computer-based caregiving technology - welcome to the spry

Caregivingof Older Adults

What’s New, What’s Next

and

Computer-Based Technology

The SPRY (Setting Priorities for Retirement Years) Foundation10 G Street NE, Suite 600, Washington, DC 20002www.spry.org

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Computer-Based Technology and Caregiving pg. 1

Table of ContentsIntroduction ..................................................................................................... 2

Part I: An Increased Need for Home-Based Care for Older Adults ............ 4

Part II: Technology Offers Support in the Caregiving of Older Adults ....... 5

Part III: Current Technologies........................................................................ 7

Part IV: Technologies in the Works ................................................................ 8

Part V: Technologies on the Horizon.......................................................... 11

Part VI: Key Issues in Using Technology to Care for Older Adults ............. 13

Part VII: Considerations in Selecting Computer-Based Technology............ 15

Part VIII: References and Contact Information.............................................. 16

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About This GuideThis guide is designed to provide youwith information about the latesttechnologies that support the care ofolder adults, as well as thetechnologies on the horizon. Theguide examines issues in implementingthe technologies on a wider scale, andin dealing with those issues from apersonal, social, ethical, financial andpolicy perspective. There is also achecklist of points to consider whenchoosing computer-based technologyto assist in caregiving, and a referencesection for more information.

Why This Guide isNecessaryOver the next few years, the need forcaregiving for the older adultpopulation will become acute.Americans are living longer, increasingtheir likelihood of developing chronicconditions such as congestive heartfailure, diabetes, and chronicobstructive pulmonary disease. By theyear 2030, when most of the babyboomers are in their 70s and 80s, thenumber of Medicare beneficiaries willdouble.

Caregivingof Older Adults

What’s New, What’s Next

and

Computer-Based Technology


Who will provide care to these olderadults? A recent AARP survey ofdisabled adults 50 years and olderfound that 86 percent receive most oftheir care from unpaid caregivers,including spouses, partners, andgrown children. These caregivers assistin the activities of daily living (ADLs)such as dressing, bathing, feeding, andtoileting. They also providetransportation to medical providers,help with medications, and performphysical therapy. For many caregivers,it is an all-consuming task.

Caregivers often must sacrifice theirjobs, ties with other members of theirfamilies, and even their own health.Family caregivers need support in theform of finance, information,counseling, stress relief, andconnection to health care providers. Anumber of organizations are testingvarious types of computer-basedtechnologies to provide help tocaregivers. These technologies includethe World Wide Web and otherInternet applications, video link-ups,robotics, and Global InformationSystems.

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Part OneAn Increased Need for Home-Based Carefor Older AdultsIn a recent AARP survey of disabledadults 50 and older, respondents saidtheir two major concerns were the lossof independence and the loss ofmobility. They overwhelmingly wantedto receive care in their homes asopposed to an institution, to choosewho provided that care, and tomanage the cost of the carethemselves.

Bringing care to the homes of olderadults via the Internet or othertechnology-based methods could helpaddress a number of these problems.Since more than 85 percent ofdisabled adults ages 50 to 64 arealready online, and almost half of alladults 65 and older are, this isbecoming increasingly feasible.

The use of computer-basedtechnologies is a promising tool forencouraging seniors to improve theirhealth practices. Benefits include

better access to their health careproviders, confidence that theirconditions are being monitored, andthe ability to keep track of providerappointments. Patients also can receivefeedback on how their compliancewith medication, exercise, andnutrition regimens is affecting theirconditions.


Part TwoTechnology Offers Support in theCaregiving of Older AdultsComputer-based technology canaddress a number of caregivingproblems for older adults. Theseinclude:

• Providing quality information tofamily caregivers.

• Helping caregivers inform andeducate additional familymembers, to engage them inthe caregiving process as a“team effort.”

• Providing the caregiver withinformation on caregivingresources available from thelocal Area Agency on Aging andother members of the agingnetwork in their communities.

• Providing health recordinformation to medicalpersonnel during an emergencyor the time of care.

• Monitoring chronic conditionssuch as congestive heart failure,chronic obstructive pulmonarydisease, and diabetes.

• Contacting emergency servicesautomatically when an olderadult is in distress.

• Monitoring the movement ofolder adults in the home todetect falls or wandering.

• Keeping the older adult visuallyconnected with the health careprovider or long-distancecaregiver.

