Ask Slashdot: Local Navigation Assistance For the Elderly?

An anonymous reader writes: I have an older (90+) relative who is experiencing mental decline. He's still fairly functional (you can have a decent conversation with him, and he's amazingly positive for someone in his condition), but his memory of anything recent is terrible. He's in an assisted living center, but he's having serious trouble for example finding his way to the dining hall and back to his room. He has visitors daily and the staff are supportive but 24/7 oversight is not an option. I am looking for a navigation system suitable for use indoors that will help him move around. The distances involved are short, and his schedule is pretty regular so it would be OK to have a schedule of where he usually is at a given time (lounge, dining hall, room) and a big green arrow that always points out which way he should go to get there (so it would need to accommodate doors and hallways etc, not just the straight line direction). Is anyone here aware of such a system? I've thought of trying to write an app for a smartphone but I'm not sure if GPS is really the way to go, seeing as it's indoors. Also, battery life would be an issue — he would have trouble remembering what to do if it stopped working and I'm not sure if he'd remember (or be able) to connect a charger. For the same reason it would need to be pretty bomb-proof — he's not in position to troubleshoot if it fails.

Comments

nothing will work

[turkeydance]

to your satisfaction. i have the same situation. tried 4 times. failed 4 times. only and ONLY 24/7 human supervision is appropriate.

Re:nothing will work

[Mashiki]

Agreed, and sadly decline can be rapid as well. While the situation I had probably isn't the same as yours or the question in general. Nothing really works except human supervision, especially since a person who can seem good one day when you're checking on them, can be the complete opposite by 5pm of the same day. They can get easily confused when non-standard things enter their lives as well, and become upset by it.

Even basic things that the person in question used to do, for say taking medications won't work either. Stuff like pre-packaged blister packs with the days of the week and simple numbering won't work either, especially when their reasoning and understanding start to become shaky.

In my case I was looking after my grandmother who had stage 4 lung cancer when it was diagnosed. From a period of September two years ago until January last year she was good, then rapid decay of her mental abilities kicked in. There was no way you could leave her alone at all, she'd walk out of the building and forget where she was, or go looking for my grandfather who was dead 5 years at that point. By the spring I was living there 24/7 to look after her and take care of her daily, by summer I also had the assistance of CCAC(nursing care entering the home so I could take a break). By September of that same year she required 24/7 nursing care and was in a nursing home, by October she was in hospice care for the terminally ill and bed ridden.

Agreed

[ArchieBunker]

Elderly and technology do not mix. Especially someone with a failing memory.

Re:Agreed

[Applehu Akbar]

"Have you considered not living anymore? If you've degraded to the point where basic life functions are no longer possible unaided, it's time to check out."

So...what's it like working for Cigna?

Re: Agreed

[BarbaraHudson]

We have euthanasia here, so I can simply choose to pull the plug while I can still make the decision.

Go into any senior's residence. Once the brain goes, why bother keeping a now-useless body alive?

In the posters case,a device won't work. Even a service dog is a poor bet unless someone else is going to tend to the dogs needs.

We don't have the equivalent of an autonomous car that we can stick on old people to guide them around. There comes a time to let go.

old school

[jjbarrows]

Lots of signage (eg "dinning --->"), a printed schedule (eg "12:30 be in dinning") and a watch (maybe with alarms?).

Try Floor Stickers

[Anonymous Coward]

For all the common areas use floor stickers. Like breadcrumbs.

For rooms that might get messy depending on number of residents and distribution

Re:Try Floor Stickers

[KGIII]

It's time to chip grandpa with an RFID tag.

Seriously, we could put it in their bracelets that they often wear at these types of facilities. They're already scanned at the assisted living center I went to visit not long ago. They use a bar code and not RFID chips in them. They're not quite the cheap plasticine/paper things you see at hospitals but they're in place, as I understood it, for things like med handouts, certain procedures, and living wills which may have a DNR associated with them. That sort of thing.

They could do this with an RFID and a button panel on the walls. The old dude can have a button panel on his wall that says chow hall, visiting room, day room, nurse's station, etc... Then a color, matching his bracelet color, can light up and the RFID can track him as he goes. As some of them are prone to wandering away, this could even be tied into an alarm system. The panel of buttons can be just a few, standardized, and all over the place so that they're easy to spot - they need only to remember to look for the panel and push the big button.

Then the arrows you mention can light up and follow them as they go. Using different LED lights for each one means less chance of a 'collision' with someone else. It'd take some work and some custom programming but it could be done and, once done and trialled, the system could be sold to other facilities. They could even open source it with no risk of anyone really taking over the business unless they wanted to do the installs and stuff. There'd be consumables associated with it as the bracelets are sure to be damaged and people will pass away - re-use is probably not an option no matter what logic is used, emotions and fears and whatnot.

Someone should do this. It might be lucrative. Build on the idea and run with it. There are a lot of people moving into the age where they may need to be placed in an assisted living center. With this is going to come a huge increase in dementia and other memory inhibiting issues. They probably should have done this ten years ago and be mature by now but it may not be too late.

Remember that a non-tech-savvy person is going to need to be able to set this up so it should be pretty tight code and have a decent UI. I can imagine it would have an API for customization. The panel shouldn't really need more than a half dozen buttons and would be cheap. The lights would be cheap. The sensors and readers are cheap. They can even use it for patient tracking. The bits and pieces just need to be put together properly.

