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Technology and elder care: the good, the bad and the robots?

by Carol Bradley Bursack, Editor-in-Chief

The wide world of technology has dug many inroads into elder care. Signals to alert caregivers of a wondering elder, personal alarm systems that allow many elders to stay at home longer, even cameras to track whether or not elders have fallen, eaten or taken medications, are available. I'm all for most of it. However, there are ethical considerations in all of this. When are we, in the name of good care, being more invasive than we need to be? And when are we, out of selfishness, replacing loving hands with cold technology?

I still remember getting my first cell phone. I had considered them nonsense until I found myself getting mail at home from a registered sex offender. Suddenly, this fairly new contraption along with a home security alarm, both of which would add significant charges to my monthly accounts, seemed like good purchases.

As a writer, editor, blogger and newspaper columnist, I am dependent on computers. I still have a landline, but my cell phone is my constant companion. I still read the newspaper in print, but I do get breaking news online. This is all to say I am not a Luddite. I have learned to embrace much technology.

As far back as two decades ago, our local nursing homes were using shrieking alarms to warn staff if a resident opened a stairwell door. They also had alarms to let people know if someone who was apt to fall was trying to get up out of a safe chair or bed. It was at this time that I became aware of how tricky technology can get.

My dad had one of those early alarms attached to his recliner and to his bed. It nearly drove him over the edge. Dad had developed severe dementia following a surgery that was supposed correct scar tissue from an earlier World War II brain injury. One of the issues he had after the surgery was understanding and accepting his own limitations.

Dad was a mild mannered man, but tenacious and independent. The idea that he couldn't grab his walker and push it down the nursing home hall without an alarm shrieking to tattle on him was a huge irritant.

Alarms don't have brains

The biggest problem, however, is the fact that alarms are just things. They don't have brains. So when someone moves, whatever the reason, the alarm goes off.

For example, when Dad was settled into his chair, the aide would clip a chain from the alarm onto his shirt. If Dad moved very much, the clip pulled the attachment free from the alarm base and the shriek would alert staff that Dad may be getting up.

Poor Dad. If he even twisted in his chair or rolled over in bed he'd be jolted by this shrieking monster. Eventually, we felt that the psychological damage the alarm was doing to Dad was extreme. We met with the nursing staff, and he was freed of this encumbrance.

Yes, after that he did fall. However, we felt that as things stood his psychological health was at risk and that was even more painful for him than the falls. We had to make a choice and I still feel we made the best choice, even taking into consideration two broken bones.

Technology can be intrusive

With new inventions such as sensors people can place around the house, some with cameras so caregivers can track, from their computers, the movements of their loved ones, come questions as to how much invasion is too much. Each family is different. Each elder is different. Some elders may be outraged at the intrusive nature of a camera where others may feel safer knowing they are being monitored.

Caregivers need to be careful when they make decisions about helpful technology. They need to weigh the perceived safety issues of an elder with the elder's feelings of safety vs. intrusion. I confidently used personal alarms for three of my elders - with their blessings. They felt safer knowing they could push a button in an emergency and help would arrive. Cameras weren't available at the time, nor was computer tracking, but I believe all three of my loved ones would have balked at being tracked by a camera. For them, their personal alarms struck the right balance.

In this new age, robotic animals are being marketed as wonderful pets for people alone at home. There are even people working on robotic assistants to fetch things for people who have problems getting around.

Personally, I cringe at the thought of a poor elder who is already struggling to comprehend a once familiar environment, now made strange by the confusion and paranoia of Alzheimer's, disease being "waited on" by a robot. God willing, we will make good use of ongoing inventions. We will let technology help us keep elders safe and cared for. But let us not think we can replace warm human voice and touch with robocare. If that happens, we will have sorely failed our loved ones.