• Offering the caregiver and theolder adult access to onlinesupport groups for specificchronic conditions andsituations.

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• Enabling the health careprovider to furnish the olderadult and caregiver with timelyfeedback on the status ofchronic conditions.

• Providing health careinformation from a distance forthose who are homebound or inrural areas.

• Reducing medical errors withthe use of a bar-coding system,which would link patients, thosewho prescribe medications, andpharmacists.

• Controlling the overall cost ofhealth care by reducingunnecessary trips to the hospital(particularly the emergencyroom).


Part ThreeCurrent Technologies

A number of computer-basedtechnologies for use with older adultsare now in place—some in widespreaduse, and others with limited butincreasing availability. These include:

• Interactive web sites with healthcare information and supportsystems for specific conditions.

• Monitoring devices that enablethe patient to send tempera-ture, blood pressure, glucoselevels, and other data to healthcare providers electronically.

• Computer and televisual set-upsto allow health care providers toconduct “virtual house calls”with older adult patients.

• Sensors that detect movement(such as falls) and variousactivities, enabling theunintrusive monitoring ofpatients in the home.

• Electronic health records that areeasily available to health careproviders and patients.

• Electronically linked systems thatcontact both emergency servicesand the patient’s physician incase of a medical emergency.

• Global Information Systems (GIS)that help municipalities figure outwhere older adults live, and thendesign “senior-friendly” neighbor-hoods with nearby health care,transportation, community centers,low-cost housing and shopping.

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Part FourTechnologies in the Works

Numerous agencies and organizationsare using computer-basedtechnologies in the care of olderadults—some on a very smallexperimental scale, and others alreadyin place and operating.

The Atlanta RegionalCommissionThe Atlanta Regional Commission inGeorgia is using a comprehensivedatabase of services to matchcommunity-based health and socialservices with older adults. After firstasking a client a series of over-the-telephone questions, the Commissionmails the client a response withinformation tailored to the client’sneeds. The Commission is alsoproviding its database to localhospitals and related agencies toreduce duplication of effort. Parts ofthe database are available to thegeneral public through theCommission’s web site. In addition to

the database applications, theCommission is using GlobalInformation Systems via satellite (GIS)to help plan “senior-friendly”communities in the Atlanta area. GIS isused to determine where seniors aresettling so that the city can make surethat public transportation, health care,low-cost housing, and other servicesare there to support “aging in place.”www.atlreg.com (English and Spanish)

The U.S. Department ofVeterans Affairs (VA) andthe Veterans HealthAdministration (VHA)The DVA and the VHA are testing atelemedicine system in Florida andPuerto Rico with 2,000 veterans. Theprogram includes a home monitoringsystem that enables veterans toelectronically send health informationto their health care provider. Theprovider, often a nurse, can thenprovide the veteran with feedback and


advice. In addition to the telemonitors,the system includes video-phones, in-home messaging devices, and personalcomputers with interactive chat rooms.This monitoring system hassignificantly reduced the number ofhospital visits of participating veteranspertaining to chronic conditions. It hasincreased patient compliance withmedications, and patient satisfactionwith care, and perceived quality of life.

The VHA also has converted all of itsmedical records to an electronicformat, which allows for readyupdating, electronic transmittal, andtrend identification. www.va.gov

National Library ofMedicine Web SitesThe National Library of Medicine(NLM) currently maintains several websites designed to provide accuratehealth information to the consumer.MEDLINEplus (www.medlineplus.gov)(English and Spanish) has sections onhealth topics, medications, physicians,and medical terminology, and is easyto use and understand. Information onthe site can be accessed throughalphabetical menus as well as through

buttons and the search window. Thenew NLM site, Senior Health, containsinformation on aging-related healthtopics, remedies, and help forcaregivers. www.nlm.nih.gov

Patient-InitiatedEmergency ResponseSystem (PIERS)The PIERS Project, developed at theJohns Hopkins University School ofMedicine, provides rapid assistance topatients with heart disease. The systemconsists of a Personal Patient Module(PPM) that patients carry with them.The PPM contains past medical history,information on current medications, abaseline electrocardiogram, and thepatient’s cardiac risk factors. When thepatient perceives cardiac distress, thePPM can take a new ECG andcommunicate that by telephone to asystem server. If the server detects thatthe patient is experiencing an acutemyocardial infarction, it automaticallysends for emergency help. The serveralso connects the patient to a cardiacteleconsultant, who interviews thepatient and determines next steps.www.hopkinsmedicine.org/lbd/otl/3949.html

