Radha BasuSenior Correspondent

M r Goh Ban Kim, 98, istoo feeble to walk,cannot talk, uses acatheter and needs to

take a dozen pills a day for a host ofmedical conditions.

When his caregiver and daugh-ter Goh Tok Cheng, 56, is at work,the family’s helper Widiya Neng-sih, 24, checks his blood pressure,sugar levels, urine and temperatureregularly. She then uploads the in-formation using a software applica-tion known as iUvo Health Notes.

Madam Goh, who lives in a spa-cious semi-detached house in Ka-tong, views all the information ather office in Shenton Way.

“This app is really a blessing,”she says. “It enables us to monitorhim just as he would be monitoredat a nursing home – except that, de-spite being very ill, he can still be inhis own room, at home.”

Her father’s happiness in his lastyears, she says, stems from being athome, among loved ones. “Ulti-mately, that’s what iUvo helps usgive him.”

As tens of thousands of Singapo-reans hurtle towards old age, soft-ware technologies and devices de-signed to help the elderly are slow-ly finding favour here.

Some – like motion sensors andsmoke detectors – ensure homesafety. Others empower people fa-cing physical and cognitive chal-lenges, so they can retain their dig-nity and independence. Yet others– like the iUvo (in Latin, “iuvo”means to “help”) – enable caregi-vers to better manage seriously illpatients at home.

Developed in Singapore by twotech-savvy general practitioners –Dr Choo Wei Chieh and Dr EugeneLoke – the app allows dozens of pag-es of medical information to be up-loaded if necessary.

“As a person ages, his medicalfile can become quite thick,” saysMadam Goh, an assistant vice-presi-dent with a foreign bank. “We canretrieve everything at the touch ofa button, to show to family mem-bers or doctors.”

When her father developed arash on his leg recently, she upload-ed photographs using the app, forhis doctor to view remotely. “Heknew exactly what to do, and I was

saved the inconvenience of takingdad to a clinic in an ambulance.”

The remote monitoring alsotakes the burden of responsibilityoff Ms Widiyah, who says: “All I dois key in the information and waitfor instructions – and follow whatmy boss says.”

Dr Choo, a home-care doctorwho looks after geriatric patients,says the biggest benefit of the appis that it is easy to use.

“It helps put patients and theirfamilies on the digital bandwagon.There is no point having a fancyapp if no one wants to use it,” hesays.

In future, he hopes to make theiUvo software interface seamlesslywith wireless-enabled blood pres-sure monitors and glucometers –that would do away with having tokey in the data manually. “The pos-sibilities are immense,” he says.

Tech-savvy caregivers like Ma-dam Goh have warmed to the won-ders of medical software, but eventhose like Ms Rose Kwek, 72 – aself-confessed technophobe – arebuying digital products, albeit lessgeeky ones.

The retired teacher is thrilledwith a “talking clock” and a pillboxwith an alarm that she recentlybought for her 95-year-old mother,who cannot see very well and some-times forgets to take her medicines.

“They make her feel independ-ent and empowered,” says MsKwek. “She had to depend on oth-ers to know the time and take herpills. Now, she can do both her-self.”

Products that help ease care-giver burdens are also in demand.Among the newest in town is theSmart Sole – a miniature GPS track-er that is inserted into shoe insolesand helps locate cognitively im-paired people who might be lost.

In use in the United States, theproduct is being retailed here bythe Ministry of SilverLining, asmall local assistive-device compa-ny run by former nurse Coco Guo.She says she imports technologiesand products based on her exten-sive chats with former patients andtheir caregivers.

Dementia specialist Philip Yapsays the Smart Sole is meant to over-come difficulties presented by oth-er wearable GPS devices – such aspendants, wrist watches and mo-bile phones – which a user mighteasily forget to wear or take along.

“People with dementia often gooutdoors on their own and risk get-ting lost,” says the senior consult-ant in the department of geriatricmedicine at Khoo Teck Puat Hospi-tal (KTPH).

