Smoke signals and caregiving apps -- what should they do?

The year of the 'care'. As one VC executive, Andy Donner of Physic Ventures, noted recently, this is the year of the 'care'. There seems to be a growing list of vendors who are trying to offer some sort of 'keep in touch' product that connects an older person with family members who may live elsewhere.  The basic element is to provide some means to signal 'concerned about you' from family members and obtain the response 'I'm all right' from the older family member back to them -- accompanied by the ability to react in the event that the response is not received. Add-ons include devices with environmental sensors, health-related self-care devices, health record tracking, reminders, and communication capabilities.

The statistics offer a compelling backdrop -- the 'Florida' problem.  If you count the 44 million people estimated to be caregivers, that's an eye-popping number -- and if you add various valuations of the care they provide at $350 billion, we're talking about a sizable phenomenon -- and an opportunity for well-designed assists from technology innovators. The core characteristic of the problem that vendors seem to be tackling is the fact that worried family members are not physically present -- the 'Florida problem.'  Aging and sun-drenched seniors have children who are scattered around the country and want to know via an electronic smoke signal that all is okay with a mom or dad. And vice-versa: Mom or Dad do not want to be pressured into leaving Florida or Arizona or wherever to live near a daughter or son in New Jersey or California.

Ask yourself -- who is the user, the buyer, the caregiver? Last year, I heard ideas about charging seniors user fees to participate in a caregiving app. That seems to have run its course, thankfully. Now in general I hear that prospective buyers in the 'smoke signal' circle are adult children, but also included in this circle are professional caregivers for notification, perhaps a call center (think service fees), and if all else fails, 911. Professionals that serve seniors can also be 'buyers' for resale to their constituent family members -- think home care agencies, geriatric care managers, and senior housing organizations -- although it's a new business model and entrants seem uncertain about it.

The caregiver market level of technology adoption. It's instructive to look at what technology caregivers say they use today: in the recent Caregiving in the US of 50+, 16% of caregivers reported using an emergency response system, 12% use some eHealth device, and 10% reported using safety-related sensors. Twenty-three percent said they turn to the Internet for information, although this seems low given that 8% also are seeking information from government programs and another 14% from disease or age-related programs, so easily found on the Internet. The top information need: 38% (up from 31% in 2004) were concerned about 'keeping recipients safe at home', followed by 'easy activities to do with the recipient' (34%).

What infrastructure do caregivers and recipients have? Let's look at the late December, 2007 responses from caregivers in the AARP Healthy@Home survey: 78% said they have a computer, 51% said they had broadband, 81% had a cell phone, and 71% said they had cable television. Staying with that same survey, two-thirds of those 65+ have a computer in their home, one-third had broadband (higher than the most recent Pew Research number of 26%)and 42% have dial-up.

Build assumptions around the facts.  Caregivers are users of technology, will access the Internet to solve problems they have, most likely will search for what they know (like PERS devices or government or age-related sites, then possibly disease-related). So as you design software and web marketing, use these assumptions to design websites and search terms. From the Caregiving Information Needs alone, combining safety and care recipient activities (games, photo slide shows, camera-based chat) would be optimal -- transforming a minimalist 'smoke signal' interaction into a quality of life improvement. Does that mean innovators have to build all that into their products? Not necessarily -- working with a channel partner or partnering with other vendors could be the most sensible strategy.  Step 1 for entrants considering whether to enter or what to do: attend a trade show event where other vendors exhibit, so that you can self-educate and decide in a larger context about functionality and partnerships.

Thoughts welcome.

 

 

The time has come to build a model AIPT-equipped home.

I think the best way to attract adopters of emerging technologies will be to install and show them in a "lifespan home" model home where local people can visit, get educated, see AIPT devices in action and take away eye-opening information about new solution sets which meet their particular aging in place and caregiving needs.

A smaller, accessible, more affordable lower maintenance lifespan home model (which showcases "smart home" technologies, eco-friendly and energy efficiency dimensions as well as faster internet connections and inhome telecare technologies) is likely appeal to baby boomer caregivers and retired seniors.

I'll be moving to St George, Utah in June where I'll be exploring the feasibility of building such a model home.

LifeLedger -- very useful for family caregivers and GCMs

Those seeking caregiver apps -- please take a look at LifeLedger from ElderIssues, which can be used to help geriatric care managers keep track of assessment, contact information, and progress notes associated with each of their individual clients.

