TECHnically Speaking: Smart Homes

Like a scene out of a futuristic movie, technology now enables us to do everything from turning on the lights, to adjusting the thermostat, to seeing who’s at the door with the touch of a button and on your phone. While the functionality of these new technologies may be cool, the bigger questions that must be asked when making the decision to make your home ‘smarter’ are around how the technology can improve your life, and are they worth the cost — both in terms of dollars, and any privacy concerns.

In this post, I will share some perspectives on some of the most popular smart home technologies we’ve found in the market that can be used to help meet some of the challenges of aging.

What is a smart home?

To start, let’s set some basic context. What exactly does someone mean when they talk about a ‘smart home’? According to Investopedia, “a smart home refers to a convenient home setup where appliances and devices can be automatically controlled remotely from anywhere with an internet connection using a mobile or other networked device. Devices in a smart home are interconnected through the internet, allowing the user to control functions such as security, access to the home, temperature, lighting, and a home theater remotely.”

Popular Smart Home Devices

There are now ‘smart’ devices for every room in your home — for now let’s focus on some of the most common categories on the market.

Voice-activated virtual assistants: Voice-activated virtual assistants or smart speakers, like Amazon’s Alexa, Google’s Home Assistant, and LifePod can help older adults in a number of ways. Smart speakers can help decrease loneliness by providing interaction, but also by making hands-free calls with friends and family easier.

These devices allow users to set reminders (for things like medications or taking out the trash), alarms, and timers. Voice-activated virtual assistants can also help alleviate boredom by allowing users to play music, podcasts, audiobooks, and voice-enabled games (like trivia or 20 Questions). These speakers can integrate with other apps and smart home devices, like Uber, Amazon and home-monitoring systems, so users can use voice activation to request a ride, order products online, and turn lights on and off.

LifePod is unique in its ability to do proactive reminders and communication, like asking how the user’s day is going or if he/she would like to hear the weather. Family caregivers set up routines for proactive communications from an online portal.

There is a range of costs for smart speakers — from $50 up to $300 or more. Some devices, like LifePod, also require an annual or monthly subscription fee.

Image Source: Tech Crunch

Security devices: One of the most common uses of smart home technology for people of all ages is for home safety and security. Smart security devices include cameras, locks, video doorbells, alarm systems, and smoke alarms.

Ring, Google Nest and SimpliSafe are three popular smart security systems. These types of comprehensive security systems generally have monthly costs, ranging from $15–$70/month, as well as one time equipment costs, which could range from $100–$250.

These smart security systems allow you to see what’s going on at your home by viewing your phone or other mobile device, so you can monitor security while you’re away. They also send mobile alerts when they are triggered.

Smart security systems can be useful for individuals who have trouble getting to the door because of stairs or other mobility issues, or who may be fearful of their personal safety at home.

“Better living” smart devices: This category contains miscellaneous smart devices that can be used to make life at home easier and safer. Think: smart lighting (motion-sensors, timers, and voice-activation), automated thermostats (Nest is probably the most popular), water and leak detection, and smart ovens. These devices can help eliminate common challenges some older adults face living at home.

The amount of money you spend on these devices will depend on which type of device you choose and how much functionality you’re looking for. For example, the Wallflower Smart Plug costs $150, plugs into an electric stove and will notify you through the app when it has been left on. The June smart oven, on the other hand, costs about $700. It has a built-in camera and an app that allows you to control the oven and monitor your food from your phone. It also has pre-programmed cooking functions. For an additional monthly fee, users can access a library of recipes and how-to videos.

The June Oven, Image Source: Werd

Entertainment devices: Television technology seems to be improving at the speed of light! Smart TVs, streaming devices, and voice controls make viewing programs from different platforms easier. These devices allow viewers to watch shows from Netflix, Hulu, YouTube, and Apple TV all on one device. If you don’t want to buy a new smart TV, streaming devices like Roku and Amazon Fire make your dumb TV smarter!

These days, you can get a relatively cheap smart TV (depending on the size). Roku sells both smart TVs and streaming players. Their smart TVs start at $140, while the streaming players start at $30.

