The caveats and conundrums qualify each rendering of buzz. The Hilary Stout article cited several of the almost clichéd concerns expressed by various University research experts: worries about privacy (‘big brother is watching you’), false alerting (70-year-old mom was painting the sun room, not having a heart attack), parental resistance to the tech (being bothered by it, or being bothered by their children who want them to use it.)  Meanwhile, the Leland article raised cautions about price and lack of reimbursement, whether the technology monitoring would let adult children off the hook for visiting their parents. And in September 2009, Business Week quoted IDC’s Scott Lundstrom, vice-president for research at IDC Health Insights: “Right now this is a niche market made up of affluent people who want to monitor their parents. The technology is going nowhere without a reimbursement model that supports it.” Yeah, yeah, yeah, but why?

So let’s swat our way through the thicket of buzz and caveats.  What will make the market for technologies for aging in place, or the inverse, technology to help with caregiving of aging parents, or the market’s largely overlapping segment, telehealth, become mainstream enough to be a given, expected to be available, and NOT newsworthy as a ‘new’ category? 

1.  Wanted, a viable channel strategy.  While it is possible that family members may hop onto the Internet and search for a remote monitoring system for their aging parents, more likely a member of the senior value chain (the industry) finds families like those in the Times article through local activities and local contact.  Systems need to be installed; high quality service must be provided; products must be leasable and returnable; pricing must enable revenue sharing; products must have easy-to-integrate interfaces — see more of this very important list provided on this blog by contributing integrator, Susan Estrada from Happy Home.

2.  Wanted, insurance reimbursement or viable pricing.  Studies continue to launch here there and everywhere to re-prove yet again the benefits of telehealth and remote monitoring of all types.  Because insurance companies and government agencies are not yet convinced, even with FCC and FDA enthusiasm, technologies that include or integrate with chronic disease monitoring fall into (or are placed there by vendors, actually) into health, disease management categories that health professionals must quantify financial benefits again and again to convince those who may be perpetually doubtful, possibly due to lack of endorsement.  As one research interviewee told me once: a dollar saved in the healthcare industry is a dollar lost by someone.”  In the absence of this elusive reimbursement, pricing must fit into the budgets of families or those who provide services in order to become mainstream.

3.  Wanted, a tech-smart senior value chain.  Hopefully some of the buzz from the Times caught the ear of what I refer to as the ‘senior value chain’ – the multiple and diverse organizations and people who really want to help support aging seniors. These include: caregivers, geriatric care managers, social workers, discharge planners, home care agencies, independent and assisted living providers. Do all members of this chain view staying current and knowledgeable about technology tools as part of their job? Even as aging in place (aka not moving) becomes a near-national mantra among families and seniors, even as home care agency businesses grow at the expense of nursing homes and assisted living, the technology categories described in the Times articles (past and present) are not mainstream among home care agency providers, for example. So families mull over what will be happening in this largely tech-free world on the off-days, and off-hours when aides are not present or don’t appear.

4.  Wanted, the ‘right’ products and services.  So let’s say the above 3 issues were all non-issues. We still have no really clear expectations of what we (the senior value chain) want from the products and services themselves.  We have phones with no GPS, we have GPS tracking without phones, we have PERS devices that are mobile without fall detection, we have products with fall detection that not mobile-enabled. We have remote monitoring devices that cost hundreds and remote monitoring devices that cost thousands of dollars. We have HIPAA-compliant and FDA-approved, and we have no-and-no to either. We are targeting markets of the still-well-enough to drive, or is it the frail-enough to be home bound? Products can be marketed direct to consumers, or no, should vendors seek distribution? Vendors must decide, channels must be recruited, manufacturing decisions must be made, but this is an industry of uncertainty about the correct strategy — because the market expectations are not yet ‘mainstream’.

The technology isn’t really new, but a mature market isn’t really here, either.  I love buzz — it is energizing, exciting, and validating for what those who are working hard in this industry — and it energizes me as well. But a few (how many?) years from now, it would be great to read stories about how adoption of all of the technology categories discussed in the two Times articles last week grew by leaps and bounds, practices are standardized, training of professionals incorporates those practices, senior well-being is clearly better in the study groups versus the control groups, and the young engineering talent of the world recognizes the opportunity to enter this well-established and mainstream market.

Line up to learn your longevity likelihood.  Aren’t you just loving the opportunity we will soon have to download that free genetic marker test kit, the one that with 77% accuracy will tell whether we will live past 100? Boston University scientists have ‘no plans to profit’ from the results, but they will make the kit available later this summer. (Warning: analysis of the results will be costly.) I am so struck by how the law of unintended consequences could play out, especially in areas of insurance — as with a home test kit for Alzheimer’s, people might be more likely to purchase long-term care insurance. With a longevity test on the market, how long will the term need to be in term insurance? Taking it a step further, should insurance companies offer free kits as a marketing device? Should your doctor know that you’ve taken such a test? Should a health insurer know? What happens to rates, deductibles and lifetime caps? What kind of housing and support systems would we want if we knew we could live to 100 or more (or if we knew we would suffer from Alzheimer’s)? What would our families do with that information?

