A study in the Journal of Clinical Psychiatry.
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While communities attempt age friendliness, US telehealth fiddles on
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.
The criteria are broad – the interpretation is local. Since WHO started the program, It was overwhelmed with applications from cities around the world asking to be included, presumably because age friendliness enhances the desirability of living in a location in which the older population continues to increase. The age friendly city participants' websites extol their various features for helping older adults improve their quality of life. In the youth-oriented urban obstacle course that is New York City (population over 8 million), for example, the program invited older residents to make suggestions, which include adding bathrooms in corner stores, better street drainage to reduce the puddle splashing at corners, and in some areas, they have succeeded in increasing the walk time permitted at intersections when the light changes, accommodating seniors with a slower pace.
Small in population, broad in goals. In County Louth, the complete opposite of NYC with a population of fewer than 100,000 people, twenty-five percent live in rural areas. The age-friendly effort includes a long list of free or low-cost services and mechanisms to engage a widely distributed population trying to stay out of nursing homes (there is no assisted living option). Like the Portland and New York City variants, there is a partnership with a local university – and a goal of creating a ‘living lab’ to encourage researchers to work on ways to improve quality of life with smarter homes, enhanced communication technologies, and promotion of the use of telehealth as a way to free up hospital beds (aka 'bed blockers'). Unique among the other denizens of age friendliness, though, is their effort to encourage the creation of new businesses, both among and to serve the older population.
The US reality, a Federal plan for a plan for telehealth gets a boost. Meanwhile, back at the ranch of count-the-initiatives-to-promote-telehealth, here’s another. Check out the 'progress’ in this Federal initiative to launch regional telehealth resource centers. Note the wording -- specifically NOT to offer actual telehealth monitoring, instead to connect organizations that are evaluating telehealth through various forums and education. Communities may be ‘age friendly’ but their healthcare systems still are not, forcing the frail the ill into car, bus and subway to visit doctors and hospitals for long-wait, brief face-to-face encounters inside emergency departments. And if the healthcare systems are not age-friendly, then no matter what the local governments do to lengthen times to cross the street, those aging with chronic diseases are still at risk of hospitalization and disease-driven decline. The next time cities update their age friendly web pages, let's hear how they are trying hard to influence real progress in the use of remote diagnostics, video and telephone-based consultations and advice, both out- and in-bound for seniors.