Aging and Health Technology Watch

It’s that awful time – the hurricane season. The time when the national hurricane center forecasts, repeated ad nauseum, are destined to frighten everyone, no matter how far from affected regions. The same broadcast can dwell on cones and paths, shout at those in beach areas that the evacuation instructions are meant for them – “IF YOU STAY, YOU WILL DIE!” Mapping the cone of the hurricane and talking constantly about evacuation sounds like a plan – but some observe that the distance required to evacuate to safety could be long – and thus talking about availability of shelters makes more sense. So residents who will 'shelter in place' stock up before stores begin closing, and gas stations run out of gas . Then they watch the 24-hour source of all fear – cable news, looking for guidance from Jim Cantore, that icon among storm trackers.

No surprise – AI tools are already part of senior living operations and planning. The research phase is nearly complete for the report on AI in Senior Living and Care.  It is increasingly apparent that AI is not a future for many. it is already solving vexing problems that proprietary or existing apps could not effectively tackle, whether in senior living or skilled nursing home environments. Although a few interviewees felt that AI tools were 'not quite ready for prime time' all saw that the future benefit, particularly in terms of more effective use of data, optimizing workloads of staff, and proactive monitoring of the wellbeing of residents. The report will quote specific executives about their experiences, but here are insights from the 20 conversations held to date:

Is aging in place a smart strategy? Here we go again.  In a brand new and similarly rosy article in the Wall Street Journal, more of the same mediocre advice is offered about how to prepare. Have a frank talk with family members. Maybe do some home modifications (those rickety stairs? Or a $20,000+ elevator), or address that lengthy distance from a supermarket? Maybe the 3-4% of older adults with long-term care insurance will pay for home care that averages $24,000/month for round-the-clock care.  Hmmm. Or voice-activated devices, says an AARP exec, will be helpful for his long-distance aging parents. Says a family, we want Mom to stay in her house, and so we pay $4000 per month for care, because staying in her house is keeping her alive. Really.

The FDA jumps to approve when Apple approaches.  This sounded familiar, and merits a look back to a blog post from September 2018: “When Apple speaks, a puzzled market listens. When Apple announces, industries crane their necks to hear. They announced two features of a new watch, ECG monitoring and fall detection. In July, Tim Cook apparently did not want to get into the world of FDA regulation. Well, that was then – or he just wasn’t saying. In this new watch, both the ECG feature and fall detection have received FDA clearance within 30 days of applying, startling some observers who noted that closer to 150 days was more typical for a medical device. Healthcare observers are concerned that false positives from ECG readings could propel people unnecessarily to already-overloaded Emergency Rooms. To date, the Apple Watch may have been of greatest interest to 40 year old males. Interestingly, 70% of cases of atrial fibrillation are among the 65+ population. Does Apple really want the 65+ population to buy an Apple watch?” Did it happen?

Aging in place is a business opportunity as much as it is a personal strategy.  The apparent enthusiasm for aging in place has fueled interest among home builders. Consumer aging in place desires provide work for home remodelers, adding features that make a home more accessible as people age. But for older adults, the motivation for aging in place is also an economic necessity.  The monthly cost of moving into senior housing, above $5500 nationwide, is out of the reach of most people. Remaining in a home and planning modest remodeling modifications will be the approach for most who want to stay.

Sensor-based remote monitoring of older adults – a good idea in 2009.  That year, GE acquired the sensor-based monitoring technology, QuietCare from Living Independently Group (LIG). Sensors could be placed around the home and alerts transmitted about the older adult – across multiple rooms, motion, and lack of motion could all be detected without a wearable. At that time, the ‘home health monitoring’ market was projected to grow to $7.7 billion by 2012. That did not happen, but fast forward to 2023 – market sizing indicates a sizable ‘remote health monitoring’ space. In the 15 years since the QuietCare acquisition, much has happened – although many players left the space when it was unclear how to make money in it.

Surveys were released recently that trigger some debate.  Consider whether the low adoption of health-related tech is due to flaws with the tech or with the survey questions?  AARP’s responders only had notable interest in fitness apps, though 63% of responders had chronic conditions that could usefully be monitored or mitigated by apps if the survey took a deeper dive. Do we really know from this non-specific survey whether older adults are trying them out? Up next was the Best Buy survey of consumer health tech – and again some irony in the responses.  Sixty-seven percent of the 65+ responders said that staying in their homes is a top priority. Yet when asked about the utility of monitoring technology for use in later life, the 65+ segment was the least interested among age cohorts, a clear “What me, worry?”  Here are the blog posts from August 2024:

Exceeding expectations in every way.  The next report was going to be titled – “The Future of AI in Senior Living” but that was so yesterday.  One 2023 document, The Future of Artificial Intelligence in Senior Living offered up  the categories where it would/could be useful – including in remote home monitoring, and its ‘emerging’ categories of AI solutions for seniors and senior living communities.  The report referred to a 2023 study about how an AI algorithm could predict patients at highest risk for readmission to the hospital – using multiple data sources as inputs. No surprise – the algorithm’s recommendations were used, and the predictions and care recommendations enabled a 21% reduction of rehospitalization.

You were not alone at finding the first page of Google search results annoying.  As has been expected, the tech user experience was annoying. There were ads and more ads to scroll past as you looked for a believable answer.  As a result of those ads, the answer seemed, well, somewhat untrustworthy.  But a few months ago, that changed, and for those of you just returning for a search, you will be startled. Asking “what AI is in hearing aids” – a longer answer is provided, with the ads for hearing aids pushed to the right side for those with big screens.  On a phone, these are not visible. No doubt Google is working on that as we speak, though its list of examples, these soon became AI (Gemini) powered paid ads.

Asking ChatGPT a question on an iPhone returns a detailed answer.  Of course, it’s slightly different when asked again. The question: “What devices are useful for monitoring older adults in their home?”  The­­ categories (and sub-categories) were not surprising – you can give it a try yourself.  They included medical alerts, smart home devices, cameras and video monitoring, remote health monitoring fall detection sensors, GPS tracking devices, medication management, environmental monitoring.   On the iPhone, adding companion robots – and an observation: “These devices, especially when used together, can create a safer and more supportive environment for older adults living independently.”