As America’s “baby boomers” gracefully age, and living longer with chronic health problems is increasingly possible, the need for in-home healthcare/assisted living is rising. Remaining independent for as long as possible is generally the preference, but for many individuals, full-time, in-home care is not an option. Nonetheless, providing adequate and compassionate care to these individuals is crucial.
Any solution must consider increasing demands on the healthcare system, the availability of caregivers and professionals, and personal factors ranging from individual financial stability to availability of friends and family. Would it be possible to design, program, build and implement a low-cost, multifunction, robotic nurse/assistant such as ALAIR (“Assisted Living Autonomous Internet Robot”)?
This research led to two definitive conclusions. First, it is, indeed, possible to build an assisted living robot – for approximately $1250, a fraction of projected retail costs of other prototypes currently in their infancy – that addresses many needs:
- Healthcare/homecare monitoring and assistance via wifi/videochat with off-site professionals
- Pill dispensing (correct pills on correct schedule)
- Fall detection
- Routine healthcare monitoring
- Oxygen saturation
- Heart rate
- Blood pressure
- Ability to locate subject within home
- Emergency response
- Record keeping and reporting to medical staff
- Little/no technical knowledge required for use
(Note that no single prototype containing all of ALAIR’s features currently exists.)
Second, this project yielded a positive response from the target population surveyed who communicated confidence
in this particular prototype, an increased sense of security and a willingness to interact with the robot.
“I do not think there is any thrill that can go through the human heart like that felt by the inventor as he sees some creation of the brain unfolding to success... Such emotions make a man forget food, sleep, friends, love, everything.” - Nikola Tesla
These emotions are felt by every passionate engineer, and drove me toward engineering since a young age. The passion of an engineer can become anything: an answer to the energy crisis or, in my case, a viable healthcare solution for America’s elderly. The main reason I built this robot was simple: I love the process. My passion for robotics solidified after attending the White House Science Fair in 2012 and having President Obama say that one of my robots “could make life better for millions of families” (WhiteHouse.gov).
The best intentions without drive are fruitless. Robots always drive me, and then, I wind up driving them!
In college, I hope to study Robotics Engineering at Carnegie Mellon University. I'm not sure yet where that will lead, but there seem to be unlimited job opportunities for people who just love robots.
Winning this contest would pay for a huge portion of my college, which I'm paying for myself. It would be amazing to focus on what I love during college instead of working at a pizzeria. I also hope a company could help me develop my invention into a market-ready product, providing safety and well-being to the elderly.
Question / Proposal
The elderly are in increasingly greater need of help. From basic tasks such as medication dispensing, orthopedic stability (i.e., remaining on their feet) and social interaction, to more complicated ones generally handled by a visiting nurse or home health aide, such as daily monitoring of heart rate, oxygen saturation, blood pressure or emergency response in case of an accident, the needs are great.
Proper help is often unavailable either for economic or social reasons. Even when a patient is willing to undertake
certain tasks on his own, dwindling cognitive capacity, decreased dexterity, declining vision, and other
health challenges may make it impossible to do so effectively, and most of these conditions only worsen with time.
At the same time, independence is often ferociously desired.
The Problem: Seniors need an efficient, cost-effective method of caring for themselves that reduces healthcare costs and also allows them as much independence as possible, for as long as possible.
The Two Tiered Purpose:
1) First, to determine whether it is possible to build an economical, multifunction robotic nurse/assisted
living aide to at least partially replace an in home nurse in many situations.
2) Second, to deploy the said robot and evaluate the reaction of the target population to the feasibility of this technology. This will include assessing their opinions regarding such factors as ease of use, cost-effectiveness, willingness to ask for help, and
comfort level interacting with a robot carrying out these previously human functions.
The research into the topic of Assisted Living Robotics was one of the catalysts for starting the project. The first question involved the scope of this issue in the future, and the answer is sobering. By 2030, there will be about 72.1 million older persons, more than twice the number from 2000. And, we are living longer.
