Aging and Health Technology Watch

Windows 8 – the interface that needed a ‘Start Me Up’ revision. The emotion that has been unleashed by the launch of Windows 8 is fun to read about – unless you have a new computer pre-installed with it. Then you are in deep trouble – you are dealing with a mysterious user interface designed for a Windows phone that nobody will buy – nor will you – but sadly, you are running it on a computer. You cannot find the Start menu, locate a network printer, find where files are placed -- and that’s actually before you’ve done any work. The lack of a Start menu alone immediately spawned an entire software industry of add-ons! But thankfully, someone tells you about a downloadable START button – and you’ve taken one small step forward – at least until the complainers are silenced with Windows 8.1.

When the 911 call may be necessary but not sufficient.  The news about the no-CPR policy in an independent living community in California brought me back.  In the incident reported everywhere, the nurse claimed that the policy in independent living did not include providing CPR – and as a result, the elderly woman died. Years ago when my mother spent some time in an assisted living facility, 911 was invoked nine times within a single year before they ejected her to a nearby nursing home, claiming they could not provide care. Each of her ER visits involved either my sister or me – racing to the ER from work so that we could explain her history – one time we stopped a dose of Bactrim that she was allergic to – another time we interrupted her inaccurate description of her medical history cheerfully being offered to an intern who had not checked her chart and apparently did not know she had dementia.

Does rising cost parallel consumer distaste for long-term care? Perhaps this caught your eye – the NY Times article on escalating long-term care costs noted that the assisted living industry, according to its trade association, ALFA, now has a national resident population of 730,000, that the move-in age is now 87, and that the average time of residence is 2 years. As has been noted several times on this blog, if the move in age is rising, the industry must be continuously marketing its capacity. Tours with those not yet in need must be painful -- the assisted living resident increasingly resembles the nursing home resident of yore -- and at the same time dementia care costs have risen to their current daunting average level. Furthermore, dementia care is the most profitable service -- and fastest growing offering -- in today's assisted living industry.

Social Security has a smart phone app.  Never one to be behind the technology times, Social Security has announced the availability of a smart phone site, noting that 35 million page views come via smart phones -- over what period, how many repeats, we can only guess. The site must be a work in process, however. Before I could even type my password into MySocialSecurity, a message informed me that the information which I had not yet requested was best viewed on a desktop. No kidding. There are more options and tidbits of information on the desktop site than on the mobile site, including the non-trivial process of applying for benefits. On a phone would be a study in persistence in the face of daunting obstacles. But life is good: "phone users can connect with Social Security on Facebook, Twitter, YouTube, and Pinterest."  Whew, if we couldn’t connect through Pinterest, I just don’t know what we’d do.

Center for Tech and Aging Builds a Mobile Health Program. “Mobile health (mHealth) technologies hold great promise for helping health care providers deliver high-quality, targeted care to aging Americans with chronic conditions. The Center for Technology and Aging (www.techandaging.org) today launched a comprehensive online mHealth Toolkit that offers key resources to organizations that want to develop a best-in-class mHealth program for chronic disease management.  The mHealth Toolkit contains vetted techniques for using mHealth interventions in many health care settings for individuals with a range of chronic care needs.” Learn more at Center for Technology and Aging.

May is Older American's Month  -- service is local, but standards of care can be national.  As the AoA puts it, unleash the power of age. And the federal government wants to help those who are aging.  A few weeks ago after ASA ended, I posted about the inverted triangle of associations and federal websites all aiming one way or another at helping older adults. As you may know, there is a Senate Committee on Aging that includes long-term care on its issues list, and a Sub-Committee on Health and Aging that includes renewal of the Older Americans Act. There is a Center for Excellence in Assisted Living (CEAL) that promotes, understandably, improving quality in assisted living. In addition to those national entities, we have the various associations of lobbying, advocacy, and concern. These include senior housing and nursing home groups, LeadingAge, ALFA, and an association of state agencies, NASUAD (home and community services). Is there a navigator tool for consumers that helps decipher the web of entities that are trying to serve? And is there a common framework, a thread that even that connects all of these, other than the words senior, older, aging?

Henry Cisneros discovers aging in place.  In August, 2012, Kaiser Health News published an interview with former HUD Secretary, Henry Cisneros, who talked about his mother who is aging in place, following some well-considered home modifications. Cisneros also edited a book, Independent for Life – and just published an op-ed in the Miami Herald discussing this new frontier in housing, using his own mother as an example. Home modifications enabled her to remain in her home -- she insisted and he was apparently too cowardly to argue. She is described as widowed, 87 years old, requiring an alarm system, her home in a "neighborhood somewhat in decline." Her neighbors on three sides had passed away, and he admits that even though he visits her frequently (every other day, come on, now really???): "Aging in place in that neighborhood means older women living on their own." Looking ahead: he could have noted that one-third of the 90+ live alone – and while aging in place sounds pretty good, one must pause and remember life expectancy and personal expectation – half of the 65+ today expect to live to 90. And they're right. If a woman lives to 65, she is likely to live to 85. But by age 90, there is an equal likelihood of each of these scenarios: she will live alone, or with her relatives, or in some type of institution.  

Every time a technology divide is crossed, a new one is created.  For years, we have documented the incremental growth in Internet use among older adults. And now, 41 million (13.3%) of the 315 million US citizens are 65+. Finally Pew announces, for the first time, that 53% of that 65+ population is online. Using whatever -- it doesn't say. But hang on now, almost 70% of affluent adults own smart phones. Yippee! But when it comes to the 65+ and smart phone use, the sleeping market giant of older adults online still dozes -- only 11% of the 65+ have them. Although smart phones represent 56% of mobile phone use, senior smart phone users represent only 23% of all those mobile phone users -- and their mobile phone usage is the lowest percentage of any of their other online access methods. So why do you suppose that’s the case? It surely isn’t for lack of money – they have significantly more wealth than younger cohorts.

Perhaps you’ve seen them, idle and bored 'memory' care residents.  If you study the calendar at a typical dementia care setting (adult day, assisted living, or nursing home) – it is possible to find a time of day in when there are no facilitated activities underway. Before and after meals, perhaps – a time period stretching an hour or more. The TV is on or music is playing. The day or evening shift staff members are doing a variety of chores, nurses are dispensing and recording medication doses – and residents are wandering or seated, in wheel chairs perhaps, or perhaps they are repeatedly approaching and deflected from exits.  

MetLife study pegs older at 40.  Down it goes. No, that’s not the value of the dollar. It’s the line at which 'mature' markets and older adults are segmented and studied in this doom-and-gloom study. The latest from MetLife -- On the Critical List – mulls the impact of obesity and the rise of chronic disease among the 40+ population, but on page 9, it’s coughing up a technology to promote independence – you guessed it, the Personal Emergency Response System (PERS). Sure. Meanwhile, on the other end of the demographic dial, we find an impressive rise in a population living to 90 and beyond. Now the fastest growing group in the older population, some suggest that a change in the definition of the oldest be moved from 85 to 90.  And life expectancy continues to rise among those who might have the money to buy goods and services, creating a viable target markets for sellers of goods and services.