Image Source: Media Post

Smart cleaning devices: Day-to-day home upkeep can become more difficult as we age, and smart cleaning devices, like robotic vacuums and mops, can be used to help reduce this burden. iRobot has created the Roomba® robot vacuum and the Braava® robot mop⁠. They can be used on different types of flooring, and can be controlled and scheduled from the app on your phone. They are robotic devices that use sensors to navigate through and clean your home. There are different models of the Roomba, which run anywhere from $250–$900.

Image source: iRobot

Smart medical care and wearable devices: There are lots of technology products specifically designed to make overall management of health easier. These devices include things like personal emergency response systems (like Philips Lifeline, Life Alert, and Fall Call), pill dispensers (see our post on medication management devices), EKG monitors, smart toothbrushes, fitness trackers, smart blood pressure cuffs, and smart glucose monitoring. We could (and might!) do separate posts on these different types of technologies.

There are several brands of Personal Emergency Response systems, but most work in the same way: The user wears a pendant with a button that is pressed in an emergency, like a fall. An operator responds through a base device to get more information. The operator will contact family, friends or emergency responders, depending on the situation.

Image Source: Medical Alert System

Again, the cost of smart medical devices depends on the type of device you’re looking for, and there is a range of costs within each type. For example, the personal emergency response systems offer different plans. There is typically a one time activation fee of $50–$150, and a monthly monitoring fee from $25–$70/month.

Should I worry about my privacy?

It is reasonable to have concerns about privacy when using certain smart home devices. Yes, there are risks associated with using some of these devices — risks of systems getting hacked, your personal data being stolen or used in ways you are not aware of, or devices listening/recording you.

There is a trade-off of privacy for convenience, but it is a trade-off you also make in your decision to use social media or smartphones, which also present privacy risks.

However, there are steps you can take to improve your privacy when using smart home devices. You should secure your home network and pay close attention to what tabs your digital assistant keeps on you. Some devices also let you delete your voice history, which you should do on a regular basis.

How do I choose the right devices for me?

I know… I’ve listed A LOT of technology products in this post. It can be overwhelming determining which devices you actually need, and which will sit in the box unused. Here are my recommendations for figuring out which smart home technologies are right for you:

  1. Determine what your internet connection can handle. Most smart home devices connect through wifi, and having too many devices on a slow internet connection will probably just cause frustration.
  2. What are your greatest needs? It is easy to fill your home with smart devices and end up not using many of them. To avoid this, we suggest thinking about what you want or need the most out of your smart home technology. Maybe you’ve never been a TV watcher and prefer other ways of staying busy, so setting up smart entertainment devices isn’t for you. Maybe you live alone and worry about your safety. Smart security devices may be a good place to start.
  3. Ask questions! When considering a smart home solution, ask the salesperson questions if you’re not sure about something or want to better understand its capabilities. If you have questions once it’s set up, call the company. The transition to smart home devices will be easier if you understand what they can and can’t do.
  4. Consider compatibility. If you’re buying devices from different manufacturers, make sure they will be able to communicate with each other. It will be really annoying if you buy smart light bulbs that won’t work with your Alexa, when all you wanted was voice-activated lights!
  5. Consider cost. Smart home technology can be a financial investment. As I discussed throughout the post, there is a wide range of costs associated with smart home devices. Some products may require a monthly fee in addition to the cost of the device itself. We recommend doing your research before purchasing any product to make sure you understand the costs and value to you.

Video from AARP: ”Make your home a smart home”

What are your favorite smart home devices? Tell us in the comments below! ⬇️⬇️️ And don’t forget to follow Assured Allies on Medium, Facebook, Twitter, and LinkedIn!

Marissa Badler, LICSW, C-ASWCM, CCM
Marissa is a licensed independent clinical social worker. She also has certifications in case management and is a Certified Alzheimer's Disease and Dementia Care Trainer®. She leads quality assurance and training on the team.
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National Alzheimer’s Disease Awareness Month: A Vision for the Future

November is National Alzheimer’s Disease Awareness Month. There are currently 5.8 million Americans living with Alzheimer’s disease, and this number is projected to reach 14 million by 2050. Alzheimer’s is a public health crisis, and has a widespread impact — on the individuals living with the disease, their families, communities, our healthcare system, and our economy. Until we find a cure, we must find other ways to help those living with Alzheimer’s disease have the best quality of life possible.

