Whenever Harold Taylor rolls his wheelchair into his bedroom or crosses his two-room suite to take another wistful look at the photograph of his deceased wife, Elsie, his movements are tracked as though he were a radio-collared elk or a prisoner on house arrest. A badge the size of a credit card, pinned to the lapel of Taylor's shirt, transmits an infrared signal to sensors on the ceiling and walls. The sensors send information to a central computer in his rest home—Oatfield Estates, a new managed-care facility just outside Portland, Oregon—and by touching the Where Is Everyone? icon on her screen a caregiver can detect that Taylor has moved.
With a few more taps on the screen the caregiver can also ascertain what time Taylor tucks in for the evening, exactly how much he weighs lying in bed (a load cell sits under each bedpost), and whether he's resting peacefully or twisting and turning. She can take his temperature by means of infrared, keep track of how often he rolls in and out of his bedroom, and create graphs documenting changes in his patterns of movement and in his heart rate and blood pressure. And if Taylor, a former steel-company repairman who is still sharp-witted at the age of ninety-one, should ever develop Alzheimer's, the Oatfield staff need not worry that he'll absentmindedly burn himself on the stove down the hall: the infrared sensors would recognize that he had entered the kitchen, and the burners would lose power at once.
Surveillance has, of course, become part of everyday life in America. Many employers now monitor their employees' telephone conversations. The police plant video cameras on street corners, and direct marketers keep close tabs on where we go on the Web. But each of these activities accounts for only a slice of our existence. Oatfield aims to capture the whole pie. It is the nation's highest-tech senior home and perhaps the first facility of any kind to e-monitor its residents around the clock. And it is continually fine-tuning its surveillance. When I toured Oatfield recently, Bill Pascoe, the architect of the facility's computer system, speculated that Oatfield might soon begin to monitor residents' breathing. "One way to do this is to hang a long, thin microphone over where the person sits, to pick up his sounds," he said. "You'd use a broad, multi-directional mike to pick up the ambient noise, and then you'd subtract the ambient noise and ..." I felt as though I'd entered the world of that ominous Jim Carrey film The Truman Show.
But I felt, too, as though I'd entered a homey small town. Opened last fall and still under construction, Oatfield will consist of a cluster of ten wooden bungalows, each containing fifteen suites, situated in the Portland suburb of Milwaukie, on a six-acre hilltop that was once an apple orchard. Each bungalow is designed to serve as an "extended family residence," a multi-generational home that will welcome seniors and allow them to "age in place"—and to garden and cook—while living alongside their caregivers and those caregivers' families.
Oatfield had only two residents when I visited, but still it had a family feel. In the central kitchen in Harold Taylor's bungalow Connie Cooper, a "live-in facilitator," whipped up some sandwiches for lunch. Her sixteen-year-old son, Tim, slouched on a nearby sofa, playing a video game called Perfect Dark; Taylor surveyed the scene in stately silence while he nibbled at some ham. After lunch his daughter dropped by, accompanied by Taylor's beloved Shetland sheepdog, Mandy. Mandy, who is fifteen years old and blind, lolled on a blanket in Taylor's living room. Oatfield's founder, Bill Reed, soon meandered in, wearing jeans and a sweater; he looked at Mandy and grinned.
Reed, who is fifty-two, is a powerfully built, balding Portland developer. He told me that his inspiration for Oatfield was his sprawling childhood home in Connecticut, where he lived with his parents, four brothers, a grandmother, and a great-grandmother. "My grandmother baby-sat for us," Reed recalled. "At night one of my brothers and I would help lift my great-grandmother's feet for her as she climbed the stairs to bed." The old women were frail, Reed said, but his mother managed their health deftly. "She had intimate knowledge of them. She knew that if my great-grandmother didn't, say, eat dessert two nights in a row, something was wrong. In the past forty years, as people have stopped living near their parents, we've lost that sort of family memory."
A few years ago Reed decided that he wanted it back. And so, in October of 1998, Oatfield's omniscient computer system, Daughter I, was born. (It was later rechristened CARE, for Creating an Autonomy-Rich Equilibrium.) During the subsequent eighteen months Bill Pascoe, a former systems integrator for a company that makes wastewater-treatment equipment, headed a team that designed ten computer programs that, collectively, enable 180 gigabytes of electronic data—a plethora of personal health stories, an epic detailing seniors' moment-by-moment physical ups and downs—to flow daily over Oatfield's network, which contains some 360 miles of copper wiring.