The Public's Health: The New Elderly Surveillance State | Public Health Post

Millions of older adults will develop dementia over the coming decades. The middle-agers who assume responsibility for this older generation face a looming concern: how can we keep our parents safe and at home? Can technology help make this possible?
If we read the popular press on this, the Internet of Things will carry part of the load of caring for our elders. New, in-home smart systems will reduce caregiver stress through electronic surveillance, allow doctors to get real-time insights into the health of our loved ones, and improve their quality of life. 
Teams of clinical, economic, security, and technical experts are now at work on a new form of “assisted living.” The model patient in her home will have passive environmental sensors (the stove turns itself off), medical devices, wearable technologies, and interactive apps connected to her body and bed, floor and door frames, collecting a fast-moving stream of data, a “velocity challenge.”
Such “living labs” are already deployed and being evaluated. These new “trusted patient homes” will require a new kind of workforce of healthcare practitioners, not only persons who can read the new dashboards but also technicians who can maintain the sensors. But will these new, technologically sophisticated homes really tackle the core problem? At the moment these homes feel, to us, like new sites of isolation. They remind us of a surveillance state, albeit one that aims to preserve health.
Yes, we will all have more data. Yes, we might better understand the physiological patterns of persons living with dementia at scale. But can we really improve the quality of lives of our elders with dementia and their families with easy-to-follow audio instructions piped in over speakers? Will a daughter feel safe leaving her mother alone at home in this surveilled new world?
The world of continuous monitoring will bring new challenges. And the technology by itself will not be the full solution. Somewhere we have to figure out the role that old-fashioned social networks, humans checking in on humans, will play, and how technology can help augment, not replace, the role that caregivers play in maximizing quality of life for those who can no longer look after themselves. That will require a serious examination of the role of work and obligation, borne by those in middle age, and how this can fit in with the increasing responsibilities that they will inevitably bear as the population ages.
We need space in the public conversation for this too.

Michael Stein & Sandro Galea