Also for individual family caregivers, LifeLedger provides a do-it-yourself desktop toolkit for the record-keeping associated with caregiving. The hosted software enables family caregivers to record personal health record (PHR) data that can be linked to Microsoft's HealthVault, delivers a place to put all care-related information, including medications and family record-keeping information. The software produces a printable Emergency card with vital contact information (free).  As part of the fee-based system ($9.95/month for its most complete functionality, according to executive John Boden) LifeLedger provides a place to record medications, contacts, and even end-of-life plans, enabling sharing the information among multiple siblings.

If you know of other software that serves all of these functions, I am interested to hear about it.

Here are more apps for caregiving.

http://www.ageinplacetech.com/blog/another-week-more-caregiving-app-vendors

Somehow technologies need to pull together into a 'picture'

Like your 'smoke signals' analogy, Laurie. (You remember the 'smoke from Paddy's chimney' analogy from my QuietCare days.)

Let me come at this from a different perspective. I'm beginning to think that it's not that caregivers (family and professional) are reluctant to use technology, it's that there are now so many products and services, each with low awareness typical of early-stage companies (even for the Philips/GE/Boschs, they are in small divisions), that it's hard for any individual to do enough homework to craft a solution on their own. The solution is almost like a decision tree or 'layers' that very well may change over time. How an individual or family starts that process right now is haphazard at best. If you start it with the home care side, that's almost too late (and focuses on acuity and the care process, as opposed to 'staying in touch'). It's not 'one product fits all' but almost individually tailored.

For instance, a 68 year old mom who's mildly diabetic or with a heart condition, is active and out most of the day, but the son lives 1000 miles away--a solution may consist of a call in/reminder service (FineThanx), a fall detector like Wellcore's that works outside the home and has reminder capabilities, a text reminder on her cell phone (AllOne Mobile), a med reminder (GlowCaps) that is simple and easy, and history of her glucose monitoring or BP/cardio on a website (MedApps, Ideal Life, etc.) that can be accessed by family and her doctor(s). For a frailer 80 year old, that solution may involve telecare, video monitoring, a stationary wellness monitor (Intel Health Guide), an interactive video screen (GrandCare's Trillium), med dispensers (like MedSignals), a care robot, reports to family members (Connect4Healthcare), etc. (Products mentioned are as examples off the top of my head and not meant as 'preferred' in any way.)

One, how do we as providers begin to create this layered process of introducing technology as assist to families in a coordinated way, and two, doing this early in the aging/chronic condition process so that aging individuals get accustomed to having assistive technology around the house, so it doesn't become a pitched battle at a critical time?

Where are the 'solutions' assemblers?

You raise excellent points -- and it reminds me of the old issue of point products versus solutions which plagues all emerging tech markets.

This industry is quite well populated with products, not well-populated with solution providers, who really should be counted among that long list of those who serve older people and their families -- like geriatric care managers, home care agencies, social workers, geriatric medical doctors or nurse practitioners or senior housing organizations -- but today they don't allocate resources to evaluating and then coordinating a combination of products into a solution that matches problems along the continuum of care.

Feel free to prove me wrong!

 

 

See NY Times article on proposed budget item - caregiving

The Caregiver Initiative. From Feb 3, 2010, The New Old Age blog -- $102 million proposed to help family caregivers.

Impossible to overlook

Laurie - A very well done post! Thanks for sharing this intelligence that so convincingly removes any shreds of skepticism surrounding how and where technologies represent such liberating and empowering forces for supporting my loved ones...and for them to enhance their own quality of life.

Although Andy Donner makes a GREAT point involving "the year of the 'care' "... the use of "year" might more appropriately be branded "decade"!

Keep-up the great work.

Jay Drayer
CareFlash "Community when it matters most"
ceo@careflash.com

Absolutely agree Laurie. I

Absolutely agree Laurie. I would think that one of the biggest hurdles is time alone! It will simply take time for caregivers to understand and accept the use of enabling technologies to take care of aging loved ones! People certainly use technology now, whether they'd like to admit it or not. Driving a car, plane, trains, etc.

You are right about using the correct search words, we can all work to make that easier and more searchable!

Laura Mitchell
GrandCare Systems

Aging in Place Myopia

AIPT providers are too product-centric!

As Joe Coughlin of MIT AgeLab sums it: Quality of aging is more important than quality of health alone. We have the tools and the need. Whats missing is imagination and will.

See: http://web.mit.edu/coughlin/Public/Publications/Coughlin-Lau%20Public%20...

Peter
Maui

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