When we first launched our Age Assured blog, the Going Purple series included interviews with experts in the field of dementia. These experts talked to us about their work with individuals with Alzheimer’s and other forms of dementia and their caregivers.

In each of these interviews, we asked the experts about their hopes for how our society will accommodate the rapid growth of Alzheimer’s disease that is projected for the not so distant future. In honor of National Alzheimer’s Month, we reflect back on their answers and think about how we can help make their hopes a reality.

The Experts

In the Going Purple series, we spoke with Dr. Mary Mittelman, a professor at New York University, who developed the NYU Caregiver Intervention, which offers family counseling and support to caregivers of individuals with Alzheimer’s disease.

  • Dr. Mary Mittelman
  • Beth Soltzberg, MSW, MBA

We also spoke with Beth Soltzberg, MSW, MBA, director of the Alzheimer’s/Related Disorders Family Support Program at Jewish Family & Children’s Service of Greater Boston. Beth’s work focuses on promoting social connection, reducing stigma, and raising awareness through a variety of dementia-friendly community-based programs not only for families affected by dementia, but for municipalities, as well.

Our next interview in the series was with Jennifer Pilcher, Ph.D., CMC, an aging life care professional, and president of the New England chapter of the Aging Life Care Association. Personal family experience has inspired Jennifer’s career working with individuals with young onset and atypical dementias.

  • Jennifer Pilcher, Ph.D., CMC
  • Brooke Patterson, LSW, CDP

We closed out the series by speaking with Brooke Patterson, LSW, CDP from the Massachusetts/New Hampshire chapter of the Alzheimer’s Association. Brooke told us about the many programs and resources available through the Alzheimer’s Association for families dealing with Alzheimer’s and dementia. We also learned about the advocacy and research being done by the Alzheimer’s Association.

Below we’ve tried to summarize the group’s perspectives and hopes for the future of how to best support those dealing with this terrible disease, and the families and friends who support them.

Hopes for the Future of Alzheimer’s

Hope 1: More opportunities for meaningful engagement

Jennifer Pilcher told us that, “purposeful, meaningful activity is so important for people with dementia, even well into the progression of the illness. Yet, there isn’t a lot of opportunity for that kind of activity. I’m not talking about Bingo or just staying busy. I’m talking about real, meaningful engagement.” She hopes that there will be more options for people with Alzheimer’s disease to contribute to society in a meaningful way through things like volunteering.

“I’m not talking about Bingo or just staying busy. I’m talking about real, meaningful engagement.”

-Jennifer Pilcher, Ph.D., CMC

Beth Soltzberg agrees. She has seen in her work that, “when people with dementia are able to participate in meaningful activities, it makes a huge difference in their quality of life.”

Beth told us about a mini-series in the UK called The Restaurant That Makes Mistakes about a restaurant run by people with dementia. We loved this idea! It shows that people with dementia can still be productive members of society, and it’s okay if they make mistakes!

Hope 2: Reduce stigma and social isolation by creating more Dementia-Friendly environments

Both Mary Mittelman and Beth Soltzberg talked about the national Dementia-Friendly movement. Dementia-Friendly communities provide education, training, and accommodations to residents, businesses, and other stakeholders to ensure that communities are equipped to support residents living with dementia and their caregivers in day-to-day life. Mary and Beth expressed hope for a broader adaptation of the movement in our society.

The Dementia-Friendly America movement works to ensure that communities across the country are equipped to support residents living with dementia and their caregivers in day-to-day life. The goal is for individuals with dementia to be able to engage and thrive in their communities. Image Source: Dementia Friendly America

Mary hopes that “[more] education about what dementia is, and trying to reduce the stigma associated with it, would allow people with dementia to participate more fully in everyday life.”

Social interactions are important not only for individuals with dementia, but for their caregivers, as well. Jennifer Pilcher sees a lot of isolation in families dealing with dementia. She attributes it to the stigma attached to Alzheimer’s disease, and to a lack of knowledge in our society about how to communicate with people who have Alzheimer’s disease. Her hope for the future is that “we become more open to having people with Alzheimer’s and dementia be part of our larger community.”

