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lite Care at Oatfield Estates is a residential care facility that was designed and built with a specific vision of creating housing and healthcare for elders and people in need of care who value community, close relationships, and self determination.
       The building design fosters intimacy and independence for community members, while the ubiquitous technology creates a safety net around the entire campus. There are no hallways but many windows. The open, family-style kitchen, dining room, and great room area are inviting and open to staff as well as residents. Technology facilitates quality of care in a variety of ways—from monitoring movement and sleep habits to automatic door locks. It can also shut off power to appliances if there is a resident in the room who should not be operating the appliances without supervision.
       Elite Care decided to develop technology to prolong independence of the residents, automate quality control, provide biofeedback, develop an early warning system for health problems, enhance resident social networks, establish an institutional memory, and automate the environment to reduce labor and utility costs. The CARE (Creating Autonomy Risk Equilibrium) system is comprised of several core software and hardware pieces. They include the tracking system, assistance call system, load cell system, walkabout watch, smart house technology, resident/caregiver interface, and management software.

Tracking System

       The wireless pendants emit signals that allow the system to track locations of the pendant wearers on campus. Residents and caregivers can also push the button on the pendant to call for assistance. The pendant location is tracked by infrared and radio frequency sensors located unobtrusively throughout the house and the campus.

Tracking Pendant

Assistance Call System

       The assistance call system uses a network of personal computers (PCs) distributed to all areas of the house, including resident suites. Once a resident has pressed the assistance call button, an audio alert (chime) is emitted from the computers in the common areas. Once the assistance has been rendered, the caregiver can use the PC or wireless personal digital assistant (PDA) to fill out an activities of daily living (ADL) report to be stored in the database. The system keeps track of when the call was placed, where it originated from, when it was acknowledged, who responded, how long it took to respond, and how long the caregiver was with the resident.

Table 1

Load Cell System

       Each resident brings his or her own bed, which sits on top of a series of 4 load cells (1 beneath each foot of the bed). This system keeps track of weight trends and sleep patterns and is also used for alerting staff if a resident identified as being at increased risk for falls rises from his or her bed. Both the alert history and the weight trending are collected from the load cells, managed through the assistance call system, and recorded in the database.

Walkabout Watch

       The Walkabout Watch system allows caregivers to locate residents in realtime. It can also be used to modify a resident’s environment, from automatically turning lights on to controlling appliances and alerting caregivers when a resident wanders too far away from the household. It also uses the home automation features to provide cognitive aid, such as turning on a resident’s bathroom light when he or she gets out of bed at night. The Assistance Call System handles the alerts.

Home Automation

       The wireless pendants and the location tracking system can provide keyless room entry for residents and staff. The residents also know when they are in front of their doors, because a light turns on when they are near.

Software

       The interface software creates an “elder-friendly,” simple interface to e-mail, Internet, Intranet, schedules, events, weather, entertainment, and smart house controls (eg, temperature). The caregiver interface can either be the desktop PC, a wireless PDA, or both. The system records care and events automatically, allowing administrators to monitor caregivers for realtime management. The system creates reports that focus on the changing needs of the resident. It can also alert the personal assistant automatically for care needs described in the personal care plan that are on a routine or hourly schedule.
       Currently, the end users of CARE technology are the residents, their families, management, and staff. Future end users will be physicians, healthcare entities, and researchers. Elite Care has a memorandum of understanding (MOU) with Oregon Health Sciences University and University of Washington, which are using resident location data to research applications for cognitive aids and to find ways to predict health events by monitoring movement patterns. Both of these projects will have conclusions in the future.
The CARE system is a comprehensive solution to today’s demands of more service at less cost, coupled with a vision of restoring the autonomy of the elderly and minimizing the risk to them—while recording and documenting procedures required by their physicians and regulatory agencies.