The telecommunications concept of “transparency” as it relates to disability access

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Considerations: BIM  implemnation and shortage of low-income housing for the elderly and disabled

“Addressing the Housing Blueroof TM Technologies in McKeesport, PA”

ABSTRACT

By Richard Behr[1], Mark Sciegaj[2], Robert Walters[3], John Bertoty[4], and Rachel Dungan[5]

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Accommodating the preference of the growing elderly population to age independently, at home and in the community, requires innovative and cost neighborhood retrofit plans. Retrofitting existing homes and in filling available neighborhood land parcels with ‘smart homes,’ equipped with technologies that enable monitoring and assessment as means of ensuring the quality and efficiency of home care and health care provision, is intrinsic to these efforts.  Blueroof Technologies, Inc. in McKeesport, Pennsylvania has developed and demonstrated a number of in-home and neighborhood-scale technologies and is working with the local McKeesport municipality to restore an economically distressed neighborhood to accommodate successful aging in place. This paper describes the Blueroof ‘BlueNode’, ‘BlueKiosk’, ‘Smart Cottage,’ and (‘McKIZ’): a McKeesport neighborhood restoration initiative, which incorporates the use of smart cottages and neighborhood-scale interventions to address the housing challenges of an aging population.  The technologies and neighborhood retrofit methods described in this paper could serve as a template for restoring low to middle-income neighborhoods to enable successful, mixed-generation aging in communities domestically and abroad.

Introduction

The aging of the United States population is well documented. The number of U.S. elders is anticipated to grow from approximately 35 million in 2000 to 75 million by 2030 (Administration on Aging, 2010); the portion of the elder population over age 85 is expected to grow fastest.  During this timeframe, the elder population will also increase as a percentage of the total population from 13 to 19.6 percent (Administration on Aging, 2010).  The demographic aging of the United States population constitutes a major achievement of the 20th century, while presenting a major challenge for the 21st.  Among other things, societal aging affects the provision of health and long term care, the sustainability of families, and the ability of communities to adapt and enable elders to remain active, and engaged citizens.

National surveys report that most residents want to stay in their communities and homes as they age.  Nine in ten say it is extremely, very, or somewhat important for them to remain in their community as long as possible (Binette, 2009).  More than seven in ten say it is extremely or very important for them to stay in their own homes as long as possible (2009). To enable elders to remain at home, there has been an increase in home and community based service options, programs to support informal caregivers, and attention to housing design and use of monitoring technology (Lawler, 2001; Alwan, et al., 2007).

This paper describes a comprehensive effort made by Blueroof Technologies Inc., a non-profit corporation in McKeesport, Pennsylvania, to address the – needs of low to middle income seniors to age in place successfully. This paper describes monitoring technology produced by Blueroof including the BlueNode, BlueKiosk, Smart Cottage and the McKeesport neighborhood (‘McKIZ’) restoration initiative. This initiative incorporates the use of smart cottages and neighborhood-scale interventions to address the housing challenges of an aging population in the Third Ward of McKeesport, Pennsylvania.

Background

Smart Home Technology

The collective aging of the global population has created an unprecedented set of circumstances, which require the use of technology in applications that enable the growing elderly population to age in place successfully. Pressures created by this demographic shift have generated interest in the development of technologies and procedures that can help mitigate the health risks associated with aging, and can help facilitate the process of aging independently.  Telemedicine seems to hold great potential for improving the quality of life for these individuals, while also increasing the efficiency and organization of the current health care infrastructure.  Application of IT resources to health care systems facilitates coordination and communication between health care providers and helps lower the overall cost of personal health maintenance.  One source estimates, “…that a full embrace of remote monitoring alone could reduce health care expenditures by a net of $197 billion (in constant 2008 dollars) over the next 25 years…”(Litan, 2008).

