How did you spend you holiday vacation? Aging in Place expert Laurie Orlov clearly spent hers thinking about what happened in 2010 and what is likely to happen in 2011 in the arena of aging in place. Although Laurie focuses primarily on the technology side, home care is the human services enabler for aging in place. Her article is a long one, but is rich with information that can help transform the way we provide care. Enjoy!
by Laurie Orlov
In the sweeping generalization category, 2010 was a year of significant progress in tech for an aging population. It was a year of greater general market awareness about the role of tech and aging thanks to NPR, more sophisticated technology capabilities, and a boost in training and interest among those who serve an older population. Let's round up 2010, a year in which the concept and goals of aging in place took off, creating buzz and greater interest in the related technologies and services to help individuals, families, and professional caregivers. As a result of 2010, let's look into the 2011 crystal ball -- when the first of the intrepid baby boomers becomes a 65-year-old 'senior boomer' (arggghhh!), predict a few things and express some hope for a few others:
- Remote home monitoring got buzz and investment. Venture capitalists stepped up for remote monitoring: Healthsense received venture funding, as did WellAWARE. Numerous news outlets pointed a consumer flashlight onto GrandCare Systems and this still fairly narrow market, now blurred further this year with remote health monitoring (aka telehealth, wireless health) -- now in some cases reimbursed due to vital sign monitoring during post-hospital rehab stays.
PREDICTION: 2011 will further blur the distinction between remote health monitoring and passive activity monitoring. Given the fertile health technology marketplace of grants for trial projects among non-profit organizations, my take is that vendors would do well to add device enablement (like blood pressure and weight scale), seek FDA approval and throw in the towel on preserving a standalone category.
- The PERS market got a Philips auto alert boost. In January, Philips launched Lifeline with Auto Alert for automatic fall-detecting PERS devices, likely at the expense of its own Lifeline device sales. By creating market awareness (yuk, that home page is still bleak, bleak, bleak!) about passive fall detection and notification, Philips offered help for competitors Wellcore, Halo Monitoring and others with fall detection capability. Meanwhile, mobile PERS with GPS location identification continued its move (pun intended) forward and outside the home -- striving to appeal to a younger and more out-and-about population.
PREDICTION: In 2008, PERS market growth was predicted to be flat -- Parks Associates asserted a $600 million flat line, supplanted by a corresponding growth in passive remote monitoring. Not so, it turns out. Today PERS is approximately a $1 billion market -- and while there are a number of new remote monitoring entrants, passive remote monitoring is still below the adoption radar. What's next? I am waiting (and may have to wait well past 2011) for elder-focused applications and trained carrier call centers that leverage the built-in accelerometers, GPS trackability, and (ha, ha!) ease of use of cell and smart phones. In the meantime, PERS sales will grow, not as fast, but steadily as the population ages into frailty -- remembering that 85+ is the fastest growing segment, that PERS contracts typically last only for two years.
- Games got gestures -- someday seniors will benefit. With the launch of Microsoft's Kinect interface, teens got a chance to jump higher while playing group Xbox games, including the ability to play group games simultaneously from separate locations. But speaking instructions and using hand gestures is an important user interface change that can transform the accessibility of apps -- check out this MIT Kinect browser navigation accomplishment posted just minutes (it seemed) after Kinect sold out at Target.
PREDICTION: Hand gestures, recognizable features, and spoken commands -- app vendors, go forth and create! At least 5 vendors focused on the older adult market will offer a Kinect-enabled application by end of 2011. Throw in specific health and chronic disease management -- many times five. Design-for-all apps, lots and lots.
- The iPad marginalized the need for an annoying PC operating system computer. In January, the iPad announcement looked pretty impressive... and the screen looked very pretty. Well, doubt no more about boomers -- these things are everywhere, boomers seem to love them and they (or their many, many imitators) are migrating into the homes and lives of older people -- someone besides Apple will tell us how many. These types of devices will, over time, make us forget that we used to need simplification software to overlay on top of complex and consumer-hostile devices.
PREDICTION: In our near-term lifetime, older adults depending on your children or Best Buy to upgrade Windows patches may become a distant memory. The same Microsoft that brought this brilliant Kinect interface into the market will hobble out its own tablet next week at CES. Maybe it will be foisted on enterprises through IT mandate, but among an older population for home use, forget it. Even though folks may have told AARP they won't buy one, they just didn't know what they were saying -- AARP surveyed too early (June) about a product that had just began shipping (late March). Newer products from other vendors will also make the concept of an operating system upgrade either quaint or invisible.
- eReaders eliminated the need for reading glasses. Meanwhile, as you can plainly see in airports, planes, trains, and TV commercials, the eReader (Nook, Shmook, etc.) is taking a big chunk out of physical books. As my husband has noted with his free Kindle reader for Blackberry, if you like to read, eReaders mean never having to search for your reading glasses.
PREDICTION: We are in a silly 'i-this' and 'e-that' phase right now -- vendors may fight to the death to keep it that way, maybe even giving eReader devices away with a purchase of 10 or more books? But in the end, it's pointless -- eReader software will be on all tablets, game controllers, portable and phone-like devices.
