In the days of segregation, the Ryan School was the only high school in rural Nelson County, Virginia, that accepted African-American students. Abandoned years later, the 30,000-square-foot building began to crumble, along with its legacy.
Today, however, the Ryan School is being reincarnated. This summer, a local community-service agency will solicit bids for turning the old school into a refurbished, 31-unit independent-living residence for low-income people aged 55 and older. In itself, that’s a worthy goal, but the Charlottesville-based Jefferson Area Board for Aging (JABA) has even loftier plans. JABA and its team of architects are developing a scheme that could make the Ryan School a model for future high-tech assisted-care facilities throughout the country.
They plan to turn the structure into an “age-smart building” that uses electronic monitoring and data-analysis technologies to help keep its seniors healthier and safer than if they lived without any type of supervision. “These technologies offer great hope, especially for our population,” says Gordon Walker, JABA’s C.E.O. “In rural areas, people move to nursing homes an average of two years earlier than in urban areas. The longer we can delay nursing-home admissions, the more everybody wins.” The facility is slated to open in 2004.
Hidden throughout the Ryan School’s apartments will be a digital lifeline for residents. The core components—motion detectors, PCs, and data-analysis software—aren’t unusual in and of themselves; each is widely used in conventional building security and retail applications. Rather, it’s how these technologies are being used (and some fear misused) that makes the project noteworthy.
Rather than watching for intruders or studying shoppers’ habits, the monitors will be placed near key areas of the apartments, including around stovetops and medicine cabinets. The goal is for caregivers to receive early warning signals if a resident leaves the stove on or neglects to open a cabinet where daily medications are stored, says Hunter Greene, AIA, director of architecture for LMW, a Roanoke-based engineering and architecture firm working on the project.
JABA is developing the elder-care monitoring system with the help of the University of Virginia’s Medical Automation Research Center (MARC). The researchers at MARC expect that by monitoring mundane activities like shower usage and how often the refrigerator door is opened, the system can develop a daily activity profile for each resident. If a normal activity isn’t undertaken for a day, a resident manager, family member, or rescue squad may be alerted.
According to Dr. Majd Alwan, MARC’s director of elder-care technologies, the key to success will be using ubiquitous but nonintrusive sensors. “We don’t use any cameras or microphones—anything that would be perceived as invasive,” he says. One prototype places motion detectors in floor mats to track a resident’s activity level.
Alwan says privacy considerations are guiding his research. MARC uses standard encryption techniques borrowed from business applications to scramble the data collected about individuals to ensure that personal information doesn’t become available to prying eyes.
MARC’s is one of several university research projects across the country that target new uses of computer technology for elderly housing. In May, the Massachusetts Institute of Technology established the “Changing Places” consortium, a joint effort of its Media Laboratory and Department of Architecture, to study sensing technologies for proactive health care, among other topics. The Georgia Institute of Technology operates the Aware Home, a test bed for unobtrusive monitoring devices [Record, March 2002, page 165]. One device embeds sensors in a picture frame to record movement in a room and develop activity patterns for residents. If these patterns change significantly, custom-designed analysis software issues an alert to appropriate recipients. Dr. Gregory Abowd, associate professor at Georgia Tech’s College of Computing, calls the sensors “technologies of awareness.” “This could give people the option of staying in their own homes longer,” he says. He adds that large technology companies, including chip-making giant Intel, are becoming interested in the commercial potential of digital devices for senior citizens.
Not all of the residential monitors for the elderly are test-bed prototypes, however. Residents of Oatfield Estates in Portland, Oregon, now wear badges that send activity data via infrared or radio-frequency signals to detectors installed in walls and ceilings. The information then travels to a central computer, where staff members can track the location and movement of each resident throughout the day. Other sensors record each person’s weight when they lie in bed, or use infrared instruments to take vital signs, such as temperature and blood pressure.
The badges are off-the-shelf security devices. Oatfield’s four- person software-development staff wrote custom assisted-living programs. The data collected about residents are archived in a central computer, and Oatfield is now considering giving each of its staff members handheld organizers that would allow them to view residents’ data remotely.
Unlike Oatfield Estates, the Ryan School project is still in its start-up phase. Although monitoring systems will be an important element in helping its residents live independently, C.E.O. Walker says, “Technology can’t do it all.” The facility will have a residential manager on-site, and a nurse will make routine visits each week to assess blood-pressure and blood-sugar levels of residents.
The renovation of the Ryan School will save the building’s outside structure as well as its interior support walls. Former classrooms will become apartments ranging from 350-square-foot studios to 1,400-square-foot, two-bedroom units. Perhaps the biggest reminder that this used to be a high school will be the spacious hallways, which will remain 9 feet wide. Architects consulting for the project say the underlying monitoring technologies will cause few problems in terms of design and construction, except for one area: the web of wiring needed to connect the scores of sensors with computers. Solutions to this problem, including the use of wireless networks, is a research priority in university test beds.
The monitoring system’s sensors, wiring, hardware, and software will add about $2,500 to the cost of a one-bedroom apartment, Kessler estimates. If similar monitoring systems become commonplace in assisted-care facilities, the added cost could drop to $1,000 or less, he believes.
In a nod to privacy, each resident will have the choice to “opt out” of monitoring, says JABA’s Walker. “We’ll wire each of the apartments, but if anyone feels it’s too intrusive, we’ll shut it off,” he says. Focus groups show that some prospective residents are leery about being monitored, especially because most don’t use any digital devices. “At first, they ask, ‘Will this be like having a bunch of Peeping Toms?’ ” Walker says. “But the more we describe this as a supplement to their care, the greater confidence they have.” He adds that the system appeals to family members who seek assurances that an elderly relative will quickly receive care in an emergency.
Aside from Big Brother fears, developers of elder-monitoring systems grapple with another problem—information overload. How can anyone make sense of the data when the tiniest details of every individual within an apartment complex are recorded 24 hours a day? MARC’s Alwan says his group is attacking the problem by devising analysis programs that use data-mining and pattern-recognition techniques pioneered by corporations and the military to spot trends and glean meaning from mounds of statistics. “Our intention is for the system to do the analyses and give the results to caregivers,” he says.
Walker hopes that if the Ryan School project succeeds, ubiquitous-monitoring technologies will eventually defer nursing-home admissions for millions of aging Americans whose physical and mental health allow them some degree of independence. Although there is no guarantee that around-the-clock monitoring will ever be accepted as the norm, one thing is clear—architects are looking for new models that help them address the graying of baby boomers. “It’s not enough to just have bingo and grab bars anymore,” Kessler says about housing for the elderly. The question is, does installing dozens of “senior cams” throughout a building cross the line from not enough to too much?