I'm sure someone can go even further with your idea than I did.

If he can't find the dining hall...

[Anonymous Coward]

How could you expect him to keep up with a small device he's not familiar with? I'm sorry to hear of his decline, but it happens - he WILL need 24/7 supervision. Don't exacerbate any confusion he already has, either bring him home and take care of him yourself if possible or find a facility that can. My mother worked in nursing homes, and I followed - any technological advance to make the elderly more "self sufficient" after they've started failing mentally just will not work.

All of you fail

[YrWrstNtmr]

LED's, arrows on the floor. smartphone, arudino, flip book, GPS...all fail

If he can't remember the way down the hall to the dining hall, how in the hell is he going to remember to pick and follow directions on the damn phone?

How to get him to the dining hall and back? Someone holding his hand in both directions.

Re:All of you fail

[Kjella]

LED's, arrows on the floor. smartphone, arudino, flip book, GPS...all fail If he can't remember the way down the hall to the dining hall, how in the hell is he going to remember to pick and follow directions on the damn phone? How to get him to the dining hall and back? Someone holding his hand in both directions.

Pretty much this, the only way to make sure he actually gets to the dining hall or back to his room is to have a person making sure of it. No matter how great the device is it's highly doubtful if he has the mental capacity to make use of it, most likely he'll forget where he has it, why he has it and how to operate it. That he could manage on his "own" with such a device sounds like a combination of nerd hubris and wishful thinking on behalf of the relative. You can't fix this with a gizmo.

Can't learn a new tool with failing short term

[perpenso]

Sadly I've experience this as well. With failing short term memory you can't really change habits, learn a new tool, etc. Its too late. Such things have to occur before short term memory becomes too bad.

In my situation we'd have intelligent conversations (yes, long term memory was rock solid) about things to do differently, we'd agree, but by the next day it was all forgotten. Various devices like medical alerts and such would sit on the dresser gathering dust. You can't get the new device added to the routine. When short term memory was still OK we had the device but the family member blew it off, "I'm OK, I don't need that yet". And that opinion gets locked in and the device remains on the dresser unused years later when it is needed.

You have to get the elderly family member to change habits and use a new tool before short term memory degrades. You have to explain the preceding, that new habits need to get wired in while still relatively healthy. Keep in mind that you will be severely limited with respect to upgrading the device. A replacement needs to be substantially similar in look and usage.

Must be open to change one's ways

[perpenso]

I am elderly and have been programming computers on a daily basis since I was 19 years old. I would like something I can live with for when my memory starts to fail.

Start now, don't wait. Get new devices, get upgrades, etc while things are normal but keep in mind that one day things will get "locked in" so look to longevity of equipment, maybe have spares or things that family members will be able to find spares for (get same model device from eBay etc). You have to be very open to changing daily habits (ex. check meds and refrigerator, call someone to checkin and share med/fridge state, wear that medical alert device).
You can *not* blow these new habits off thinking "I'm still OK, I don't need to do this yet". You will probably not be aware of passing the point where your memory is such that you cannot form new habits.
Don't be fooled into thinking you are OK because you can remember detailed things from 50 years ago. Long term and short term memory are two very different things, the later can fail while the former is still perfectly functional.

Service Dog

[candude43]

A memory aid dog. An acquaintance of my brother has a brain injury, and he uses (and actually trains) dogs to help him around. Might not be practical in an assisted living situation though. Read more about him here. https://www.psychologytoday.co... http://www.cbc.ca/news/canada/...

Depends on the form of dementia

[RogueyWon]

This is going to depend a lot on the form of dementia. If you'll forgive a horrible over-simplification, the big question is whether you are dealing with Mild Cognitive Impairment (MCI) or with one of the progressive forms, of which Alzheimer's and Vascular Dementia are the most common varieties. I've had one grandparent with MCI and another with Vascular Dementia and they require very different responses.

If you're dealing with MCI (and it is the most common form of dementia), then some kind of technological solution might get you somewhere, depending on how comfortable your relative is with technology. MCI tends to advance slowly and the symptoms could remain mild for years to come. A device that gives a few easily-recognised prompts might help.

If you are dealing with one of the progressive forms of dementia, then forget it. With Alzheimer's and Vascular Dementia, the symptoms will progress rapidly and viciously. Your relative's current state, where he is basically coherent but forgetful, will not last long. His personality will rapidly change and, over time, he will appear to withdraw into himself completely (though you will potentially pass through stages along the way where he wanders and becomes depressed or even aggressive). Within a year or two, he is going to require full-time nursing assistance for even basic bodily functions and he will increasingly not even recognise close family members. There are some interim steps you can take to manage your relative's quality of life in the early-to-mid stages, but clever technological tricks are not likely to play a role.

Vascular Dementia took about 3 years from diagnosis (so probably 4-5 years after initial symptoms) to turn my granddad into what was basically a hollow shell. The progression is not the same in every case; while the usual pattern is for short term memory to go first, the point we realised my granddad had something more than MCI was when his long term memory was damaged fairly suddenly and he lost all recollection of everything before the age of 20 or so (including the fact that he had grown up in Ireland and only moved to England in his late-teens).

You might already have done this and just not thought to mention it in the article you submitted, but I would suggest that your first step should be to seek a diagnosis. Only once you have that can you begin to think about how best to manage things and whether technology has a role to play.

Re:There's navigation equipment for the blind...

[gnupun]

From google:

http://www.medgadget.com/2015/...