The product has a “geo fence”feature that alerts the caregiver bySMS if the patient ventures beyonda pre-defined “safe” zone.

“This is indeed useful should acognitively impaired patient wan-der off alone,” says Dr Yap. The de-vice can also be used for those whohave autism or are mentally ill.

Mr Kelvin Lee has been lookingfor such a product ever since his77-year-old father, who has vascu-lar dementia, wandered off by him-self. It has happened a couple oftimes in recent months, and he didnot answer his mobile phone.

“We were worried sick that hemight get lost or injure himself,”says Mr Lee, 46.

Before the illness struck, his fa-ther was an active and independ-ent man who loved meetingfriends, going to the movies andtravelling. “We don’t want to cur-tail his independence,” says MrLee, who is attending a training pro-gramme in Australia for caregiversof dementia patients. “So this pro-duct holds promise.”

He tested the Smart Sole lastmonth after hearing about it fromhis father’s doctor at Changi Gener-al Hospital. “It was unobtrusive,and we could easily log onto theportal and track the Smart Sole’s lo-cation in real time,” he says.

However, it costs nearly $600,so many might find it expensive.Also, currently, it does not workwell in basements and MRT sta-tions.

Mr Lee is worried about softwaremalfunctions as well, and whetherthe product could be discontinuedhere because there are few takers.

“If the price is reasonable, andthese concerns are addressed, wewill consider buying it,” he says.

He has a point. Technology trou-bles can be hard to outgrow. Pro-ducts that once held promise canperish fast.

Indeed, even though manynew-age devices intended to helpolder folk have been launched herewith much fanfare in the past de-cade, few have stood the test oftime.

Cost and the fact that seniorswere largely averse to technologywere big stumbling blocks, say doc-tors, caregivers and IT experts.

Even newer devices such as theGPS-enabled insoles might not findacceptance among the elderly to-day, points out Dr Yap.

Many of his patients are used towearing sandals or slippers thathave no insoles, and they might beunaccustomed to wearing insoles.

Dr Yap’s colleague, IT industryveteran Alvin Ong, says the limita-tions of technology are another ma-jor challenge.

Some products require the userto press a button, which might notbe possible if he is suddenly inca-pacitated by a stroke or heart at-tack, for example. Many are there-fore reluctant to pay monthly sub-scription charges for call centres.

“There are automated systemsthat do not require pressing a but-ton, but those have the possibilityof false alarms,” says Mr Ong, thechief information officer at Alexan-dra Health System, which managesKTPH.

A short battery life and the ina-bility of patients to keep wearing

devices or uploading informationare other problems. New habits arehard to form, and old ones diehard.

Constantly having to keep upwith fast-changing technology is afurther challenge, says IT entrepre-neur Kelvin Lek. Five years ago, helaunched a wearable emergency de-vice for older folk called eAlert,which was widely publicised as thefirst such “panic button for the eld-erly”.

But the product was connectedonly to fixed phone lines, ratherthan mobile phones, and it was re-stricted to indoor use. It became ob-solete pretty fast.

Mr Lek is now in talks with anAustralian technology firm to intro-duce a new-age panic button thatworks both indoors and outdoors.His company, Emo 2 Enterprise, isone of at least four that say they arelaunching similar products in thecoming months.

“Technology becoming obsoletehas been an occupational hazard,”says Mr Lek. “We’ve had to alwaysmove with the times.”

Still, he believes that as peoplebecome more tech-savvy and afflu-ent, and as more sophisticated yetuser-friendly technologies enterthe market, demand will pick up.

The industry is about to turn acorner, he says. Ageing baby boom-ers will definitely value these pro-ducts.

“This time, I feel we’re here tostay – and stay for good.”radhab@sph.com.sg

When Madam Mary Tan, 79, feltdizzy and had chest pains lastmonth, she pulled an emergencycord in her one-room flat.

Within minutes, Ms KhaingKhaing Nyunt, 35, a trained nursefrom Myanmar, was by her side.