Which brings me to home care — what we want. So let’s just imagine that many more of us are going to make it to 100, that we fear nursing homes and obsessively want to stay in our own dangerous-but-familiar houses. Of course, we will want to be there all alone in our later years, visited only by home health or companion aides from the growing home care industry (hopefully they won’t visit us too often, though, and draw attention from the SEC). Hopefully the aides are background-vetted, well-paid, well-trained, dedicated and conversational, and are the low-turnover folks. Hopefully they will take us out to events and social activities, make sure that we are well-monitored and Skype-connected to our far-flung relatives, if not in the home then by driving us to places like this just-opening and Skype-enabled Clearwater Aging Well Center.  Hmm. Do you believe this?

We have the time to craft a better experience. Let’s face it, the lonely boomer at home at 100 is unlikely: our mis-managed bodies may not permit it — even if the above scenario was realistic. That doesn’t mean we aren’t going to live far beyond ye olde expectations. If we knew how long we might live, we also need to imagine and advocate for lower-cost, longevity-friendly housing for those ‘middle’ decades of the 70′s and 80′s, but that will house us when we’re 95 and low on money. We need a rethink of nursing homes, blending them into services for seniors in a community — so that they move past the current shrinking anathema status. That might mean more consolidation, along with blending of skilled services first into communities, and then those services into group housing that will match our budgets and interest profiles. 

Care we want — can we get it? Where we’ll be living, the aides are kind to us: they form friendships and support each other and are well-supported by management. They enable us to find friends and continue to do activities we like — with others, not alone. Where we’ll be living, monitoring our well-being will be welcome and standard; enabling our tech-connectedness will be understood and supported by management and staff. When we move in, we won’t need to take our tech gadgetry with us — they’ll be part of the residence, with Kindles and Nooks in the library, wireless in our home, and appropriate use of video. Maybe useful and friendly robots (not just Paro-fluffy-friendly) will free up the repetitive and low-skilled labor, doing so at a low cost, freeing up staff to focus on higher-skilled tasks. This has happened in every single other industry in the past 50 years — why not this one?

We are in a crisis of mistaken expectation — thus tech opportunity.  In today’s economically challenged world, we suffer from a lack of product and service marketer realism (see Tom Mann’s Mature Market blog about senior housing developers) all along the continuum of care to the consumer. Everyone wants things the way they were (as in the above senior housing example) or they don’t know what they want but are shocked at what they actually get, whether it is with the doctor, the hospital, or the home care agency. Those who are creating and selling tech-enabled products and services have an opportunity to sell into the gap — whether it is in cost-reduction, family expectation management, or enabling standardized back office consolidations for service providers — who want to enable a better longevity experience at a lower cost.

Mature Market Experts – more news and stats you can use on boomers, seniors and the mature market – The BBC Brain Training study — let’s flip it around: There’s no such thing as bad publicity.  This study is being reprinted on every website that has even a remote connection to boomers, seniors, or game-playing or is suffering from a slow news day. (Although you have to wonder how senior housing executives will react to seeing it published in McKnight’s). So I am not going to set foot into the quagmire about whether this is a good study or a bad study — as observed by Alvaro Fernandez of SharpBrains and Steven Aldrich of Posit Science.  I will also bet that this study will not slow the cognitive fitness market down, which SharpBrains sizes as $1 billion within 5 years — you have to work hard to slow a market that fits so well with the fear, uncertainty, and doubt of baby boomers about aging and brain-related impacts. And like all studies (wine is good for you, wine is bad for you, more exercise, but not too much), no doubt there will be another study contradicting it soon enough. Instead, let’s turn it around.

Those who surfed the web for general knowledge improved at finding it.  Looking at the BBC study news item, let’s read this sentence: “A third control group was asked to browse the Internet and seek out answers to general knowledge questions. The results are clear,” said Adrian Owen, a neuroscientist at the Medical Research Council, in a statement. “Statistically, there are no significant differences between the improvements seen in participants who played our brain-training games, and those who just went on the Internet for the same length of time.”

What’s that mean? So let’s just assume that surfing the Internet reduces risk of depression, that looking for information online improves your skill at finding it, that taking advantage of access to 62,000 health-related websites makes one a better-informed healthcare consumer, that using connected health technologies can help us ‘age well in a connected world’ (Cisco). To name just a very few endorsements of Internet access for older adults. What if we use the BBC study to confirm that healthy older adults who surf the web seeking knowledge will get more skilled at doing this if they practice — and that if they practice, they might learn a new skill, reduce depression, or even connect to other people who share their interests?

