As I nearly cut myself this morning trying to pull/persuade/yank the tab from a new carton of half-and-half, I am reminded that we have entered a new era. Product vendors read health, environmental, safety regulations and stats – and they try to ‘help’ us with packaging that protects product quality, makes the car safer, lowers the cost of production, or…is what they think we want, maybe because it is what the innovator wants. But trying to help us is hurting, frustrating, and scaring an older population. Please save us from some of this ‘helpful’ innovation that tells us we are not up to the device, the package or the car like:
Okay, okay, we get it – everyone wants to age at home. How do we know? AARP say so. Forget that AARP’s survey sample might be skewed towards the younger end of fifty- and sixty-somethings, not 80-90 year olds. Forget that life expectancy is lengthening -- the good life or the not-so-good – apparently indistinguishable among the life expectancy extender-types, aka the healthcare system. Forget that this is a gloomy and isolating picture for those with limited transportation in their 80’s and 90’s, those living alone with mild to moderate dementia, and those for whom it is a great chore just to get up and about.
The American home ownership dream fizzles -- is that bad? On a recent business trip in Switzerland, I was told that home ownership there isn't the be-all, end-all that it is here, that people are comfortable with renting and putting their money to other uses. It looks like a small and similar trend is happening in the US -- apparently we have begun the simultaneous housing downsizing of boomers and the creation of a rental culture. You may have noticed a new report (no, not the one that said the telehealth market would hit $6.28 billion by 2020) about housing in the US -- this Harvard report noted that home ownership dipped below 67% in 2010. In addition to excess housing inventory from foreclosures, the echo boomers (born 1986 or later) apparently are entering their peak household formation years without forming traditional ownership households. And one-third of households aged 65-74 reported moving, many to smaller households. Of course, the other two-thirds are aging in place, a euphemism these days for not being able to sell the house, the furniture, and get out to a more reasonably-sized dwelling. The report also asserts that many existing homes are being converted to rentals. Imagine if those who want to downsize either rent out a portion of their home to a student or find a compatible older adult who can defray expenses. Imagine if those lucky enough to sell their houses pocketed the cash, enabling flexibility in finding work where the work is, instead of where the house keeps a stranglehold. And perhaps they took the money they didn't spend on housing -- and spent it elsewhere in the economy.
The xHealths prefer to ignore the elephant in the room. Every day I am treated to a plethora of updates (remember my 24 LinkedIn Groups) about this conference and that event for Health 451.0, Connected YouKnowWhat, Wireless WhatsUp, and Mobile Name-that-disease. The very word ‘health’ connotes opportunity (avoid 30-day hospital readmissions!), visions of reimbursement, and smiling clinicians on the far side of webcams. After all, shouldn’t the xHealths target employer-funded health insurance programs, monitoring ailments among employees and their kids’ childhood diseases? And doesn’t the ‘m’ in mHealth mean mobile, mean smart phone, always-on, on-the-go and on-the-run? Tweet your stats to your friends and get a friendly e-mail from your doctor’s iPad.
Some consultants and investors make me grumpy. In my line of work I speak with junior members of giant consulting firms and newly minted researchers within the back offices of VCs. When I talk to these young folk, I cringe in the face of ignorance about aging, never mind about the markets they are studying. Recently one of these investors opined this gem: "I like to invest in areas where there is demonstrated demand." Let’s mull that over, I thought. But don’t you own a number of technologies that a few years ago had zero customer demand?” Well, yes, that’s true, he admitted and we silently contemplated tablets and smart phones, portable GPS devices, and iPods, where consumers gravitated toward an invention they never knew they needed. Did anyone actually demand telepresence, location-based restaurant meet-ups, Skype video conferences, smart bandages or interactive TV? For that matter, in the 1980’s did anyone conceive of an assisted living industry, telehealth nurses, or self-checkout in a store?
Analyst firms have re-discovered telehealth – and it’s big, big, big. So trumpets Information Week’s coverage of a new study from market researcher InMedica. They size the global market at $6.28 billion by 2020, up from its current cited size of shipments at $163 million in 2010. This must mean that we have a tipping point of uptake within vendor marketer lines of sight. And no wonder, so many other markets driven by seized-up consumer spending are tepid or shrinking. If you believe this forecast, certainly it’s about time for a market that has languished for years, not to say decades, despite the Veteran Administration validation and rollout, and numerous reports that verified effectiveness at keeping patients out of the hospital. Hmm, though, maybe the tipping point is sooner. BCC Research, another analyst group already valued the ‘telehome’ subset of telemedicine at $2.9 billion in 2010, rising to $7.9 billion by 2015.
Who’s WHO and age-friendly communities. A few years ago, the World Health Organization announced that it was forming a global network of age-friendly cities (see linked checklist of criteria). In the US, those include Portland, Oregon and New York City and worldwide they include Brussels, Canberra, Geneva, Nice and many others. The list also includes Louth County in Ireland – where I spoke this past week at an event sponsored by CASALA – a partnership that includes the Dundalk Institute of Technology. CASALA, along with the Institute's Netwell Centre and government and health service providers, research and actively promote the use of technologies that can improve the quality of life of older adults in the region.
My neighbor can't hear me. I live near a 67-year-old man who likes to talk, but has difficulty hearing the response, which usually has to be repeated before he gets it unless he is sitting close and looking you straight in the eye. We've known him for quite a few years and although his hearing seems worse, he doesn't wear a hearing aid. It isn't because of money -- since he still works at a good job, can afford a new car and just bought a boat.
You'd think by now that some type of instant messaging would have 100% adoption. Recently the Atlantic published a long article on the growing adoption of social media by the oldest adults, noting an upcoming study about Internet use from the University of Alabama which found a "30 percent decrease in depressive symptoms among older adults who used it regularly." The Atlantic's article was particularly focused on the use of social media (like Facebook) for older adults who are unable to get out and about regularly. The article was particularly excited about the rapid growth in online use among the 74-plus population up to 30% as detailed in Pew Research's Generations 2010. Unfortunately, in more recent Pew Research studies (August 2011) -- only 42% of the 65+ population, according to Pew, go online at all. And of those who do, only 33% are social networking users.
Something different -- a positive study of aging and cognitive decline. Last week in the midst of worse and most worse economic news, USA Today published the results of a decade-long study through Duke, Harvard and others that tracked 1049 older adults age aged 56-102 who at the beginning of the study showed no signs of dementia. At the end of the study, two-thirds of the participants showed at most only “slow cognitive decline,” not the level of decline typically associated with requiring assistance or medical care. Why is this interesting? Remember the often-quoted statistic that nearly 50% of seniors aged 85+ suffer from Alzheimer’s? This study undermines that estimate and therefore the domino effect of the assumptions that are derived from it.
