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9.11.22 – Pittsburgh Post-Gazette- HALLIE LAUER

A house in Pittsburgh that is 105 years old is serving as a “Healthy Home Lab,” where University of Pittsburgh students will try out solutions to help older adults age in place.  

From the outside, the three-story house sitting at 257 Oakland Ave. looks like any other Pittsburgh home. But inside, University of Pittsburgh students will soon be working to find solutions to problems older people often face when trying to stay in their homes rather than moving into nursing homes, known as “aging in place.”

The house is Pitt’s new Healthy Home Lab, which will aim to support aging in place by designing and developing assistive and smart home technology.

The 105-year-old home that the university purchased in April was an ideal amalgamation of problems real-life homeowners in the city are experiencing.

The house had asbestos and lead issues, one of the chimneys was unsafe, there were structural problems that needed to be addressed, some of the electricity needed rewiring and – as is the case in many Pittsburgh homes – the basement was damp.

Some homebuyers might have taken one look at that list of flaws and run in the other direction. But the challenges made it a dream house for the university.

In the lab, students will try to come up with ways to make home environments healthier for people, especially seniors and people with disabilities, who “want to remain in their homes and live independently as long as possible,” said Everette James, the director of the Pitt Health Policy Institute.

A number of years ago, but particularly as the COVID-19 pandemic set in, researchers began really focusing on home environments as an aspect of health, according to James.

“We’ve always known that the home and where people live in their home environment is a very important aspect of their health,” he said. “And the importance of the home as the center of health has really accelerated the last couple of years.”

The Oakland Avenue home had been owned by a single family for generations after it was built by their great-grandfather. When the university purchased it, there was a queen-size bed in the dining room because the grandmother couldn’t navigate the many stairs anymore.

James, who was the Pennsylvania secretary of health from 2008 to 2010, explained that as the over-65 population continues to rapidly grow, many people are opting to age in their own homes rather than transfer to a nursing home or assisted living facility.

That desire often presents a host of problems that Pitt is hoping to address in the new lab.

Using 2019 data from the Department of Housing and Urban Development, Porch, an organization that connects homeowners with home services, completed an analysis that found Pittsburgh had the highest percentage of homes in the country – 8.2% – that had severe issues either with structural integrity, heating, plumbing, electricity, pest infestations or a combination of those.

And the area also has a high number of older residents. According to the U.S. Census Bureau’s population estimate from July 2021, 19.7% of Allegheny County residents are age 65 and older, compared with the national rate of 16.8%.

“I think Pittsburgh is such a unique environment that’s maybe the most challenging of environments,” said Jonathan Pearlman, the chair and associate professor in Pitt’s Department of Rehabilitation Science and Technology. “And so given the opportunity to really focus on aging in place and how technology is used in the home was a great opportunity for us and one of those things that really fit like a glove in terms of our skills and interests and ability to participate.”

Jonathan Pearlman, center, with Rayhan Afsar, left, a research assistant and director of engineering, and Keyshawn Shaahid, with UPMC, tour Pitt’s Healthy Home Lab in Oakland.Pam Panchak/Post-Gazette

According to Census Bureau data, 48 million households (39%) include at least one person age 65 or over, one person with a disability, or both. And about 1 in 8 households have a member who uses a mobility device for a long-term condition.

Researchers often build replicas of things like bathrooms or kitchens to test devices in, but having an actual home “breaks down the artificial environment” that comes with a clinical lab and create “a more genuine experience,” Pearlman said.

That genuine experience is further amplified when considering the wet basement and aging staircases in the building. 

“These are the real conditions that we’re trying to deliver care in,” Pearlman said. “It’s just kind of an essential step for us to be able to develop the true interventions and true support for people to age in place safely and independently.”

As part of the focus for the lab, researchers will be testing sensors that monitor things like moisture levels and particulate matter in the air.

By monitoring these things, social workers or clinicians can determine if it is healthy for someone to live in the house and make suggestions for what could be done if it isn’t.

The entire house will also be equipped with smart home technology: automatic lights, door locks and window shades and programmable thermostats.

“These are things that we all buy at Best Buy or on Amazon .. and then we install them ourselves and hope they work,” Pearlman said. “That’s not a feasible way to deliver what needs to be a really reliable technology solution for somebody.”

He said that one the main issues with smart technology is that it seems to be effective for only a certain period of time.

If an elderly person is relying on this technology, it has to be more reliable, Pearlman said. 

Eventually, Pearlman hopes to bring patients from a UPMC geriatric clinic into the home to have hands-on learning with the smart technology and “include users in the development of research studies.”

Pitt will also be designing and testing its own innovations around improving mobility and accessibility. Some of these new innovations will be designed and built in the basement of the house and then taken upstairs for testing in the main living areas. Pearlman expects that students will be in the lab by October, starting to design and test this technology.

They are currently working on new iterations of stair lifts and developing other technologies to help support people as they walk upstairs.

“When you look at the technologies for stair climbing, you have the handrail that was developed hundreds of years ago and then you have a stair lift that’s 20 to 30 years old … but you have no other technologies that have been developed to help people” get up the stairs, Pearlman said. “It’s one thing to teach someone how to use crutches or a wheelchair in a clinic, but it’s entirely different to think about how they will be able to move about their home with those devices.”

When patients learn to use assistive technology in a hospital setting, for example, they may not encounter the challenges of older houses like narrow doorways and steep staircases.

Another system Pearlman’s team will be testing in the Healthy Home Lab is a way to make molding in the home – like crown molding – structural as well as decorative.

Pearlman wants to make molding functional by securing it to studs so that grab bars or railings can be installed.

A major complaint about assistive technology is that it looks clinical because the majority of it was designed to be used in a hospital or outpatient treatment center, Pearlman said. This is one way they can incorporate this technology into the design of an older house. 

“This is a really good example of how it’s thinking outside the box and saying if we want to have this kind of impact in the community … we have to be in the community,” Pearlman said. “That’s what’s been, I think, really energizing for the whole team.”

Hallie Lauer: hlauer@post-gazette.com

First Published September 11, 2022, 6:00am