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Worker InteractiveNetworking (WIN)ProjectThe Worker Interactive NetworkingProject, operating out of the HebrewRehabilitation Center for the Aged inBoston, Mass., provides an Internetlink between the home of the olderadult and the workplace of the primarycaregiver. The purpose of the project isto alleviate the stress and anxiety feltby many caregivers who feel tornbetween job and caregivingresponsibilities. These individuals areable to receive information about theirloved ones during the day, obtainprofessional advice, and participate inan online workers’ support group.www.hebrewrehab.org/currnews_detail.cfm?ID=40


Part FiveTechnologies on the Horizon

NursebotThe University of Pittsburgh School ofNursing, Carnegie Mellon University,and the University of Michigan arecollaborating to produce the Nursebot.This mobile robotic device helps olderadults with their daily routines byconnecting them with family andhealth care providers with aninformational touch-screen; helpingthem to get around their homes;transporting small objects; andreminding them to adhere to theirhealth regimens. www.cs.cmu.edu/~nursebot

Sensor-Based MonitoringSystemThe Medical Automation ResearchCenter (MARC) at the University ofVirginia is developing a system thatmonitors the functional abilities ofolder adults from a distance. Thesystem includes unobtrusive sensorsplaced in the home that detect

movement and pressure; software forcollecting and interpreting the data;and hardware to transmit theinformation to the older adult’s healthservice provider. The sensors help toestablish the normal pattern of theadult’s activities of daily living, so thataberrations due to sickness oraccidents can be transmittedimmediately to the service provider.The goal of the system is to enabledisabled older adults to remain in theirown homes. http://marc.med.virginia.edu

Intel’s Assistance forAlzheimer’s PatientsProgramIn collaboration with groups such asthe American Association of Homesand Services for the Aging and theAlzheimer’s Association, Intel is testinga number of technologies to supportthe care of older adults in the home.One of these is designed to help early-stage Alzheimer’s patients to eat and


drink as well as identify the location ofthe individual in the home.www.alsuccess.com/hotnews/37h25103519.html

Online Support Group forParkinson’s DiseasePatientsThe Wellness Community and theUniversity of California at San Franciscoare collaborating to test online supportgroups for caregivers of Parkinson’sdisease patients. Preliminary resultsfrom the test show significantreductions in caregiver depression andhopelessness. www.twc-chat.org

Internet-Based DementiaCaregivers Support SystemThe Scripps Gerontology Center hastested the assistive value of Internetmonitoring technology with 19caregivers of dementia patients. Thetest consisted of monitoring the use ofthe technology through wired camerasand wireless sensors over a 24-weekperiod. The goals of the monitoringsystem were to help the caregiverreduce stress, connect with supportsystems, and keep the patient safe.

www.scripps.muohio.edu/scripps/general/Links.html

CARE (Collecting ADLs forRemote Evaluation)SystemThe Assistive Technology ResearchCenter (ATRC) of the NationalRehabilitation Hospital is testing a systemto evaluate the functional status ofpatients in their homes through the useof switches attached to moving parts inthe home (drawers, faucets, lightswitches, etc.). The ATRC plans to usethe data collected from the switches toestablish how well the patient isconducting his or her activities of dailyliving throughout the rehabilitationprocess. www.atnrc.org/index.html


Part SixKey Issues in Using Technology to Care forOlder AdultsWhile computer-based technology canbe a huge asset in the care of olderadults, a number of issues must beaddressed before the technologymoves to wider use and acceptance.Such issues include:

PrivacyElectronic health records, physicalexaminations using remote videocameras, sensing devices, and web-based support groups and chat roomsall have the potential of revealinginformation about an older adult thathe or she may not want shared withthose who have no right to it. In thefuture, confidential information shouldbe encrypted so the patient will knowwho has access to personal healthinformation. It will also be importantthat the patient gives permissionbefore any potentially invasivetechnologies become part of the care.

