Old folk in a smart new world

Mr Goh Ban Kim, 98, is too feeble to walk, cannot talk, uses a catheter and needs to take a dozen pills a day for a host of medical conditions.

When his caregiver and daughter Goh Tok Cheng, 56, is at work, the family's helper Widiya Nengsih, 24, checks his blood pressure, sugar levels, urine and temperature regularly. She then uploads the information using a software application known as iUvo Health Notes.

Madam Goh, who lives in a spacious semi-detached house in Katong, views all the information at her office in Shenton Way.

"This app is really a blessing," she says. "It enables us to monitor him just as he would be monitored at a nursing home - except that, despite being very ill, he can still be in his own room, at home."

Her father's happiness in his last years, she says, stems from being at home, among loved ones. "Ultimately, that's what iUvo helps us give him."

As tens of thousands of Singaporeans hurtle towards old age, software technologies and devices designed to help the elderly are slowly finding favour here.

Some - like motion sensors and smoke detectors - ensure home safety. Others empower people facing physical and cognitive challenges, so they can retain their dignity and independence. Yet others - like the iUvo (in Latin, "iuvo" means to "help") - enable caregivers to better manage seriously ill patients at home.

Developed in Singapore by two tech-savvy general practitioners - Dr Choo Wei Chieh and Dr Eugene Loke - the app allows dozens of pages of medical information to be uploaded if necessary.

"As a person ages, his medical file can become quite thick," says Madam Goh, an assistant vice-president with a foreign bank. "We can retrieve everything at the touch of a button, to show to family members or doctors."

When her father developed a rash on his leg recently, she uploaded photographs using the app, for his doctor to view remotely. "He knew exactly what to do, and I was saved the inconvenience of taking dad to a clinic in an ambulance."

The remote monitoring also takes the burden of responsibility off Ms Widiyah, who says: "All I do is key in the information and wait for instructions - and follow what my boss says."

Dr Choo, a home-care doctor who looks after geriatric patients, says the biggest benefit of the app is that it is easy to use.

"It helps put patients and their families on the digital bandwagon. There is no point having a fancy app if no one wants to use it," he says.

In future, he hopes to make the iUvo software interface seamlessly with wireless-enabled blood pressure monitors and glucometers - that would do away with having to key in the data manually. "The possibilities are immense," he says.

Tech-savvy caregivers like Madam Goh have warmed to the wonders of medical software, but even those like Ms Rose Kwek, 72 - a self-confessed technophobe - are buying digital products, albeit less geeky ones.

The retired teacher is thrilled with a "talking clock" and a pillbox with an alarm that she recently bought for her 95-year-old mother, who cannot see very well and sometimes forgets to take her medicines.

"They make her feel independent and empowered," says Ms Kwek. "She had to depend on others to know the time and take her pills. Now, she can do both herself."

Products that help ease caregiver burdens are also in demand. Among the newest in town is the Smart Sole - a miniature GPS tracker that is inserted into shoe insoles and helps locate cognitively impaired people who might be lost.

In use in the United States, the product is being retailed here by the Ministry of SilverLining, a small local assistive-device company run by former nurse Coco Guo. She says she imports technologies and products based on her extensive chats with former patients and their caregivers.

Dementia specialist Philip Yap says the Smart Sole is meant to overcome difficulties presented by other wearable GPS devices - such as pendants, wrist watches and mobile phones - which a user might easily forget to wear or take along.

"People with dementia often go outdoors on their own and risk getting lost," says the senior consultant in the department of geriatric medicine at Khoo Teck Puat Hospital (KTPH).

The product has a "geo fence" feature that alerts the caregiver by SMS if the patient ventures beyond a pre-defined "safe" zone.

"This is indeed useful should a cognitively impaired patient wander off alone," says Dr Yap. The device can also be used for those who have autism or are mentally ill.

Mr Kelvin Lee has been looking for such a product ever since his 77-year-old father, who has vascular dementia, wandered off by himself. It has happened a couple of times in recent months, and he did not answer his mobile phone.

"We were worried sick that he might get lost or injure himself," says Mr Lee, 46.

Before the illness struck, his father was an active and independent man who loved meeting friends, going to the movies and travelling. "We don't want to curtail his independence," says Mr Lee, who is attending a training programme in Australia for caregivers of dementia patients. "So this product holds promise."

He tested the Smart Sole last month after hearing about it from his father's doctor at Changi General Hospital. "It was unobtrusive, and we could easily log onto the portal and track the Smart Sole's location in real time," he says.

However, it costs nearly $600, so many might find it expensive. Also, currently, it does not work well in basements and MRT stations.

Mr Lee is worried about software malfunctions as well, and whether the product could be discontinued here because there are few takers.

"If the price is reasonable, and these concerns are addressed, we will consider buying it," he says.

He has a point. Technology troubles can be hard to outgrow. Products that once held promise can perish fast.

Indeed, even though many new-age devices intended to help older folk have been launched here with much fanfare in the past decade, few have stood the test of time.

Cost and the fact that seniors were largely averse to technology were big stumbling blocks, say doctors, caregivers and IT experts.

Even newer devices such as the GPS-enabled insoles might not find acceptance among the elderly today, points out Dr Yap.

Many of his patients are used to wearing sandals or slippers that have no insoles, and they might be unaccustomed to wearing insoles.

Dr Yap's colleague, IT industry veteran Alvin Ong, says the limitations of technology are another major challenge.

Some products require the user to press a button, which might not be possible if he is suddenly incapacitated by a stroke or heart attack, for example. Many are therefore reluctant to pay monthly subscription charges for call centres.

"There are automated systems that do not require pressing a button, but those have the possibility of false alarms," says Mr Ong, the chief information officer at Alexandra Health System, which manages KTPH.

A short battery life and the inability of patients to keep wearing devices or uploading information are other problems. New habits are hard to form, and old ones die hard.

Constantly having to keep up with fast-changing technology is a further challenge, says IT entrepreneur Kelvin Lek. Five years ago, he launched a wearable emergency device for older folk called eAlert, which was widely publicised as the first such "panic button for the elderly".

But the product was connected only to fixed phone lines, rather than mobile phones, and it was restricted to indoor use. It became obsolete pretty fast.

Mr Lek is now in talks with an Australian technology firm to introduce a new-age panic button that works both indoors and outdoors. His company, Emo 2 Enterprise, is one of at least four that say they are launching similar products in the coming months.

"Technology becoming obsolete has been an occupational hazard," says Mr Lek. "We've had to always move with the times."

Still, he believes that as people become more tech-savvy and affluent, and as more sophisticated yet user-friendly technologies enter the market, demand will pick up.

The industry is about to turn a corner, he says. Ageing baby boomers will definitely value these products.

"This time, I feel we're here to stay - and stay for good."

radhab@sph.com.s

This article was first published on Apr 26, 2015.
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