That sounds like a GOAL to me.  Maybe a computer, a broadband connection (see Project Goal), and some training could help older adults just improve the quality of their lives? What if warding off brain-related problems and decline could be improved simply by access to knowledge and something interesting? Now that Project Goal has launched to improve broadband access and use among older adults in the US, how about its sponsors getting together to launch a baseline study that evaluated all of these factors before and after acquiring broadband access? Who knows, maybe a side effect of that access will turn out to be improved cognitive health?

Work — what they (sort of) mostly do and expect to retire at 66.  Now here’s where things get interesting: 8% work part-time, 6% are self-employed, 5% are looking for work, 7% are on disability, and 8% are fully retired.  Let’s turn that around and see it for what it is:  only 60% work full time for companies! Somewhat ironically, they expect to retire at 66, although 50% plan to either take their social security benefits earlier (before they are eligible for full benefits) at age 65 or get the partial benefit at age 62. Delusionally-speaking, 69% have set the date for taking social security as exactly the same as they said it was two years ago — despite declining value of their assets and the state of the economy, not to mention their level of employment.

What, me worry?  Here’s where the delusional part really begins in earnest. Sixty-six percent of them have one or both living parents. Half of them have children still living at home. But what are they concerned with — despite these two arguably significant future care-related issues? Twenty-five percent worry about affordability of their own health care, and only 18% of the respondants worry about remaining useful. Only 15% imagine they will want to or have to work part-time in their retirement years; only 13% of them worry about funding long-term care needs, and only 12% of them are concerned with outliving their money.

Middle boomers — read the older boomer tea leaves. In another MetLife report from October, the real world of older boomers is explored in the pleasantly-titled Buddy Can you Spare A Job? Three-quarters of today’s older boomer workers expect to work for pay after retirement, but fewer than 35% report actually making it happen.  Meanwhile, turns out that working in retirement correlates with better health. From this, we can conclude that older boomers need the money. Middle boomers will need the money too, and not just for their own health care costs. And it doesn’t hurt that working can be engaging, that it provides you with a purpose, and that it keeps your mind from rotting.

If you can, sit down at the piano.  For several years, I played the piano in my mother’s nursing home, where ladies with Alzheimer’s — who never spoke or who only swore — would suddenly break out in song. My favorites and theirs? Gershwin’s “Someone to Watch Over Me”, Blue Moon, or George M. Cohan’s “Over There.” Eventually I assembled their favorites and mine into a book that could provide one hour of great music — people would dance, my mother would sing along, and all would be clapping wildly at the end during “It’s A Grand Old Flag.”

Or send in your iPod. If you can’t play the piano or don’t have one nearby, here’s another option. I was delighted to read that the actual effect on the brain that I observed is now documented by scientists — and actually improves mood, cognitive function and taps long-dormant memories.  And the Institute for Music and Neurologic Function, http://www.imnf.org, founded at Beth Abraham Health Services in the Bronx, NY, will program a customized iPod based on an individual’s musical tastes.  (Personally, I think they’re missing a few songs.) They are also looking for donated iPods to use for those who can’t afford.

Musically inclined — here’s another career change for you.  Apparently music therapy isn’t more widely used with Alzheimer’s patients because of a lack of manpower. There are only about 5,000 certified music therapists and fewer than 20% work with geriatric patients. The IMNF launched the ‘send in’ program to help bring music therapy into patients’ homes. So for you career-changers who are musically inclined, go for it.

Editor’s Note (Tom Mann) – Laurie’s blog is on the money. I’ve seen the power of music invigorate healthy, independent retirement community residents … ignite movement to assisted living residents … and restore spirit to skilled nursing care patients. If you want to see a great program in action, take a look at this short video on Conductorcise that NBC’s Today Show ran.

Full Disclosure: Conductorcise is a client of TR Mann Consulting. That being said, their program is amazing.

Even centenarians read e-mail and web surfing keeps the aging brain active. The Evercare survey of 100 healthy hundred-year-olds could really look like a trend to technology optimists like me. You may remember that 19 percent of responders use cell phones and 7% were using e-mail. And of course we know (studies show this through age 76) that surfing the web is good for the aging brain. But let’s not confuse technology optimism with reality. Questions in my mind remain about the oldest among us:

