Part of the Healthy Home Lab team including, from left to right: Joey Engelmeier, Jennifer McCartney, Jon Pearlman, Zachary Roy, Yong Choi, Pamela Toto, Dave Brienza, Patricia Karg and Paulina Villacreces. Standing in second row are Everette James, Jemima Ohwobete, Jack Fried and Bill Ammer
Thoughts of home conjure up countless images.
They’re different for everyone, but most revolve around memories of family, friends, holidays. Perhaps we hear sounds of laughter, music or children playing. Maybe we remember the smell of Grandma’s pasta sauce or homemade cookies, fresh from the oven. Whatever our memories of home, all of the adages hold true. Your home is your castle. Home is where the heart is. It’s a place of refuge. And, hopefully, safety.
For millions of aging Americans, their family home is not always a safe place.
But the new Healthy Home Laboratory (HHL) at 257 Oakland Avenue, near the heart of the University of Pittsburgh campus, is an innovative, collaborative resource where scientists, engineers, rehabilitation experts and community partners are coming together to maximize the health and safety of a typical home environment and allow more people to age safely and independently at home.
According to the U.S. Census Bureau, only about 10% of U.S. homes are “aging-ready.” What’s more, by 2050, the U.S. population over the age of 65 will almost double to reach 83.7 million, and the number of people over the age of 85 living alone will quadruple.
“I don’t know if I’ve ever been more excited about a project than the Healthy Home Lab,” reports SHRS Dean Anthony Delitto. “It is so relevant, so potentially impactful for millions of people. It is the future of our professions, from physical and occupational therapy to rehabilitation engineering.”
Delitto says the HHL is the result of ongoing collaboration, not only between SHRS departments, but also across other University of Pittsburgh Health Sciences Schools, the School of Engineering and the Health Policy Institute.
“Over the years, SHRS has been a leader at Pitt in bringing together different health professions to solve challenges,” notes Everette James, director, University of Pittsburgh Health Policy Institute. “The Healthy Home Lab is a place where interdisciplinary teams are coming together to address gaps in existing systems of care, especially for older adults and persons with disabilities who want to remain at home and thrive in their communities.”
At the Healthy Home Lab, research is being translated into practice through the design, development and evaluation of new and existing technologies, by advancing healthy home services and interventions, and creating comprehensive health and environmental assessments.
Toto describes how simple modifications to a bathroom such as a shower hose or shower transfer chair can provide cost-effective solutions to help adults age in place.
Finding the right balance.
According to HHL Director Pamela Toto, who is also a professor in the Department of Occupational Therapy (OT), having an actual home to use as a laboratory is essential. “Occupational therapists are trained to find just the right balance between a person’s environment and their goals.”
“We want to provide solutions that make sense for people—solutions that are accessible, cost effective and bring the greatest joy and wellbeing,” Toto continues.
She says it’s important not to look at the weaknesses of older adults, but to focus on their strengths. “How can we leverage what a person actually can and wants to do in order to stay in their home?” she asks. “Occupational therapists can provide respectful, meaningful interventions that gain a person’s trust and empower them to live safe, independent lives.”
The meaning of “home” is about more than just bricks and mortar. To capture that essence in the HHL, students in the Doctor of Occupational Therapy program were charged with arranging furniture and adding décor that replicates a real home, not a sterile environment.
“We know that a real home sometimes poses challenges for older adults,” explains Toto. “Maybe their favorite chair is low and they have difficulty getting in and out of a seated position. It’s our job as OTs to help people find solutions so they can still sit in their favorite chair and watch TV but do so safely and independently. If area rugs or electrical cords pose tripping hazards, how do we make changes that improve safety?”
Adjustable bars such as this one at the bedside can help older adults be more independent.
Older adults who fall are three times more likely to transition to skilled nursing facilities.
Toto says the HHL provides a great learning environment for OT students. It’s also an excellent resource for community partners who are committed to helping adults age in place.
Toto has been initiating aging in place programs since 2005. In 2019, she was part of a team that partnered with the Allegheny County Area Agency on Aging (AAA) to implement CAPABLE (Community Aging in Place—Advancing Better Living for Elders), an evidence-based program that aims to increase independence and safety in daily activities for older adults.
“CAPABLE aligns perfectly with the services and intervention arm of HHL,” explains Toto. “We hope that everything we do will eventually filter out to the whole community. In this case, we’re bringing back what we learn to the lab and identifying ways to enhance effective programs like CAPABLE.”
Roy demonstrates a prototype of RailBot, a low-tech, movable handle system that aids with stair ascent and descent.
