Are older adults living offline lives – now? It’s so tough predicting the distant future when the pace of adoption accelerates. The Boston Globe ‘Ideas’ column on the Future of Old interviewed a plethora of pundits on just how social our online lives might be, so different and remarkable when today’s 30-year-olds turn 70 in 2050. Think how much of a contrast that video game playing, cat video viewing generation would be to today’s old folk – struggling with isolation, boredom and Alzheimer’s (43% of people over the age of 85 show symptoms, cites writer Leon Neifakh.)
Read it and weep -- the conundrum of home health tech. The large (130 pages) Healthy@Home 2.0 report written by Linda Barrett released on Friday by AARP shows several dimensions of market self-delusion, not the least of which is the perspective of the 940 seniors age 65+. Although they have no doubt seen the world around them go from the happy-go-lucky period of the 2007 survey to a not-so-great world in 2010, what they want is for things to 'stay the same', relying on "a lot of luck", a "good attitude" and "hope". Amazingly, most say they do not need to make any changes to their home within the next 5 years. They're mostly in good shape -- but 27% of them have limits on physical activities, 32% have low vision or hearing impairment, and nearly 1 out of 5 reported their health as fair or poor. Meanwhile fewer than 20% are using any home safety technologies, including an alarm system (!); and fewer than 10% use any personal health and wellness technologies mentioned in the survey. These include medication dispensing (described to responders as an electronic pill box), medication management (communicates information to a provider), or a home-based transmitting self-care device for blood pressure readings or diabetes results.
If it’s a Thursday, April 28, I must be -- Aging in America. Where are the restrooms? With so much travel these days, it’s easy to get disoriented – have I seen this exhibit floor before and which one of my seven PowerPoint slide decks is labeled Thursday at 2:30 pm? From talking to attendees and later reading AARP and Linda Barrett’s comprehensive and updated Healthy @ Home 2.0 -- it looks like as we are becoming older, we are more tech-aware (and apparently saturated with PCs), but still not galvanized into caregiver tech adoption urgency. It also seems to me that industry professionals hear about technology products and see more potential for introduction to their parents than for their elderly constituents. Oh, and by the way, they are waiting for integrators to bundle them into well-tested packages, short lists and solutions for family and professional caregivers.
When disruptive tech disrupts -- hindsight is 20-20. Even famous executives like Michael Dell can be surprised by market change -- his comment about the rise of the tablet: "I didn't completely see that coming" made me wonder a bit about his marketing staff. But it was his remark about Android that made me pause: "if you look at 18 months ago, Android phones were like, "What is that?" And now there are more Android phones than iPhones." Consider this description from another WSJ article, which notes that "the handset logs calling data, messaging activity, search requests and online activities. Many smartphones also come equipped with sensors to record movements, sense its proximity to other people with phones, detect light levels, and take pictures or video. It usually also has a compass, a gyroscope and an accelerometer to sense rotation and direction." And Android phones support voice-activated search, e-mail response, and navigation. It would not be unreasonable to expect all smart phones to do all of these things, oh, maybe by next Thursday. And the following version may be quite usable.
Aging in a capital P Place. The 90-year-old Motion Picture Television Fund campus in Woodland Hills is (total understatement here!) not your typical continuing care retirement community. It was developed for those who have worked in the industry at least 20 years, whether they were secretaries, set designers, cameramen, actors, directors, producers -- or the surviving spouses of same. The tour tends to stun even jabbermouths like me into silence after seeing the Roddy McDowell Rose Garden with the statue of Roddy McDowell in his role in the Planet of the Apes, after looking at the beautifully designed cottages and villas, seeing the on-campus movie theatre, then the in-house television station, the tiny John Ford chapel, the warm arthritis pool, watching the water aerobics class, peeking at the community gym and sitting for a few minutes with a charming resident and former film director whose wall was covered with signed photos from movie stars and a mind filled with memories from a long Hollywood career.
