By MARTY LEVINE
“In medicine we are always trying to fix people,” said Pamela Toto, recently named director of the Healthy Home Lab – an Oakland house that Pitt purchased in 2022 and has outfitted as a mock residence for testing the idea of “aging at home.”
“We’re not trying to fix the person here,” she said, as she gave a tour of the lab. “Here we’re looking at people’s strengths,” while aiming to improve the environment of older adults who wish to remain at home while facing physical or cognitive impairments.
“This house is not just about safety, it’s about independence too,” Toto said. Currently, she added, “our environments aren’t friendly for our aging bodies,” especially in older homes on two or even four levels, from basement to attic. A lot of older adults will accept some risk to maximize independence, but in Pittsburgh, with about 90 percent of homes not being age-ready (essentially all on one floor), “we have to figure out ways to bridge this gap” between existing homes and homes that allow for safe living through later decades in life.
The Healthy Home Lab tests new technology to make all this possible — both devices designed here and in other Pitt labs and those commercially available. Through this lab, students from multiple Pitt health-care disciplines rotate to learn the methods of caring for older people. And the lab partners with community organizations to bring in volunteers to experience new devices and advise on how to make them better. Lab personnel also take those devices to housing sites to test, especially among those who wouldn’t usually have experience with the latest tech — or wouldn’t normally be able to afford it.
Toto has been a senior leader in the lab since its opening in August 2022 and was instrumental in directing its development and evolution; she became director this past March. She is also an occupational therapy faculty member in the School of Health and Rehabilitation Sciences, and has been in clinical practice for more than 20 years, working mostly with older adults. Few people work in the lab full time, she notes. “It’s my job to keep an eye on all these moving parts and make sure we’re making an impact. My role is to move all three of those roles along” — research, education, community.
As Toto showed a group of visitors around, she pointed out that, normally, the home is an active lab with engineers bent over work benches. “You would definitely see technology being built,” she said.
In the kitchen, there are smart appliances connected to Alexa, to help those with cognitive impairments, while radiator covers prevent falling against their hard, often hot, surfaces. The dining room table is built for wheelchair access, with legs in the center, and to its hutch drawers have been added handles easier for those with physical impairments to pull.
There is smart technology throughout the home. Saying “Alexa, I’m going to bed” turns off all the lights. Another voice command locks and unlocks the front door. The bathroom has a lighting strip under the sink cabinet that comes on by command, since improved lighting is the best preventive measure against falls. A new type of stair climbing device is under construction to help residents to and from the second floor; it is not the traditional chair but may allow people to walk stairs more easily.
“Sometimes you don’t need technology — sometimes you just need to learn new ways to do things,” Toto said, pointing out the basement’s simple table and chair to allow for older users to remain down there with an activity rather than using the stairs multiple times, and a laundry carrier with backpack-like straps to leave hands free when carrying laundry loads.
On the living room windowsill are multiple air monitors being tested to see how well they detect invisible hazards such as dust and mold. This room is also set up with its normal obstacles — a coffee table near the middle, couch and lounge chair too low to get out of easily — to test devices that might help residents get up from or around this furniture. Next to the chair, for instance, there is a pole with an adjustable bar that would allow those seated to grab and pull themselves up. Although the bar is commercially available, it came on a pole too low for the lab house’s ceilings, and lab personnel had to lengthen it.
“The house has allowed us to identify a lot of problems” and work on solutions, Toto said.
The main living room light hanging from the ceiling is also a fall detector, from a company called Nobi, with whom the lab is partnering to test this device. It takes intermittent photographs of what’s below to detect falls, and can be set to alert the fallen resident’s family.
The Nobi light investigation is part of the latest grant the Healthy Home Lab has received — a second grant from the federal Housing and Urban Development (HUD) department, this time of nearly $1 million. It will be led by Yong Choi, assistant professor in SHRS’s Department of Health Information Management, who is also the smart home division lead for the lab.
Choi’s team will study up-and-coming technologies to potentially supply to seniors, from smart home and fall detection devices to smart medication management apparatuses. The grant will also be looking at how these devices can involve the caregivers of these older adults, to let them make better decisions and have peace of mind — including those not living in the home.
Such devices can track activity levels: Is the person stable or deviating from their normal patterns? They can track a person’s location, for instance — whether they spent an unusual amount of time in one place — and ask whether the person is OK, and alert family or caretakers.
The lab, Choi said, is “a test bed for these technologies.” It is already partnering with many local agencies and nonprofits, such as the Allegheny County Housing Authority, as well as national concerns, such as AARP’s AgeTech Collaborative. The grant will enable the lab to bring devices to the homes of older adults and see how well they work and what questions arise from the users. “We want to ask older adults how we can improve them,” Choi said.
The lab has a research registry of about 1,500 older adults willing to be contacted for such projects. Age Friendly Greater Pittsburgh will help the researchers with community meetings and surveys to get even broader input from local older adults, while the county’s housing authority will conduct interviews with residents of its Homestead Elderly Community Apartments about the devices.
For the project’s final phase, the researchers will bring devices to install in a dozen of the Homestead Apartments as a pilot study, “to see how we can understand better the technology literacy portion” of this population and then devise ways to improve it.
The three-year HUD grant starts Aug. 1, but Choi says his team will seek other grants to extend this research. “Our goal is to really be that innovator in this technology and aging space, to see what works and what doesn’t work.”
Marty Levine is a staff writer for the University Times. Reach him at martyl@pitt.edu or 412-758-4859.
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