Patient SafetyThe mission of the Patient SafetyInstitute (www.ptsafety.org), a nonprofitnational medical information exchangenetwork, is facilitating carecoordination by providing ready, yetsecure, access to a patient’s healthinformation. The goal of thiscentralized system is to reduce medicalerror by providing the most accuratepatient health information to variouscare providers at the time of care. TheInstitute has tested its system on a city-wide scale, and is now moving tostate-wide implementation in Delaware.

Equitable AccessNew technologies will be costly, sofinancial support systems should bedeveloped to ensure access for thosewho cannot afford them. This will be anissue for policy makers—another facetof the nation’s “digital divide” problem.


Research AgendaFor computer-based caregivingtechnologies to become moreaccepted and widespread, researcherswill need to establish the efficacy ofsuch technologies. The Agency forHealthcare Research and Quality, theRobert Wood Johnson Foundation, theIntel Corporation, the Centers forMedicare and Medicaid Services, theDepartment of Veterans Affairs, theNational Cancer Institute, the NationalLibrary of Medicine, the NationalRehabilitation Hospital, and a numberof universities are all supporting orconducting research on the use ofcomputer-based technologies andcaregiving. It will be important for thegeneral public to be informed aboutthe results of such research so thatthey, and their health care providers,can make reasonable and intelligentchoices about the use of suchtechnologies in home health care.

Provider AcceptanceThere has been some noted healthcare provider resistance to usingcomputer-based technology forcaregiving. Health care providers needtraining to implement “telehealth” and

other technologies effectively. Often,however, they are not given either thetraining or the time to adjust to thenew systems that some health carepayers require them to use. Inaddition, the use of telehealthtechnology can increase the provider’sworkload, since more patients can beseen in the same amount of time. Yetpayments to providers may notincrease to reflect the heavierworkload.

StandardizationNumerous companies, organizationsand agencies are developing a varietyof computer-based technologies forhome caregiving. At this time,however, there is no standard set ofspecifications in place for the hardwareand software used in theseapplications. Such standards will needto be established before there can bewidespread use of the technologies inboth home and professional healthcare settings.


Part SevenConsiderations in SelectingComputer-Based Technology❑ What is the problem you are trying to solve with the technology?

❑ Are there reliable sources of information about computer-based technology used tocare for older adults with the problem?

❑ What are the advantages and disadvantages in using the technology?

❑ Is the older adult a willing partner in the use of the technology?

❑ How much does the technology cost?

❑ Is the cost a one-time-only expenditure or will there be further costs for service?

❑ Will insurance cover all or part of the cost of the technology?

❑ How does the primary care physician fit into the support systems for the technology?

❑ Is the older adult’s home (or other care facility) properly outfitted for thetechnology? For instance, does it have an Internet connection?

❑ What agency, if any, has certified that the technology you are considering iseffective and safe to use?

❑ Does the technology protect the privacy of the older adult?

❑ Is a training program available for the older adults and/or caregiver in order toassure proper use of the technology?

❑ Is there a reliable “help source” to assist in resolving any operational problems thatmay occur in using the technology at home?


Part EightReferences and Contact Information

Government Web SitesAgency for Healthcare Research andQuality (AHRQ). www.ahrq.gov. Providescaregivers with information on healthconditions/diseases, health plans, prescrip-tions, prevention and wellness, andhealthcare for older adults. English andSpanish.

Centers for Disease Control andPrevention (CDC). www.cdc.gov. CDCserves as the lead national agency fordeveloping and applying disease preven-tion and control, environmental health,and health promotion and educationactivities designed to improve the healthof the people of the United States. Pro-vides the caregiver with preventativehealth information and items of immedi-ate concern, such as the flu. English andSpanish.

Centers for Medicare and MedicaidServices (CMS). www.cms.gov orwww.medicare.gov. Provides detailed infor-mation on Medicare and Medicaid services,as well as a nursing home quality initiativefor communities called “Nursing Home

Compare” located at www.medicare.gov/nhcompare/home.asp. Nursing HomeCompare provides a Nursing Home Check-list to aid in making decisions regardinglevel of quality, inspection result informa-tion, staff information, and general factsabout individual nursing homes. English,Spanish and Chinese.

Department of Health and HumanServices (DHHS). www.dhhs.gov. Com-prehensive source on health information,diseases and conditions, safety andwellness, aging, as well as a resourcelocator.

