Editor's Chronicle

Volume 13, Issue 2, 2009

Alarming developments

Nowadays people are getting older and older. Life doesn’t end with retirement, instead, for many it is
twenty more years to go. All the same, the older we get the more fragile we are. At some point we will
need to be taken care of – the way will depend on the condition we are in. This is the good side of the
demographic trends of today. But the good comes with the bad. The bad thing is that our societies
won’t have the resources to give us all the care we need in the way they have done so far. Old people
will be too many and young people too few to provide resources and manpower to handle things the
way we might expect them to be handled.

All over the industrial world the demographic trends are the same. We get older and older and already
at the year 2020 about 25 % of the population will be 65 years or older. Some countries are worse off
than others; Italy, for instance, will become the leader in this demographic tournament and will pass
Japan in a couple of years. In Sweden the caring occupations are not attractive to young people and
Statistic Sweden anticipates that there will be a shortage of about 150.000 people in the home care
sector in10 years from now. Today there are about 250.000 employees in this sector. The trend is also
that we should stay put in our home when we get older and not count on a move to a nursing home
with professionals taking care of our needs. The professionals will come visiting us instead. In that
way the cost for care can be much cheaper, the call for nursing homes less extended and only for the
ones most in need – but at the same time we can remain in our comfortable social environment. But
the comfort relies on the trust that if something happens, and if we need advanced medical treatment,
it will be provided for us. If there is no-one to look after us 24/7 and we live alone, as many of us will
when spouses and friends are gone and other relatives live lives of their own, we must develop
systems to make it safe and secure to age in place with all the services we need within reach.

In the last twenty years, old people have had safety alarms in the home connected to the POTSnetwork
(Plain Old Telephone System). It has provided a lifeline to support services in case of
emergency or need for help. You just push the button (on your wrist or around the neck) and you reach
a Call Centre, which can establish a communication with you wherever you are in your apartment,
through an in-built speaker and a microphone. This has been a security for both the old ones and their
families. But suddenly things have changed. And it has changed in the dark. The POTS doesn’t exist
anymore. It has been replaced by communication through the “triple-play”-network that comes into
your building. This is a digital communication network system that provides you with TV, Tele and
Data communication, all through the same pipe. It is just one cable instead of two or three. Smart, yes,
more efficient, yes. But the problem is that the safety alarms that exist today are based on analogue
communication and they don’t function properly with a digital system. So there must be an
analogue/digital converter put in between the safety alarm and the network. Then it seems to work and
since your old phone is analogue you will naturally get such a converter when the digital network is
installed in the house so that you can use your phone as you have done before. And when you press
the safety alarm button the alarm is set of as before but sometimes it loses some of its content and that
might be the bit that alerts the Call Centre. So when you think you have called for help, actually you
haven’t because no one hears you.

This has happened in Sweden, with fatal consequences for the caller. So when we develop our new
systems for health care and point our mission to the home, we must be sure to involve both carers and
technicians, otherwise we run the risk of creating more problems than we solve.

Stefan Lundberg, Lecturer
Centre for Health & Building
Royal Institute of Technology