Post CES reflection on role of technology and Alzheimer's.
Boston, mid-May, 2016
That clanking you hear is media drum-banging and robots walking. While the robotics world is literally rocking industries from manufacturing to surgery -- as caregiving robotic technology, there is still nothing much in our time, Paro, Jibo, and other media magnets not withstanding, still on the drawing board or at a price point that only a grant-funded pilot could love. Stated convictions that robots will be here because 'we need them' -- are just that -- stated. As every single article about robots and caregiving has concluded for the past oh-so-many-years, these marvels are in the future and when the caregiving variants do finally arrive, will be accompanied by an interesting set of challenges. Like electric and self-driving cars, the concept precedes the reality of distribution and resellers, battery charging configuration, maintenance and repair processes, rent or buy? And actually, consumers put caregiving robots in the same skeptical category as Google Glass and drones, which means even if they were available, marketing may be a challenge. And while robots as a concept keep popping up in senior housing publications -- nothing much has happened beyond the talk and the concept.
What problem are we solving? The perceived future need for caregiving robots is related to another well-understood problem -- the availability of people to care for the aging baby boomers when they get to that presumed care-needing age of 80+. The premise of this AARP Public Policy report is that there is a care gap and it will get worse, maybe, as boomers age. The gap is 7:1 now (available people aged 46-64 for the population aged 80+), shrinking to 4:1 by 2030. That report triggers some though about the concept of availability. The projection is based on the population that is statistically available, but are these alleged people (not necessarily family members) actually available to provide care to those who need it? What if based on a weak job market, the paid job categories of caregiving become more appealing? And finally, even if a population is statistically available to provide care, would they?
Looking at today's caregiving statistics -- the care gap is closed by family and low paid work. As of 2012, more than 40 million people provided unpaid caregiving support to older adults -- are they candidates for caregiving robots? The median pay of a professional caregiver is below $25,000 per year, lower than the median pay for all occupations ($33,000). Like fast food work, the pay is so low that many workers have 2 (or more) jobs to support their families. And even with high demand for home care and long-term care Certified Nursing Assistants (CNAs) in Florida, the pay is even lower, even though job growth is good (outpacing all other occupations in the state through 2020). So what if there are plenty of people are available and willing to work at low wages, especially as an on-ramp to the multiple steps of a nursing career? And what if there are plenty of people behind them? Will a future care gap (if there is one) need to be mitigated by robots? Let's imagine 2030, when the baby boomers turn 80 and beyond. Given changes in life style and longevity, will they need as much care, what kind of care will they need and how will they obtain it?
En route to mitigating the care gap, alternatives proliferate. Baby boomers are thinking about their future care, partly in the context of their own parents -- as in the Silicon Valley-startup example of UberHealth, but also for themselves. See regional development of co-housing, the village-to-village network approach, or the concept of virtual assisted living. Innovation is making its way s-l-o-w-l-y into traditional CCRCs and assisted living -- but tech companies, while hopeful, would likely agree that the senior housing providers have yet to fully embrace sensor-based or video remote monitoring. And the industry is now competing unfavorably with the perceived benefits of aging in place, perhaps supplemented by home care and unpaid family caregivers -- for at least as long as that approach works. Is there room in the house for a robot? At the right price point (hundreds, not thousands of dollars), the right surrounding infrastructure and processes, and the right oversight -- as is now happening in some hospitals -- maybe. In the next decade for caregiving? Unlikely.