When I first researched assisted living technology, I expected to find hundreds of robots, even if they were just rudimentary ideas. I found otherwise. I could only locate 3-4 viable assisted living robots that were anywhere close to being ready for testing. The few robots that I found, such as Hector from CompanionAble, could only remind the elderly when medicines were due and detect falls. These are both important features but can’t replace a nurse in most cases. Yet Hector has had $10,722,000 dollars of funding, and the last post on its promo website was January of 2012.
Other promising programs seem to have been abandoned. Moreover, ALAIR’s “Base Station” model is the only one of its kind, that projects to operate via a staff of medical/home healthcare professionals who would monitor patients remotely, 24/7.
I was dissatisfied with the lack of healthy competition. I’m lucky to have several very old grandparents, and all of them need more and more help. Before the current prototypes can come close to implementation, they need years of testing, and they do not even contain all the necessary features that would allow an elderly person, or any handicapped/homebound patient, to remain at home safely. ALAIR also addresses the concern of skyrocketing healthcare costs and could easily fit into the healthcare system in the form of durable medical equipment. Since assisted living is often out-of-budget, living at home alone for many people becomes a risky venture that only adds to healthcare emergencies or false alarms, both of which take their toll on healthcare costs.
The social and community aspects of implementing such a device was reviewed in-depth. This included research on topics like general assisted living, elder care, senior challenges, economic feasibility for baby boomers, national and global demand, emotional/physical issues of aging, healthcare laws, key concerns of family/friends in managing elder relatives or physically challenged, the meaning of “independence”, and more.
Specific age-related/health-related impediments, such as dwindling cognitive capacity, decreased dexterity, declining memory/vision, and other challenges were reviewed in an effort to decide which robotic functions would be most useful, and how these functions would have to change or evolve with the patient over time. Research suggests that by creating and continuously updating an ongoing record of patient information, stats, vitals, etc., new or unused autonomous functions could “kick in” over the course of the patient’s lifespan with ALAIR. With time, the patient’s healthcare picture should be extremely stable, as ALAIR will autonomously respond to the patient’s changing needs or stable condition, and report back to the “Base Station” staffed with healthcare professionals.
Method / Testing and Redesign
1) Design/build ALAIR
Conception and design of this robot went through various levels of development, all based on evolving research in this area,
needs of target population (i.e., the patients), safety and ease-of-use. With the base operational, functions were added such as videochat, emergency contact hook-up via wifi, vital signs monitoring (oxygen level, blood pressure and heart rate), pill dispensing and fall detection.
A brief summary of construction of this prototype – which involved hundreds of repetitive
steps, trial and error, redesign, reprogramming and reconfiguration – follows:
An electronic wheelchair base was decided on and reconfigured for maneuverability safety concerns. Remove all previous circuitry and hardware, besides frame, from Hoveround. From two front wheels, cut off one wheel and mount in the middle to form a triangular base which will allow creation of a bumper that surrounds the wheels that can also fit through a door.
Create bumper suspended by springs contacting limit switches to allow detection of obstacles when contacted. Frame with plywood surrounded with Masonite.
Cut four pieces of unistrut approx. 4’ high. Mount cabinet drawers onto unistrut for laptop and electronic access. Construct linear slides for pill dispenser and pulse sensor using all-thread and motors mounted on drawer slides.
3D print medicine dispenser after designing in autocad. Mount medicine dispenser to gear assembly from old printer in order to convert the <180 degree rotation into 360 degree rotation. (Not to be confused with continuous rotation- the position function of a standard servo is still necessary)
Cover electronic drawer in Lego sheet for easy mounting. Glue Lego pieces onto everything that needs to be mounted in the electronic drawer, such as the Arduinos, voltage converters, etc. Connect each Jaguar motor controller to 12v power supply through two relays that are capable of supporting current above 40a for emergency shut off. Wire signal and ground from Arduino to motor controllers for linear slides from Arduino Mega. Connect pill dispenser to Arduino Mega.
The Arduino Mega will handle control of the biometric sensors and the drawer slides, making them accessible over the internet independent of the robot's internal computer, while the Arduino Uno will control the drive motors and pan/tilt functions.
