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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 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.  


What is the conclusion – tools are not user friendly? Really? User friendliness is always an issue, but is that the problem? Discomfort with tech is rampant among the oldest old– and it is a fully justified distrust. According to the study, seniors are not filling prescriptions online, contacting a doctor, or handling insurance issues online.  Says study authors: "Future innovations should focus on usability, adherence and scalability to improve the reach and effectiveness of digital health for seniors," they write.  But what about complete breakdown of trust in actual protection of their information?  As in data breaches through 2014? Apparently, that does not fall not in the scope of user friendly. And let’s mull over 50% non-adoption of the Internet by those aged 75+ (see page 5 in that report that shows a summary from Pew).  Never mind that smartphone adoption in 2014 by the 65+ had only reached 18%.  Finally, do doctors care or encourage their oldest patients to use ‘digital health tools’.  No, actually – they don’t really like 'digital health tools.'   


And then there is the Harvard home care pilot – were care workers being patronized?  “The program which purports to pilot a new approach to aging care “found that caregivers who utilize a short checklist about their patients' conditions were able to report a number of changes that could result in more serious care interventions if left untreated. While the study looked at home care patients, residents living in senior living communities could similarly be tracked for changing conditions, the study’s authors say.”  For example, using ClearCare Online tool with added check-in/out questions, “if a caregiver notes any changes in condition, they receive additional questions.” Okay, for example?  ”Does the client seem different than usual? Has there been a change in mobility, eating or drinking, toileting, skin condition or increase in swelling?" By the way, do the home care companies use the term 'patients' when talking about their clients?  Maybe not.


And now the insight – did this tool make the care any better? Not exactly – and it is not about a problem with the ClearCare software. Said David Grabovksi, Ph.D, one of the study’s authors from Harvard Medical School, most interviewees suggested that changes in condition would not have been reported without the in-home checklist.” Really -- do you believe that? A lone objection was voiced: "One care manager explained that, before the In-Home pilot, caregivers would call the office to report a change in an individual’s condition. Thus, she felt that the In-Home program was somewhat redundant." Somewhat. So are you in the home care industry, including managers at RightAtHome, agreeing to being characterized as needing a checklist to note that the care recipient is, uh, different than usual? From some staff: "the checklist was not the right mechanism for chronic conditions, because many of these changes were caused by predictable flare-ups."  And this article was suggesting that the checklist (presumably software-based) be added to senior housing care management. Agree?

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