One of the most difficult family decisions can be whether to move an aging parent(s) out of their own home and into assisted living or even a nursing home. I’ve seen families face this dilemma numerous times. (After my psychiatry residency, I completed a geriatric psychiatry fellowship and also spent the first few years in practice consulting at nursing homes.)
Nobody wants to face this situation.
In fact, I’ve seen repeated instances of families in denial about the fact that their aging parents were declining mentally — often slowly but clearly drifting out into the sea of dementia. Usually the adult children were concerned about the well-being of their parents but understandably didn’t want to admit to themselves that there was a problem. Add to this the fact that patients developing dementia often lose their social skills later in the course of the illness, and many who have only brief social contacts with the person may very well be fooled into believing that they haven’t changed. Other patients may not be losing their memories, but they may have experienced a decline in their physical health that has caused themselves and others to question whether they can continue to live alone.
It’s not a panacea, but we’re going to continue to discover new ways to use technological advances to solve old problems. For some families, it may be possible to utilize technology to help voluntarily provide supervision to those struggling to maintain their independence because of physical and/or mental challenges.
The New York Times recently published an article that gave examples of technology being used to monitor aging persons in this manner. One system cost a family $8,000 to install, but given the fact that that amount of money gave the family peace of mind, reduced guilt (a common emotion in adult children of aging parents, especially when they live far away from each other), and equaled only 2 months in an assisted living facility made the investment worth it. This particular system allowed the adult son of an aging woman to login over the internet and see her vital signs, which cabinets and doors had been opened, and whether she had taken her medication. The mother was somewhat reluctant at first to have this installed in her home, but now she really likes it.
I believe that the key to such a system being implemented in an ethical manner, as pointed out by a psychologist interviewed in the article, is that the person who will be monitored absolutely must agree voluntarily with its implementation.
Some will reject the general idea of monitoring technology, citing that it is intrusive, controlling, and maybe even “evil.”
Technology is not evil!
As with so many things in life, how it is used is what matters. If such monitoring is done covertly, even with good intentions, then it’s just plain wrong. On the other hand, as awkward as it may be for most adult children to discuss such an issue with their aging parent(s), if they all can agree on such monitoring and work collaboratively to provide supervision while maintaining dignity and independence, then I believe it will be a viable alternative to moving into an assisted living facility or nursing home for some people.
What do you think about this? Is it frightening, or is it an opportunity that, if used appropriately could help people?
Jeffrey Knuppel is a psychiatrist who blogs at The Positive Medical Blog.
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