Eldercare Locator (AoA).www.eldercare.gov. Eldercare Locator is anationwide service that helps older adultsand their caregivers find local area servicesthat are provided to seniors. Users simplyenter their state and ZIP code, and theEldercare Locator will link to information,referral services, and their state and areaagencies on aging. These programs helpfamilies identify appropriate services in thearea where they or their family memberresides.


FirstGov. www.FirstGov.com. Officialportal to all U.S. Government websites.

Food and Drug Administration(FDA). www.fda.gov. Provides a widerange of information on food and drugregulations for consumers, health carepatients, and health care professionals.English and Spanish.

Healthfinder. www.Healthfinder.gov.Carefully selected information from healthinfo web sites from government agencies,clearinghouses, nonprofits, and universi-ties, including A to Z in the areas ofprevention and wellness, diseases andconditions, plus medical dictionaries, amedical encyclopedia, journals and more.Also provides information about doctors,dentists, public clinics, hospitals, long-term care, nursing homes, health insur-ance, prescriptions, health fraud, Medi-care, Medicaid, and medical privacy.English and Spanish.

Medline Plus (National Library ofMedicine). www.medlineplus.gov. Pro-vides up-to-date information on healthtopics, drug information, a medical ency-clopedia, dictionary, news, and directoryfor those who need information abouthealth care. English and Spanish.

National Institute on Aging.www.nia.nih.gov/health. Provides a re-source directory for older adults, includinga database of state and national organiza-tions and agencies. Patient or caregivermay search by subject area or by name oforganization.

National Institutes of Health (NIH).www.nih.gov. Provides an overview of NIHhealth resources, clinical trials, healthhotlines, MEDLINEplus, and drug informa-tion, as well as the 27 departments,including National Cancer Institute,National Heart, Lung, and Blood Institute,and National Library of Medicine. Englishand Spanish.

NIH SeniorHealth.gov.www.nihseniorhealth.gov. This web site isorganized by health topic and currentlyincludes information on Alzheimer’sdisease, exercise for older adults, andcaregiving. Within each topic there aresections containing general backgroundinformation, open-captioned videos, shortquizzes, and answers to frequently askedquestions (FAQs). High contrast text, textenlargement, and speaking website allavailable.

Social Security Administration.www.ssa.gov. Plan your retirement, calcu-late your benefits, apply for retirement ordisability benefits online, and otherinformation. In 16 languages.


U.S. Administration on Aging (AoA).www.aoa.gov. The Administration onAging is the official federal agency dedi-cated to the delivery of supportive homeand community-based services to olderindividuals and their caregivers. The AoAwebsite has a special section on familycaregiving. In nine languages.

U.S. Department of Education.www.ed.gov or www.disabilityinfo.gov. Thissite provides access to disability-relatedinformation and programs available acrossthe government on numerous subjects,including civil rights, education, employ-ment, housing, health, income support,technology, transportation, and commu-nity life. English and Spanish.

U.S. Department of Veterans Affairs(VA). www.va.gov orwww.myhealthevet.va.gov. My HealtheVetprovides one-stop shopping for VA ben-efits, special programs, health informationand services. Also provides a commercialhealth education library to provide up-to-date information about medications andconditions, tools to measure health status,a prescription checker, and the latest inhealth news. In the future, users will beable to reorder VA prescriptions, viewappointments, maintain their own personalhealth logs, and review their VA healthinformation online. English and Spanish.

Caregiving InformationOrganization Web SitesFamily Caregiver Alliance.www.caregiver.org. FCA is the lead agencyin California’s system of Caregiver Re-source Centers. FCA provides support andhelp to family caregivers, and championstheir cause through education, services,research and advocacy. Services are spe-cific to California, although informationcan be accessed nationally.

Foundation for Accountability (Rob-ert Wood Johnson Foundation).www.CompareYourCare.org. Uses interac-tive tools to help a patient gauge thequality of care and information a physicianis providing by comparing it to the normof other doctors.

Merck Institute of Aging and Health(MIAH). www.miahonline.org. Merck isdedicated to improving the health andindependence of older adults around theworld by communicating vital healthinformation; educating the public andhealth professionals; and encouraginghealth research in the aging field.HealthCompass (www.healthcompass.org),a joint project with the American Federa-tion for Aging Research and MIAH, is aself-study program designed to helpconsumers make well-informed health andlifestyle choices, by learning ways to findand evaluate information and research


findings on health and aging.

