Tom's Story

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Tom Capsil’s New Life

This document describes a brief story illustrating a vision of how technology can help, in the foreseeable future, to maintain independent, high-quality life for elders. Some of the technologies incorporated in this story are already deployed in the field or in the laboratory, several are the focus advanced research and others need to be investigated. The described environment is focused on unobtrusive sensing and assessment and on minimally obtrusive interventions. The underlying algorithms incorporate the state of the art statistical pattern recognition and optimal decisions under uncertainty. The reader may notice the unobtrusive and subtle way that the system adapts to the elder’s values and preferences. The economic feasibility of the technology-based approach and clinical effectiveness require further research.

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Tom Capsil’s New Life Zooming along a familiar winding road on his way home from his Thursday consulting session, Tom Capsil turned off the autopilot in his leased electric car – enjoying the feeling of control. He likes to take over from the autopilot to keep up his driving skills – his coach encourages him to practice, as much as possible, without automation. Tom allows himself the luxury of the leased car since his 75th birthday while he is still commuting to his part‐time work – he is actually enjoying helping a couple of young kids starting their own bakery; besides the money that helps he loves the fact that he can make a difference. Several hundred meters after he turned of the highway, as clockwork, the traffic slowed down to a crawl at a very familiar intersection; this is the place where his parents started their first business. As he often did, he began to reflect on his father’s life some 27 years ago when his Dad was exactly Tom’s age.

His Dad’s life after retirement was much harder than Tom’s; on top of his own struggles with arthritis, obesity, and diabetes, he had to worry about Tom’s Mom who probably had Alzheimer’s disease – at that time the only definite diagnosis was an autopsy. His Dad agonized about everything – from Mom wandering away or falling down in her bedroom, to whether she took all her medications and vitamins in a complicated, difficult to remember regimen – clinicians then had still exaggerated beliefs in the effectiveness of vitamins . In those days, Tom lived a couple of hours away from his parents, with his own family and although he kept in touch by telephone as much as possible it was never enough. On the phone, his Dad would always be upbeat and Tom was never sure what was actually going on. But now Tom’s thoughts were suddenly interrupted by a chime – the automobile safety system detected an attention lapse by his eye movement pattern and by EEG measurements using remote laser sensors. The chime came just in time – he almost hit a pedestrian crossing the street in the front of his own house. This does not happen frequently in the outskirts of the city.

The garage door as well as the front door opened as soon as the security system in his house detected the RFID signal transmitted by his watch. He appreciated the welcoming whiff of balmy air assured by the remote climate control anticipating his arrival. Tom, supported by a smart cane, walked into the kitchen later than usual and was greeted by the friendly voice of, Carobot, his robotic valet, gently reminding him of the session with his remote coach. But Tom did not start his coaching session yet – he was a little embarrassed since he did not yet do his daily exercise. Instead, using a voice command, he started his exercise game routine. Being overweight most of his life, he had not been not much of a jock, but this game‐based system was actually fun! It was physically and mentally challenging, without embarrassment, within the privacy of his bedroom. He was totally amazed because he was clearly improving – imagine at his age. Today, he pushed himself particularly hard because he wanted surpass his previous record. He can push himself hard because Tom is well aware that the system monitors his vital signs and does not let him overdo it. This close monitoring is particularly important because of his congestive heart condition diagnosed a couple of years ago.

The results of his exercise were instantly communicated to his coach, and when Tom actually initiated the session there was already a message praising him for his accomplishments. The coaching system had already incorporated today’s weight measurements (automatically assessed by the load cells in the bed as well as a scale in the floor mat in of the bathroom), blood pressure measured by a sensor in his ring, and chemical analysis for sodium ion concentration in his urine performed by the toilet. The coaching system, as well as his coach, were pleased with his outside activities, socialization and diet. Even his balance had improved so much that his Carobot, a recent robotic addition to his house, just stands by when he gets up at night to go to the bathroom rather than providing him with mobility support. Today is a very good day, and it will get even better; like a small child, Tom can hardly wait for tonight.

Tom has some time to rest before he needs to get ready and so he sits down in his favorite chair. As frequently happens, his mind wanders, reminiscing about the recent past. It wasn’t always this good. Only a year and a half ago he was in the middle of a deep depression: He was just diagnosed with congestive heart failure, his best friend had died, and he had no one to turn to. Of course, his children Michael and Eva love him and would do anything, but they have their own lives many kilometers away, and the last thing he would want to do is to be a burden to them. At his lowest point, a neighbor of his told him about the integrated elder care system, Living Independently with Functional Technology (LIFT) that seems to be sweeping the world. Tom is now quite aware that LIFT was the result of major research and development efforts supported jointly by the European Commission, the US government, and private organizations.

At first Tom was resistant, he did not want to be monitored, but then what did he have to lose? And the rest was history – he is a different man now with a new outlook on life. His activities are continuously monitored, including his nutrition, bathing. When he gets up in the middle of the night to go to the bathroom, the light turns on gradually and gently illuminates the bathroom and the robot stands by to give him a balance support – only when he needs it; the system has adapted to his habits and only responds when something out of ordinary happens. Even then, before an alert is sent out, Tom has the ability to cancel it, if he is OK. Tom feels much safer than before and became much more active, although he allows only a small number of people to have access to this information. In a funny way, this monitoring system brought him close to his son. Tom learned very quickly, that Michael actually checks his status several times a day, even when he doesn’t call. The thought brings tears to Tom’s eyes.

His thoughts are interrupted by a video‐telephone call from his granddaughter. He marveled at the simple technology behind this marvel: his favorite chair is wired to let Michael’s family know that Tom is sitting in his chair and may be available for a phone call. Tom breaks into tears when his granddaughter proudly shows off her science project. She reminds him so much of his darling wife that passed away unexpectedly almost five years ago.

Time flies and it is time to get ready for Tom’s Thursday night outing. About half a year ago, Tom, with a great deal of reluctance, joined this group of film buffs; they usually get together once a week in a local pub, have dinner, show a film, and then they talk about the film. But what excites Tom tonight is that is thoughts about Ana. She is a beautiful, younger woman in her early seventies that he noticed shortly after he joined the club. She makes the most insightful comments, and shares with Tom his taste in films, politics and food. But he did not have the guts to talk to her, and Ana did not notice him until recently, after he lost his first 15 kg and gained his old self‐confidence and joy for life – thanks to the vigilance of the coaching system. He would have never believed that he could lose all this weight and build up his muscles and self‐confidence at his age. For the last twenty years he felt unattractive and never really had any social life – especially after his wife passed away. Now he feels all nervous, like a high school kid, because tonight he plans to ask Ana out.

Approaching the door with his coat on, the context‐aware reminding system sounds a gentle alert reminding him to take his medication. Even though it is 30 minutes before the medication is due, the system figured out that Tom is likely to leave his house without taking his medication on time. The film tonight, “When Harry Met Sally” was perfect setup for his mission. After a short debate about love, he got his courage to ask Ana out and she said “yes.” They decided to meet in town next Saturday evening. Tom, back in his house, taking care of his teeth, lying in his bed as the LIFT system slowly dims the light and lowers the intensity of the simulated distant sounds of an ocean. Tom Capsil, a happy man falls into a deep sleep, knowing that his safety and well being is continuously assured by the always alert LIFT system.

Gaps

• Auto-pilots for motor vehicles are not commercially available.
• Attention-span devices (for cars for example) have been researched but are not commercially available.
• The personal assistant Carobot. Personal robots are not available for consumers.
• Physiological measurements are not currently used as input to coaching or cognitive monitoring devices. The two types of device operate as seperate devices. They need to be brought together.