Laurie Orlov's blog

You know the statistics and they are alarming.  Doctors and nurses are burning out, especially in the ER.  Turnover is highest in the lowest-paid care positions – home care is at a high point at 77% as of 2022.  Pressure is growing in senior living to ‘keep people well’ in conjunction with a higher level of acuity of care needs. Demand and costs are up, and availability of workers is down. Add the baby boomer population growth – all will pass 65 in just 7 more years -- in conjunction with a shortage of workers able and willing to help them. Hospitals are closing, particularly in rural areas – boosting expectations about care delivery in the home.  And in 2023, AI technology is emerging  to manage and even improve care. Here are four observations from the just-completed research interviews on this topic: 

Setting the stage for The Future of Care Work research.  Did you know that the number of workers per social security beneficiaries continues to shrink? That two-thirds of doctors and nurses are experiencing moderate or a great deal of burnout at work.  That over 85% of US adults suffer from one chronic illness.  That 33% of those aged 85+ have Alzheimer’s or dementia?  These points and more are the backdrop for the upcoming November report, The Future of AI and Care Work. Meanwhile, here are five points from September, 2023.

 Aging 2.0, from very small to very big. Begun in 2012 through the efforts of Katy Fike and Stephen Johnston.  The goal: address the biggest challenges and opportunities in aging. In 2021, Aging 2.0, at that point with "40,000-plus innovators in 130 chapters across 31 countries," was acquired by the Louisville Healthcare CEO Council.  Despite denial that this acquisition was not changing the mission, it has migrated from its long-time loosely connected chapters with a few members here to a thousand there. Louisville ownership has transformed both its members and sponsorship -- senior living, skilled nursing, healthcare, insurers.  Here are five exhibitors/content from the Aging 2.0 Optimize event beginning today in Louisville:

Older adults and caregivers are served by a number of offerings and events. And CES 2024 is still more than 3 months away.  Events are ahead like Aging 2.0 Optimize in September in Lousiville, LeadingAge’s Annual Meeting in November in Chicago, and the What’s Next Longevity Innovation Summit in December in Washington.  Each of these will no doubt feature startups of services and technologies, many incorporating AI) in multiple areas.   In the meantime, here are five recently announced innovations and services for the older adult marketplace worth checking out:

AI hype, fear and loathing are on the agenda.  Today marks the 10^th month since the near hysteria surrounding the arrival and rapid adoption of ChatGPT.  It struck fear into the hearts of many, redirecting programmers (see arrival of Google Bard).  Forrester’s CEO George Colony just predicted the death of search and the web as we know it – his American Airlines flight experience is instructive (see the GenAI Imperative). The Gartner hype cycle on AI is now published – and predicts, of course, a future plateau in generative AI.  And finally, to cap things off, today the big guns of the tech industry, will spend seven hours behind closed doors discussing how to regulate AI.  

August, so warm, so replete with nursing home doomsayers and endless scam calls.  You may be one of the dwindling population (34% are homeowners) who have landlines in the US (even digital phone-service based). You may feel like it is a waste, especially given the remarkably robust phone-scam industry populated in noisy call centers by reps who know nothing about the so-called Do Not Call list, and whose measurement must be based on getting you to pick up the phone again and again.  Your relatives only text. Even your dentist and doctor prefer text. So why keep it? Maybe you run a business and need to call clients. Maybe you are legitimately afraid of not being found by emergency services (see below).  Maybe you are an older adult living alone and just want to chat with someone.  Here are the five blog posts from August:

The halfway point -- research about Future of Care Work. Each interviewee was asked for thoughts in the context of the categories suggested by ChatGPT and any other categories that will improve the work processes for those in the care-related industries – home care, home healthcare, senior living care (including nursing homes), and hospital discharge processes to any of those. Few conversations focused on ChatGPT – instead it became apparent that innovation, including AI, is underway to optimize care work, focus on the workforce, and help keep care recipients at home:

You may know someone of Medicare age with a phone?  Since age data is widely available, and even well-organized lists are available for purchase, it is not surprising that phones of older adults ring multiple times per day. Did you know that 60% of all phone calls in the US are robocalls or spam? This, despite ostensible government efforts to prevent continued use and/or resale of the lists. Sometimes the call begun with a recording about possible additional Medicare Advantage benefits that are available. But this is sloppy scamming based on weak data – maybe the caller only knows phone numbers, despite spoofing the geographic location so that it appears to be a neighborhood call.  Next, the robocall is then transferred to a ‘supervisor’ in a noisy call center who then attempts to obtain actual age, and whether the call recipient has Medicare. Presumably after that step is successful, the so-called ‘Medicare Advantage’ pitch can begin.

It's news -- 600 nursing homes closed so what’s the strategy to fix? Rant on.  You may have read a depressing article this morning in the Wall Street Journal about the number of people stuck in hospitals with no place to go because there are no nursing homes to take them – which is the status in the UK’s National Health System (NHS).  That was an embarrassment in the UK – and this is a scandal in the US. It never should not have gotten to this point. So many factors crushed nursing homes -- Covid and Private Equity nursing home ownership were big players, followed by government strategy to undermine them. For 14 years, Florida banned new nursing home construction. The federal “Money Follows the Person” was introduced in 2005 to enable seniors to avoid them and receive Medicaid-paid services. Reauthorized repeatedly, it is now authorized through 2027. 

Social isolation has become an insidious problem among older adults. It’s at the point where the surgeon general recently declared it to be a serious health risk: "29% increased risk of heart disease, a 32% increased risk of stroke, and a 50% increased risk of developing dementia for older adults. Additionally, lacking social connection increases risk of premature death by more than 60%.  Certainly one factor is the growth in the number of older adults living alone, including 44% of women aged 75+.  Technology’s role in mitigating it is being studied in research programs and healthcare. In one study of studies, the authors concluded that while it seems apparent that it can be helpful, specific technologies were not studied separately.  In another pilot program, Talking Tech, participants were surveyed as being less lonely following increased technology literacy and access to tools to connect with others and boost social interactions. And in New York State, the rollout of AI companion robot ElliQ to 800 seniors reportedly resulted in a "95% reduction in loneliness."