You are supposed to be able to control everything, from the thermostat to a lift that will get you out of bed, put you on the john, with a blink of an eye, a sip or a puff, a press of a button or your voice. That’s what they’re aiming for at the newly opened Smart Apartment in the Helen Hayes Hospital in suburban West Haverstraw, N.Y.
Of course, it’s not that simple.
At the apartment’s press debut, Rosie, the efficient-sounding female voice that responds to all voice commands, balks. She’s not listening to the therapist who is hanging like a stalk of bananas from a ceiling hoist. For the moment, Rosie has decided not to let him move into the bathroom.
It reminds me of a favorite story about the nervous passenger on a plane that’s about to take off from New York to Los Angeles. As it begins to taxi, a voice announces, “Congratulations, you are on the first transcontinental flight without a pilot. Just sit back and relax. Nothing can go wrong, go wrong, go wrong …”
Eventually, Rosie comes to her senses and obeys the therapist, but I am having doubts about the so-called Smart Apartment, and wondering how the average crip will pay for all this whiz-bang technology. Besides, voice recognition often doesn’t work too well for me. Most humans have no trouble understanding me, but machines sure do. For example, when I would tell my new van’s Bluetooth device to call home, it would ask in rapid-fire French if I wanted it to change languages. “No! No!” I would shout, “Call home!”
Inexplicably, it then questioned, “Do you want to call Mo?” He happens to be my next-door neighbor. Before I could answer, Mo’s number was ringing and I was guiltily hanging up. Eventually, I gave up trying to call home. I changed the command from home to house. My Bluetooth robot liked that much better.
At the press briefing, they explain that assistive technologists and physical, occupational and speech therapists will all use the apartment to work one-on-one with residents. Besides gimps in chairs, the facility is for people with cognitive impairments, the elderly and people with locked-in syndrome. Each therapist will be finding and customizing the most appropriate technology to meet the goals of their client.
They say the goals vary and may include:
• Increased safety, security and comfort throughout the home
• Automation of lighting, temperature controls, and other ambient functions
• Programming of home entertainment systems, computers, mobile devices, and phone systems
• Automation of door and window operations and appliances
• Facilitating communication
What Makes it Smart?
I left Helen Hayes Hospital that day full of doubts. Weeks later, I returned to watch a therapist working with a quadriplegic. The therapist’s knowledge and her determination were awesome.
But before I tell you more about that, let me describe the apartment and give techies some of the details they love. For starters, Helen Hayes says its new facility is “the first state-of-the-art interactive model apartment on the East Coast to be located within a rehabilitation hospital.” That means residents don’t have to go outdoors in bad weather. It also helped hold the total cost of the apartment (and its equipment) to a rock bottom $325,000. Staff members did the construction, and two hospital foundations raised the money. Donations covered much of the design work, equipment, furnishings and technology.
Almost everything in the apartment works through wireless communication controls. These use a combination of infrared, UPD controllers and hardwired relay signals. They also embedded highly sensitive microphones in the walls throughout the apartment. The apartment’s “brains” rely on two integrated central home automation systems: the HAI Omni Pro — it controls lights, temperature and security functions, and the HAL 2000 system — it handles voice control and macro construction PCs and customized programmable remote controls.
The Smart Apartment is surprisingly compact. It has a so-called great room that looks conventional. You’ll find a computer, a stereo, a man-size flat-screen TV, a sofa and other living room furniture in it. The bedroom’s ceiling track and its lift keeps it looking anything but ordinary. It has a hospital bed, a somewhat smaller television set and several computers. The closet features a clothing rack that you can lower and raise on command. There’s a laundry area with a modern clothes washer and dryer, which are available today from any appliance dealer. They just happen to be the perfect height for wheelchair users.
The hospital knows that people often enjoy less than ideal accessibility at home and may not be able to afford to make modifications. With that in mind, they set the apartment up to both show what’s available, and how to cope with the actual, low-tech problems wheelers might face at home. That’s why, in addition to the bathroom with a roll-in shower, there’s a tub.
That’s also the reason the kitchen has two of almost everything. For example, you can roll under one sink but near it is another that blocks your legs. A dishwasher pulls out like a drawer — easy to load from a wheelchair. But they also have one that loads in the usual way.
Smart … But Affordable?
I went back to Helen Hayes several weeks later to watch them use the new facility to help 49-year-old Greg Slane, a C4-5 quad. He grew up not far from the hospital. One warm fall afternoon, when he was just 16, he dove into to the Hudson River and broke his neck. Slane still lives with his mother and father, his principal caregivers. He is familiar with computers. He’d worked for 12 years as a programmer for a magazine company.
Back then, Slane had a helper monkey who went to work with him every day. The monkey would pick up his dropped mouthsticks and insert floppy discs into his computer. Unfortunately, chronic serious skin problems forced him to stop working after 12 years. His time in his sip-and-puff chair is limited. When he’s in bed, one of his parents must answer the phone and switch the channel for him. He’s at the hospital to find a way to do both independently.
Tammy Goedken, a rehabilitation technologist, is assigned to work with Slane. A graduate of the University of Southern California, she’s been at Helen Hayes for 10 years, the last three in assistive technology. She clearly loves her job. “I work primarily in the field of computer access,” she explains, “helping individuals with physical limitations use a computer, or other technology and help with set-up and training of technology solutions. It’s to help them be more independent.”
Goedken and Slane make a bright, attractive pair and it is fascinating to watch them interact. She’s going to give him a tour of various high tech technologies. Her questions are rapid-fire and so are his answers. “How many hours a day are you up in your chair?” she asks. “How many hours a day are you in bed?
“I would say nine hours up,” he tells her.
“Do you know what kind of bed you have now?”
“Not a clue.”
If you want to get control of the bed, you need the manufacturer and model, then you would know exactly how to hotwire it for remote alternate access, she explains. “Some are easier than others,” she says.
“Did you ever try a head mouse?” she asks.
“I tried it but it is strange.”
“When was the last time you tried it?”
“A long time ago — maybe more than five years,” he admits.
“You have enough head movement so that you could use a head mouse. The technology is better now, so you might give that another try. You said a mouse stick is too difficult to use in bed so you can’t use it there?”
“A head mouse is absolutely easier to use in bed. And that gives you access to the computer, and with the computer you can do almost anything,” she points out. “These days you have things like Google voice, so if you have a computer you can make phone calls to anywhere in the world for free. That’s something to consider. Once you have good computer access, you have a lot of other options.
“Are you able to change the channel on the TV with a cell phone?” Slane wonders.
“Yes, cell phones are able to do more and more stuff. There are multiple ways to control a TV. That’s one of the difficulties. You can download an app from the cable company — most of them have them. It will give you the ability to change channels without relying on infrared.”
Otherwise, he’ll have to use channel up and channel down.
Now she has him try voice control to raise a computer table. “How may I help you?” Rosie asks.
“Raise computer desk,” orders Slane. Nothing happens. Goedken tells him to try again. He repeats the order. “Good night,” says Rosie. Somehow, I am not surprised.
I talked to Slane just recently. He’s had a second session with Goedken and might have another, but he’s learned that any voice-activated system that he could use from bed would cost around $4,000. “That’s totally out of my price range and it’s not covered by insurance,” he said.
Although the hospital is hoping for outside funding, he sounded discouraged. “I’m just looking for a voice activated phone right now,” he said. They have one that he thinks costs about $400. He can afford that.
“The problem with so much of this newer technology,” he said, “is it’s really expensive.” I couldn’t argue with him about that.