Millimeter-wave radar and water/electricity monitoring enter home-based elderly care, but AI care still faces barriers to adoption

A decade ago, walking into an elderly person's bedroom, the safety devices by the bed were nothing more than a call bell and a surveillance camera. But now, the risk-warning hardware and solutions for home-based elderly care have undergone a complete upgrade.

As China's population aging process accelerates, the care needs of elderly people living alone, the very old, and those with disabilities continue to grow, and the traditional model of elderly care relying on manual labor can no longer meet increasingly refined home-based elderly care demands. The deep integration of a new generation of information technologies—artificial intelligence, the Internet of Things, big data, cloud computing, and others—with smart health and elderly care scenarios is bringing upgrades to the development of the elderly care industry.

However, having the devices is only the first step; there are still many bottlenecks to overcome in the process of rollout and promotion.

"For elderly people, chronic disease warning and vital sign monitoring are very important, and AI can play a big role. Age-friendly technology can be divided into four categories, including health monitoring, care and rehabilitation, home safety protection, and emotional support. Among them, the application of health monitoring technology has begun to become widespread in recent years, such as age-friendly smart bracelets used to monitor heart rate and blood pressure, millimeter-wave radar, and smart mattresses," said Du Peng, director of the Institute of Gerontology at Renmin University of China.

A Yicai reporter learned through interviews that blood pressure monitors, blood glucose meters, and similar devices are already fairly common. Smart mattresses are a move by the home furnishing industry in recent years to tap the value of the existing market; they can monitor elderly people's sleep quality and breathing problems, and if there is severe breathing difficulty, they can prompt the elderly person to seek medical treatment promptly.

Millimeter-wave radar can more accurately reflect the safety of elderly people's daily activities in their living environment. "We have been carrying out digital transformation of elderly care services, relying on millimeter-wave radar technology to provide safety monitoring services for elderly people's daily lives. For example, installing millimeter-wave radar at the head of the bed can reveal the elderly person's sleep situation; if an elderly person who normally gets up and about does not get out of bed for a long time, it will trigger an alert. Installed in the bathroom, it can monitor the safety of the elderly person using the toilet; installed in the living room and other places, it can determine whether the elderly person is walking normally, and if an abnormal situation occurs, it can send an alert to the monitoring center and can also help the elderly person call an ambulance," Bu Jiangyong, founder of Shanghai Tianyu Smart Elderly Care Service Co., Ltd., told Yicai.

It is reported that electromagnetic waves with wavelengths between 1 millimeter and 10 millimeters are called millimeter waves, and they can penetrate clothing and glass. In elderly safety monitoring, radar transmits electromagnetic waves toward the human body and continuously collects these tiny changes, which can separate out respiratory rate and heart rate; when care staff walk around the room, the radar continuously tracks their trajectories and, combined with the state of the person being cared for, determines whether actions such as turning over or assisting someone to get up have been completed, thereby judging whether to issue an alert. Compared with cameras, millimeter-wave radar monitoring does not take photos, protecting privacy.

At present, these technologies have begun to be put into practical use.

Grandma Li, who lives in Huishan District, Wuxi, has a "Huhu Sleep Butler" installed in her home, a vital sign monitoring and guarding device developed on the principle of millimeter-wave radar. At 1:10 a.m. on February 16 this year, an out-of-bed alarm came from the elderly person's home. Customer service responded quickly within 3 seconds, checked the backend and saw that no one was near the device, and immediately called the elderly person; after three consecutive calls, no one answered. At 1:15 a.m., customer service called the elderly person's family member, and the family member rushed to the elderly person's residence. At 1:26, the family member called to report that the elderly person had slipped in the living room and had abrasions. After confirming the information, customer service called 120 at 1:29 and sent the elderly person to the hospital. The next day, customer service followed up again with the family member, who said the elderly person was in stable condition and that it was fortunate they had been sent to the hospital in time, otherwise the consequences would have been unimaginable.

Yang Wei is the director of Shanghai Dahua Welfare Institute, which began research and development of smart elderly care many years ago.

"We have invested tens of millions of yuan to develop a system that covers the management of care staff, elderly people's daily life and outings, meals, consultations and medication dispensing, emotional companionship, and more. We have installed millimeter-wave radar at the head of the bed and in the bathroom, mainly used to monitor whether elderly people are in bed or out of bed, and it also has vital sign monitoring functions such as respiration, blood oxygen, and heart rate, and regularly generates periodic reports. The device also sends alarm signals to prevent elderly people from falling out of bed," Yang Wei told Yicai.