National Alliance for Caregiving.www.caregiving.org. The National Alliancefor Caregiving provides support to familycaregivers and the professionals who helpthem. The web site helps family caregiverslearn about information, videos, pam-phlets, etc. that have been reviewed andapproved as providing solid information.

National Association for Homecareand Hospice. www.nahc.org. This organi-zation for home healthcare agency provid-ers allows family caregivers to use theInternet to access a list of member agen-cies across the country.

National Caucus and Center on BlackAged, Inc. www.ncba-aged.org. Dedi-cated to improving the quality of life forelderly African American and low-incomeminorities. Provides aging resources,programs and services, and publications.

National Council on the Aging.www.ncoa.org. NCOA is the nation’s firstassociation of organizations and profes-sionals dedicated to promoting the dig-nity, self-determination, well-being, andcontributions of older persons. IncludesBenefitsCheckUp, found atwww.benefitscheckup.org, which helpspeople over the age of 55 find federal,state, and local public and private pro-grams that may pay for some of their

medical care costs, including prescrip-tions.

National Family Caregivers Associa-tion. www.nfcacares.org. The NationalFamily Caregivers Association (NFCA) is agrassroots organization created to edu-cate, support, empower and advocate forthe millions of Americans who care forchronically ill, aged, or disabled lovedones. NFCA is the only constituencyorganization that reaches across theboundaries of different diagnoses, differ-ent relationships and different life stagesto address the common needs and con-cerns of all family caregivers. NFCA servesas a public voice for family caregivers tothe press, to Congress and to the generalpublic. NFCA offers publications, informa-tion, referral services, caregiver support,and advocacy.

National Health Council (NHC).www.nationalhealthcouncil.org. Includes115 organizations representing manyareas of healthcare. Web site has tele-phone numbers and links to informationon specific conditions such as Alzheimer’sdisease, heart disease, lung disease,stroke, and cancer.

National Hispanic Council on Aging.www.nhcoa.org. Identifies resource pro-grams to aid the Hispanic community inelderly caregiving. English and Spanish.


Pfizer, Inc. Older Adult Health Infor-mation. www.pfizer.com/do/mn_health_older.html. Provides facts aboutcaring for older adults, information aboutchronic diseases and health maintenancetips. There is also a survey for older adultsto assess if they are at risk for declininghealth, as well as online health glossaries.English and Spanish.

Visiting Nurse Associations ofAmerica. www.vnaa.org. Visiting NursesAssociation of America promotes commu-nity-based home healthcare. Familycaregivers can contact them to find theirlocal Visiting Nurse Association.

Advocacy Web SitesAARP. www.aarp.org. Anyone over theage of 50 can join AARP for only $12.50per year, and membership includes yourspouse or partner, free. Provides discountinformation, tips for healthy living, retire-ment planning, and more. English andSpanish.

Medicare Rights Center.www.medicarerights.org. The Centerprovides hotlines for direct services,education/training, policy briefs, and a listof discount drug programs. The web sitealso has a list of phone numbers for eachstate’s State Health Insurance AssistanceProgram (SHIP).

National Committee to PreserveSocial Security and Medicare.www.ncpssm.org. Serves as an advocate forthe landmark federal programs of SocialSecurity and Medicare and for all Ameri-cans who seek a healthy, productive andsecure retirement.

ReferencesGibson, M. J. (April 2003). Beyond 50.03:A report to the nation on independent livingand disability. AARP.


To Contact the SPRYFoundation:SPRY (Setting Priorities for Retirement Years)Foundation10 G Street NE, Suite 600Washington, DC 20002202-216-0401 (voice)202-216-0779 (fax)

For more information on SPRY’s current projects andpublications, please visit www.spry.org.

About the SPRY FoundationThe SPRY (Setting Priorities for Retirement Years)Foundation, founded in 1991, is a national,independent, non-profit organization that con-ducts research and education to help all peopleage successfully. The SPRY Foundation focuses ontranslating primary research into applied settings,particularly those applicable at the communitylevel. SPRY focuses on four interrelated areas:

wellness and physicalhealth, mental health,financial security, andintellectual connectivity.SPRY has emphasizedthe development of

computer and internet-based, multigenerationaland educational learning strategies to help peopleaccess quality information so they can maintainindependence and pursue a high quality of life. Incarrying out its activities, SPRY seeks to operate inpartnership with other private organizations andgovernment agencies. As an outcome, SPRYdevelops information and strategies that havenational implications. SPRY’s vision is to help re-shape society’s view of aging, and recognize thatas all people age, they have rights, benefits,abilities, and responsibilities.