1. Who is the customer? I visited a Selfhelp independent living complex in Queens today, where I had a pleasant chat with a 90-year-old woman who still walks 6 blocks to the library for a concert, plays Mahjong with her friends daily and does her own shopping. She had QuietCare motion sensors throughout her apartment. I tried to interest her in the concept of a cell phone since her friends have them — no need, she said. Her dial wall telephone kept her nicely in touch with her adult children — when she is in. What about a computer?  She smiled very graciously and told me that she took the training and can’t see the point. Online Mahjong? Order her groceries? E-mail with her kids? No thanks, she smiled. [Note: And Selfhelp has the wonderful benefit of a full-time tech administrator]. 
2. What is the profile of those most served? On the other hand, home bound seniors — those who are visited by care or case managers, who don’t get out of their apartments to the library or anywhere else — seem like obvious candidates to use technology. But could you push a Quiet Care (or WellAWARE or  Healthsense or GrandCare) system into the home of the most stubbornly independent? Who will pay for a home bound 90-year-old’s system? How will they find out about such a risk-avoiding technology? And as in this example, if they are healthy and active, is it necessary? Reassuring? Superfluous?
3. What is the compelling argument about cost of computing? Let’s assume that you could persuade a) the very independent that they would enjoy a computer, that you could encourage the b) frail and home bound (or their families) that an enormous social benefit could be realized with a computer or c) that hospitalization could be avoided with home monitoring, as studies have shown.  Who buys the computer? Who pays the bill for tech support?  Who provides the tech support arrangement or covers the ongoing service fee? Perhaps grants and state funds can help — as in the case of Selfhelp in New York and NewCourtland in Philadelphia. 
4. Are adult children the right customers for home monitoring? I was reminded of this when a friend told me about his still-sharp 94-year-old father and 89-year-old mother who has mild memory impairment — both of whom separately suffered bad falls in their house — neither were discovered right away. She wasn’t noticed by her husband who had the TV at high volume and can’t hear well. And on another day, he fell backwards off his chair and couldn’t get up until someone looked in on him.  Meanwhile, the adult children are trying very hard not to interfere with their parents’ ‘independence’ and denial, recognizing a crisis is looming.

For the oldest, the profile of receptiveness and access appears narrow. So I wonder. Today, if you have technology advocacy in senior housing AND social work AND seniors are receptive AND family members are aware and interested AND a payer can be found, then 85-and-older individuals may encounter the risk avoidance of home monitoring systems. Similarly, access to a computer and the internet is constrained by awareness, financial capability, availability of tech support, and, not least, adequate training. 

Solutions — more needed. Here are a few thoughts. I would like to see large corporate users of PCs examine their technology refresh cycles (typically 3 years) and donate their computers to senior centers. I would like to see volunteer networks of tech-smart individuals (including retirees) formed into well-organized clusters around neighborhood senior housing, homecare organizations and senior centers. AARP could be that organizing entity, although its center of age gravity appears headed downward.

I would like to see computer vendors like HP, Microsoft, Dell, IBM, follow the example of Verizon and HopeLine (for victims of domestic violence): donate technology to senior centers, but go one step further — and donate train-the-trainer time and fund videos of training that can be circulated. Pay for public service advertising that could get the attention of adult children. Remember that 1 out of 2 baby boomers has at least one living parent. The odds are good that this parent may be one of the 5.3 million age 85 or older, the fastest growing age segment.

People will age longer at home, but it won’t be pretty. This year we know according to an AARP public policy study, that 89% of people of age 50+ want to stay in their own homes. MetLife Mature Market Institute found the same thing. News article after article has confirmed that aging in place is a trend that is happening, maybe fueled by a real estate slump. Remodeling of Peter Pan houses is taking off.  Meanwhile, January 1, 2011, the first wave of baby boomers turns 65. Despite our never-get-old mentality (60 is the new 40, 80 is the new 60, etc), when you’re not 64 anymore, you slip into a new and not entirely problem-free life stage.

The post boomer demographic is becoming senior. That’s the age in which the majority will have 2 chronic conditions — perhaps arthritis, diabetes or heightened risk of heart disease. It’s the demographic in which risk of Alzheimer’s disease spikes (1 in 8 are likely to acquire, putting the total for baby boomers who suffer from it or a related dementia at 10 million, or twice the current population with Alzheimer’s of 5.2 million). It’s likely that 4.3 million of us (you) will have severe vision impairment. Bad knees, weak hips, poor balance, shaky memory, and fading eyesight.

What technology you need.  Let’s just make a few assumptions. Just to chat with your dispersed family members, never mind research your looming medical issues on the Internet, you need broadband, a home network, a reasonably lightweight laptop, a printer, maybe a touch screen, maybe a built in camera, a decent cell phone with built-in GPS, a low-cost but high function home security system that watches out for your environment, and a good long-distance dialing plan. You are quite willing to plug everything in and turn it on, or maybe hire someone to show up and do it. As you become somewhat frailer, you want a small amount of home automation that doesn’t require an engineer to manage — perhaps automatic temperature controls (you’re in, heat’s on, along with the lights; please reverse this when you’re out.) Eventually you and your family want home monitoring with integrated web camera, motion and fall detection, plus extended PERS (beyond 500 feet).