At the Dahua Welfare Institute site, the Yicai reporter saw that the institute also has dedicated medical staff who conduct basic consultations and dispense medication for elderly people. The institute has introduced smart tongue diagnosis devices and facial diagnosis devices, that is, using smart instruments to diagnose elderly people in the institute and dispense medication, and also provide corresponding health guidance, with a recording function that allows users to compare with previous test results.

When it comes to the daily medication process for elderly people, a smart pharmacy is used. At the site, the Yicai reporter saw that the smart pharmacy pre-packages medications for elderly people through the system, with names and corresponding inventory information on them, ensuring that each elderly person's medication is accurate. For externally prescribed medications, the system automatically matches inventory and packages them according to the doctor's prescriptions; insurance-covered medications are taken directly from the drug storehouse because the system platform already has the relevant data, avoiding duplicate operations.

The Dahua Welfare Institute has also introduced the "Xiaoyu" robot to provide emotional companionship for elderly people. In addition to conversing and communicating with elderly people, this type of AI companion robot also obtains big data on elderly people's daily information; this big data is monitoring of elderly people's life safety, preventing emotional problems among elderly people.

“The application of smart elderly care is very meaningful. We once had a completely disabled 80-year-old in our institute. The sleep report generated by the multifunctional smart bed found that the elderly person's fatigue index was abnormal, so we promptly sent them to the hospital, where they were diagnosed with multiple organ complications. Because they were sent in time, they were saved, and after 10 days in the hospital, the elderly person returned to the nursing home,” Yang Wei told Yicai. She said that adopting a smart elderly care system can increase the efficiency of some business segments by 50% and reduce manual errors. For example, in handling discharge procedures, efficiency is increased by 50% with zero error rate. The smart system can directly and synchronously establish basic information files, share data, and form a closed workflow loop, realizing intelligent and precise elderly care services.

Detecting safety through water and electricity use

Some remote monitoring systems are also being put into use.

In recent years, multiple cities in China have piloted smart water-use monitoring projects: installing smart water and electricity meters for elderly people living alone, dynamically grasping elderly people's home status based on water and electricity usage data, and attempting to build a full early-warning closed loop from risk identification to handling feedback.

A 76-year-old person living alone in a certain subdistrict in Guangzhou had a very stable daily pattern of water and electricity use. One day this year, based on the profile of the elderly person's water and electricity data, Guangzhou's “Water and Electricity Guardian” detected two consecutive hours of water use and immediately triggered an alert. Under the online plus offline response mechanism of “alert—verification—handling—feedback,” staff called to verify and learned that the elderly person was temporarily staying at a relative's home; the staff informed the family members of the alert information and reminded them that there was a water-use hazard in the original residence. The family members rushed back to check and found that the bathroom faucet had not been tightened and was continuously dripping. They immediately turned off the faucet to eliminate the leakage risk.

“Water and Electricity Guardian” is an initiative launched by the Guangzhou Municipal Civil Affairs Bureau together with the municipal water company, the municipal power supply bureau, and other units, aiming to safeguard the safety of elderly people through smart early warning.

Relying on the data connection between Sui Yiyang (Guangzhou's comprehensive platform for elderly services) and the water supply and power supply systems, and based on elderly people's historical water and electricity use data, an intelligent model capable of self-learning is established for each household, seamlessly identifying risks such as long periods of no water/electricity consumption and abnormal surges in usage, automatically triggering alerts, transforming passive response to risk situations into proactive discovery, and realizing seamless monitoring of elderly people's home life.

The Guangzhou Municipal Civil Affairs Bureau told Yicai that Water and Electricity Guardian is a seamless form of monitoring, with advantages such as no disturbance, no privacy monitoring pressure, no need for active operation by elderly people, and low operation and maintenance costs. This initiative is currently in the stage of exploratory implementation and steady expansion, prioritizing groups living alone and elderly people without family, prioritizing communities that have completed smart water and electricity meter renovations, jointly promoted by civil affairs authorities together with power supply bureaus and water companies, piloted in multiple subdistricts, and has already formed a replicable grassroots handling process.

The implementation of seamless water and electricity monitoring involves data sharing and relay handling by multiple parties. Getting this early-warning closed loop to run smoothly is not easy.

