Promoting Independent Living Through Technology

1. Promoting Independent Living Through Technology Jeanne & Mike Sydenstricker December 6, 2012

2. Innovative Independent Living Project (IILP) Overview • 3 1/2 year grant from Cleveland Foundation and Billie Steffee Family Foundation • LEAP (contract recipient and program lead) • Cuyahoga County Board of DD • Welcome House • Jewish Family Services Association (Ascentia) • North Coast Community Homes • Objectives (all achieved) • Assist 6 to 10 families to create healthy safe homes where their adult sons/daughters can live the life they choose • Identify, test and incorporate technology into customized support options for independent living • Develop tools which can be used by others • Financial, Legal, Training, Processes • Become a model others can replicate and expand

3. IILP Overview - continued • Families had to be • Interested in community based independent living • Willing to invest personal resources (time and money) • Willing to work continuously with professionals and other families • Collaborative in nature • Participant requirements • Age 21 or over • Not medically fragile • No behavioral issues that might be a danger to the participant or others in the home • Involved in a job or day program; or independently assessed to be able to safely remain home during the day

4. Where are we now? • Now have 3 houses with 9 young men living independently • Technology has been a key to affordability, safety and independence • Financial model and parent manual completed and available to anyone through the internet (http://www.leapinfo.org/living_with_technology0.aspx ) • Films including parent/professional perspectives and technology use available on same web site • Both parents and residents are very pleased after 3 years of independence

5. House #1 Description • 4 young men in their mid 20’s live together • 2 originally moved in June 2009, with a 3rd in Feb 2009, 4th in 2011. • All work during the day • One family owns the house, others pay rent • Share expenses equally • Families use remote camera monitoring system to check in and provide oversight • Parents take turns providing meals, buying supplies, etc. • Residents have Level 1 waivers and receive State Plan services

6. House #2 Description • 3 young men in their early 30’s live together • All moved in together in Sept 2009 • All work during the day • One family owns the house, others pay rent • Share expenses equally • Technology of many types provides essential support • Live-in “typical” adult receives room and board in exchange for being there from 9 PM to 7:30 AM • Systems set up to enable independent meal planning, grocery shopping, etc.—not yet perfect, but improving!! • Residents have Level 1 waivers and State Plan services

7. House #3 Description • 1 young man in his early 30’s lived alone for 2 ½ years • Moved in summer 2009 • Actively looked for a roommate – found in 2012 • Parents provide 100% of support • Minimal use of technology • Had stove removed for safety reasons • Uses Skype to connect to family in evenings

8. Funding • House and related costs (utilities, lawn care, upkeep, etc.) paid for by residents and families • Support costs are the most challenging issue • Each person’s needs are different • Good reliable caregivers are hard to find and expensive • Our houses use a combination of • Family and friends • In-kind support • Technology in lieu of caregivers • Level 1 waivers • State Plan (Medicaid) funding

9. Technology • Critical to the success of our houses • Initially hard to find appropriate technology • Much more available now as companies design for the aging population • Used in a variety of ways • Enhance safety • Promote independent functioning • Reduce personnel costs • Ranges from very low to very high complexity • Value differs for each resident

10. Technology: What has been tried so far? • Solutions range from simple to complex, and from low tech to high tech • Example: to keep residents safe for preparing and eating food, you can • Have no oven and just use the microwave • Cook somewhere else (family home) and bring food into resident’s home • Use an induction stove which has a cool-to-the-touch surface and is less likely to burn someone; safer cooking

11. Other Items • Garage door automatic closer • Outside motion detector that monitors movement in the driveway gives advance notice of visitors • Flashlights that light in the event of a power outage • Vacuuming and floor washing robots (Roomba and Scooba) Light bulb that stores Power for power outages

12. Camera Monitoring systems • We tested: • Rest Assured • Web-based system that connects the consumer with real people using the latest wireless technology over the Internet • Full time staff is employed • Engaging Technology Ltd • Developed as a parent monitoring system, video cameras are mounted in the home but monitoring is done by families, not staff. • Parents use home computers and iPhones to check in • Others are now available

13. Power point instructions • Easy for many people to create and edit • Inexpensive • Useful for many tasks • Scheduling • Lunch box preparation • Recipes & Cooking • Can also include voice if individual can’t read or for general interest

14. Skype & Face Time • Allows people to see each other while they talk, in real time • One button dialing so anyone can do it! • FaceTime on the iPad and iPhone • Tango for Android • Others

15. Video system for answering the door: to assist in decision making about when to open it for visitors

16. iPAd, IPOD, iPhone, Other Smart phones • Hundreds of “apps” that can be downloaded, some for free, others for minimal cost • Social stories • Language and communicators • Organizers, list makers, calendar reminders • Cameras for training, demonstrating, etc. • GPS locators • Dozens of new applications daily

17. So what does all of this mean? • Technology must be tailored to the individual needs • Very Sophisticated and very low tech are equally valuable depending on the problem you are trying to solve • Low tech is always preferable if it works • Technology can be frustrating, a bit scary, and intimidating but the benefits are many • Can enable positive improvements in individual independence • Often results in significant improvement in self esteem • Can save a lot on expenses

18. Considerations • Staff is still needed, but technology can significantly reduce costs if used appropriately • Few tools are available to provide guidance • Cost considerations must include initial items as well as ongoing maintenance and upgrades • Funding is difficult to find—but progress is occurring • Available technology changes almost daily • There will always be new and/or better solutions • But you don’t have to always upgrade • No network to find partner families with whom to collaborate • Be prepared for a LOT of work—and great rewards

19. Some Resources • From LEAP’s Innovative Independent Living Project ( http://www.leapinfo.org/living_with_technology0.aspx ) • Two videos: • parents & residents • program management and professionals • Manual (200+ pages) • Internet searches • Smart Homes • Care for elderly and aging • Assistive technology • University projects related to disability areas

20. Questions?