Today, technology provides a means by which vital signs of an aging or ailing patient can be monitored remotely. In addition, peripheral monitoring systems and emergency care units have been designed to enable these individuals to live in their own homes without having to sacrifice the safety and security that may be guaranteed by an alternate institution, like an assisted care facility.  Video conferencing and general messaging devices have also been developed to facilitate remote communication between patients and their health care providers or loved ones.  Many of these devices and procedures rely heavily on the use of sensors to monitor vital physiological data, to document movement and events that occur within a home environment, and to prevent potential crises using survey data.  These technologies are often grouped into three broad categories based on their function and value: those which (1) address safety at the environmental level, (2) secure health and wellness at the individual level, and (3) enable social connectedness at the community level (Alwan, et al., 2007).

In recent years, efforts have been made to make these devices more accessible to the general population. However, few attempts have been made to integrate these technologies into a comprehensive system that can be used to equip homes for lifestyles conducive to successful aging in place.  Several organizations have developed systems that can be used in assisted care facilities, and others have worked to design homes hardwired to enable use of these technologies.

Designed by Front Porch, the Eskaton National Demonstration Home is one such housing unit. Eskaton Village, a compound of approximately nine of these independent houses, is located in Roseville, California and is celebrated as one of few comprehensive independent living communities.  Homes featured here come hardwired with the technology necessary to help elders age independently, and grouping them into a community encourages social connectedness and prevents those living independently from feeling isolated (“Eskaton,” 2010).

Elite Care offers similar housing options in Tigard and Milwaukie, Oregon; called Fanno Creek and Oatfield Estates, respectively. These communities also feature “smart homes” that come hardwired to support independent aging in place.  Elders seeking to live in these homes opt into the assisted care community in the same way they would upon entering a nursing home, for example (“Elite Care,” 2010).

The New Courtland LIFE program offers similar social benefits to aging seniors through their membership in an institutionalized living environment. The New Courtland facility located in Germantown, Pennsylvania offers housing in nursing home environments as well as cottages equipped to enable residents to, “…live in a home setting with a family member or loved one”  (“New Courtland,” 2010).  These cottages are hardwired with sensor technology, which helps caregivers monitor health remotely by collecting data based on vital health information.

Mill City Commons in Minnesota is organized in a similar way (“Mill city commons,” 2009), as are the senior living facilities and health service organizations sponsored by the Diakon Lutheran Social Ministries in Pennsylvania, Delaware, and Maryland (“Diakon,” 2010). The communities sponsored by this organization operate on a model that is fairly consistent with other assisted care facilities; living options include either communal housing facilities that are technologically well-equipped, or independent living spaces designed primarily for those seeking to age in privacy who may not have the additional need for remote monitoring technologies and devices (“Diakon,” 2010).

These initiatives provide evidence that such technologies have been successfully applied and utilized in planned communities. However, the work of Blueroof Technologies, Inc. represents the first documented effort to create an entire neighborhood of independent living spaces that includes both hardwired cottages and retrofitted homes in a mixed generation, mixed use context.  The adaptability of the Blueroof Smart Cottage design distinguishes it from others, because it provides elders with the opportunity to age safely in their preexisting home environments without having to sacrifice their personal privacy, health, or security.  The ability to integrate Blueroof technologies economically into existing homes means that fully preparing this part of McKeesport for the pressures of aging requires the new construction of only a few additional smart homes.  This ultimately helps to lower the associated costs significantly, and to mitigate the unanticipated pressures that such a community might face as its population ages.

McKeesport Pennsylvania

McKeesport is a city in Allegheny County, Pennsylvania and is part of the Pittsburgh Metropolitan Area. For most of the 20th century, McKeesport was the leading manufacturer of iron pipes in the United States and its economy thrived on steel production. At its peak, the city’s population totaled 55,000 residents.  With the decline of the domestic steel manufacturing industry, McKeesport’s economy struggled and its population fell to approximately 24,000 by the 2000 census.  Currently, there are 5,349 seniors over age 65 living in McKeesport, which constitutes approximately 21% of the city’s total population.  This city has a large elderly population, relative to others in Pennsylvania Blueroof Technologies, Inc. began operations here as a non-profit corporation in 2002, to help enable successful aging in place through the application of cost-effective smart home technology. (“City of McKeesport,” 2010)

Blueroof Technologies, Inc.

