In Situ Monitoring of Health in Older Adults: Technologies and Issues

Authors

  • Hyun Gu Kang PhD,

    1. From the Kinesiology and Health Promotion, California State Polytechnic University, Pomona, California
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  • Diane F. Mahoney PhD, GNP,

    1. School of Nursing, Institute for Health Professions, Massachusetts General Hospital, Charlestown, Massachusetts
    2. Harvard Medical School, Boston, Massachusetts
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  • Helen Hoenig MD,

    1. Physical Medicine and Rehabilitation, Durham Veterans Affairs Hospital, Durham, North Carolina
    2. Center for the Study of Aging and Human Development, Duke University, Durham, North Carolina
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  • Victor A. Hirth MD,

    1. Department of Internal Medicine, School of Medicine, University of South Carolina, Columbia, South Carolina
    2. Internal Medicine, Palmetto Health, Columbia, South Carolina
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  • Paolo Bonato PhD,

    1. Harvard Medical School, Boston, Massachusetts
    2. Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Charlestown, Massachusetts
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  • Ihab Hajjar MD, MS,

    1. Harvard Medical School, Boston, Massachusetts
    2. Institute for Aging Research, Hebrew SeniorLife, Boston, Massachusetts
    3. Gerontology Division, Beth Israel Deaconess Medical Center, Boston, Massachusetts.
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  • Lewis A. Lipsitz MD,

    1. Harvard Medical School, Boston, Massachusetts
    2. Institute for Aging Research, Hebrew SeniorLife, Boston, Massachusetts
    3. Gerontology Division, Beth Israel Deaconess Medical Center, Boston, Massachusetts.
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  • for the Center for Integration of Medicine and Innovative Technology Working Group on Advanced Approaches to Physiologic Monitoring for the Aged


Address correspondence to Hyun Gu Kang, Kinesiology and Health Promotion, California State Polytechnic University, Pomona, 3801 W Temple Ave, Pomona, CA 91768. E-mail: hgkang@csupomona.edu

Abstract

With the upcoming reform of the healthcare system and the greater emphasis on care in the home and other living environments, geriatric providers will need alternate ways of monitoring disease, activity, response to therapy, and patient safety. Current understanding of the dynamic nature of chronic illnesses, their effects on health over time, and the ability to manage them in the community are limited to measuring a set of variables at discrete points in time, which does not account for the dynamic interactions between physiological systems and the environments of daily life. Recent developments of sensors, data recorders, and communication networks allow the unprecedented measurements of physiological and sociological data for use in geriatrics care. This article identifies and discusses the important issues regarding the use of monitoring technologies in elderly patients. The goals are fourfold. First, some emerging technology that may improve the lives of older adults and improve care are highlighted. Second, the possible applications of technology in geriatrics settings are discussed, with a focus on acute falls, dementia, and cardiac conditions. Third, real and perceived concerns in using monitoring technology are identified and addressed, including technology adoption by elderly people; stigma; and the reduction in social contact; ethical concerns of privacy, autonomy, and consent; concerns of clinicians, including information overload, licensure, and liability; current reimbursement schemes for using technology; and the reliability and infrastructure needed for monitoring technology. Fourth, future approaches to make monitoring technology useful and available in geriatrics are recommended.

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