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August 2016

Tech-enabled home care -- what is it, what should it be?

Who expects that most seniors will move to assisted living? Not that many. Our clues: # 1) one of the long-time thought leader consultants in senior housing, Ryan Frederick, is now involved in multi-generational housing development.  Or Clue # 2) Occupancy is unchanged in senior housing – still at 89% for the past three years. And don’t you just love the phrase 'inventory has outpaced absorption'? Or the next big challenge for senior housing – serving the middle class? And the profile of the resident in assisted living?  Clue # 3) The typical resident is an 87-year-old woman who remains for an average of 22 months.   Clue # 4) The net worth for folks aged 75+, presumably the feeder group for assisted living, inclusive of home equity, is $155,714.

New university studies are released -- but their value may be lacking

Finding new findings is slowing down in these last days of August.  First we learn that older people are happier. Whew. And we also learn that seniors don’t seem to take to digital health tools, according to a JAMA-published National Health and Aging Trends Study, a project out of the school of public health at Johns Hopkins University. “Notably, the seniors in the NHATS were willing to get on a computer to respond to this annual, in-home, computer-assisted, longitudinal nationally representative survey of community-dwelling Medicare beneficiaries 65 years and older.” Okay – hence it must be valid.  Says study author Dr. Levine: "Little is known about how this population actually uses technology." Well, actually quite a bit is known -- and published during the study years of 2011 – 2014.  For one, consider the 2011 Linkage survey of individuals age 65-100.  Then there are the numerous surveys from Pew, for example, this one from 2014 on older adults and technology adoption.  Or from Nielsen.  

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PACE accelerates into dubious for-profit nursing home avoidance

Nursing home avoidance – the home care wave fits the profile.  So we know that tech-enabled home care has received several infusions of cash lately.  Whether this is an anomaly -- once new-age firms realize that home care consists of difficult and backbreaking labor – or signals a trend, remains to be seen.  The apparent bloom of the home care business opportunity appears to be the inverse of the business gloom in senior housing, as noted in these Chapter 11 filings. These businesses are failing at the same time as nursing home bed capacity is anticipated to become constrained.   As AARP has endlessly repeated, 90% of older adults want to remain in their own homes. Or maybe it is 87%.  But regardless of intent, most will stay because they can’t afford anything else.  

Refunds for international buyers of Jibo Robot -- the peril of hype

See a product swamped by global media hype miss expectations.  Refunds for international backers of Jibo. In December, 2015, cute ‘social’ robot Jibo “received $16 million from Asian VCs to enable it to speak and sell in Japan and China.” And that was just a portion of the total of $52 million raised, the first chunk on IndieGogo found 5,554 supporters raising $2.3 million.  But what just happened should not be a surprise. Why? Because “it won’t function up to our standards in your country… and will create more issues with Jibo’s ability to understand accented English than we view as acceptable.” Why all this money for a poorly defined, loosely described $500 table-top and presumably robotic companion beloved in the media?  Why indeed, as the GeekWire article rightly observes, Amazon Echo began selling at the same time, with many of the original Jibo hyped features and at a lower price point.

Five Caregiving apps – some people use them, but what are they?

In June, Parks Associates observed low utilization of caregiver apps.  Their research published at the time showed "27% of current caregivers and 41% of future caregivers are very interested in a connected health app featuring medication lists with reminder functions."  Parsing that a bit, caregivers today are not big users of apps to help them with caregiving, but perhaps today’s millennials (future caregivers) will be more interested.  The graphic associated with the press release reaffirmed any doubts about the viability of the PERS industry -- topping the chart -- panic button, tracking and fall detection. Okay – so if current caregivers were to use apps more productively, what might they use? And will the most likely use end up with families who have engaged home care workers?  These imponderables aside, the information from the five noted here was drawn from the websites or public press material:

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Something’s rotten in care of the elderly – what does this week’s KHN tell us?

Do hospitals mismanage support for vulnerable older adults?  And we wonder why people, including doctors, avoid hospitals. We knew that an older adult going into the hospital experiences or departs with an unwanted side effect. Half a million per year acquire C.Difficile in hospitals -- costing $4.8 billion; ICU risk of death is 35% higher for elderly. And MRSA has a 12-month death rate of between 20 and 35% -- with the most vulnerable, you guessed it, the elderly.  But did you know that one-third of hospital patients over age 70 and half of the patients leave the hospital more disabled than when they arrived?  Question raised: what about appointed or actual advocates when elderly patients are admitted – is someone present or appointed by the hospital who will observe care, including vigilance about hand-washing or ICU treatment– perhaps the state-by-state Care Act address this in a future update.

The Thrive/Honor VC investment -- has the home care market heated up?

Is the home care franchising world doomed by tech-enabled home care? First clue: Google’s $46.6 million investment in June in Care.com (child, elder and pet care to housekeeping). Then the Honor jaw-dropping investment of $42 million in Series B. The home health industry is a "fragmented" system that Honor aims to fix, according to its new investor and the Business Insider article: There are an estimated 2.5 million home care workers out there, and about 12,400 home health agencies managing them all.  According to "Thrive VC Kareem Zaki, he told Business Insider that it was important that Honor owns the whole system." And per Seth’s vision for the platform, he said: “It'll be like a car: There's a lot of complex technology going on behind the scenes, but driving the car is easy enough for anyone to do."

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Tech firms giveth to innovation for seniors – and taketh away

Sometimes the biggest firms lose interest in older adults almost immediately.  That was Amazon 50+. And some, like Apple, never get started, despite interest from their supporters or an integrator like IBM.  Others might get started thinking about a good idea – but within a year or so, executives hold a meeting and one of them says – 'What? What? When did we start to focus on older adults?' How is that a growth proposition, especially for the oldest old?  And so the companies get started, move a bit and/or cancel the effort altogether. Or like Google, they focus on the really far-end of the aging continuum – solving death.

Five Technology Innovations for Older Adults -- August, 2016

Innovation from companies that have been there, done that.  It's intriguing to observe companies that have been in business for a while.  Sometimes there is a redirect into a new space or channel (see Philips and its direct-to-consumer approach) and sometimes innovation arrives that may augment an existing portfolio.  The market of technology and services for older adults continues to expand (see a near-hysterical Huffington Post article.)  So flipping around the cliché that 90% of all startup companies fail, wonder if there is another one -- 90% of all existing tech-related companies launch a tech or a service targeting seniors and caregivers within the next 5 years?  Here are five offerings - all text is from the company sites or press releases.

What is reality? Headlines distort information about aging and health

So you read a headline and say, what, what?? But of course we regularly find ourselves incredulous.  Can that headline be accurate? What did that study say? Who did they survey to get that result?  This has been a particularly bad week for distortion headlines – and not about politics, actually.  These are about topics seniors and families would care about and be disappointed when they read more.  Let’s start with the Wall Street Journal article title:

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