Blueroof Technologies, Inc.’s mission is to use innovation, invention and entrepreneurship to develop state of the art living facilities that keep older adults and persons with disabilities safer, healthier, and living independently at home as long as possible. As part of this mission, Blueroof Technologies has developed a comprehensive program to help McKeesport, Pennsylvania become a leader in Smart Home Technology. It utilizes information technology, sensors, computer hardware and software to monitor and optimize the lives of citizens, thereby avoiding or postponing institutional care by insuring the safety of home environments.

The Blueroof Smart Cottage

In 2005, Blueroof Technologies completed construction and dedication of its model Smart Cottage, located at 400 Spring Street in the Third Ward of McKeesport. The model Smart Cottage was built to demonstrate and test the monitoring technology features and functions.  In addition, Blueroof used the Smart Cottage to guide the development of a floor plan that utilized universal design concepts; this enables it to be adapted to the ever-changing and unique personal needs of each individual owner (“Center for Universal Design,” 2010) in compliance with the Americans with Disability Act  (“U.S. Department of Justice,” 2010). A modular home is a structure designed and built for residential use; constructed in one or more three-dimensional modules in a factory, and transported to the home site for final assembly and completion on a permanent foundation.  Using modular home construction techniques, the Smart Cottage is easily replicated for new construction at a cost of approximately $150,000, excluding land cost. About $10,000 (6.7%) of this $150,000 cost is associated with the technology add-ons (materials and labor) to facilitate aging in place.  The basic information technology infrastructure (wiring, controller, basic sensors) adds ~$2,000.  Internet connectivity, a computer server and an enhanced sensor array add ~$3,000.  Networked cameras and a more advanced sensor array add ~$5,000.

The model Smart Cottage is constructed as a two-story home: the second floor houses the administrative offices of Blueroof, while the first floor (Figure 2) reflects the floor plan of an actual Smart Cottage. This first floor is also used to demonstrate the various features of the Smart Cottage and to train elders about the appropriate use of the technologies it employs.  Smart Cottages designed for actual use by seniors would be only one level to help mitigate the risks associated with falls on internal and external stairways.

FloorplanSmart

Figure 2: First Floor Plan for Blueroof Smart Cottage.

The Smart Cottage first floor plan is 1,040 square feet (note: the staircase in Figure 2 provides access to the administrative and research offices of Blueroof Technologies, Inc. It would not be included as part of a typical smart cottage designed for use). The Smart Cottage’s 1,040 square feet of living space is on a single level, which enables easy and safe access to all rooms. All entrances and hallways in the space are ADA compliant enabling easy access to all rooms.  Pocket doors are used in all interior doorways to facilitate opening and closing of doors, and to promote the safe and efficient use of the space.  The bathroom features a lipless shower area to allow for walk-in and wheel chair accessibility. Data channels (Figure 3) are embedded in the walls of the cottage during the manufacturing process.  Wires from each sensor can be dropped down these channels and connected to the controller at any time (now or later).

Fig3Smart

Figure 3: Data Channel Extending into Basement.

This design feature greatly enhances the technology system and facilitates the installation of sensors and other devices as needed.

Quality of Life Sensors

The Blueroof Smart Cottage employs a variety of sensors and devices, depicted in Figure 4, which work together to help ensure high quality of life for those living independently. Arrows in Figure 4 indicate the locations of hard wired data channels in the model Smart Cottage. Preexisting homes can be also retrofitted with these technological devices using wireless capabilities, enabling individuals to age more successfully within the comfort of their own home. The use of wireless devices also negates the need to imbed hard wires inside the walls of existing homes, which is sometimes difficult and always labor intensive.

smartfig4

Figure 4: Smart Cottage Sensor and Data Channel Locations.

Once installed, the devices and sensors in Figure 4 are logged into the overall network and monitored remotely. Several general types of sensors are used to monitor various activities and “events” that occur within an independent living environment.  Some basic sensors indicate simple changes in status: e.g., on or off, pressure/motion/contact or none, etc.  Other sensors can be linked to various household systems and can function as catalysts to generate change within an environment; e.g., turning a light on or off in response to a signal from a pressure sensor in the floor.