Patient Tracking Testing:
2) Deploy/test ALAIR with target population and survey results:
Demonstrations of ALAIR were given to a representative population of end users in their own home environment. Volunteers were asked to visit with ALAIR and allow demonstration of one or more of ALAIR's basic functions, for example: monitoring of basic vital signs, dispensing of nontoxic candy “pills” to simulate real pharmaceuticals, visiting via videochat with simulated healthcare professionals (offsite), and calling for help. Afterward, subjects were asked to provide feedback regarding their experience. areas surveyed included ease of use, opinion on practical implementation, opinion on projected implementation in their lifetime, comfort-level, sense of security, sense of companionship, sense of independence and confidence in the technology.
This experiment’s Two-tiered Purpose is accompanied by the following Two-tiered results:
1) Construction of ALAIR was complicated, time-consuming, but successful. The design and build process were economical when compared to other advertised prototypes, and ALAIR as a whole was more comprehensive, and with greater functionality than any other available assisted living device specifically targeted for this group. The design and build are also replicable, customizable and upgradeable. Numerous future functions are envisioned, and the current design has ALAIR well-positioned for implementation of those additional features at any future time. The robot was constructed for just over $1250 dollars. Like any prototype, there is room for improvement- but for one teenager, $1250 dollars, and a year of time, it is already further than what currently exists.
2) ALAIR deployed and demo’d well to the target audiences, elderly residents of a minimum age of 62 years living in a HUD residence which requires them to be capable of independent living. The average age of the sample group was 78 years old. This population generally transitions into assisted living facilities, hospitals, hospice or family care. Given the age and current lifestyles of many of the test subjects, the level of interest in this new, potential technology was particularly keen. 73% of subjects tested indicated they could see themselves using a robotic nurse like ALAIR in the future, and 92% felt that a robot like ALAIR – with videochat to real doctors/nurses – could replace in-home nursing.
Test subjects were surveyed on a variety of factors relating to their experience with ALAIR, as well as their past experiences with assisted living aids/visiting nurses. They were also surveyed on three experiential points relating to their personal willingness to ask for help, and their ability to afford the same. Since these questions were not directly related to the subjects’ experience with this technology, responses were noted, graphed separately, and used for background purposes.
Overall, responses to this new technology were favorable. An overwhelming 80% of test subjects indicated they would feel comfortable using ALAIR as a home health aide, while 100% indicated that they would trust ALAIR to help them manage their pills, instead of doing it by themselves. 90% of subjects indicated that ALAIR was easy to use, and over 95% said ALAIR provided a favorable user experience.
An impressive 100% of subjects surveyed indicated that they felt ALAIR provides a sense of companionship/security. Regarding personal independence, 67% felt ALAIR provides more independence than a visiting nurse. While this is still a clear majority, future field tests will explore this question in more depth. Overall, the general consensus shows that this population is open to the technology. A second demonstration was conducted with approximately 30 members of an assisted living facility. Future sample sizes will be increased. (Currently, approximately 80 subjects have participated in demonstrations lasting approximately three hours each, on three separate occasions, at different facilities.)
Conclusion / Report
This experiment’s Two-tiered Purpose is accompanied by a Two-tiered conclusion:
1) The engineering design portion of this experiment proved the feasibility of building and deploying an economical, multifunction robotic nurse/aide to support general living and nursing activities. Such a robot could allow the elderly, or anyone with chronic health conditions, to remain in their own homes longer, with reduced need of one-on-one healthcare professionals. ALAIR was constructed on a budget of approximately $1250– a fraction of the projected retail cost of a scant few other prototypes currently in their infancy. As ALAIR was designed, created and field tested by one non-professional, in one year, for $1250 dollars, its complexity and level of development are encouraging relative to other options. This also suggests a positive outlook regarding advances in this field, especially if public awareness of the issue is added to the equation. And who, in any audience or demographic, is not aging and also hoping to stay independent…?
2) Data from this research showed that test subjects embraced ALAIR as an alternative to an actual human nurse/aide. The initial test population (aged 62-91) was typical of one that would generally transition into assisted living facilities, hospitals, hospice or family care. A majority of subjects indicated that a robotic nurse/aide like ALAIR could help them maintain their independence longer. Given the age and current lifestyles of many of the test subjects, the level of interest in this new, potential technology was particularly keen. Their comfort level seemed to increase when reminded that ALAIR can link to an offsite professional with a touch of a button.
