effectiveness of different types of sensors in different scenarios.
“The challenge is matching the technology with the clinical needs; it’s an iterative and collaborative process to arrive at a solution,” says Knoefel.
Dr. Knoefel and the Bruyère team will identify health parameters that caregivers need to be able to measure in order to assess the functioning of older adults. From there, Dr. Goubran and the Carleton team will test specific sensors within the Assured Living system and propose additional sensor modalities that may be able to address those clinical concerns. Based on a continuous feedback loop between the researchers during the study, adjustments will be made to the system to ensure optimal functioning in real scenarios.
In addition to providing assistance with data acquisition and analytics, Best Buy Health will help bring the researchers’ ideas to life, says Knoefel.
He explains: “Best Buy Canada is an established retailer with expertise in manufacturing, distributing and installing technical systems in people’s homes. By partnering with Best Buy Health, we ensure that the results of our research will make it into the homes of older adults who need it.”
Making a real impact in the lives of Canadians is a value that the retailer shares, too.
“Best Buy Health is always looking for new ways to enrich people’s lives through technology,” explains Sara Aghvami, director of Best Buy Health. “Our Assured Living system was developed with that in mind and is an ideal wellness monitoring system for this research. We are thrilled to partner with postsecondary and community partners to support practical research and solutions that positively impact Canadians in more immediate terms.”
The Assured Living system and other smart home technologies are intended to support aging in place—delaying institutionalization for as long as possible and giving older adults independence and dignity, while also providing their caregivers and family members peace of mind.
But, as Goubran points out, there are other health applications for this type of sensor technology that will result in significant societal benefit; these include early discharges from the hospital following surgeries and other procedures, triage for individuals on hospital or clinic waiting lists, and support for individuals with disabilities. The implications of shifting these monitoring tasks to an at-home environment could be profound.
“Instead of observing someone post-surgery for days or weeks in a hospital setting, we can do that in their home—bringing them back to hospital only in the event of complications or improper healing,” Goubran explains. “Similarly with triaging, we can first observe behaviours and conditions at home—for example, monitoring sleep to detect potential sleep apnea—and bring them in only if intervention is required.
“At-home monitoring of this nature is less costly and takes pressure off the healthcare system as it frees up hospital beds—a point of particular interest during the current COVID-19 crisis. For individuals, there are marked benefits as well: they lessen their chances of infection and generally improve their recovery, both physically and mentally.”
This technology, says Knoefel, is going to change the way care is provided in the very near future. And from his perspective, that’s exciting.
“It’s exciting for me now, when I see the impact it will have on my patients. But it’s also exciting for me in the future, when I think about how I want to live my own retirement.”
Dr. Goubran and Dr. Knoefel agree that close collaboration with diverse organizations and individuals is required in order to deliver the disruptive solutions afforded by this research.
“Dr. Knoefel and I are grateful for the partners with which we’ve been able to connect through AGE-WELL, a national organization and leader in the area of healthy aging,” says Goubran.
Knoefel adds: “There’s a lot of momentum building; the future looks bright for this technology.”
At the Hub for Good, read more partnership stories, explore opportunities to get involved and learn how Carleton University makes an impact around the world.