How about some help from your favorite vendors? Unfortunately, once you own all of the above, from that point on, if it’s computer-related, it’s all about fear and loathing of this ever-more-frustrating junk-to-be. From the ‘Send error report to Microsoft’ to the gotta-hire-a-geek-just-to-print. The silence is deafening from large US-based vendors on how to tackle this pending incompatibility between what we want and how we live with our gear. The super successful Cisco offers only networking products that confound both novice and technical people in their homes. Microsoft is committed to health care, but it’s Guide for Aging Computer Users hasn’t been updated in a year and a half — and there is no other public clue that the company cares about its aging-in-place customers. Meanwhile, Intel cares about aging enough to fund virtual boatloads of research — but actual product development into the market — basically zero. Silence from HP and Dell.  Maybe that’s because only 25% of Windows-based laptop purchasers are over age 50? But 25% is still quite a few laptops, more than 5 million, for example, in 2007 alone).

And a word about Apple. So we know that Apple’s personal computer marketshare has grown to exceed 10%.  And surprisingly, 46% of its buyers are 55 and older (which could possibly be because it’s perceived to be easy to use…but I digress.) Yet Apple’s marketing. Now there’s a contrast.  Baby boomers? Seniors? Aging? Not on your stylish pink MacBook life. How silly is it to ignore nearly half of your buyers and design for appeal to teenagers? Do they think that their 55+ customers just want to look cool? Maybe if they acknowledged the AARP demographic, they could grab another 10% share.

Big vendors should invest in small vendors. This blog is filled with numerous mentions of vendors who offer all of the pieces and parts that we’ll need to age in our own homes. But they’re mostly small. With an infusion of cash (not research… cash!) from the large vendors (like Cisco, Dell, HP, Microsoft, Intel, Apple) — the small vendors could be intentionally included as members of the large vendor’s ‘ecosystem’ (to quote Microsoft). One reason Microsoft invests in Health Vault is because its leaders acknowledge the health-related implications of an aging population. Ditto with Intel (Health Guide) and Cisco (Health Presence). But we’re not going to be sick all of the time! We’re just going to try to live in our homes as connected to others as we can be. Maybe we just need a few investments in the innovations of small startups to ensure that we can.

Should the old get out of the way to make more planet room? Dr. Rich observed that by 2030, 84% of those 65+ will have completed high school and 24% will have a bachelor’s degree, compared with 15% with a college degree today. She noted that tomorrow’s centernarians will be very comfortable with smart phones, Internet, and whatever else is around to enable them to access any information resources — including being very demanding healthcare consumers. She worried that the planet cannot accomodate all of what she terms ‘Geezerdom’ and that perhaps it would make sense for the old to voluntarily ‘get out of the way’ to make room for everyone else.

Evercare’s ‘healthy and articulate’ 100-year-olds are engaged in life now. Who would have thought that half of centenarians are familiar with Ninetendo’s Wii Fit, 21 percent go online, with 10 percent using e-mail weekly, 5 percent watching TV shows, 4 percent downloading music, 3 percent use Twitter, and 2 percent would want an iPod if stranded on a desert island.  Half are walking and hiking, more than half watch quiz shows, and 77% read to stimulate their minds. Both the centernarians and college seniors talk to friends and family to manage stress. Somewhat worrisome for our future, 63% of 100-year-olds said they ‘do something to help others’ as a secondary stress reliever, while 78% of college seniors report that they resort to ‘me time’ to manage stress.

The Judith Rich column includes advice for extending your life span. She quotes a laundry list of widely publicized advice on how to increase your lifespan (15 minutes a day laughing, not smoking, and having a positive outlook add more years). But that list doesn’t include staying connected to community, doing something to help others, staying on top of current news and world events, or using a computer to stay connected to family. Let us remember that the Evercare interviewees are already 100 years old — and this is what a surprising number of them do. Maybe if we want to live to 100, we should emulate them. This being a tech blog — here’s my twist:

Own a computer. I am still hearing that tired line from vendors who make proprietary (non-PC) products that 65+ customers are baffled by computers — that’s why their product isn’t built on a PC. It’s especially ironic to me that telehealth vendors send technically knowledgeable people into the home of 65+ to install monitoring units, will train them on the use of those products, but the PC is just too overwhelming a platform. Enough already. Ignoring the communication needs of your ‘patients’ by giving them single-purpose devices is, politely put, insensitive. Telehealth nurses tell me that patients appreciate monitoring because it shows that someone cares. Imagine their enthusiasm if someone showed them how to use a touch screen for email, sent them some e-mail and showed them how to join an online community for PatientsLikeMe?