The majority of individuals surveyed acknowledged that they could foresee such a robot being part of their future. This detail is particularly notable in light of the fact that the test population is typically slow to transition and learn new technologies. In the interest of their own personal healthcare and futures, this resistance seems to have been less present.
Also notable were the results yielding an overwhelming 100% of responders indicating they would trust ALAIR to help them manage medications. This implied a distrust, or doubt, in their own ability to manage medications, which is often a daunting task. One subject verbally reported taking “twenty-four pills” a day, and to having previously “taken them more than once because I forgot I took them”. Indeed, the ill-effects of polypharmacy are prevalent in this population, and arise from factors ranging from decreased cognitive skills to waning eyesight. "There are over 100K deaths per year related to polypharmacy, and medication misuse and adverse reactions, which brings it to one of the leading causes of death in this country.” (ABC News) The misadministration of pharmaceuticals is a huge area of concern; as more medications are prescribed, proper dosing and timing of doses are growing concerns.
This project demonstrates that an economical, homemade assisted living robot is possible. Test subjects welcomed the technology with open arms and an impending sense of necessity. ALAIR can successfully satisfy a great need.
Bibliography, References and Acknowledgements
This project would not have been possible without the support of many people.
I would like to thank several individuals and companies who supported this research through supplies offered at no cost or reduced cost: Mike Horde and the rest of the people from Sparkfun, and also 3D Systems for donating a 3D Printer to me, which was used for prototyping and for creating the pill dispenser. I would also like to thank Sparkfun for being not only a huge resource of parts for the project, but having troves of information on how to troubleshoot and implement every part.
I would like to thank all my teachers at Salesianum High School for their dedication to excellence and their passion for learning, which they share with students on a daily basis. In particular, I would like to thank calculus and physics teacher Mr. Matthew Kegelman, who also supported me by sponsoring this project as the only student in my high school to compete in science fair this year. I would also like to thank my physics teacher, Mr. David Stevens, who has really made math come alive for me this year through his amazing, intuitive teaching of physics. I would also like to thank my AP Computer Science teacher Mr. Jason Guinaugh for his formal teaching of Java.
I would like to thank all of the mentors on the First Robotics Team (MOE 365) that I am a part of for donating their time to increasing STEM education. Specifically, Lucie Wilkens for being the first person to teach me programming.
I want to thank my grandfather, Peter Hylak, who is a chemical engineer and inventor, and whose many patents and love for science inspired me to believe in myself. I would also like to thank my 7th grade science teacher Mr. Bloh for teaching me that science is cool.
I want to thank my father, Joseph Lee Hooker, whose attention to detail on all areas of our family life is best showcased by his incredible work in the recording studio. His creativity as a songwriter inspires me to be innovative in my own creations.
I want to thank our family friend and my mentor, Bob Furmanak, who worked with me on certain elements of ALAIR’s body design at his wonderful workshop, and helped me brainstorm on other areas. Bob continues to help me broaden my workshop skills using tools and machines. Bob is a calm, methodical thinker whose approach to problems almost seems to amuse him. I admire Bob for that, and hope to be like him.
I want to thank my mother for editing my writing. My mother also helped me greatly to keep on track during this experiment and to “focus on priorities”.
I wish to thank the open source community, specifically Arduino, for the amazing libraries they have written and for being open hardware with all schematics and open source with all software which allows people to build upon them and build things that they could never have by themselves. I would also like to think anyone who has contributed to the open source libraries that were used in this project and for every person who has ever posted an instructional docket online in the area of STEM research.
I wish to thank Dale Dougherty, founder of MAKE Inc., for being a true inspiration in the area of creativity and innovation for altruistic reasons. I am inspired by Dale’s commitment to help the world be a better place by encouraging each person to come alive and MAKE.
I wish to thank my grandmother, Marlene Hylak, all the residents of Luther House in West Grove, PA who enthusiastically received ALAIR as a guest, and who freely gave their time and opinions regarding the plausibility of this invention.
I'd also like to thank Nikola Tesla, but I would rather not go through a list of things that wouldn't have been possible without his work.
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