By now, you’ve probably heard about or seen it. PBS’ Frontline and ProPublica spent a year researching care, life and wrongful deaths in the largest of assisted living companies, Emeritus Senior Living. After the broadcast, some honest self-examination, but also those expected positioning statements and self-righteous comments emerged from Emeritus, industry observers, plus defensive responses from the industry lobbying leaders – ALFA and Leading Age. Larry Minnix (Leading Age) tells ALF executives to ask themselves, “What are your staffing levels?” Indeed. And we should ask as well. What should they be in an AL memory unit? He doesn’t say. Read the Frontline attached interview with a regulatory agency CEO -- and how variations across state boundaries can be justified. Really. So shouldn't facilities be shut down after horrible incidents like these? Remember the Miami Herald series Neglected to Death? Not just one company (as in the Frontline story) but many organizations, large and small, throughout Florida, not just one incident but multiple. As with many incidents, company growth may slow a bit, organizations may consolidate under new ownership or new names, but rarely are they shut down.
It’s a new era – patient engagement – but does that include seniors? According to a recent health journal article, welcome to the era of patient engagement. What’s that? “Empowering patients to actively process information, decide how that information fits into their lives, and act on those decisions is a key driver to improving care and reducing costs.” Like many of the heavily-invested Health IT improvements over the years, patient engagement strategies offer the industry a feel-good approach to preaching to and reaching the converted – those tech-enabled individuals with a fetish for looking stuff up and tracking it (see Google Health). Ah, but those with the least access to technology may need the most engagement -- they're not likely to peer at their patient portals. At last Pew count only 13% of the 65+ even looked online for information as a diagnostic tool. And fewer than half of those followed up with a medical professional based on what they found.
Let’s reflect on the market of tech for older adults. In December, 2011, a number of assertions were made about the future – as we move forward, let’s look back and examine if these predictions came to pass, or if they were more fantasy and hope.Those predictions opined that mobile devices would become more important and cut into the house-bound tech market. And tablets and smart phones are transforming multiple tech markets that impact seniors and their families – including apps and senior-specialized PCs, feature phones, and even game consoles like the Wii. Consider the specifics:
See the new features in THIS upgrade – now go forth and suffer! I admit it. I am one of the millions of Android phone users. That makes me something of a glutton for Google-induced pain. This week, I was trying to provide helpful navigation assistance in downtown Boston, where any navigational aid is a blessing. I discovered that Maps and its associated and fast-talking Nav app were somehow upgraded -- and thus rendered mysterious. Maps still works – if you don't mind two crashes, the third startup is a charm. But it now has an unrecognizable set of icons and hidden options – and Nav is no longer a separate app. Sadly, I was not helpful navigating. Later I learn from the angry hordes on the Android forums that there is an Uninstall option to enable return to the previous version. And further research reveals a setting for the aptly named Google Play Store -- Do not auto-update apps. For good reason. The default is, naturally, the reverse.
Five Market Overview versions later -- let's recap. Launching a business venture takes excessive confidence -- or an extreme lack of common sense. Four years ago, after 7 months of random ranting in a blog, an awkwardly-titled Aging in Place Technology Watch analyst business was launched at the 2009 What’s Next Boomer Business Summit. Both of those were in conjunction with posting and promoting an initial report -- Technology for Aging in Place Market Overview (2009). Now more than four years later, an updated version has been posted on this site. The press release titled "The Longevity Economy Goes Mobile" is ready -- and so there's time for a bit of reflection. Since 2009, how much has changed: the environment in which technologies are discovered and utilized is radically different. Entrenched social media tools like Facebook, Twitter, LinkedIn et al. make it different; the rise of smart phones and tablets as platforms, so different; and the rise and fall and rise of crowd-funding make starting up a company very different; boatloads of blog sites offering a cacaphony of tidbits also makes learning about new technology difficult -- and different.
How the mighty app has crumbled into a tiny, trashy bucket of bits. Yesterday I spent time wading through smart phone and tablet app descriptions that sounded like they are for caregivers on iTunes and the Google Play Store. That is, the word 'caregiver' could be found in the description. The reviewers and links of many of these so-called apps are revealing: "this app crashes my phone" or "server error" and other less printable descriptions forced me to move on. Looking for a link to a developer website? Hmmm. Are you looking for a phone # to call about a so-called service? There’s only a Contact Us Form – no e-mail address, no phone # -- really, what we mean is don't contact us -- we have no budget for answering e-mail or the phone. At the end of the day, a few were found that will be in the 2013 Market Overview published later this week on this website. These are firms that I believe are reachable, are not trashed in reviews and oh, they just might run on smart phones or tablets!
Studies are the pre-requisite for product introduction and change. One of the conundrums of our society is that institutional change is typically made possible by the presence of studies cited to verify that the change should be made. These studies can demonstrate that a product is safe until it is proven otherwise. For example, studies of drug efficacy by drug companies (even with overstated favorable outcomes) are the basis of approval and introduction into the market; studies about automobile safety (funded by car manufacturers) have preceded introduction of safety features, and so on. Other studies about older adults, however, raise the question of whether studies are structured (or at least described in the press) to embark on proving that our common sense is, well, sensible. For example:
Caregivers could see the future of mobile apps – and it came to pass. A few years ago, the National Alliance for Caregiving and United Health Group published a study, conducted during 2010, called the e-Connected Family Caregiver: Bringing Caregiving into the 21st Century, which surveyed family caregivers about their propensity to use any of 12 different technologies to help them with their caregiving responsibilities. The conclusion: "two-thirds of family caregivers who have used some form of technology to help them with caregiving believe web-based and mobile technologies designed to facilitate caregiving would be helpful to them." But as KHN noted below, it's the wild west for (40,000!) smart phone apps -- doctors are suggesting, but not yet prescribing apps for the e-Connected caregiver:
Online searches – not always helpful -- underpin the caregiving role. The latest Pew research about health information and family caregivers reinforces what we know. Family caregivers search online for information to help them provide care. Information about medical problems, treatments and drug information top what they seek – and I bet they find. The Internet has become a 'neighborhood' for asking what might be difficult to ask your next door neighbor. In this online neighborhood, you find that others have symptoms like yours, experienced relief from medications or found a cheaper pharmacy. Yet these resources are not quite like the neighborhood of old: Given that 84% of family caregivers have gone online seeking information, only 59% of caregivers with Internet access indicate that online resources have helped them with caregiving, and only 52% indicated that they help with caregiving stress.
Connecting through glass by older adults – forward, but slowly. The Pew numbers are out and offer confirmation that -- as consumer devices -- feature phones are nearly dead and laptops may be dying. But smart phone ownership among seniors is marginally up from the previous 13% – now 18% of the 570 surveyed adults aged 65+ and 39% of boomers aged 55-64. What’s different is the dominance of the device among younger adults – 55% of those aged 45-54 and 69% of those aged 35-44 have smart phones. Meanwhile tablet ownership among the 65+ has progressed to that same 18%. (Uh, could those be the same folks that own smart phones?) And tablet ownership, a newer category and less dominant than smart phones, fits an older crowd: 49% of adults aged 35-44 own one, and 38% of those aged 45-54 have them.