Brooke Patterson from the Alzheimer’s Association also hopes for the elimination of the stigma around Alzheimer’s disease. The Alzheimer’s Association is taking steps to remove stigma by working to increase concern and awareness about the disease through programs, events and advertising.

Hope 3: Treat dementia as the public health crisis it is

Beth Soltzberg does not think that our society as a whole views Alzheimer’s disease as the public health crisis that it is. She feels that families are left to shoulder the burden on their own. She told us that, “there’s just no way individual families will be able to handle the financial, emotional, and caregiving impact.” Her hope is that local, regional, state and federal government will play a larger role in supporting families dealing with this disease. She also hopes that we can learn from public health care systems around the world, which have prepared for the budgetary impact of the disease.

“There’s just no way individual families will be able to handle the financial, emotional, and caregiving impact.”

-Beth Soltzberg, MSW, MBA

Brooke Patterson and the Alzheimer’s Association recognize that Alzheimer’s is already a public health crisis, with more than 5 million Americans living with the disease, and 16 million family and friends providing their care. “We know that without prevention, treatment and a cure, these numbers are going to continue to rise,” said Brooke.

Watch this video for a summary of the Alzheimer’s Association’s 2019 Facts & Figures report, which maps out the impact of the Alzheimer’s public health crisis.

Hope 4: Increase Research & Awareness

The Alzheimer’s Association is the world’s largest nonprofit funder of Alzheimer’s research, and the leading voice for Alzheimer’s disease advocacy. Brooke Patterson hopes that the Alzheimer’s Association can continue to fight for critical Alzheimer’s research, care and support initiatives at both the state and federal level.

Image Source: The Alzheimer’s Association

Beth Soltzberg hopes that we can make national changes by looking to other countries, like Japan, that are better prepared to handle the growing number of individuals with Alzheimer’s and other forms of dementia. Beth told us that Japan has found a scalable way to train their entire population about the disease, and she would like to see a similar initiative in the US.

Hope 5: More help for families to pay for and access care

“We need some vehicle to make long-term care insurance affordable and widely available to move that market forward very quickly,” said Beth Soltzberg. She hopes for a national long-term care insurance program to help families cover the cost of care, and feels inspired by states who have already taken steps to do so. She also hopes for better workplace flexibility for caregivers, more day programs and residential options to give families better access to care.

“We need some vehicle to make long-term care insurance affordable and widely available to move that market forward very quickly.”

-Beth Soltzberg, MSW, MBA

The Alzheimer’s Association helps families dealing with dementia access care, and offers many support programs, like the Care Coordination program, where Brooke Patterson is the clinical manager. Brooke hopes that the Alzheimer’s Association is able to continue to support families until a cure is found. “Until we find a treatment or a cure, the Alzheimer’s Association will always be here for individuals and families that need them, providing the care and support they require.”

In addition to the Alzheimer’s Association, there is work being done at the state and national level to help support families dealing with dementia. The National Family Caregiver Support Program (NFCSP) provides grants to states and territories to fund various supports that help family and informal caregivers care for older adults in their homes for as long as possible. The NFCSP provides information to caregivers about available services, assistance to caregivers in gaining access to the services, individual counseling, organization of support groups, and caregiver training, respite care, and supplemental services (on a limited basis).

New changes to Medicare Advantage (MA) plans are also designed to better support families dealing with dementia. Starting in 2020, MA plans may cover respite and other support for caregivers (such as counseling and training courses), adult day health, in-home support services, and other benefits to help people live at home longer.

Thinking Ahead…

Without a cure, what can we, as professionals in the field, do about the public health crisis that is Alzheimer’s disease? We need to create and embrace new and innovative approaches to the problem. The Dementia-Friendly movement, changes to Medicare Advantage plans, state-funded long-term care insurance programs, new models of housing, legislation to support families are all steps in the right direction. We know that the burden of Alzheimer’s disease is growing and the systems supporting it are crumbling under the pressure. We need to share ideas, collaborate, and build new systems.

What is YOUR vision for the future of Alzheimer’s disease? Tell us in the comments below! ⬇️⬇️️ And don’t forget to follow Assured Allies on Medium, Facebook, Twitter, and LinkedIn!

