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Laurie Orlov's blog

For care delivery and older adults, is the time now for AI in Healthcare?

AI hype, fear and loathing are on the agenda.  Today marks the 10th month since the near hysteria surrounding the arrival and rapid adoption of ChatGPT.  It struck fear into the hearts of many, redirecting programmers (see arrival of Google Bard).  Forrester’s CEO George Colony just predicted the death of search and the web as we know it – his American Airlines flight experience is instructive (see the GenAI Imperative). The Gartner hype cycle on AI is now published – and predicts, of course, a future plateau in generative AI.  And finally, to cap things off, today the big guns of the tech industry, will spend seven hours behind closed doors discussing how to regulate AI.  

Five worrisome aging and health blog posts from August 2023

August, so warm, so replete with nursing home doomsayers and endless scam calls.  You may be one of the dwindling population (34% are homeowners) who have landlines in the US (even digital phone-service based). You may feel like it is a waste, especially given the remarkably robust phone-scam industry populated in noisy call centers by reps who know nothing about the so-called Do Not Call list, and whose measurement must be based on getting you to pick up the phone again and again.  Your relatives only text. Even your dentist and doctor prefer text. So why keep it? Maybe you run a business and need to call clients. Maybe you are legitimately afraid of not being found by emergency services (see below).  Maybe you are an older adult living alone and just want to chat with someone.  Here are the five blog posts from August:

Tech and the future of care work – five research midpoint observations

The halfway point -- research about Future of Care Work. Each interviewee was asked for thoughts in the context of the categories suggested by ChatGPT and any other categories that will improve the work processes for those in the care-related industries – home care, home healthcare, senior living care (including nursing homes), and hospital discharge processes to any of those. Few conversations focused on ChatGPT – instead it became apparent that innovation, including AI, is underway to optimize care work, focus on the workforce, and help keep care recipients at home:

Spam calls targeting older adults – Unstoppable without crackdowns

You may know someone of Medicare age with a phone?  Since age data is widely available, and even well-organized lists are available for purchase, it is not surprising that phones of older adults ring multiple times per day. Did you know that 60% of all phone calls in the US are robocalls or spam? This, despite ostensible government efforts to prevent continued use and/or resale of the lists. Sometimes the call begun with a recording about possible additional Medicare Advantage benefits that are available. But this is sloppy scamming based on weak data – maybe the caller only knows phone numbers, despite spoofing the geographic location so that it appears to be a neighborhood call.  Next, the robocall is then transferred to a ‘supervisor’ in a noisy call center who then attempts to obtain actual age, and whether the call recipient has Medicare. Presumably after that step is successful, the so-called ‘Medicare Advantage’ pitch can begin.

The Nursing Home Closure Debacle – does it help anyone?

It's news -- 600 nursing homes closed so what’s the strategy to fix? Rant on.  You may have read a depressing article this morning in the Wall Street Journal about the number of people stuck in hospitals with no place to go because there are no nursing homes to take them – which is the status in the UK’s National Health System (NHS).  That was an embarrassment in the UK – and this is a scandal in the US. It never should not have gotten to this point. So many factors crushed nursing homes -- Covid and Private Equity nursing home ownership were big players, followed by government strategy to undermine them. For 14 years, Florida banned new nursing home construction. The federal “Money Follows the Person” was introduced in 2005 to enable seniors to avoid them and receive Medicaid-paid services. Reauthorized repeatedly, it is now authorized through 2027

Five technologies to mitigate social isolation in older adults

Social isolation has become an insidious problem among older adults. It’s at the point where the surgeon general recently declared it to be a serious health risk: "29% increased risk of heart disease, a 32% increased risk of stroke, and a 50% increased risk of developing dementia for older adults. Additionally, lacking social connection increases risk of premature death by more than 60%.  Certainly one factor is the growth in the number of older adults living alone, including 44% of women aged 75+.  Technology’s role in mitigating it is being studied in research programs and healthcare. In one study of studies, the authors concluded that while it seems apparent that it can be helpful, specific technologies were not studied separately.  In another pilot program, Talking Tech, participants were surveyed as being less lonely following increased technology literacy and access to tools to connect with others and boost social interactions. And in New York State, the rollout of AI companion robot ElliQ to 800 seniors reportedly resulted in a "95% reduction in loneliness."

The death of landlines -- yes, it DOES harm older adults

You may not have noticed much about the death of landlines. But it has been underway for a while, and now the government is supporting their demise. For some time now, telephone companies like AT&T have been trying to eliminate landlines and are no longer required to maintain these copper connections. You probably think, well that must be good, because those landlines cost as much as $55/month. So that’s a cost savings, right? But wait.

For older adults, consider the context of tech change in 2023

Taking stock of the tech market for older adults – what’s happened? Past the halfway mark in 2023, it’s increasingly clear that the older adult tech market has been disrupted by changes in demand. Its increasingly transformed by new technologies emerging from new funding sources, tech disruption, and entrepreneurial initiatives. Some might say that tech adoption is still slow in some sectors, but it is not for lack of widespread funding sources and innovator motivation. What is the context for technology change in 2023?

July Blog posts -- fall detection, dementia tech, aging in place and more

And in other news, CMS really wants older adults with dementia to remain in their homes.  The government agency seems to have given up on improving the quality or affordability of dementia care in senior living or nursing homes. The new GUIDE program will support caregivers and ‘enable people living with dementia to remain in their homes and communities.’ But is that the best setting for dementia care? No way to share meals with others, access staff-run activities, and build on the expertise of caring for people with dementia that the senior-related industries already established?  Never mind enabling caregivers to enter a robust job market away from their homes. Just asking. Here are the posts:

Five Dementia Care Offerings in 2023

New progress for dementia care.  Home Care Magazine provided details about the just-announced Dementia Care policy changes, called the GUIDE Model, including care coordination services, support and payment to family caregivers to help keep care recipients out of nursing homes, as well as obtain respite help.  This is an 8-year program, and a part of the CMS Innovation initiatives. Notably, the GUIDE Model currently does not note or suggest any of the available technology, including home automation, that could improve dementia care. So here are five new technology offerings or update announcements, information from company websites or news media, that may help in the care of those with dementia:

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