Reducing barriers.
In the Department of Rehabilitation Science and Technology (RST), researchers and engineers are thinking outside the box to develop practical solutions that address gaps in the current market.
“RST operates at the intersection of rehabilitation and technology,” explains Jonathan Pearlman, professor and RST chair.
“Typically, our department focuses on disability and how to empower people to make their world more accessible,” he continues. “At the HHL, we are using our expertise to develop practical solutions for older adults, especially in areas of mobility and safety.”
Among other things, Pearlman and an interprofessional team of scientists, engineers, public health experts and community partners are conducting indoor air quality assessments, assessing various smart-home technologies, and evaluating both low- and high-tech solutions to mobility.
Doctoral students Joey Engelmeier and Jemima Ohwobete monitor indoor air quality.
The majority of houses in the city of Pittsburgh were built before 1930.
Stair-climbing solutions are a priority because many older adults must use stairs to reach second-floor bedrooms and bathrooms or basement laundry facilities.
RST Research Engineer Zachary Roy (BS ’22) works at the Healthy Home Lab while pursuing his Master of Science in Bioengineering–Medical Product Engineering at Pitt’s Swanson School of Engineering. He’s the HHL project coordinator and part of the interdisciplinary team of designers, engineers and clinicians who are assessing and developing various types of step-climbing devices.
“Right now, what we’ve seen is that older adults are primarily faced with two options that are at the opposite end of the movement and mobility spectrum,” says Roy. “They can either use a handrail as support as they climb the stairs or sit passively on a seat and let an electronic stairlift do the work.”
“Stair-climbing is great exercise,” Roy continues, “so developing solutions to safely preserve and encourage mobility while addressing these gaps in the market are reasons why we are researching this area.”
The HHL team is exploring alternatives that range from a low-tech ergonomic movable handle system that is positioned in front of a person to provide support while going up and down the stairs to a high-powered assistive device that uses cables to offer mechanical support as a person climbs the stairs.
Villacreces shows how Mobius can be adapted to different locations in the home, providing support and stability for older adults.
Creating solutions.
Many products are tested right in the Healthy Home Lab, while prototypes for novel devices are often designed and constructed at the RST laboratories at Bakery Square in Pittsburgh.
By 2050, 25% of Americans will be over the age of 65.
Assistant Professor Paulina Villacreces is an industrial designer who is leading the development of Mobius, an adaptable rail system that can be reconfigured to add accessibility components such as grab bars in the home.
Developed with funding from a VA Specially Adapted Housing Assistive Technology grant and the Pennsylvania Department of Health, Mobius utilizes an inner structural rail system that attaches securely to the studs of any wall. Decorative architectural molding with removable sections then snaps over the structural rail.
The removable sections can be taken out for the installation of grab bars or other accessibility components.
Villacreces says Mobius allows grab bars to be placed exactly where they are needed, whether it’s along a hallway, in a bathroom or at a person’s bedside, not just where wall studs exist.
“Once the aluminum structural rails are in place, there’s no need for costly modifications by professional installers,” states Villacreces. “Homeowners or their caregivers can remove pieces of the decorative molding and add more accessibility components on their own.”
There is a patent pending for Mobius, and different kits are being designed for various rooms in the house.
SafeStep uses a cable-driven “moving” escalator similar to a ski slope tow rope to provide extra assistance going up and down stairs.
“As we’re identifying different problems in the house, we’re engaging different departments, different schools and community partners,” says Pearlman. “We’re also seeing small businesses stepping up to support commercialization of some new products, especially in the area of mobility and health monitoring solutions.”
“The momentum is building. It’s amazing that so many innovative solutions are being developed so quickly. It’s a tribute to collaboration,” Delitto adds.
James points out that while a few other universities are doing important work in the area of aging in place, Pitt’s Healthy Home Lab stands out for its ability to translate research into practice.
“After testing our products and services in the Healthy Home Lab, we partner with organizations like the UPMC Health Plan, Allegheny County AAA and businesses in the AARP AgeTech Collaborative to deliver them to people in need,” says James. “The combination of Pitt’s world-class expertise, the HHL and forward-looking partners to implement our research is unique and is helping build Pittsburgh into a hub for commercial translation in the aging space.”
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This article originally appeared in the Fall 2023 issue of Facets magazine. Continue reading these articles about the Healthy Home Lab:
- For this Health Informatics Assistant Professor, Aging in Place is Personal
- The Pitt Healthy Home Lab was Once a Family Home
- The Pitt Healthy Home Lab is a New Home for Student Training
- Pamela Toto named director of the Healthy Home Lab