Pressure-contact sensors under bed mattresses and sofa cushions are used to measure the amount of time an individual spends resting or sleeping. These sensors are low cost, small in size and very reliable and they enable the monitoring of sleeping patterns and daily activities such as TV watching.  This can help caregivers identify how to better understand and regulate these patterns to suit patient needs.  Additionally, pressure sensors embedded in the floor can be used to track an individual’s movement throughout his or her household.  Pressure and motion sensors can work together to serve as a fall detection system; evidence of motion toward a specific room followed by a lack of pressure at the anticipated destination suggests that an accident may have occurred along the way.  This event detection provides caregivers with valuable information they need to respond quickly to emergencies and possible injuries.

Contact sensors can be used to record the number of times closets, drawers, and cabinets are accessed. Assuming caregivers are familiar with the layout of the home, this information enables them to make relevant inferences regarding the elder’s ability to access daily necessities like food and medications.  These sensors can even be linked to items like toothbrushes to aid in observing patterns of personal hygiene.  On/off sensors are connected to major appliances (television, stove, refrigerator, etc.) to record times and patterns of usage.  Water flow sensors on toilets and faucets help determine which devices are being utilized and for how long. This type of monitoring can provide valuable information about behavioral patterns like eating, performing daily tasks, and even watching television.  Measurement and regulation of these patterns helps caregivers know that an individual is functioning normally, and assists in recognizing abnormalities in patterns of activity so interventions can be made if necessary.

Additionally, assessment of activity patterns based on these sensor data can potentially offer insight into physiological health status (metabolic rate, circadian cycles, etc.) as well as the onset and progression of less obvious disorders such as depression and dementia. This ability to collect data bodes well for future research opportunities using the existing infrastructure.

Cost Effective Wireless Monitoring Technology for Successful Aging in Place

While the Smart Cottage demonstration house described above is a viable and cost-effective construction option for seniors seeking new homes, it is not an option for the majority of elders who already own a home. To address the needs of existing home owners who wish to age in place, Blueroof has recently developed a suite of cost effective wireless technologies that are well suited to home retrofit applications. These wireless data acquisition/transmission systems are intended to function at both the scale of an individual home (the ‘BlueNode’) and also of a neighborhood (the ‘BlueKiosk’).

The BlueNode is a wireless technology system (Figure 5) for appliance control, security, health/wellness monitoring and easy internet connection to communicate with care providers and loved ones. The BlueNode also has the ability to collect and analyze a great deal of medical data, quality of life data, and home safety data, and then create a succinct, usable output for health care providers and family members.

5figSmart

Figure 5: The BlueNode System.

The BlueNode system (Figure 6) consists of a wireless mesh for the residence, unique quality of life (QoL) sensors to interface to the BlueNode via a wireless mesh, and a whole house hard drive to record all events and associated data. Circuitry, including a small PC/server to interface to a LCD HDTV/monitor, a cable modem, a router and a wireless access point enables the ‘BlueNode’ to connect to the Internet for in-home activity monitoring and remote access to the monitored space – if the appropriate access authorizations are in force. The BlueNode design allows it to be used readily for retrofitting homes and apartments.  In the present Blueroof Smart Cottage, all sensors are interfaced to the master system via hard wires, which lowers the cost of new construction.  In existing residences, however, retrofit hard wiring increases installation costs significantly.  The wireless feature of the BlueNode decreases retrofit installation costs significantly.  Each BlueNode costs approximately $2,000, while the BlueKiosk, still under development, has a target unit cost of approximately $5,000.

 

Figure 6: BlueNode Block Diagram.

 

The medical monitoring component of the BlueNode consists of a home based system developed by commercial vendors. This system enables the collection and analysis of medical data to be performed in each residence, without requiring travel to hospitals or doctor offices.  The BlueNode is able to send messages to caregivers and family members via email and telephone messages, using a conventional telephone land line.  Interfaces to the phone system and to the cable are contained in the BlueNode.

Each BlueNode is able to control five lights (e.g., a bathroom light) in each home or apartment and record to the usage of the HVAC system and other electric appliances. ‘Vizia’ (Zwave) is the primary method used to interface with lights and appliances.  Zwave is a technology that uses RF (radio frequency) signals to control lights and electrical loads from any location inside or outside the home.  Zwave needs no new wires; it is an inexpensive and reliable solution for home automation through signals sent over the in-home electrical power lines (“Zwave,” 2009).