“If you are old and live alone,you can panic when you feel un-well,” says the housewife, who hasbeen living on her own since herhusband died seven years ago. “Iam lucky that I can get medicallytrained nurses at my bedsideshould I need them.”

She is fortunate to live in anAng Mo Kio housing block fittedwith a medical emergency re-sponse system that can be attendedto 24/7.

As part of a programme startedin the early 1990s, around 15,800Housing Board rental flats and6,800 studio apartments for the el-derly have been equipped withthese alert-alarm systems. How-ever, the vast majority get help on-ly during office hours.

Madam Tan’s block is special be-cause it happens to house a com-munity home for seniors who haveno family support.

Run by the Asian Women’s Wel-fare Association (AWWA), a volun-tary welfare group, the home has anursing team on-site round theclock.

“We realised that having anemergency system that worked on-ly during office hours wasn’t ofmuch use,” says AWWA chief exe-cutive Tim Oei.

“People often need help whenneighbours are asleep. Since wehad nurses on-site, we decided toextend the round-the-clock moni-toring facility to the entire block.”

As is the practice islandwide,during office hours, emergencycalls at Madam Tan’s block are an-swered by staff of the local senioractivity centre, which is also run byAWWA. At night and on public ho-lidays, the community home nur-ses are in charge.

Islandwide, senior activity cen-tres responded to an average of 25alerts per rental block a month lastyear. The majority – more thannine in 10 – were “non-emergen-cy” calls, an HDB spokesman said.

These calls are monitored by thecentres during office hours, butmost centres have taught residentsto attend to distress calls when thelocal centre is closed.

Efforts are now on to twin thealarm technology with care ser-vices.

As part of a pilot scheme startedlate last year, some of these samerental blocks now enjoy the ser-vices of community nurses andhome-help aides. They can dealwith patient emergencies during of-fice hours, and also take care of thepersonal needs of those who arevery old and have no caregivers.

Apart from Ang Mo Kio, the pro-gramme is also in place in Kreta Ay-er-Kim Seng.

Temasek Cares, a non-profit ini-tiative under Temasek Holdings,has given $1.8 million over threeyears to fund the project, which isexpected to benefit nearly 1,000seniors.

In Kreta Ayer, the scheme ismanaged by the Kreta Ayer SeniorActivity Centre. Since October lastyear, community nurse Helen Al-burque’V – who speaks Malay, Hok-kien, Cantonese and Mandarin –has been traversing the corridors ofrental blocks in Chin Swee Roadand Banda Street to tend to peopletoo old or ill to look after them-selves.

Among them is retired magicianLee Kok Siang, 93, who has a hostof medical problems. MsAlburque’V found him whileknocking on doors to see who need-ed help.

On Dec 1, at around 7am, MrLee fell and bruised his cheek. Hethen pulled the emergency cord. Al-though neighbours had beentrained to help outside officehours, no one came to his aid untilMs Alburque’V and staff from thecentre arrived. They rushed to hisflat right after they got to work ataround 9.30am.

“He was hurt, but did not wantto go to the hospital initially,” MsAlburque’V says. “We were able toconvince him to go.”

The father of two had sufferedtwo falls before. So while he wasaway in hospital, Ms Alburque’Vand her team rearranged his furni-ture with his permission. Furni-ture, boxes and bags had blockedthe way from his bed to the toilet.“We cleared a path for him.”

After he returned home, MsAlburque’V visited him every dayto help him shower, eat and do hisexercises. Now that he has im-proved physically, she drops inonce a week. “He is definitely inbetter spirits.”

When The Sunday Times visitedhis flat, Mr Lee was obviously en-joying the company and care ofthe cheerful nursing team. Hepointed out that he was older thanthe late former prime minister LeeKuan Yew.

“At my age, I need help. Andthey help me,” he says with a smallsmile.

Radha Basu

ST PHOTO: KEVIN LIM

When widow Mary Tan, 79, was sickand pulled the cord, nurse KhaingKhaing Nyunt rushed to her side.