Caught in nowheresville -- neither nursing home, ALF or safe home care. Today we are in a no-man's land of legislative initiatives to keep (or move) seniors at home and out of a shrinking number of nursing homes -- between the CLASS Act, CMS program experiments, PACE program here and Medicaid payment (see Leading Age/CAST report about which states reimburse PERS et al.) -- the only really clarity is that government agencies believe that the costs of care are lower at home. On the other hand, we are at an amazingly under-deployed stage of the use of technology in delivering home care services (if you have any statistics that prove otherwise, please come forth!) So on the one hand, we chip away at the viability of nursing homes (1000 have closed within the past 10 years), we don't chip away at the cost of assisted living, however, which is financially out of reach when there is no pricey home to sell. Yet 24x7 home care is priced by MetLife at a US-wide average of $183K/year (in comparison to a US-wide average of $40K/year for Assisted Living). So what are families to do?
Cathedral builders still wanted. Nearly three years ago, in my naive tiptoeing into the tech market for aging in place, I wrote a dismayed blog post about how so many universities have age-related research programs that design and then evaluate efficacy of technology and older adults -- and then disappear when the students move on. Despite a then-slumping economy since October 2008 when that was written, there are still plenty of research programs that live on (see MIT AgeLab), studies have been done to prove efficacy and effectiveness of technologies to help people age in their own homes. So here's another research effort, this time through the University of Missouri and an associated independent living complex called Tiger Place. Nice work has been done to validate that passive sensor technology in conjunction with nurse care coordination can help keep at-risk seniors out of nursing homes (not unlike the Philadelphia PACE project with Healthsense). Intellectual property commercialization into products is not part of the Missouri project, however. In my conversation with lead researcher Marilyn Rantz, she noted her hope that prospective commercial vendors will come forth to license the AgingMO work for future products.
Hearing the band play on. Seeing an opportunity to attend a day of the Assisted Living Federation of America (ALFA) annual Conference and Expo in Orlando -- I had to go -- hoping to see what's new and different. These have been a difficult few years for this for-profit industry, with expansion constrained by a difficult lending climate, with filling capacity challenged by later move-in dates and shorter stays, with the need to do more innovative marketing to entice prospects -- and with those that do move in having both higher expectations along with greater frailty and other issues commensurate with age or need. This year I was surprised to hear talk of the need for wireless networks throughout buildings (and being deployed -- see ESCO's CareConnect, for example), that new residents are arriving with their laptops in tow. Given the age range as a result of older move-ins, there was also a continuing focus on memory care, safety and wellness.
Back from the Alzheimer's Association of the Northwest. Walking the aisles of the exhibit floor, one could get the impression that the key for family members and professionals is finding a good home care agency or assisted living placement. Which reminds me, that despite the best of intentions in the aging services worlds, I rarely see evidence that it is at the top of the priority lists of these organizations to ensure that those they serve know what technologies might be of some benefit to them. (The exception is LeadingAge (formerly AAHSA) which has sponsored CAST -- check out the link that LeadingAge CAST has just released an analysis of state payments for Aging Services Technologies (AST). But I digress, here are some technologies to mitigate various issues confronted by caregivers -- some mentioned previously in random posts. Please comment with other suggestions or any feedback about these vendors or suggest additional products:
Good luck dudes -- boost savings through virtual reality. So it seems that as a society, we are not great savers. Some researchers seem to think if young people could only imagine what they would look like in the future, they might boost their savings efforts earlier. Scientists in a Stanford lab are experimenting with the 'Proteus effect', morphing a photo of a 22-year-old into an image of what she might look like at 68 -- showing it to her through a virtual reality headset as her image in a mirror. Hmmm, now gray-haired, face sagging -- it's enough to make a 22-year-old nervous for a few minutes, long enough to answer questions about her attitudes on money, demonstrating newfound awareness and a desire to save. Maybe just looking at her grandmother, volunteering in an assisted living facility or making the trek to The Villages would produce the same 'scientific' outcome, prompting a 22-year-old to save more for retirement. The reality (not virtual)? In another poll, 18-34 year olds are more determined than older age groups to save money. Maybe Stanford could save a few bucks and apply its research to something more near-term -- how to train bankers.
