After the genetic test, living to 100 had better be better

Line up to learn your longevity likelihood.  Aren't you just loving the opportunity we will soon have to download that free genetic marker test kit, the one that with 77% accuracy will tell whether we will live past 100?* Boston University scientists have 'no plans to profit' from the results, but they could make the kit available later this summer. (Warning: analysis of the results will be costly.) I am so struck by how the law of unintended consequences could play out, especially in areas of insurance -- as with a home test kit for Alzheimer's, people might be more likely to purchase long-term care insurance. With a longevity test on the market, how long will the term need to be in term insurance? Taking it a step further, should insurance companies offer free kits as a marketing device? Should your doctor know that you've taken such a test? Should a health insurer know? What happens to rates, deductibles and lifetime caps? What kind of housing and support systems would we want if we knew we could live to 100 or more (or if we knew we would suffer from Alzheimer's)? What would our families do with that information?

Which brings me to home care -- what we want. So let's just imagine that many more of us are going to make it to 100, that we fear nursing homes and obsessively want to stay in our own dangerous-but-familiar houses. Of course, we will want to be there all alone in our later years, visited only by home health or companion aides from the growing home care industry (hopefully they won't visit us too often, though, and draw attention from the SEC). Hopefully the aides are background-vetted, well-paid, well-trained, dedicated and conversational, and are the low-turnover folks. Hopefully they will take us out to events and social activities, make sure that we are well-monitored and Skype-connected to our far-flung relatives, if not in the home then by driving us to places like this just-opening and Skype-enabled Clearwater Aging Well Center.  Hmm. Do you believe this?

We have the time to craft a better experience. Let's face it, the lonely boomer at home at 100 is unlikely: our mis-managed bodies may not permit it -- even if the above scenario was realistic. That doesn't mean we aren't going to live far beyond ye olde expectations. If we knew how long we might live, we also need to imagine and advocate for lower-cost, longevity-friendly housing for those 'middle' decades of the 70's and 80's, but that will house us when we're 95 and low on money. We need a rethink of nursing homes, blending them into services for seniors in a community -- so that they move past the current shrinking anathema status. That might mean more consolidation, along with blending of skilled services first into communities, and then those services into group housing that will match our budgets and interest profiles. 

Care we want -- can we get it? Where we'll be living, the aides are kind to us: they form friendships and support each other and are well-supported by management. They enable us to find friends and continue to do activities we like -- with others, not alone. Where we'll be living, monitoring our well-being will be welcome and standard; enabling our tech-connectedness will be understood and supported by management and staff. When we move in, we won't need to take our tech gadgetry with us -- they'll be part of the residence, with Kindles and Nooks in the library, wireless in our home, and appropriate use of video. Maybe useful and friendly robots (not just Paro-fluffy-friendly) will free up the repetitive and low-skilled labor, doing so at a low cost, freeing up staff to focus on higher-skilled tasks. This has happened in every single other industry in the past 50 years -- why not this one?

We are in a crisis of mistaken expectation -- thus tech opportunity.  In today's economically challenged world, we suffer from a lack of product and service marketer realism (see Tom Mann's Mature Market blog about senior housing developers) all along the continuum of care to the consumer. Everyone wants things the way they were (as in the above senior housing example) or they don't know what they want but are shocked at what they actually get, whether it is with the doctor, the hospital, or the home care agency. Those who are creating and selling tech-enabled products and services have an opportunity to sell into the gap -- whether it is in cost-reduction, family expectation management, or enabling standardized back office consolidations for service providers -- who want to enable a better longevity experience at a lower cost.

* 114,000 in the US will turn 100 in 2010

Tech products & tech-enhanced services

Good points, Laurie.

The home care you describe above (vetted, trained, well-paid, engaging) will be more affordable and deliver higher quality if technology is used in two ways:

1.  First, technology should be integrated into the overall overall care plan with the express purpose of reducing the cost of care while maintaining safety, health, and quality of life for the client;

2.  Second, the home care providers themselves should use technology for communication and care delivery to get data to the people who need it faster, so that appropriate steps can be taken when needed, and so that remote family members are up to date when they are not.

We are stuck in a 20th Century model of home care delivery.  We throw bodies at all aspects of the care challenge.  As in other industries, we can use technology better, and in so doing can raise the quality of care while lowering the cost.

For example, when the issues are data collection and reporting, or patient monitoring, it is easier and cheaper to use technology - sometimes in the hands of a low-skilled operator, and sometimes without any human intervention. This reduces the cost of care, or frees dollars for higher-value care when needed.

Examples include simple devices like medication dispensers that can be remotely configured and can report data to health professional or families, to more complex tele-health communications, to suites of sensors, cameras, and GPS devices that can be configured and monitored to respect clients' privacy while protecting their health and safety.  If a patient is a wander risk, there is not always a need for the 24x7 human care that is often assigned.  If insuring proper dosage and timing of meds, paying a person to stand and observe is often the most expensive option, but not always the best.  When on-site care is delivered, daily reports can be made available to remote family members via a private, secure, family portal.

This is not simply a matter of more technology products; it is largely an integration issue. Many products already exist but simply are not integrated into the overall care strategy.  The home care industry's only update to our technology in the past 30 years has been the cellular phone. We can and should do better here.

Jim Reynolds, CEO
Caring Companion Connections
www.CaringCompanion.Net

Interesting that something so obvious is such a shock....

Let's face it. We all knew that the prospects of reaching 100 are more and more likely with advances in modern medicine. But I think we are all shocked at how knowing this will rock our world. All the questions that you pose are great ones. This knowledge can be capitalized upon from many different angles. The question is, how much longer will it take to take this reality and get it into the realm of mainstream construction, medicine, social management. An article was published this week in the business section of the Boston Globe highlighting the current number of million/billionaire octogenarians http://boston.com/business/gallery/octogenerianceos/ - Sumner Redstone, Ned Johnson, Warren Buffet, Rupert Murdoch, T. Boone Pickens. I would have hoped that the combined wealth and entrepreneurship of these gentlemen would start to exploit this market as one that they can shortly relate to. But then again, perhaps their ability to relate is remote as twilight of life quality is clearly not a problem for the wealthy.

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