Dr. Chip Teel is on a mission, a mission to transform the way we care for our grandparents and parents.
His prescription involves a bit of low-tech gear, the kind you can buy at a store, like your local Radio Shack, a sprinkling of common sense, and old-fashioned neighborly love.
As the nation’s political and business leaders wrestle in Washington over the fate of the health care system, Dr. Allen (Chip) Teel is quietly reinventing it for his patients.
“I am a little guy in a little town in Maine. I am just working in my own niche,” he said.
Instead of putting people in hospitals, nursing homes and assisted living facilities, Teel is trying to keep his patients at home.
Take Neal Ward, 86, a prominent retired teacher and restaurant owner in Damariscotta.
Ward, one of the founders of Damariscotta Bank & Trust, admits he is getting up in years and now has a bit of a memory problem. When he talks about Teel, he wants a visitor to understand he is not panning assisted care facilities, like the one where he, and 87-year-old wife, Ginny, once resided.
“I am not putting down Chase Point (a Damariscotta assisted care facility). They have a nice facility and good people. It is like a nice hotel and the meals are good,” he said.
“But it is not home. It is not our home,” he said.
Service by remote control
For the last four years, Teel and his company, called Elder Power, have signed up more than 40 patients for a unique health care service that monitors their lives by a remote computer camera system.
Teel explains by sitting down in front of a large computer screen and booting up a computer program he bought off the shelf, a program he says is mostly used by hardware stores to record video images of their back parking lots.
Once on line, Teel can peer into the homes of his patients, including those with memory loss.
Using another program, which tracks sensors installed in their homes, he can track their habits, when they sleep, go to the bathroom, open the ice box and record the inside temperature of their homes.
Teel says by itself, the data does not help him diagnose ailments, but after a few weeks, it gives him a good idea what is “normal” for each patient. When something is different, the computer lets him know “something is up,” alerting him that he needs to look in on this person.
As an example, Teel clicked on his father’s name and peered into his home.
Looking in the kitchen, he notes a coffee cup on the table, slippers nearby, and dishes in the sink. In the bedroom, he can see the bed has been made. No one is in the bathroom. In the living room, he can see his Dad is sitting in a chair and reading a book.
This quick video tour of his father’s home is enough to reassure Teel.
“Good. I know he is OK, ” he said.
The physician continues by explaining that his father usually gets up at 9 a.m. When he is not up within an hour or so, he knows to check on him.
“If a patient usually goes to the bathroom once a night, and he visits the bathroom four times on one night, I know to check on him.
“Now, it may be nothing. He may have stayed up and watched the Boston Celtics play a late West Coast game, and had a couple of beers, or it may be something else. So I know to check on him. I can check on him, even when I have a very busy day; that relieves a great deal of anxiety,” he said.
Anxiety and fear is a common emotion for sons and daughters, especially those who live far from home, who discover their folks can no longer live on their own. They sometimes feel that when you put someone in a “home,” they become someone else’s responsibility.
That feeling, however, is not universal.
“I had one woman, an 85-year-old in Waldoboro. She has some early Alzheimer’s symptoms. Part of her family wanted to send her to an Alzheimer’s unit out of state, but her daughter, a school teacher here, wanted to find out if there was any thing else they could do.” said Teel.
“We set up a video monitoring system that would let us watch her during the day, and the daughter would take care of her mother after school; both are happy,” Teel said.
Some of the relief is fiscal.
“When I take someone out of the hospital and put them under 24-hour home care, that is pricey,” Teel said. “If I put in the camera equipment, I can keep an eye on them. If I can use a net book (for $200) and hook it to your TV set, I can make it easy for elders.
“I can get a ton of information from the remote monitoring equipment, and it does not cost very much.”
For most patients, especially those with a bit of memory loss, an Elder Care volunteer, a senior citizen herself, checks on them three or four times a day. If something is not right, they call Teel and his right hand person, Carol Richards.
Elder Power services range from $100 to $600 a month plus. Additional services are available at extra cost.
For Neal Ward, the difference between Elder Power monitoring and living in an assisted living facility is dramatic. His family says he spends about $8000 a year for Elder Power. The facility cost about $7000 a month.
“We have three (price) packages and several others have signed up for a special TLC plan, but we do whatever it takes to keep them in their home,” he said. “We are trying to create a model with flexibility, that is reproducible in any community.”
Not a nickel for change
What does the medical establishment think about it? Not much, he said.
“You would believe they would be interested, but the state programs are dependent on federal dollars and when you cut costs, you cut their funds from the feds,” Teel said. “For example, if you can monitor someone while they are sleeping for $1 per hour, or pay $20 to have some one watch them sleep, you would think it would interest them, but it is a problem for the health care system. No one wants to spend a nickel on change.”
Vicki Purgavie, the executive director of the Home Care & Hospice Alliance of Maine says technology driven programs like Elder Power are “very exciting.”
“We in the field get excited about this before the payers,” she said.
She cited other tech systems that monitor vital signs, and other conditions that allow professionals to check on patients.
“These systems are right around the corner,” she said.
While some sophisticated technologies for home in patient care are covered by Medicare and/or Medicaid, neither federal program reimburses patients for the home care uses, she said.
The Center for Aging Services Technologies, an arm of the American Association of Home and Services to the Aging, is a coalition of business, professional and health care institutions.
According to a statement on the center’s website: “Statistics clearly demonstrate an urgent need for innovative technology-based tools that enable older adults to live independently and maximize care givers efficacy by providing timely health information and delivering more effective care.”
Technology can allow primary care providers to perform an evaluation of the monitored older adult’s health that is more comprehensive than the “snapshot” assessment obtained during an annual physical examination, it said.
Other professionals, who declined to be named, raised questions about liability and qualifications of Teel’s care givers.
“I think the concept is good, but it needs work,” said one.
Teel responds to the critics this way.
“They say it will work in 10 years. I am doing it now.”
A ready answer
Is installing a camera in a grandma’s bedroom and kitchen a problem? Has it turned Dr. Teel into Dr. Big Brother invading her private spaces?
Teel has a ready answer.
“I’ll tell you what is a real invasion of privacy. When they take you out of your own home, put you in a sterile room with a stranger and make you share a bureau and a bathroom,” he said.
Teel says most folks want to stay home, and they like to know if something happens, somebody will know about it and help.
For children, it is a leap of faith to allow Teel and his cameras to watch their parents, especially those children who live elsewhere. Understandably, they are worried and feel better when their folks are in a facility, but the cost is huge, and many parents don’t want to leave their home and their possessions.
For relatives, even those who live out of state, Teel can set up a link so they can peek at their elders using their own computer.
All he has to do is convince them to give his system a try.
“We argue we can blend the technology of the cameras with the neighborly approach of an old friend,” he said.
He admits there has been some fear that he may be hurting the business of assisted living facilities and nursing homes, institutions which spend huge amounts on physical plants and employee salaries and benefits.
Teel, who owns seven assisted living units, admits the camera/computer monitoring system cannot serve all patients.
“Well, the camera can not make a person’s bed, or help him get in the shower. Some people prefer living with others, but it is all about choice,” he said. “These places should be populated by people who choose to be there.”
“I am not opposed to residential care facilities, I started Hodgdon Green and the others, but some of these facilities promote learned helplessness. If I just feed you pills and let you rust, I am not doing my job,” he said. “Plus, we can do things for 10 to 15 percent of their cost.”