In Hong Kong, a 24/7 hotline ser-vice run by a social enterprise hasbeen providing emergency aid toseniors in distress since 1996.

It was set up by a popular radiohost and a professor of social sci-ence after about 100 elderly peo-ple living alone were found deadat home during a prolonged, bit-ter winter that year.

The Senior Citizens Home Safe-ty Association currently has morethan 80,000 clients who can calla personal emergency hotlinewhich offers referral, care andcounselling for as little asHK$115 (S$20) per month.

For those willing to pay an ad-ditional fee, it uses GPS technolo-gy to help families locate demen-tia patients who have wanderedoff.

Around 10,000 clients who arepoor receive the service free forlife.

Around 14 per cent of peoplein Hong Kong are aged 65 andabove, compared to 12.4 per centin Singapore. Hong Kong is alsoone of the few places in the worldwhere people live longer than theaverage Singaporean.

The association’s “Call andCare Centre” receives around2,000 calls a day, said chief execu-tive Irene Leung, who was in Sin-gapore earlier this month to share

more about the system withhealth and community officials.

Around 140 older folk in dis-tress who call are sent to hospitalevery day, but nine in 10 calls arenot emergencies. “Very oftenthey just need someone to talk toand that’s what we try to pro-vide,” said Ms Leung.

The emergency hotline – apanic button known as the Per-sonal Emergency Link which,when pressed, links to the callcentre – was the only service till2008. However, it can be usedonly indoors and is connected tofixed phone lines.

The association now offers arange of mobile services. There isa safety phone, which can be usedoutdoors, as well as a GPS-basedmobile link service to locate de-mentia patients. Around 11,000people use these outdoor services,with location-tracking functions.

A missing person report ismade to the call centre every twodays.

Monthly subscription fees forthe additional services are higher.The one for dementia patients,for example, costs around $50 amonth. “We can now customiseservices based on differentpeople’s needs and preferences,”said Ms Leung.

Significantly, 85 per cent of

the association’s total revenuecomes from income generatedby its various services. The restis from donations.

The association also providescounselling, befriending andnursing advice on the phone.

It does not record thenumber of calls made “acciden-tally”, but even those are fol-lowed up. “We don’t dismiss acase just because an older per-son says she called by accident,”said Ms Leung.

The centre recently receiveda call from a woman well pastmidnight. “The moment some-one picked up, the caller saidshe had pressed the button acci-dentally and wanted to hangup,” said Ms Leung.

But the trained call centre at-tendant kept talking to thewoman. “She understood justfrom her tone that she neededemotional support,” said MsLeung.

It soon emerged that theolder woman, who lived alone,had just been released from hos-pital. She was confused aboutwhich medicine to take and wasworried that not taking the med-icine in the correct order wouldworsen her health. As a result,she could not sleep.

The next day, the call centreattendant helped connect thewoman to a nurse, who assistedher in sorting out her medicine.“So a call that seemed an‘accident’ was actually a verygenuine cry for help,” said MsLeung.

Radha Basu

At first glance, Mr Foong KengSoon’s spartan two-room flat looksjust like any other.

But peer closely and you’ll seeone big difference. Palm-sized sen-sors dot the whitewashed walls, inthe bathroom, above the stove, be-low the mattress. There is even a ti-ny one in his pillbox.

They are designed to collect da-ta, track motion and ambient airquality, and check whether hetakes his pills daily.

The 77-year-old retired accountsclerk is divorced, and his only child– a daughter – lives in Hong Kong.Having lived there himself for mostof his working life, he has fewfriends or family here.

He cannot walk very well be-cause of an old leg injury and uses amotorised wheelchair to getaround.

Last year, he slipped and fell inthe dark. With no one to help him,he had to pull himself up and getinto bed himself. “It was painful,but I had no choice,” he told TheSunday Times. It was a key reasonhe signed up to get his home wired.

