Last winter, Lydia Lundberg and her husband, Bill Reed, flew from the assisted-living facility they own in Oregon and came to Washington, D.C. for the White House Conference on Aging.
In a busy exhibition hall, they opened up their oversized laptop computer and showed off the technology they had been working on for the past five years. It allows them to track the several dozen residents who live at Oatfield Estates.
Residents wear badges that signal to the dozens of infrared and radio-frequency sensors inside the facility and outside on the grounds. That allows Lundberg and Reed -- and others -- to track residents at the facility 24 hours a day, seven days a week.
In the exhibit hall at the White House conference, Lundberg pulled up the tracking information on a resident named Ray Croft. With her computer, three time zones away and on the opposite side of the country, Lundberg was able to check on Croft’s location and his activity -- at that exact moment.
"I can go to a live view," Lundberg said, "and it shows that he's in bed."
The computer doesn’t show live pictures of Croft; the facility does not use video cameras. But a device hooked to Croft's bed sends data readings to the computer.
"The icon shows he's snoozing away, and he has been in his room for 12 hours," Lundberg reported.
A graph popped up on Lundberg's laptop, with a blue line going up and down.
"Basically this is his breath, what you're looking at," said Lundberg. The graph fluctuates with each breath Croft takes, so Lundberg could even tell when he was breathing out and when he was breathing in.
Oatfield Estates
On a recent morning in Milwaukie, Ore., a suburb of Portland, Lundberg visits Croft at Rainier House, the group house where he lives. Croft zips outside in the motorized wheelchair he has used since his left leg was amputated after complications from diabetes.
As Croft fires up his pipe, a worried look crosses Lundberg's face.
"Where's your badge?" she asks. "They forgot to put it on you today?"
"Yes, they did," Croft says. "And that's a big no-no."
Croft isn’t wearing something that's almost always clipped to his shirt: a black badge. It's the small, triangular pendant that communicates with the sensors so that the monitoring system can record where he is and where he's been. It even notes when he's eating, when he's in the bathroom, even who he is hanging out with.
On a chilly morning, Croft is wearing just his white T-shirt.
Within moments, aide Ruth Yaws bounds down the stairs, holding Croft's long-sleeve shirt and his badge.
"What're you doing out here without your shirt on?" Yaws gently scolds Croft.
He says he wanted to go out to smoke but didn't want to bother the aides who were finishing with serving breakfast.
The young aide carefully helps Croft put on the heavier shirt and attaches the badge.
Some might think all this monitoring is a little creepy, so it's worth pointing out that Oatfield Estates is a very nice assisted-living facility.
It's a place where Croft has just eaten his daily breakfast in bed: pancakes the way he likes them. And his group house, on top of a hill, offers a stunning panorama. Off in the distance, there's snow-capped Mount Hood, Mount Adams and Mount St. Helens.
Maybe Oatfield Estates is nice because the owners, Lundberg and Reed, built a place where they would want to live. They call it a "summer camp for old people."
But Lundberg says the thing that really makes this place work is the monitoring technology.
"People don't argue with data. They believe it," she explains. "Because data doesn't have an agenda. Data's not trying to make someone look better or worse."
Lundberg can use the data to tell whether an aide takes too long to respond when a resident pushes a call bell or whether a resident is losing too much weight.
Once an aide was accused of goofing off. But the data showed he was the staffer who spent the most time with residents.
Most of all, co-owner Bill Reed says the data give residents a freedom that they wouldn't have in other long-term care facilities.
"They would probably be in locked facilities," says Reed. "They would be the ones who'd be at the doors trying to get out or escaping."
As Reed says this, he's watching a group of residents plant a garden. About two-thirds of the people living here have some dementia or Alzheimer's. At Oatfield Estates, they live in the same group homes -- on the same floor -- as everyone else. They're free to roam, inside and out.
Reed says because people are monitored at this assisted facility, there's no need to build fences here.
"These are big, strong, fairly full-of-energy people," Reed says. "So they'd try to escape away from the facilities. So you'd build fences for them. Then they'd be hard to contend. So you'd give them drugs to slow down their anxiety or their anger."
Melissa Richmond was hired as the landscaper at this facility. But part of her job -- and the part she enjoys most -- is to get the residents to help her with the gardening. Some were farmers before coming here. Others, like Dorothy Kimmel, had their own gardens.
"Dorothy, do you think it's too early to plant tomatoes?" Richmond asks.
"Well, I can't even think of what month it is," Kimmel replies.
Another resident, an elderly man with a shovel, digs holes in the ground. Then Kimmel -- in a pink sweater -- takes the young plants out of small plastic pots. She pulls the bottom leaves off each plant, as Richmond showed her, then leans down and places each plant in a newly dug hole.
Caregiving from Far Away
A few days later, hundreds of miles away in an office cubicle in Tucson, Ariz., Kimmel's daughter, Marcia Riedel, sits at her computer at the end of her work day.
She types in her user ID and password, and with just a few clicks of her computer, she reads reports about what her mother does each day.
"Planting tomatoes," Riedel reads. "If I can click on 'planting tomatoes,' it gives me more information. It says they started at 3:30 and ended at five o'clock. It was outside in the main garden. And it tells who the employees there were."
It's hard to be a caregiver from far away. Before, when Riedel called her mother on the phone, Kimmel couldn't always remember what she had done that day. Now Riedel phones and checks on the computer a few times a week.
"I can track her weight," Riedel explains. "I can tell how much time she spent in bed. I can tell how restless she was. There's a graph that keeps track of that."
With the collected data, Riedel says she's more involved in her mother's care now.
The owners of Oatfield Estates say that's the point: to use data to bring families closer together.
It doesn't always work that way.
Back at Oatfield Estates, a race is about to start. In the parking lot, Ray Croft and his red motorized scooter is racing against three-year-old Jacob Nickerson and his new red tricycle.
At the agreed upon starting line, Jacob's mother, Kelly Nickerson, gets behind the boy's tricycle to push.
"OK. Grandpa Ray. You ready?" she asks.
"Come on, Mom," says Jacob, ready to go.
"Let's go," shouts Kelly Nickerson as she starts pushing and the race begins. "Go Jake, go! Go Jake, go!"
Jacob laughs and shouts, "I'm going. I'm going. I'm going. I'm going."
Croft lets Jacob win these races. And although it's Jacob who crosses the finish line first, the little boy insists that "Grandpa Ray" won this time.
Nickerson works at Oatfield Estates in the marketing department, while she goes back to school to get her nursing degree. She and her son live in one of the large group homes here. They eat meals with the other residents. Of all the residents here, Croft is the one that Jacob calls "Grandpa."
After the race, Croft says his monitoring badge is a good thing.
"The Big Brother thing doesn't bother me pretty much at all," he says. "No, I think it helps. I mean, an intelligent person, halfway intelligent, is going to appreciate the fact that people can be monitored for their own good. And their own safety."
But Croft has had problems with the monitoring devices, or at least the way one of his daughters used the information. He's a diabetic, and she saw his weight zoom up.
He says his daughter started nagging him.
new graf "She was really just giving me a hard time over her expectations for my diet, for my weight, for my exercise. Just about my whole life here", Croft says.
He got fed up and revoked permission for her to see any data on him.
That fight was a couple of years ago. Croft says he hasn't spoken to his daughter since. He says they'd been estranged before. Still, he misses her. Most of all, he thanks her for finding this place for him.
Croft says he couldn't live anywhere better, and that the information that's gathered on him is -- for the most part -- used to help him.
Produced by NPR's Jane Greenhalgh
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