MU using TigerPlace to develop ‘Aging in Place’ technology

When Oldenia Crow walks to the kitchen of her apartment for a snack, sensors monitor every step the 91-year-old woman takes. When she shifts in bed while sleeping, a sensor under the mattress graphs it. And when she leaves the apartment and heads down a hallway of the retirement home, another sensor sends that information to the program that’s been tracking her for years.
“There are sensors all over the house,” Crow said. “I don’t even know they’re there.”
It sounds invasive, but Crow doesn’t mind. She sees it as “help for the future.” And it is, both for her and the millions of baby boomers expected to require assisted living services during the next few decades.
Crow is one of many volunteers whose movements are recorded by small sensors throughout their rooms at TigerPlace, a 56-apartment facility on Falling Leaf Lane. The data is sent to University of Missouri researchers with the Aging in Place Program. They look for patterns and changes in behavior, which are often indicators of a health problem, and use the information to alert nurses that something has changed so they can investigate.
Marilyn Rantz, a professor at MU’s Sinclair School of Nursing, and Marjorie Skubic, a professor of electrical and computer engineering, lead the university’s interdisciplinary research team. They use inexpensive sensors to monitor residents’ movement and develop programs to analyze the data so it can alert caregivers of potential problems. They see their research contributing to products that allow people to live in their own homes longer or systems that help nursing facilities keep their patients healthier.

For instance, sensors in a 96-year-old patient’s room picked up changing behavior for two weeks before her death: She wasn’t moving around in her sleep as much, and her pulse rate at night was lower than usual. That’s the kind of data the researchers hope to isolate and use to alert nursing staff.
The research conducted at TigerPlace is already attracting long-term care providers anticipating the business opportunities a graying population will create. (TigerPlace itself is in a growth mode; workers finished an expansion early last year that added 24 apartments and are now building another wing, which will add 100 more beds to the facility.)
And with national health care reform expected to create incentives for in-home nursing care and a new insurance program for long-term care, the MU research is more relevant than ever.
“We have old problems in nursing and caring for older people who need new solutions,” Rantz said.
Although using sensor technology for long-term care is becoming more popular, Rantz said TigerPlace and the research conducted there are unique. It’s privately owned by Sikeston-based Americare Systems, and MU uses it for research. Rather than developing a technology and applying it to senior care like many programs do, the MU research seeks out technological solutions for long-term care problems, Skubic said.
“We have been careful from the very beginning that everything is driven by the needs of this population,” she said.

The sensor research conducted there is going further than the safety-oriented applications most companies focus on. Rather than sensing problems after the fact (e.g., someone doesn’t get out of bed in the morning), the MU team is coming up with ways to identify behavioral shifts that can alert caregivers to a potential problem or illness earlier.
If a resident’s movement decreases over a period of time, that generally indicates a condition such as depression or a heart problem, Skubic said. Alerted by that data, nursing staff can make sure to provide the extra care required or bring a doctor to investigate.
“If we can identify early signs of changes, that oftentimes coincides with some kind of impending health event,” Skubic said. “If we can identify those earlier, small problems can be fixed before they become big problems.”
After starting the program in 2004, researchers have secured more than $8 million in external grant money for a number of studies using sensors to analyze residents’ physical and cognitive functions. Skubic and Rantz are working on a project now to monitor patients’ risks of falling by looking at how they move.
“If we can identify when someone’s at a high risk of falling and prevent it, that’s huge,” Skubic said. “And we all know someone who’s fallen.”

To address privacy concerns, the researchers use software that only records a patient’s silhouette. Analyzing that, they can identify certain movements that correspond with a higher fall risk. If that risk increases, it usually means there’s a problem no one has noticed, Rantz said.
Rantz thinks this application will have huge market potential, especially for hospitals, where falls are a persistent problem. And the surprising thing is it won’t take years until the technology is affordable enough to be integrated into nursing facilities, hospitals or homes.
“Deliberately, we’ve made the decision to use inexpensive, off-the-shelf equipment when possible,” Rantz said.
The fall risk study, for instance, uses consumer Web cameras that cost less than $100. Skubic said they’ve compared their Web camera data with data from a $150,000 motion detection system and found it to be within 2 percent of the more expensive equipment’s accuracy.
With the success they’ve enjoyed, Rantz and Skubic have considered going into business together, but they ultimately decided to leave marketing the technology to someone else.
“I’m a researcher; I’m not going to kid myself that I’m suddenly going to be the CEO of a company,” Rantz said. “It’s not going to happen. I’m more comfortable writing grants in my office.”
The two have already found a company interested in commercializing their research. John Knox Village, a Lee’s Summit-based nursing care business, has created a spin-off to focus on utilizing the sensor technology, they said. The pair is negotiating a licensing agreement with MU so they can sell their findings, mostly in the form of software. And Rantz and Skubic hope more companies will soon follow.
“Hopefully we can hand off what we learn, and new companies can evolve and get it out to consumers in their homes,” Rantz said. “That’s what we’ve had in mind from the beginning.”