As described above, each BlueNode system has its own web page that allows caregivers and family members to view and control selected activities in the home or residence. Video conferencing is another important component of this system, and the BlueNode contains a high quality, robust and easy to use video conferencing system using Skype and a commercially available high definition web camera.  This system allows residents to communicate routinely with family, friends and medical personnel (“Skype,” 2010).

Used in congregate elder housing (e.g., apartment buildings, assisted living facilities, etc.) individual BlueNode systems can transmit data in a wireless transmission mode to a local BlueKiosk in the Community Room or to a remote Data Analysis Center (DAC). Alternatively, each BlueKiosk could service the information exchange needs of a cluster of close by individual homes equipped with BlueNodes.  These data are processed in the DAC, and information is delivered to many different types of users. (Figure 7).

 

Figure 7: Block Diagram of the Overall Blueroof Technologies Data Acquisition and Dissemination System.

 

The McKeesport Independence Zone (‘McKIZ’) Smart Community

Blueroof has embarked on Project McKeesport Independence Zone, called ‘McKIZ’, an initiative that enhances McKeesport’s long term development plan by producing new housing to promote “downtown living” and establish a community model, potentially replicable in other communities across the state and nation. Project McKIZ is a multi-year initiative that holds the promise of enhancing the quality of life for residents in the area, while also encouraging community development, employment growth and economic stimulation through local job creation. Local contractors and labor are used wherever possible. Blueroof has broken the McKIZ project into four phases as follows:

Phase I 2007-2008 Design, layout, site planning and recruit partners.
Phase II 2008-2011 Construct 5 homes to demonstrate concept and commitment.
Phase III 2012-2014 Construct 10 homes using local labor.
Phase IV 2015-2020 Manage and operate McKIZ. Ensure that it grows into a     desirable community.

 

This project involves the development of a cluster community of Smart Cottages in McKeesport that is affordable, accessible, green and technologically equipped to meet the unique needs of challenged individuals including, but not limited to:

  • Veterans with disabilities
  • Individuals living in group homes
  • Older adults
  • Other people with disabilities

The McKIZ Community is located in the Second and Third Wards of McKeesport, within walking distance to the downtown area of McKeesport and to a Port Authority Transit station. McKIZ will enable extension of the paradigm of a smart and assistive home to the broader context of a smart, assistive, mixed generation community. McKIZ will incorporate devices and methods, proven effective in the Blueroof Smart Cottage, into a small urban community; homes, recreation facilities, retail establishments, home and community based long-term care facilities, and pedestrian friendly city streets that also accommodate vehicular traffic and public transportation.  Project McKIZ will enhance the redevelopment of McKeesport and make the area more desirable to potential home buyers and commercial activities.

Figure 8 is a sketch of the architectural plan of McKIZ.  As of the second quarter of 2010, Blueroof finished three homes and is currently working on two more adjacent to the group homes.

Legend


  • Smart Cottage
  • Group Home
  • Blueroof Research Cottage
  • Future(2010)
  • Future (2010)


Figure 8:  The McKeesport Independence Zone ‘McKIZ’ Site Plan.

The McKIZ concept is one that could be replicated across the United States and abroad, to help revitalize economically distressed areas containing a high concentration of low to middle income senior citizens.

Conclusions

Accommodating the health care costs of the ever increasing numbers of retirees in “the rich world” has been called “the biggest bill in history” (“Biggest bill,” 2009). Clearly, we must address this daunting demographic challenge with broad, innovative and cost effective solutions.  Providing for the low to middle income segment of the elderly population will present a great challenge, as expensive aging in place solutions (e.g., expensive technologies and newly constructed assisted living/nursing facilities) will not be replicable on a large scale due to economic constraints.

Highlighted in this paper is a comprehensive set of appropriate, technology-driven solutions developed by Blueroof Technologies in McKeesport, PA; designed to enable successful aging at home and in communities with other low and middle income residents of all ages. The prototype “smart home” designs, equipped with powerful, yet cost effective wireless sensor technologies, could represent viable solutions for a new generation of manufactured housing options and for cost effective retrofits of existing houses and neighborhoods.  Such retrofit solutions will be absolutely necessary for our society to accommodate the needs of our increasing aging population.