Stay informed — news and new ideas. Despite my fondness for them, we probably won’t be reading paper newspapers too much longer — too hard to distribute, too expensive to buy, and tough to get rid of when you’re done reading. But even if you’re still buying them, you can still set automatic e-mail feeds from newspaper companies, set Google Alerts for topics that interest you, and keep up on what’s what in the world of trends and ideas.

Get exercise — physical and brain.  It doesn’t really matter what you do as long as you propel yourself out and about, get your heart going, and give your bones enough stress to keep them from thinning. If where you live means Wii Fit, so be it. And give your brain a workout while you’re at it — anything that involves stimulating, including training your brain to keep your driving skills, or learning something. See stay informed.

Buy smart phones – and keep them charged. No point in getting lost on our way to age 100 — might as well get a BlackBerry or iPhone that gives you portable e-mail access, but where you can also be guided with directions, find a restaurant or gas station, chat with your grandchildren, and even use the phone to call 911 in an emergency. They’re useless when the battery runs out, so manage a charging lifestyle habit early — required for the computer too. See own a computer.

Find like-minded communities. The ‘Lifespan’ advice in Dr. Rich’s column said that going to church regularly adds 3 years to life expectancy.  If we broaden that advice to suggest finding like-minded people — in person, online, on the phone — engagement with others is the key. If we are like 50% of those over 65 today, we will have 2 chronic diseases — even more important to find others who have figured out how best to manage them. See stay informed, buy a smart phone, own a computer.

Consider online medical services. As we near 100, there will be no reason to feel trapped in the house, unable to access medical advice. We can subscribe to online services (phone, e-mail, virtual visits) from companies like TelaDoc or American Well, or LiveNurse on a Jitterbug phone.

My thought — being 100 in this scenario overcomes some of the physical isolation that can result from physical frailty (and losing your nearby friends and family). To me, that looks like a better deal than Dr. Rich’s idea of checking out in order to free up space.

Nursing homes may be the most cost effective, unless… First of all, even though today we seem to be in a ‘no nursing home, no way’ mindset — it may be at some point in the future that the pendulum will swing back to nursing homes as the more economical place to be when 24-hour Medicare-certified care is needed. Once Medicare coverage expires we are going to be abandoned to our own devices…

…Remember that technology has lowered the cost of every other industry. If, as we seem to insist, we want to be in our own homes, then what can drive down the cost of that home care? Will it be telehealth diagnostic technologies for chronic conditions as validated by the VA (see our Trends page)? Will it be smarter in-home monitoring of our well-being — including safety and medication adherance? Will it be comprehensive transportation services like SilverRide that bring us to where we can interact with others? Or will it be virtual interactions — using cheap cameras that connect us to doctors?

To learn more, I guess you’ll just have to watch this space.

Are they wearing airbags?

Mature Market Experts: more mature market news and stats more often – Smart Clothing — Coming To A Store Near You? Not long ago I gave a presentation to a group of seniors about technology for aging in place. One question made me pause: “Why can’t clothing help seniors be safer and more independent?”  Good question. And asked by many in university and corporate research programs. Let’s pick a few — and I am inviting comment posts with additional examples:

1) Last year Apple patented the term ‘smart garments’ enabling a gadget like an iPod to authenticate a connection to a smart garment, perhaps a shoe, indicating to the user ‘the rate of wear of the shoe’. Unapproved garments (not a Nike shoe, perhaps), presumably cannot communicate with the device. This is available today in a Nike-iPod kit to transmit data from the sensor to an iPod to track runner data. Not yet targeting seniors, but Apple clearly saw an opportunity, hence the patent.

2) Also last year, research on the possibility of a human airbag to open in the event of a fall, which I commented on when the press ran with in numerous articles — Prop is the Japanese company that is developing the airbag, targeting frail elderly, people with severe osteoporosis, and people with epilepsy — at roughly $1000, inflates if falling backward, not for sale yet in the US or through a distributor I have found. Please advise if you know where to purchase.

3) Also last year, MIT researchers are using NASA research on balance to develop the iShoe, using technology that was originally developed to help astronauts with balance issues when they return from space. Erez Lieberman and others in a Harvard-MIT Health Sciences Program have applied for a patent, tested the product with 60 seniors, and OhioHealth released a statement in February 2009 saying the product would be available next year (2010) for $100, to be covered by most insurance: “Erez Lieberman’s iShoe contains pressure sensors, a built-in memory and a wireless Bluetooth radio that transmits the data to a laptop or mobile phone.”

4) Announced this year with a prototype expected for later this year and possible release in 2010, the GPS shoe is intended for tracking individuals with Alzheimer’s disease, a collaboration between GTX Corporation and Aetrex (a maker of orthopedic shoes), the GPS shoe is expected to retail for $200-300 and can be accompanied with a tracking service for $20/month. Noted elsewhere in this blog, there are other tracking devices for those with Alzheimer’s, but this is actually a piece of clothing.