Some other sensors being usedin flats here detect mainly inactivi-ty, but these Singapore-made devi-ces can also sense falls and sendalerts to caregivers’ phones. Theycan even alert caregivers if a seniorforgets to take his medicine.

Mr Foong knows the system isentirely voluntary but, given hishistory of falling, he signed up read-ily. He has a panic button, which

he can wear and activate if he fallsagain. “It gives me peace of mind.”

About 100 Housing Board flatsin Marine Parade are being hookedup with sensors as part of a pilotproject initiated by Singapore Man-agement University (SMU).

When fully operational, theywill be able to check ambient air qu-ality as well, and trigger an alert if,say, a person has left the gas on fortoo long, said research programmemanager Elina Yu from SMU’sSchool of Information Systems,which is helping to devise the tech-nology for the project.

The project is unique and notjust because of the technology. Itspromise lies in its ambitious at-tempt to marry technology withcare services for frail or elderly poorpeople who have no caregivers.

While other sensor and emergen-cy alarm projects enable older folkto connect to a family member or

call centres they pay a monthly sub-scription fee for, this project con-nects those who have little or nofamily support to volunteer caregi-vers in the area, who can check onthem if something goes wrong.

“We are trying to create a com-munity where neighbours and vo-lunteers can stand in as caregiversfor those who have no one to lookout for them,” said Goodlife direc-tor Desmurn Lim. The centre for se-niors is run by non-profit groupMontfort Care.

Mr Lim’s staff are responsible forfollowing up on emergency callsduring office hours. But early in themorning, late at night or duringholidays, volunteers step in. Thereare nearly 25 currently, including15 who opted to have their homeswired. “They are eager to help outtoo and give back,” said Mr Lim.

The system has been activated acouple of times since being in-stalled in October last year.

Once, an elderly man livingalone pressed the emergency but-ton on a weekday evening. “He wasdizzy and breathless, but after mystaff spoke to him and calmed himdown, he said he did not need togo to the hospital,” said Mr Lim.“Sometimes, it’s just fear, and theyneed someone to talk to.”

SMU is not the only universityresearching how sensor-enabledsmart homes can be used to helpolder folk who live alone.

Similar projects are under way atNanyang Technological University

(NTU). The Research Centre of Ex-cellence in Active Living for the El-derly (Lily) – a partnership with theUniversity of British Columbia inCanada – was set up in 2012 to en-able researchers to develop techno-logy solutions for the elderly, in-cluding ones that enable them toage at home. Researchers have al-ready developed software gamesthat can help predict a person’s riskfor illnesses such as Parkinson’s.

Some of the prototypes are alsobased on unobtrusive sensor tech-nologies. Sensors are designed tomaximise the privacy of seniors,said Lily centre director Miao Chun-yan, who is from NTU’s school ofcomputer engineering.

“The sensor-enabled service pre-serves both the dignity and inde-pendence of the elderly,” she said.

Among the prototypes being de-veloped is the eHealth portal, a soft-ware-based social support hubmeant to provide information andalerts for older folk living alone.

Taking cues from data gatheredby the sensors, an “e-nurse” can re-mind a senior to take his medicine,turn off the gas and even suggest so-cial or educational activities adver-tised online that he might enjoy,said researcher Wang Di, who isworking on the project.

“Eighty-three per cent of seniorshere already own smartphones, sofuture cohorts are likely to be farmore tech-savvy than before,” saidDr Wang. “That’s an opportunitywe want to tap.”

Radha Basu

ST PHOTO: LIM YAOHUI FOR THE SUNDAY TIMES

Retiree Goh Ban Kim, 98, with hisdaughter Goh Tok Cheng and familyhelper Widiya Nengsih, checking hismedical data on a tablet PC.

Technology is powering solutions for seniors and caregivers

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HK hotline offersfree care for the poor

Old folk in a

SMARTNEW WORLD

Sensors help keep seniors safe at home

Help is just atug of a cord away

PHOTO: LIM YAOHUI FOR THE SUNDAY TIMES

The sensors in 77-year-old retiree Foong Keng Soon’s flat track his movementsand will send alerts to caregivers’ phones if he falls, giving him peace of mind.