DisclaimerThis guide does not offer medical advice and nothingcontained in the guide is intended to be professionaladvice for medical diagnosis or treatment.

SPRY has developed the guide in order to provideresources for older adults and their caregivers whouse the World Wide Web (the Web) to find informa-tion on computer-based technology and caregivingfor older adults. This guide includes examples ofWeb sites from the federal government, non-profitorganizations, private organizations, and educa-tional institutions. The SPRY Foundation’s referenceto these sites is not an endorsement of the sites andimplies no association with these sites or theiroperators. Further, SPRY is not responsible for thecontent of these sites, and does not make anyrepresentation that they will continue to be main-tained as they are on the date of the publication, orthat they will be updated to include advances inmedical knowledge.

SPRY assumes no responsibility for how users use theinformation provided in this guide, or on any Website that is referenced by this guide. The use of third-party Web sites is at the user’s own risk and subjectto the terms and conditions of use for such sites.SPRY cannot assure that the information that isavailable through these Web sites is exhaustive orcomplete on every subject or that it will necessarilyinclude all of the most recent information availableon a particular topic, or that the site will be suitablefor a particular individual or for a particular purpose.

Individuals should always seek the advice of a healthcare provider prior to starting any new treatment,and to obtain information that is specific to theircondition. Likewise, individuals should never delay,ignore, or fail to seek medical advice based oninformation obtained through any Web site.


About This PublicationThis guide is the result of the SPRY Foundation Conference: Computer-Based Technology and Caregiving of OlderAdults, held at the Natcher Center at National Institutes of Health on October 2-3, 2003. The SPRY Foundation wouldlike to thank the institutions that supported both the conference and the development of this guide, particularly theAgency for Health Quality Research and the National Library of Medicine:

Conference Co-Sponsoring Organizations: U.S. Government Agencies

Department of Health and Human ServicesAdministration on AgingNational Institutes of Health

National Institute on AgingOffice of Research on Women’s HealthNational Institute of Nursing ResearchNational Cancer InstituteNational Institute of Diabetes and Digestive and Kidney DiseasesNational Institute of Arthritis and Musculoskeletal and Skin DiseasesNational Heart, Lung and Blood InstituteNational Library of Medicine

Agency for Healthcare Research and QualityOffice of Disease Prevention and Health PromotionCenters for Disease Control and PreventionHealth Resources Services and AdministrationCenters for Medicare and Medicaid Services

Department of Veterans AffairsDepartment of Education

National Institute on Disability and Rehabilitation ResearchFirstGov for Seniors

Conference Co-Sponsoring Organizations: Private Organizations

Merck Institute of Aging and HealthPfizer, Inc.Intel CorporationAventis PasteurAARPVerizon CommunicationsHomeMedNational Committee to Preserve Social Security and Medicare


Conference Co-Sponsoring Organizations: Other Conference Partners

Pan American Health Organization/World Health OrganizationThe Gerontological Society of AmericaAmerican Society on AgingAmerican Geriatrics Society Foundation For Health In AgingAmerican College of Physicians FoundationAlzheimer’s AssociationNational Association of Area Agencies on AgingNational Council on the AgingNational Alliance for CaregivingNational Caucus and Center on Black AgedNational Family Caregivers AssociationNational Hispanic Council on AgingAlliance for Aging ResearchAmerican Academy of NursingAmerican Medical AssociationAmerican Public Health AssociationAssociation of Gerontology In Higher EducationBenjamin Rose InstituteGrantmakers In AgingSeniorNetCenter for the Advancement of HealthMarkle FoundationAmerican Telemedicine AssociationUniversity of Georgia Gerontology CenterUniversity of Pittsburgh: Center for Health AgingBaylor College of Medicine: Huffington Center on Aging

DistributionThis guide is published by the SPRY Foundation in cooperation with Caresource Healthcare Communications, Inc.,426 Yale Avenue N, Seattle, WA 98109.

To order or reorder, please call (800) 448-5213 or visit www.caresource.com.

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