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How the XBox Kinect Will Revolutionize Caregiving

The gaming system is just beginning to show its potential value as a tool for doctors and caregivers

By Gary Drevitch

Your kids' favorite video-game system may be the key to your parents' ability to age in their home or extend their time in an assisted-living community.

As it turns out, facilitating game play without the need for hand-held controllers may be the least interesting thing Microsoft's Kinect for the XBox can do. The device is already being tested by hackers, doctors and senior residential communities to devise new ways for family caregivers and medical personnel to monitor and interact with elders aging in place.

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As The New York Times reported in a recent piece about the Kinect, technology experts immediately recognized the potential of the $150 device when it was introduced in November 2010:

“Kinect hackers” were drawn to the fact that the object affordably synthesizes an arsenal of sophisticated components — notably, a fancy video camera, a “depth sensor” to capture visual data in three dimensions and a multiarray microphone capable of a similar trick with audio. Combined with a powerful microchip and software, these capabilities could be put to uses unrelated to the Xbox.

Eventually, after 10 million Kinects had been sold, Microsoft released a free software development kit so that, as Laurie Orlov, who produces the blog Aging in Place Technology Watch, puts it, "millions of hackers, university researchers and scientists can do what they do best — invent something Microsoft hasn’t thought of yet."

One of the highest-profile Kinect deployments yet is at TigerPlace, an independent living community for seniors in Columbia, Mo., co-developed by the University of Missouri's Sinclair School of Nursing. In a test involving 65 residents, researchers are using the Kinect to monitor changes in behavior, health and routines. A Kinect is mounted on each room's ceiling to provide 360-degree monitoring, in combination with separate sensors over each doorway and embedded in mattresses, to detect early symptoms of illness and identify fall risks.

If a resident is detected using the bathroom an excessive number of times, the nursing team might be alerted to evaluate him or her for a urinary tract problem. If the sensors observe restless sleep or insomnia, doctors might be asked to determine if the resident is experiencing anxiety or depression. Wandering at night could be an early sign of dementia or Alzheimer's disease, prompting further tests. And if the Kinect's motion-capture technology identifies changes in a person's gait, the community's staff can take steps to prevent the risk of falls.

Many people resist such thorough monitoring, which to be most effective should be deployed throughout a home, including bedrooms and bathrooms, but the Missouri program addresses privacy concerns. “The Kinect uses infrared light to create a depth image that produces data in the form of a silhouette, instead of a video or photograph,” Erik Stone, an engineering doctoral student who helped develop the system, said in a statement. “This alleviates many seniors’ concerns about privacy when traditional web camera-based monitoring systems are used.”


The Missouri team believes Kinect-based monitoring will allow people to maintain their independence longer, either in their own homes or in an assisted-living community, as it delays the need to move to nursing homes.
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Orlov, who has written extensively about the Kinect's potential, believes monitoring is only the beginning. "The game in Kinect was a distraction," she says. "It’s a user interface that begs to be applied to caregiving, family communication and home health applications. The wonderful thing about it as a platform is that it can do multiple things that otherwise would need to be distributed across multiple devices."

Another advantage is that the Kinect does not rely on a user being computer savvy, since the device interfaces with a TV (or other monitor), not a PC. "Think about replacing expensive home monitoring sensor systems with apps that know you’re home when you turn on the TV," she says, "or that enable you to connect to your family members with the wave of a hand that smoothes the launch of a Skype session."

The fact that the Kinect requires no controller — combined with its powerful facial-recognition ability — can lead to breakthrough applications for people aging in place with conditions that limit their mobility, such as Parkinson's disease or arthritis. "It can recognize you as opposed to someone else, and you can interact with it through gestures," Orlov says. Through a television connected to the internet, "you can interact with a physical therapist or health care provider," precluding the need for many in-person appointments, which is a significant plus  for people who find it difficult to travel.

"It's superb for engagement" in any way medical professionals can imagine, Orlov says, "anything involving engaging patients without them having to touch a physical controller."

And there will be more developments as researchers go further to connect the Kinect to other software, she predicts: “Let’s see a social Kinect app that enables older adults to participate in group activities at other locations, experience a check-in at the end of the day from a family member and receive comprehensive tele-caregiving from a geriatric care manager."

Gary Drevitch was senior Web editor for Next Avenue's Caregiving and Health channels. Read More
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