Tech-savvy seniors“Eighty-three per centof seniors here alreadyown smartphones,so future cohorts arelikely to be far moretech-savvy than before.That’s an opportunitywe want to tap.”DR WANG DI, a researcher helping todevelop an ‘e-nurse’ for the elderly

How technology is helpingseniors live independently.

ST ILLUSTRATIONS: MIEL DENGCOY ST GRAPHICS: JASTER NGUI PHOTOS: TIFFANY GOH, GRAB TAXI,NTU,ID-LIFE

BRIGHT IDEASWHAT IT DOES: This software application is a personal digital health diary. It allows a caregiver to store, track and chart health data in real time, including temperature, blood pressure and blood sugar readings, which can be reviewed remotely on tablets, computers or mobile phones by family members and doctors when the need arises.

AVAILABILITY: Currently available free for trial

FOR MORE INFO: http://www.iuvohealthnotes.com/

‘GRAB TAXI’ FOR NURSES WHAT IT DOES: When a caregiver calls in requesting a home nurse, she gets assigned someone who lives nearest the patient’s home, This helps save travel costs and caregivers can get cheaper rates. A front end portal, similar to Grab Taxi, is being developed. It will enable families to directly find nurses who can serve them in the neighbourhood.

AVAILABILITY: The backend portal is already operational.

PRICE: Starts at $40 per visit

FOR MORE INFO: https://ebeecare.sg/

SMART SOLESWHAT IT DOES: A GPS tracker is fitted in the insoles of shoes worn by elderly dementia patients. If a patient wanders beyond a designated “safe zone” the system will send an alert to a designated caregiver’s phone. Patients who are lost can also be tracked using GPS.

AVAILABILITY: Available for testing

PRICE: $599

FOR MORE INFO: http://www.mosl.com.sg

SOS WATCHWHAT IT DOES: The ID-Life GPS Watchcomes with an “SOS button” which wearers can press during emergencies to send an immediate alarm to designated next-of-kin. If family members don’t pick up the call, it can be routed to a 24-hour call centre to ensure immediate assistance in emergencies.

AVAILABILITY: Should be available by June this year

TENTATIVE PRICE: $198ID-Life 24/7 call centre service chargesOne-time registration fee: $25 (including setting up the designated SOS call numbers and training); monthly subscription: $15

FOR MORE INFO: http://www.id-life.com

DATA-DRIVEN STORY-TELLINGWHAT IT DOES: Sensors installed in homes collect data on an older person’s sleep, movement and even eating patterns. A back-end computer system then generates short “stories” or reports to send to a caregiver’s phone. This may help caregivers discover problems – such as insomnia – that an older person may suffer from but is hesitant to inform loved ones about.

AVAILABILITY: The technology is in the early stage of development at NTU

FOR MORE INFO: http://www.ntulily.org/

Sensors that tell you if you've forgotten to turn off the gas, talking pill boxes, smart shoes for dementia patients and emergency buttons. In Part 2 of this series on ageing well, our correspondent looks at past, present and future technologies to enable older folk to live out their later years in the comfort of their own homes.

IUVO MOBILE HEALTH NOTESThe ID-Life GPS Watch

wearers can press during emergencies to

next-of-kin. If family members don’t pick up the call, it can be routed to a 24-hour call centre

SILVER ASSISTANTSWHAT IT DOES: Software applications – including a virtual nurse and smart butler – can connect the elderly to a host of social and healthcare related information and generate alerts to remind them to take medicines.

AVAILABILITY: The technology is in the early stage of development at NTU

FOR MORE INFO: http://www.ntulily.org/

SMART SOLESWHAT IT DOES: A GPS tracker is

[ special report: ageing at home ]

40 thinkthesundaytimes April 26, 2015

41thinkApril 26, 2015 thesundaytimes