References

Administration on Aging (2010) Profile of Older Americans, 2009. Retrieved from http://www.aoa.gov/AoARoot/Aging_Statistics/Profile/index.aspx on March 2, 2010.

Alwan, M., Nobel, J., & Wiley, D. (2007). State of technology in aging services. Interim report submitted to: blue shield of California foundation. Retrieved from http://www.agingtech.org/documents/bscf_state_technoloy_phase1.pdf on March 2, 2010.

Biggest bill in history. (2009, June 13). The Economist, 13.

Binette, J. (2009, December). New York livable communities surveys of AARP members 50+: fact sheets, annotations, and methodology. AARP: Surveys and statistics. Retrieved from AARP — http://www.aarp.org/home-garden/livable-communities/info-12-2009/ny_livcom_09.html on March 2, 2010.

Center for Universal Design: NC State University. (2008). Retrieved from http://www.design.ncsu.edu/cud/about_ud/udprinciples.htm on March 2, 2010.

City of McKeesport. (2010) History. Retrieved from http://www.mckeesport.org/ on March 2, 2010.

Diakon Lutheran Social Ministries. (2010). Retrieved from http://www.diakon.org/ on March 2, 2010.

Elite care: the future of elder care. (2010). Retrieved from http://www.elitecare.com/ on March 2, 2010.

Eskaton senior residences and services. (2010). Retrieved from http://www.eskaton.org/index.html on March 2, 2010.

Lawler, K. (2001). Aging in Place: Coordinating Housing and Health Care Provision for America’s Growing Elderly Population. Retrieved from http://www.jchs.harvard.edu/publications/seniors/lawler_w01-13.pdf on March 2, 2010.

Litan, R.E. (2008). Vital signs via broadband: remote health monitoring transmits savings, enhances lives. Better Health Care Together. Retrieved from http://www.betterhealthcaretogether.org/www/docs/broadband.pdf. on March 2, 2010.

Mill City Commons. (2009). Retrieved from http://www.millcitycommons.org/homepage on March 2, 2010.

New Courtland. (2010). Retrieved from http://www.newcourtland.org/index.php on March 2, 2010.

Skype. (2010). Retrieved from http://www.skype.com/intl/en-us/home on March 2, 2010.

United States Department of Justice, the. (2010). Retrieved from http://www.justice.gov/

Zwave Products, Inc. (2009). Retrieved from http://www.zwaveproducts.com/ on March 2, 2010.


List of Figures

Figure 1: The Blueroof Model ‘Smart Cottage’ in McKeesport, PA.

Figure 2: First Floor Plan for Blueroof Smart Cottage.

Figure 3: Data Channel Extending into Basement.

Figure 4: Smart Cottage Sensor and Data Channel Locations.

Figure 5: The BlueNode System.

Figure 6: BlueNode Block Diagram.

Figure 7: Block Diagram of the Overall Blueroof Technologies Data Acquisition and Dissemination Plan.

Figure 8: The McKeesport Independence Zone ‘McKIZ’ Site Plan.

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[1] Richard Behr, Ph.D., P.E.: Charles and Elinor Matts Professor of Architectural Engineering, Director of the Smart Spaces Center, the Pennsylvania State University  ([email protected])

[2] Mark Sciegaj, Ph.D., MPH: Associate Professor of Health Policy and Administration,  Associate Director of the Smart Spaces Center, the Pennsylvania State University ([email protected])

[3] Robert Walters, P.E., MSEE, Professor, the Penn State University, [email protected]

[4] John Bertoty, BS in Ed, MEd, Executive Director of Blueroof Technologies, Inc.

[5] Rachel Dungan: Research Assistant, Penn State Smart Spaces Center, Junior, Schreyer Honors College, Majors in Biobehavioral Health and Music Composition ([email protected])

====as possible while maintaining a high quality of life.

http://news.psu.edu/story/161340/2011/01/24/smarts-spaces-focus-architectural-engineering-seminar

 

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