- Caregiving software -- is this really a standalone market? Along with initiatives to help caregivers, caregiving applications sprouted in 2010, but is this a category? With software as a service, these apps really seem to be functionality that is part of a larger caregiver portal, possibly white-labeled by a service or healthcare insurer/provider (like Kaiser Permanente) or offered by a home care agency as part of a solution that includes devices -- including home health monitoring and/or web cameras.
PREDICTION: For those caregiving applications that are part of the professional caregiver services toolkit, 2011 will be the year in which the largest home care agencies (family/companion and health) expand their tech reach. They will include standard caregiving functionality that updates and includes family participation. They will consider Skype (or its equivalent) to be a core competence of Geriatric Care Managers -- as with SeniorBridge. They will replace the requisite post-visit telephone call tag with the kind of simultaneously-viewable update that families can create with a portal like CaringBridge.
- Dementia undermines aging in place. All remote, health, and gadgety tech notwithstanding, let's consider Alzheimer's and the CDC's statement that "nearly half of those age 85 and older may have the disease." (Feel free to spend some time online trying to nail down that definition, the percentage, and/or its source, but I digress...) Wander prevention technology presumes a willing and available responder to receive those close-by alerts or forming a relationship with the local police to find the missing. It presumes someone is wearing a tag, device, necklace or bracelet. But we're better at locating prisoners and dogs than we are at preventing people from wandering to the point of danger.
PREDICTION: During 2011, more vendors will emerge with unobtrusive tracking devices linked to smart notification software that incorporates a hierarchy of responders and a multiplicity of ways to reach them. Hey, maybe we'll even see that GPS shoe (as of today predicted by Foot.com to ship in early February 2011). If there's no associated service, though, the shoe will be absolutely useless.
- Vendors of age-related products and services still struggle to address the market properly. The pathway to sales is littered with the simultaneous obstacles of poor economic climate, limited funding, few solutions-versus-products, long sales cycles in many cases, complex decision-making relationships (adult child? senior? professional caregiver? who?) and new management learning curves. To tackle some of these obstacles and promote sharing of lessons learned, last year's Silvers Summit spawned an AgeTek Alliance of vendors and supportive organizations, which will this year will hold training and networking sessions at CES.
PREDICTION: 2011 will (hopefully) see more coherent and reusable channel cultivation, more multi-vendor product bundling, growth in training of service providers and resellers, and greater awareness of appropriate tech among referrers like doctors, GCMs, and senior housing organizations. In 2009, I speculated about certification of service providers in technology for aging in place -- in 2010, NAHB's CAPS -- Certified Aging in Place Specialist) program wisely split into two parts -- Marketing and Communication Strategies for Aging and Accessibility (CAPS I) and Design/Build Solutions for Aging and Accessibility (CAPS II) -- the latter includes an assessment of needs which will, hopefully, include tech communication requirements. In 2011, there will also be forward movement that exposes minimum product requirements -- like usability, ease of installation, and ease of operation -- through ever-greater exposure of actual user experiences. Although it makes sense to consolidate objectives and outcomes among age-related consortia and groups, that is highly unlikely in the near term. Finally, for those of you considering entrance into this market, please follow these Ten Tips.
- Bad prescription -- hospitals and the elderly. Maybe you missed it a few days ago -- more than 1 in 5 of those admitted to hospitals (2008) were over the age of 75. And those aged 85+ were 2.5 times as likely to need nursing care upon discharge as those age 65-74. Interestingly, Microsoft's HealthVault Community Connect, "a portal solution that helps connect healthcare institutions to their referring communities and patients," according to Microsoft's Luisa Monge, is just beginning to be deployed as part of hospital admission -- where discharge planning must begin if it is ever to function properly.
HOPE: To get to the hospital, someone has to call 911 (or drive in the car). My dream is that whoever does the calling or driving has the ability to produce a list of current medications on a sheet of paper that has all identifying information, including the name of the doctor, next of kin and contact info. This is so low-tech -- if the very old can't stay out of hospitals, can they at least arrive armed with their own data?
- Design for all or design for aging? Finally, let's tackle the thorny issue of whether there is such a thing as 'tech for seniors' or should all tech incorporate certain core principles -- in effect, 'design-for-all?' How about devices with good lighting, adjustable font, audible display options, color adjustments? And as Dr. Joseph Coughlin noted, shouldn't tech be more FUN to use, not just utilitarian?
HOPE: In 2011, let's hope that marketing senior-related products doesn't have to be fear-focused to effectively reach the consumer. Let's hope that it becomes less and less important to design tech exclusively for the use of older adults. Let's hope that everything we use is wonderfully easy to figure out, that the buttons on our new TV remotes are bigger, that configuring web-enabled television can be done in fewer than 5 perilous steps (this requirement was comfirmed by Best Buy), that the user manual is only a nice-to-have that comes with our phones, readers, tablets, and games. Let's hope that if we want the full-featured, heavy-duty sophisticated options -- or we want tech to be friendlier in the event that our dexterity, vision, or hearing declines ever so slightly -- that even though you can't always get (exactly) what you want, you can usually get what you need.
Ankota provides software to improve the delivery of care outside the hospital. Today Ankota services home health, private duty care, DME Delivery, RT, Physical Therapy and Home Infusion organizations, and is interested in helping to efficiently manage other forms of care. To learn more, please visit www.ankota.com or contact Ankota