5) Halo Monitoring, maker of a wearable chest strap for fall detection, has developed a sports bra version that enables the chest strap to slide into the garment. When a fall is detected, the device transmits to a gateway that can either dial a telephone or use a broadband connection to reach a call center, which then contacts the senior, caregiver, and/or emergency services as appropriate. The pricing is a bit higher than other Personal Emergency Response System (PERS) devices — but the key difference is that the wearer does not need to press a button to call for help.

Looking forward to others — please post!

Guess I was right: Wireless and web-based education are in the sightlines of senior housing executives. This just in — a McKnight’s survey done last fall and now summarized confirms they were anxious and worried about their future. Will they have the ability to compete with staying put, especially as they stare down a future of high-expectation baby boomers?

2013: time to differentiate with services. Execs tidat are struggling to balance and fill their capacity — in a time when seniors can’t sell their homes and afford to move in. That’s also how I read words and behaviors at the recent ALFA conference in Philadelphia. According to this Mather LifeWays Institute on Aging survey representing 435 senior living communities around the country, 22% of communities now offer Web-based education (life-long learning) for residents, but 69% will do so in 4 years. And the percentage of ‘smart homes’, aka those with wireless networks, will grow from 8% to 39% in that same period. This is all part of programs to ‘promote quality of life as residents age in place.’

The future is — well, in the future. The reality is that survey responses are not an obligation to change behaviors or environments and actually make purchases — they simply confirm a non-committed and no- -money-down distant future ‘intent’. So let’s look at the vendor exhibit hall participants at the recent ALFA event in Philadelphia — because if there was ever an indication of intent or even possibility, it is the presence of vendors who want to make a sale — either now or cultivating potential.

Where’s the tech for residents today? I walked up and down the aisles and noticed 3 vendors (out of 300) at the May event who were presenting technology aimed directly residents’ quality of life. IN2L (It’s Never Too Late), MyWay Village, and PointerWare. If we add Personal Emergency Response, Emergency call systems, and resident monitoring, we add a few more. However, I put these in the category of staying alive, not quality of life. The rest of the technology vendors were all over the problem of running the facility operations: marketing, payroll, finances, billing, etc.

Residents need access now. I have been through many facilities – from small ALFs to the big and stylish CCRC, from nursing homes for the upscale to those occupied by the very poor. With a few exceptions, I see little technology for the use of residents, even though it could grab their minds and break up a day that is too often largely punctuated by meals and naps. Ironically, the more immobilized the resident, the more they would benefit from Internet surfing with Big Screen Live or listening music delivered through a kiosk by Linked Senior.

Put small money where your survey responses say you’re going. While at ALFA, I spoke with a number of executives to test their interest in a future panel on tech for residents. What I surveyed: eyes glazed, most assured me that they were not the right contact, that someone in their organization would be a better contact. Anecdotal information, for sure, not demonstrating their clearly surveyed intent to do something by 2013.

So these vendors have something to offer that boomers and seniors want — and in a slumping economy, now is as good a time as any to create messages and acknowledgements of these segments — even a few photos for the website!

To be included on the list below, web surfers have to do backflips to find boomer/senior messaging or scenarios on their website — or when you search for senior, it’s a high school student or an exec VP:

1) AMD.  AMD is deep into the gaming platform (AMD Game!), including simulation and popular war games, home PC (Acer, HP Touchsmart, Fujitsu), entertainment (AMD Live!) arenas, well-marketed and embedded in lots of products.  I think boomers and seniors LOVE, LOVE, LOVE, all of that — according to Forrester, 83% of older boomers play games on their PCs.

2) Apple. The MAC and iMac, the iPod, iTunes, the iPhone — one company, Apple, has something for every boomer and senior under the sun, including Florida and Arizona snowbirds and retirees. So search Apple’s website for baby boomer and you will get 1 iTune, 1 TV show and 2 podcasts.  I guess it is a good ‘i-start’.

3) Dell. Well you know they have all of the PC product line boomers and seniors could want for home and home office, and a 2005 press release related to veterans and visual impairment, a nice community environment for ideas and discussion, but nothing I could find that mentioned baby boomers or seniors outside of user-provided discussion.

4) Verizon. Corporate strategy includes expanding broadband access, which is good. But the successful communications giant has a hard-to-locate 65+ cell phone plan.  Further buried is the boomer and senior usefulness of Chaperone for locating your teenager, but, yes, you could also find a wandering your mother-in-law through this service. And now the company has introduced a home communications kitchen counter telephone/video/picture/text landline phone replacement called Verizon Hub. No clue that it might be for the kitchen of older adults. Finally I found this plaintive question — ‘are there any phones for seniors?’  in a Verizon community forum. The one-line answer — “You could try the Samsung Knack, ‘cheers’.”  

