In the sweeping generalization category, 2010 was a year of significant progress in tech for an aging population. It was a year of greater general market awareness about the role of tech and aging thanks to NPR, more sophisticated technology capabilities, and a boost in training and interest among those who serve an older population. Let's round up 2010, a year in which the concept and goals of aging in place took off, creating buzz and greater interest in the related technologies and services to help individuals, families, and professional caregivers. As a result of 2010, let's look into the 2011 crystal ball -- when the first of the intrepid baby boomers becomes a 65-year-old 'senior boomer' (arggghhh!), predict a few things and express some hope for a few others:
Ho, ho, ho-hum: more older adults use the Internet. Maybe 2011 will be the year I stop whining about older adults not being online. Pew just released its Generations Online 2010 report -- one of the few data sets that breaks the 65+ population down into subgroups. Surveyed in the spring, Pew reports that now online are: 76% of aged 56-64, older baby boomers; 58% of the 65-73 age range (Silent Generation???? Silent about what?); and 30% of those age 74+ (GI Generation). These percentages are all up a bit from the slightly different categorizations from the 2009 report. And there's more:
Seniors want to stay where they are – especially women. In November, AARP reported results of its survey of older adults (sigh: now 45+) about where they want to live. Similar to other AARP studies, 88% of the 65+ population is in agreement that they want to stay in their current residence for as long as possible, pushed up to 89% for women overall, and up further to 90% for the 50+ population with incomes between $25K and $50K per year. Maybe we interpret that as happy with one's current comfort level or maybe that represents responders' inability to afford a move that would provide the same degree of comfort or community.
Assisted living cost structures are outrageous. Perhaps you saw it -- the New Old Age article about one family's encounter with ballooning costs in Assisted Living (year-over-year cost growth of 5.2% nationwide), now an 18% (additional $12,000) hike proposed for this 72-year-old gentleman because he 'needed the next level of care.' Then there's the nursing home story I heard recently of a woman who has been 'private pay' in a nursing home to the tune of $100,000/year for years -- because she had the ability to pay. She spends her days reading books in the hallway. Or another -- 12-hour/day non-facility companion aides to 'watch' and prevent wandering on top of $4600/month 'assisted living' charges, bringing the total expenditure to $11,000/month. Another example: a locked memory care unit in a wealthy town, where a studio apartment starts at $7400/month. All of them have 'prices' of care completely out of proportion to the labor and actual delivery of the care itself. From the Times article: "The institutions often urge families to approach assisted living a bit more realistically." Yes, realism would be good -- regular meetings and clarity on future costs would also be good. "It’s important for people to remember that their loved one is moving into assisted living because they need services," said David Kyllo, executive director of the National Center for Assisted Living. "They’re not moving in because of a change in address. It’s needs-driven." I find that to be a rather snippy comment on the circumstance of a family understandably appalled by price hikes.
Grandma at the virtual Thanksgiving table this year. I heard two examples this week of Skype-ing an aging relative into last week's family meal; you probably know more examples. Pushy tech-sharp adult children make sure that Grandma is sitting in front of a camera for her meal (nursing home, assisted living or in her home) and able to chat during dinner, seeing the grandchildren, the dog, without having to make an exhausting and destabilizing (especially these days) trip to visit the long-distance family. In another call, I was told that everyone over the age of 75 who is going to go online is already there. Given the distance-collapsing nature of video, I just don't believe it -- every adult child who has children is going to find a way to get a video phone, a camera-enabled iPad, or a camera-enabled laptop into the home of an aging relative.
Two tin cans and a wire -- is that common sense? Over the hopping month of November, we learned that 500 million people will be using mHealth (mobile Health, sometimes also called wireless health and telehealth) by 2015. But wait -- not so fast. Then came the wet blanket study from Yale -- the NY Times article described the 'disappointing results' with remote monitoring efficacy. The article quoted Eric Dishman, who "noted that the monitoring system in the Yale study relied on the patients to phone in their daily results. Many failed to do so." So what the Yale study proved is that the use of technology with a bad process produces a disappointing result. No kidding. And because it was in the New England Journal of Medicine and written up in the NY Times, no doubt initiatives that are underway to extend deployment of remote monitoring of chronic disease will now be hobbled into re-justifying and explaining why their study is different, that their results (like the Veteran's Administration) are positive, blah, blah. That their forward motion is based on automatic transmission of results, automatic analysis of exceptions to baseline status, and a phone call TO the patient from a nurse. That after three months, more than 55% would still be participating because they received a benefit from being part of the study. Now that would show common sense.
Geriatric care managers are cautious and waiting. (Warning: rant on). Last week I spoke about technology for aging in place to a room full of New England geriatric care managers (and a few home care agencies and senior housing folks as well). When I talked about technology, particularly remote monitoring, filling the gap in hours covered by home care aides, they enthusiastically nodded in agreement. But when I ask if any are using this technology, I heard about interest, curiosity and upcoming pilot programs (no vendors picked yet), and the like. Ditto with the home care agencies represented in the exhibit area. What I didn't hear about -- confident or near-term likelihood of advocacy of a specific product.
The first boomers are about to turn senior. One might think that the excitement of the first boomer turning 65 in January would have waited a few weeks closer to January, but silly me. So one boomer will turn 65 every 8 seconds starting in January. Is it the beginning of one of society's great tragic periods -- too few jobs, dwindling public funds for safety nets, declining health, and a fundamental recasting of the societal dependency ratio (see WSJ article)? Or will it be the beginning of a long and joyous 'senior boomer' or 'booming senior' marketing marathon that rises and then slowly ebbs over 30 or 40 years when the 46-year-olds run out of money and steam? Your perspective may vary: it matters whether you make a product for an aging population but want to move the age downward and broaden the appeal (see GreatCall). Or whether the opposite is true and you're Toyota and want to create a vehicle that will tackle problems of aging head on (no pun in tended). Or whether you're in a complex senior-focused market, like MetLife and long-term care insurance, where the economics of longevity and the recession have both shrunk the target buying audience and made the cost of claims untenable.
Market indifference -- the mobility gap. You've seen the driver -- too short to see over the wheel, too timid to change lanes safely, maybe taking multiple chronic disease medications -- and still driving. In 15 years, 1 out of 5 drivers will be 65 or older. "The result is a 'mobility gap,' Joseph Coughlin, head of the Massachusetts Institute of Technology's AgeLab, which develops technologies aimed at keeping older people active" said in an interview. Cars can be made smarter, he says, to help save us. But as a society and marketplace, what are the solutions for today's older driver -- let's say just those 4 million above the age of 80? They can call the bus, take the RIDE, ask a friend, but as the current scenario stands -- to stop driving is, as he says, to be on 'house arrest'. Who would want to tell them to stop driving with this patchwork of transportation alternatives, especially in the suburbs where most live?
Kinect-ion mania. This was an interesting week -- aside from the mid-term elections, which were as riveting a score-keeping experience as I've watched since the days before the 2004 World Series. But immediately after the election came the arrival and quick store departure of Microsoft's Kinect sensor units: the Target near my home sold out in one (brief) day. After reading the various near-rhapsodic reviews in the NY Times -- and this June's hopeful speculation about boomer-senior Kinect benefits from the Senior Director, Worldwide Health at Microsoft -- you have to wonder. Says Dr. Crounse: "How about home physical therapy or medical rehabilitation with expert avatars or live health professionals guiding me? What about supervised exercise programs for weight control? How about applications for people with cognitive disorders or neuromuscular challenges?" Yes -- how about all of that?