Marissa Badler, LICSW, C-ASWCM, CCM
Marissa is a licensed independent clinical social worker. She also has certifications in case management and is a Certified Alzheimer's Disease and Dementia Care Trainer®. She leads quality assurance and training on the team.
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TECHnically Speaking: Medication Management

Medication management is another challenge faced by many older adults and caregivers. It can be tricky to manage taking multiple medications at different times of the day. Cognitive issues can make remembering to take medications even more difficult. But, in our ever improving technological world, there are many innovative solutions helping to make medication management easier. Below, we review six of the most popular products in the industry.

The AdhereTech medication management system uses “smart” pill bottles in place of standard pill bottles. The AdhereTech system is integrated with a pharmacy’s system and does not require any setup. AdhereTech sends medication reminders through text messages or phone calls when a dosage is missed. AI is used to identify things like patterns of adherence. The system provides personalized support for refills and medical issues. Caregivers can also sign up for text/phone notifications.

If there is an issue requiring the assistance of the pharmacy, AdhereTech will send a notification requesting a phone call for the user. Nurses and pharmacists are also available through the AdhereTech system to store and view users’ health information, and provide information about medications.

AdhereTech partners with established healthcare companies and does not sell direct to consumer. It’s always free for patients, and is paid for by large healthcare companies. AdhereTech is currently used for many of the largest specialty medications, and it’s distributed from nearly every major specialty pharmacy in the United States. If you are interested in using AdhereTech, we recommend contacting AdhereTech and/or your pharmacy to see if your pharmacy is a current partner.

The Hero system includes a pill dispensing machine that connects to an app. The machine can store up to 10 different kinds of medications, and holds a 90 day supply of pills. To program the machine, users enter their medication regimen through the app. The machine notifies the user when it’s time to take medications. Phone or text reminders can also be set up. If medications aren’t taken within 15 minutes, another notification will be sent. The device will also notify the user when a medication is running low so refills can be ordered.

The Hero app provides information about medications and can analyze medication lists to find interactions. It also allows you to store other health information like, notes about symptoms, weight, blood pressure, and blood glucose levels. Caregivers can also be added through the app and receive notifications.

Hero also provides pharmacy and medication delivery services through Hero Fill. The machine can detect when users are running low on pills and will notify the pharmacy. Medications will be delivered to the user’s home, and there are no delivery costs.

There are two different plans to choose from, at either $29.99/month or $99.99/month with a $99 activation fee. Both plans require a 1 year commitment. The higher priced plan includes additional monitoring features, including enhanced follow-up support and offline monitoring. You can purchase Hero through their website.

TheMedisafe app allows users to store a medication list and set reminders to take medications. Medications can be entered manually or imported from Apple Health Records, a pharmacy or clinic. When medications are entered, the app allows users to store a number of details about those medications, making life easier in the future. Medisafe can store the dosage, frequency, time of day it is taken (setting the reminder alarm), the appearance of the pill, how many pills are left (with the option to set a reminder when you have X pills left), the prescription number, and the condition the medication is for. The app allows the user to mark whether or not the medication was taken, or reschedule them for another time.

The app provides a wealth of knowledge about each medication, including videos about how to take it, possible side effects, what to do if the user misses a dose, symptoms to watch out for, and how to store it. It will also notify the user of drug interactions.

Medisafe allows users to store other medical information besides just medications, including measurements (like such as vitals and lab results), appointments, and doctors’ information. There is also a diary to help track things like side effects, or other concerns the user may want to address with his/her doctor.

This app is helpful if there are family members and/or friends who are looking for peace of mind. Medisafe allows users to add a Medfriend, who can receive text messages, emails, or phone calls if medications are not marked as taken. Users can also pull up a report of weekly adherence, which can be helpful for family and/or friends to review.

Medisafe is a free app that you can download through the app store on your phone.

MedMinder is a “smart” pill box with a built-in cellular connection that does not require internet connection or a phone line. Users can set audio and visual reminders. If medications are not taken on time, the service will call the user. If the medications are still not taken after the phone call notification, a caregiver can receive an email, text or phone alert.

There are four models of MedMinder that allow the user to choose whether he/she wants locking features and/or medical alert services. The locking feature locks all compartments except the one for that day. The medical alert allows the user to push a button and connect to MedMinder’s emergency monitoring center.