Four cheers if any of these vendors take a strategic look at older adults and explicitly acknowledge them as a marketable segment.

1. 2008- three out of four boomers don’t think they’re going to move. Prior to the current financial meltdown, AARP surveyed and found a variety of distinctions between older, younger, men, women boomers on the subject of moving to a one story home, warmer climate, etc.  But if 3 out of 4 on average aren’t relocating, then what are providers like Verizon and Comcast offering them as content in the home?

2. 2009- Sure enough — Boomers and seniors are staying home.  Now the financial meltdown has happened, Pulte buys Centex to prepare for an upturn in home purchases that may not occur for a long while.  So where is Home Depot’s packaged home retrofit offering (not just for earthquakes in Seattle or saving energy)?

3. The population is steadily aging.  Ironic, most firms avoid the word ‘aging’ in their marketing. But there it is. So let’s call it the ‘living independence’ marketing campaign, introduce it in time for the 4th of July, and see Lowe’s, Sears and Best Buy craft multi-dimensional offerings and low price points that help mitigate issues with stairs, entrances and exits, offer packages of stylish bath safety products, and bundles of computers and home networking solutions that Geek Squads can install?

4. Not enough caregivers are available to provide adequate care. Forget futuristic robots and training more nurses running into the home. It is amazing to me that despite multiple home monitoring vendors in the market now, that they are becoming available in selected communities, one reseller or facility at a time. Now I am back to the cable company/ISP, already in the home. Who would a DSL or cable installer or repair rep tell if they believed that a resident could use some technology assistance and/or monitoring?

5. Cost will drive home health care to replace institutional care of seniors. Turns out the VA has already figured this out and been using remote telehealth to great success, including video phone, messaging, biometrics, digital cameras, and telemonitoring. Next up — city WiFi projects (which seem to be everywhere) can branch out. City-to-home, connect where you are, campus to condo. As we’ve seen with the WiFi initiatives, lots of innovation is possible once tech vendors and city planners get together.

6. Adult (55+) communities are headed to the obsolescence heap. So active adults bought into a wonderful lifestyle during the housing updraft — but now they can’t sell, so these communities are re-evaluating age restrictions and a damper has been put on developer enthusiasm. To get these properties sold to younger age groups, clubhouses will need game rooms, outdoor space will need playgrounds, marketing will need to match first-time home buyer messaging. What an opportunity for nationwide realtor firms and even Pulte — which owns oodles of Del Webb 55+ communities.

7. Alzheimer’s — incidence and cost are up — so is fear. At the fear end, the cognitive fitness market of baby boomers seems to be ready, willing, and anxious, no doubt due to family histories. So keeping brains active, although not proven, feels almost like a preventative tactic.  So who will bring the next low-priced (or free) BrainAge to market? Why not Microsoft as part of the next version of Windows 7? Maybe it’s time for Microsoft to buy a brain fitness software company and start integrating. And then at the other end, it’s time for Verizon and Sprint to add a few short words to their market messages about services like Chaperone: perfect for multi-generational familes. See? It doesn’t even have to say ‘aging’!

8. Technology — there’s more of it and it’s more functional. As the 40+ vendors in the 2009 Market Overview make clear, there are many, many vendors of technology out there NOW. So service providers, integrators, resellers, distributors — it’s feasible to package and market these products — at multiple price points, through press coverage of demos, advocacy from councils on aging, even with all of the fund cutbacks and economic slowdown. Really.

9. Baby boomers have parents in need. During the real estate and interstate migration boom, many of us spread out across the country. But with videophones from D-Link or Skype, a camera, and a PC, we can be connected, use home monitoring technologies for motion detection, help with med reminders, and offer a detectible cell phone. Vendors can message to a continuum of caring, during that interim period before boomers decide to yank mom or dad out of their home and closer to them.

10. Nursing home residents are moving back into community. For good or ill, communities are on a rampage to get individuals out or avoid entrance into a nursing home. So the most frail, most at risk individuals are going to find their way back into continuing care, independent living, apartments, and homes. Are home care agencies, personal emergency response vendors, and medical supply firms all thinking through the services and products that this implies?

Finally, a lesson in seizing opportunity — the stimulus plan ink is barely dry and tech vendors are already running sales training programs to help non-profits, schools, agencies prepare grant requests. Training packages were being assembled before the bill was signed. From the WSJ: “With the recession forcing corporations and institutions to cancel projects, technology suppliers are eyeing the economic-stimulus package as an elixir to keep revenue flowing. It earmarks more than $100 billion that could be spent on information technology.” You gotta love it.

Editor’s Note: Laurie Orlov blogs for Aging In Place Technology Watch