“Livable Cities”: What it takes for today’s cities to cater to our aging population!!

Technologies & Requirements to Enable Independence for Seniors in Cities

A musing by GrandCare founder, Charlie Hillman

GrandCare creates technology to empower the elderly to age and heal in place.  Our mission is to reduce the societal cost of long term, post acute, chronic condition, and hospice care while providing a safer, healthier, and happier life for seniors.  The notion of livable cities is of particular importance to our aging population.  Many cities, particularly those in nicer climates have seen large increases in their senior populations. Certainly part of this is the natural aging demographic of the first world, but there is clearly a movement of seniors from rural and suburban venues into the cities.

And it makes sense – cities have a number of big advantages for seniors.

• They can walk to products and services.
• There is mass transportation, often with senior discounts
• There are downsized accommodations without lawn work.
• There is easy access to senior services.
• There is good access to healthcare, a particularly important need of seniors.

And, seniors are good for cities – they pay their taxes, they represent considerable wealth, they require services, they volunteer, they provide the wisdom of the ages, and of course, they have a pretty low crime rate.  Given all of this, a larger senior population also presents challenges to cities. Many of these seniors are the recipients of some sort of government assistance. While the federal or state government may be the ultimate payer, the Cities are often responsible for the actual frontline provision of services. Clearly the goal is to provide these services in a compassionate and yet efficient manner.

It is my contention that technology can play a vital component to meet these challenges.

Allow me to muse for a bit and describe what that technology might look like.

I will start with the notion that often with age comes loneliness and social isolation. As people age, they lose normal modes of social connection. They retire and lose their work connections. Their children move away, friends pass on, and mobility can be limited. This can be bad for both mental and physical health.

Fortunately, it is a great time for our seniors as we live in a time of unparalleled virtual connectivity. There is no reason that seniors and those who provide care for them should not take full advantage of modern technologies. But there are certain requirement and caveats.

The first requirement would be cyber infrastructure which fortunately is readily available in most cities. Our ideal system should have this embedded connectivity without need to bother with cables, routers and the like. With ubiquitous 3G and 4G networks, this is clearly possible. And allow me to make a plea to the cable and wireless providers out there. Most seniors are low bandwidth users. I’d ask that pricing reflect this so that grandma doesn’t have to subsidize the 20 something unemployed gamer next door.

Perhaps more critical are the special needs in terms of ergonomics and interface.

First, the system must be large enough to make up for visual impairment. I love my smart phone, but it is not much good to someone with macular degeneration. Seniors are generally less mobile, so can sacrifice some mobility for a larger window to the world.  Fonts must be big, colors bright, and color schemes flexible to support various visual ailments. The system should provide both visual and audio interfaces, maybe even tactile clues. This is where many of the tenets of universal design come into play.  All the modern forms of communication should be supported yet with an age appropriate interface.

A FaceBook account might be too cumbersome but it would be nice if a Facebook picture feed from grandchildren could be remotely enabled. If a daughter sees a cute YouTube video that she knows her mother would enjoy, instead of emailing a URL, it would be nice if that would just show up on a button.

Video conferencing is a necessity but with a much simpler interface than normal Skype. One would imagine that a single button push with a big picture of a contact. Maybe even an auto answer capability would be nice but only for trusted relatives. We’ll come back to this capability more when we talk about healthcare.  In such a scenario, it would be nice if a younger loved one could remotely assist with getting the initial address set up and populate it with friends, family, and caregivers.

Email and texting should be supported but once again without the complexities of Outlook. The senior should also be completed protected from unwanted cyber intrusions such as spam and viruses. The system must be bulletproof and have the ability to be maintained remotely. I know my father would not be a very cheerful participant in a support call to India.

Healthcare issues are of course a major application. Healthcare providers and social services can help by building people and process infrastructure to allow much greater use of video conferencing. Looking into someone’s eyes provides a quick, easy, and efficient way to determine wellbeing. Doing it with Skype avoids that difficult trip to the clinic or the need for professional caregivers to make an unnecessary visit.

And while we’re at it, why not provide an easy way for seniors to track their biometrics and provide that directly to healthcare professionals. Note that raw data need not apply. The quickest way to destroy the great benefits of telehealth is to provide too much information to physicians, the modern equivalent to the boy crying wolf.  Instead, some relatively simple triage analytics prescribed by a doctor can insure that help is summoned only when needed. This makes the healthcare more efficient as interventions become more meaningful.

But an even more important reason for this is to engage the senior in their own wellness. One cannot, as we say at GrandCare, AGE RESPONSIBLY without information. Aside from feedback on say glucose or blood pressure readings, imagine on-board videos providing advice on how to best deal with one’s specific chronic condition. Even better, imagine a discharge nurse making a quick video for someone just released from the hospital. It can be played over and over to increase the odds of a successful rehabilitation. Perhaps the simple task of self assessment can not only provide additional information to the caregiver but can influence the patient to adopt a healthier diet or lifestyle. We have been surprised at some of our clients who will balk at the advice of a daughter but will actually listen to their non-judgmental system

With aging comes memory issues and certainly technology can be a big help. The obvious example is a system that helps the senior comply with a medication schedule. Failure in this area is one of the largest drivers to assisted living and represents a very unnecessary cost on our healthcare system. With the looming dementia epidemic, there could be so much more. There are already many applications that can shore up the failing memory and maybe even improve cognition.

Finally there is the issue of safety. Simple and relatively cheap detectors can assure the caregiver that mom made it up this morning, alert them if dad walks out of the house at 3am, or remind a senior to drink more water. This is certainly where the old adage of a stitch in time saves nine comes into play. Perhaps a bit of proactive smart home technology can be incorporated to turn on lights at dusk, keep an eye on the temperature, perhaps light the way to the bathroom when someone gets up at night.

All of this technology is readily available, just not quite in one handy package.

But, just like it takes a village to raise a child, it will take some real cooperation among all parties to make this work. This will include some reengineering of people, organizations, and process to insure we achieve the maximum benefit from the technology.

At GrandCare, our internal name for this is the Borg Project, which as you Star Trek fans know, is the notion of a collective consciousness linking seniors, their families, social workers, and healthcare professionals.

Personally, I think our developers just want to put up a poster of “7 of 9”.

 In conclusion, technology can play a big role in helping cities to meet the age wave challenge.  If we continue with our current ways, there is no doubt that the boomer generation will bankrupt their children and their grandchildren.  It is within our grasp if we can cooperate.

“Resistance is futile”

GrandCare Founder               Charlie Hillman