Laurie Orlov's blog

It's 2021 -- are older adults well-served by technology? Some progress has been made -- Apple and Amazon seem interested in the older adult segment. Smartphones are being adopted by the majority of older adults, including those aged 70+. That’s despite their touchy screens, inconsistent app designs, and now silly warnings about app tracking on Apple devices. Those self-righteous warning are especially amusing, given that Gmail is the most frequently used email client (with 53% of the US market), including on iPhones. And you know that for Gmail and other ‘free’ software (like YouTube, Twitter, Facebook, Instagram), you are the product for advertisers and more. But we digress. In home care, technology plays a tangential role at best, though tech exists, including AI and machine learning, that could improve care of older adults. And the potential for a smarter (and healthier) home is growing -- an upcoming research report will describe that potential in December. For now, here are four blog posts for October:

Beacon Hill Village created a concept out of need... Long ago, the topic of aging in place was born within the pioneer community of the ‘Village’ movement -- Beacon Hill Village.  Judy Willett led the way 19 years ago in Boston to help neighborhood seniors stay in their homes longer. That’s not a small trick if you consider that Beacon Hill is a neighborhood of steep cobblestone streets, no easy-in subway stop, and --- argggh – every year, residents, most in their 70’s at that time -- must cope with winter! Today Beacon Hill Village has 400 members who benefit from aggregated services that include "social clubs, weekly exercise classes and lectures, transportation to doctors’ offices and grocery stores, and access to reduced-fee home medical care and home repair services."

Our technology language and expectations change. One day a phenomenon that might once have seemed startling becomes so accepted that we scarcely notice what changed. Technology once perceived as innovative and useful, degenerates through actual usage into a worrisome trend that begs for individual and/or parental control – even inviting government interest and possible oversight as in Europe. Here are four technology trends with origins that might not have seemed alarming at the beginning:

What could have happened in the home care industry didn’t.  In 2012, based on interviews with the best and the brightest in and around the home care industry, an idea was born and documented.  It was radical – the idea of a network for sharing relevant information across organizational boundaries about a home care recipient with stakeholders, family, health providers. In this vision, the care recipient was at the center of this information sharing across the stages and steps of living independently, senior housing, rehab, hospital, and home.  Instead of this vision outlined in The Future of Home Care Technology 2012, we have today’s franchised and fragmented home care industry – regionally focused, achieving the most minimal advances in technology deployment.

September 2021 – it got away. But much happened during the month, including the release of the 2021 Linkage technology survey of older adults, rarely fielded and so their tech behavior is poorly understood. Meanwhile, September was a month to consider the business practices of social media monopolist, Facebook – in print (WSJ, Washington Post), on 60 minutes, and as some might say, blah, blah, blah. Will regulation happen? Will people seek a new platform, search for other online photo sites, find an offline hobby, go outside? At this moment, investors doubt anything will change, despite plenty of posturing. Here are the four posts:

Apple gets it that its customers are aging – and have their devices.  That was not always the case. Long ago, maybe as early as 2009, a query was placed to the analyst relations team at Apple to find folks to discuss Apple and technology adoption of older adults.  The answer was: "Apple does not do aging."  Then in 2010, on behalf of an AARP-sponsored research effort to contact a few of multiple Apple groups already involved one way or the other (Apple Health!), got no response to requests to interview execs that would have been interested based on their roles.  That was then. Fast forward to 2021 and the fact that baby boomers have all the money (and many health issues, too). Note Apple Health, Apple Accessibility, fall detection on the watch, detection of gait changes, changes in AirPods that clearly target conversational hearing issues. And that doesn’t count the health-specific features on the watch that will no doubt include blood pressure checks.  

AI – it’s everywhere, including tech for older adults. So what is AI? Artificial intelligence (AI) is a wide-ranging branch of computer science concerned with building smart machines capable of performing tasks that typically require human intelligence. AI can use machine learning based on large data sets, and has a number of well-known applications, including recommendations from Netflix, Siri and Alexa, bots and robo-advisors. AI plays an increasing role in healthcare, including the growing use of chatbot tools used by patients. In addition, there are multiple examples of use in the care of older adults. In some cases, these are the result of partnerships, in others from product development. Here are five recent examples leveraging AI, with all information coming from vendor announcements and websites:

Once upon a time, there were photo albums. You know, the kind that have leather-like binders, with plastic covers for the prints. People would buy extra prints for their friends and relatives after a big event like a wedding (remember wedding albums?). Binders would fill bookshelves (remember bookshelves? They once held books). Then along came Facebook so that families could keep up with each other’s kid and dog photos. A study in 2013 noted that this was a bit worrisome -- "people don’t relate well to those constantly sharing photos of themselves." How quaint. It turns out that populations don’t relate well to sharing of political slams, holocaust denials and incitement of riots and genocide. Defensive in the face of the WSJ series, though, Facebook insists things are under control. 

Shining a harsh light on Facebook – the company. Founded by a near-teenager in 2004, the company is a social networking monopoly, with 91% of revenue in that market that includes messaging (What’s App, Facebook Messenger). It also owns Instagram (one-quarter of its 2019 revenue). With 1.84 billion daily users, it is top of mind for marketers – and some 200 million small businesses reach their customers nearly exclusively through its platform. It is a regular news source, though ironically not trusted for political news. The news about Facebook is more compelling than the news from Facebook – including this week’s Wall Street Journal reports of Facebook applying different rules to a select subset (5.8 million) of its users, including allowing them posts that include harassment, inciting to violence or other bad behavior. Who uses Facebook? Well, most people, according to Pew: Facebook is used by 77% of US women, versus 61% of US men, with women aged 25-34 representing the biggest user group. Older adult usage of Facebook has dropped from 62% of the 65+ in 2016 to 50% in 2021. But that could be the result of family migration to Instagram for photo sharing.

Few of the oldest are ever surveyed about tech adoption – least of all using paper. Link-Age Connect has surveyed the oldest about tech use since 2011, with periodic surveys fielded to older adults via their member organizations. In 2011, that represented 122,000 residents drawn from its member communities across 22 states.  The member communities in 2011 distributed 5000 paper surveys and got back 1789 completed, a 35% response rate. Many were completed with assistance for people with limited vision or mobility. All were transcribed for analysis and use in the published report, Technology Survey Age 65 to 100, Extending Technology Past the Boomers.  In 2011, 71% of the responders were older than aged 75.