“At present, the overall response chain of this mechanism is clear, grassroots rights and responsibilities are well defined, and coordinated linkage among departments and at all levels has been achieved. During operation, some elderly people also report concerns about data collection. Whether elderly people need water and electricity early warning is based on the principle of voluntariness,” the Guangzhou Municipal Civil Affairs Bureau said. If elderly people go out to visit relatives, are hospitalized for a short period, or travel, water and electricity abnormality alerts may be triggered. Such cases are “false risks” and will occupy the verification manpower of grassroots grid workers. In this process, the results of each verification are also continuously sent back to the power supply bureau and water company to help the latter continuously train algorithms, optimize models, and gradually reduce the false alarm rate. At the same time, existing Yikang center talent teams are also integrated, grassroots elderly care service forces are reused, water and electricity early warning is combined with regular care visit services, and early-warning verification is integrated into normalized service work to reduce additional costs.

The digital divide challenge

Health data monitoring, behavior data monitoring, and life data monitoring—different smart elderly care safety monitoring methods each have advantages and disadvantages.

“Compared with the first two, the prominent advantage of life data monitoring lies in its minimal intrusiveness and integration into daily life, making it less likely to create a sense of being monitored or a psychological burden for elderly people. However, compared with devices worn close to the body such as smart wristbands, life data monitoring infers elderly people's conditions through changes in traces of daily life, so when helping elderly people respond to emergency problems such as sudden myocardial infarction or stroke, there may be lag in rescue measures, and it is also difficult to understand the developmental problems faced by elderly people through life data monitoring,” Chen Xu, associate professor at the School of Sociology of Wuhan University, told Yicai.

At present, there are many categories of home safety monitoring devices in the field of smart elderly care, and there is still some disconnect between market recognition and actual implementation.

A person in the smart elderly care monitoring device industry told Yicai that the elderly group faces an obvious digital divide: limited income, insufficient digital operation ability, and so on.

“Promoting smart elderly care products into households is difficult. Device prices and private data are the two major difficulties. The former is directly related to the accessibility of services, and the latter is directly related to the guarantee of services,” Chen Xu said. The difficulty in popularizing home-based smart elderly care products lies first in the mismatch between smart elderly care products and elderly people's care needs, second in the misplacement of smart elderly care products and real elderly care scenarios, and third in the mismatch between smart elderly care products and elderly people's willingness to use them.

Chen Xu said that the reason monitoring based on changes in water, electricity, and gas data is favored by more elderly people lies in its advantages of zero learning, zero adaptation, and zero impact, which also provides a new path for elderly people to cross the digital divide.

The difficulty of data sharing

Smart health and elderly care cannot be separated from data sharing.

In Chen Xu's view, for smart devices to enter communities and households, the implementation and rollout of hardware devices are the basic conditions, and the way to handle data alerts is an important link, namely who is responsible for responding, how to respond, and how to effectively connect with community grid-based governance.

Deng Yong, director of the Health Rule of Law Research and Innovation Transformation Center at Beijing University of Chinese Medicine, told Yicai reporters that data sharing is both the core support for the development of smart health and elderly care services and the main compliance difficulty currently faced.

Compliance challenges are concentrated in four aspects: First, data ownership and the boundaries of rights and responsibilities are unclear. Elderly-related data is scattered among government departments such as civil affairs and health, as well as market entities such as elderly care service institutions and technology companies. There is a lack of a statutory list of data sharing responsibilities, and cross-departmental data barriers are prominent. Second, it is difficult to balance privacy protection and data utilization. Information such as elderly people's health and location is highly sensitive data. At present, data desensitization standards are not yet unified, and there are risks of collection beyond scope and shared information. Third, it is difficult to implement informed consent mechanisms. Elderly people have relatively low digital capabilities, and rules on data representation rights for disabled and semi-disabled elderly people still have gaps. Fourth, industry data standards are not unified. Interfaces of various monitoring devices and business systems are incompatible, raising the technical cost of data sharing.

Deng Yong suggested that improving relevant policies and regulations should focus on five major directions: strengthening top-level institutional design, issuing management standards for elderly-related data sharing, building a unified data exchange platform, and clarifying the rights and responsibilities of each department for data sharing; establishing a data classification and grading system and a minimum necessary use system, and defining the conditions and boundaries for sharing sensitive data; refining age-friendly informed consent rules, clarifying the authorization process for legal representatives of disabled elderly people, and safeguarding elderly people's data rights and interests; building a security management and accountability mechanism covering the entire data lifecycle, unifying security technical standards, and increasing penalties for violations; improving incentive policies for data sharing, providing fiscal and tax support to entities participating in data sharing, and promoting the implementation of unified industry data standards.