The MedMinder is filled manually, unless the user opts to participate in the MedMinder pharmacy, which will deliver medications already organized in trays that can be placed right into the machine. The MedMinder pharmacists will take care of transferring prescriptions. Copays and insurance coverage will stay the same. MedMinder will also contact the doctor’s office for refills.

The costs for each of the four models of MedMinder range from $39.99/month to $64.99/month depending on which features you want, and are shown in the image below. There is no extra cost to enroll in the MedMinder pharmacy aside from your copay. You can order the MedMinder pill dispenser and complete the pharmacy enrollment form on their website.

Pillo is like a combination of Alexa and Hero. Themed dispensing machine is similar to Hero, but has the added bonus of a personality! The system offers medication management for up to 28 doses of medication, including reminders, refill alerts, and caregiver permissions. Pillo goes beyond medication management by also serving as a companion for users, and can tell you the weather, time, and other general knowledge. Pillo even has a cute face on the display!

Pillo’s use of AI makes this system more advanced than most of the others out there. Facial recognition software is used to ensure that medication and health information is shared only with the intended user. The device can also recognize the user’s voice and gets more familiar with preferences over time.

The Pillo app allows users to see their medication schedule and track health information. Family and professional caregivers can also access this information if given permission. Caregivers can monitor the user’s health remotely through alerts and video calls.

The cost of Pillo is not listed on their website, and it does not seem to be a direct to consumer product for purchase at this time. You can contact Pillo through their website for more information about cost and how to purchase a system.

PillPack is a medication delivery service run by Amazon. PillPack sorts medications by day and time into a packet that the user just tears open and takes. Each packet is labelled with the time, day, date, and names/dosages of the included medications. The packets can include vitamins and over-the-counter medications, as well. Other items, such as inhalers, creams, and testing supplies, can be delivered with the rest of your medications through PillPack. The box containing the pill packs has a label that includes the list of medications with a picture of each, the dosage and quantity, and instructions for taking the medication. There is a QR code on the box that you can scan for more information.

To enroll, PillPack requires a list of your medications, your doctors’ information, and insurance information. Pharmacists will handle transferring prescriptions. Once the user’s account is set up, PillPack will work directly with the doctors and insurance company on an ongoing basis to address issues and make adjustments if prescriptions change. Refills will be set up automatically. PillPack pharmacists are available 24/7 for support.

Although PillPack doesn’t have a “smart” medication box or pill dispenser, it is very easy to use, and offers many of the same benefits without an in-home technology device. The delivery feature of PillPack may also be desirable to many people, and is not offered by most of the other products on this list.

The PillPack app that allows users to set pill reminders, talk to a pharmacist, manage medication lists, and track shipments.

PillPack is cost-effective. There are no delivery costs or monthly fees for PillPack. Users just pay the cost of over-the-counter medications, insurance copays, and out-of-pocket costs, which is what they would pay at their local pharmacy. You can sign up for PillPack on their website.

Recap…

It can become overwhelming to manage a medication regimen. For some people, difficulty managing medications may lead to the hiring of a paid nurse or caregiver, or even a move to a facility that can better handle medications. But technology and innovation are helping to address the difficulties around managing medications in a variety of ways.

For people who don’t want or need a device to organize multiple medications and/or just want to receive reminders and support, Adheretech or Medisafe should do the trick. For those who need help with organization, in addition to reminders and support, but aren’t super comfortable with technology, PillPacks or Medminder are good options. PillPacks, MedMinder, and Hero offer pharmacy services with medication delivery, which may be a desirable feature for many people. Hero and Pillo are the most technologically advanced of the group, and Pillo has the added bonus of a home assistant. Hero and Pillo also have a sleeker appearance then MedMinder. For a more detailed comparison of these systems, review the chart below.

If you have used any of the devices on this list (or others not on the list!), we want to hear about it! Tell us what you thought in the comments below⬇️⬇️⬇️

And don’t forget to follow Assured Allies on Medium, Facebook, Twitter, and LinkedIn!

Marissa Badler, LICSW, C-ASWCM, CCM
Marissa is a licensed independent clinical social worker. She also has certifications in case management and is a Certified Alzheimer's Disease and Dementia Care Trainer®. She leads quality assurance and training on the team.
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