Age 85+ is becoming the fastest growing demographic in the U.S.
And those of us (the so called “boomers”, aged 51-69) who may be caregivers for those elderly parents may still be at the tail end of funding college kids or starting to babysit grandkids. They don’t call us the “sandwich generation” for nothing.
As we stress and fret about taking care of our aging parents, we are also starting to see the world that we will soon be navigating for ourselves. (We are also secretly hoping we have at least one standout child who will care for us when our own frailty and dementia sets in.)
By 2050, the population of boomers aged 65 or older will increase 120 percent from 40 million to more than 88 million; imagine; one in every five Americans will be 65+.
And we old folks aren’t too healthy, either. According to the American Psychological Association, approximately 80 percent of older adults have at least one chronic disease, with 60-65 percent having two or more conditions. And according to the Alzheimer’s Association’s estimates, 1 in 8 adults over 65 has Alzheimer’s disease.
So how do we avoid caregiver burnout today, and make things easier on ourselves as we struggle to survive our own longevity?
There are many products and services sold or in development today to help people “Age in Place”, meaning, to help them stay in their home as long - and as safety - as possible. Here is an overview, in terms of the problems they solve.
Safety and Security (“I’m alone and may fall”)
Personal Emergency Response Systems (PERS): According to the CDC, one out of three adults over age 65 falls each year. With a PERS device there is a basic level of protection,at least in and around the home. They are – at least virtually – never alone.
There are pendants and watches with a panic button to an emergency call center (having the loved one’s health records and contact info); some provide fall detection (“Philips Lifeline”), are waterproof, provide GPS/locations services (“Numera Libris”) and have other functionality (“Lively Safety Watch” offers step counting, using movement as a vital sign; and medication reminders).
Questions to ask include, does the device link to landline or require cellular service; what is its coverage (home and yard? is it mobile beyond the home?); is there a speaker on the device itself (if your loved one falls and is far from the base speaker they may not be able to talk to the operator); is it something a loved one will wear (or forget to wear)? How often, and how difficult, is recharging the device; or do batteries have to be replaced?
Wandering/Tracking, GPS: There are many GPS tracking options, a very simple one being “GPS Smartsoles”, which are insoles that contain a small GPS tracking chip on them. You can monitor your loved one’s movements on a smartphone or PC. The insoles just need to be charged every few days. This gets beyond the issue of your loved one not remembering to carry their tracking device!
“Comfort Zone Check-in Mobile” is an application endorsed by the Alzheimer’s Association, which provides the ability to monitor location of a loved one carrying either a cellphone or a small tracking device.
Remote Monitoring: There are many levels of remote monitoring, most use scanning technology to monitor a loved one as they move through their house and daily habit, two examples being “Grandcare” and “BeClose”. Scanners can be placed on medicine cabinets, refrigerators and outside doors. Systems report data over the Internet, and parameters can be set-up to issue alerts to caregiver’s phone if your loved one doesn’t open up the refrigerator in the morning (assumes not eating breakfast), or doesn’t open up the medicine cabinet.
These applications may also provide social connectivity with photo sharing and video chat and also medication reminder and other alert capabilities. Some can become “caregiver hubs” and have all caregivers, even doctors, participate in sharing singular information. The “Grandcare” system can also be integrated with telehealth devices such as blood pressure and glucometers.
Questions to ask: For systems providing your loved one a user interface (most of this is for engagement purposes), is the user interface workable, in terms of any dementia, eyesight or hearing issues? Upfront costs are typically higher, ensure you understand what you are contractually committing to, and what support is provided should a sensor fail, etc.
Medication Management (“I’m forgetful”)
Individuals ages 65 to 69 take an average of nearly 14 prescriptions per year, and that increases to 18 prescriptions per year ages 80-84.
According to the CDC, not taking prescriptions as prescribed is responsible for 30-50% of treatment failures (and 125,000 deaths annually), and non-adherence to cardio-protective medications is responsible for 10-40% increased risk in cardiovascular hospitalization, and a 50-80% increase in mortality.
There has been research that shows reminder devices can improve medical adherence in elderly patients having mild cognitive impairment.
“RXmindme” and “Pill Reminder” (by Drugs.com) are two examples of free iPhone/iPad applications that offer medication reminders. You type in your loved one’s medications and dosage instructions, and they get reminder alerts. Of course, this requires they be looking at their iPhone or iPad. Note that several of the PERS devices mentioned earlier also offer medication reminder capabilities.
“Med Minder” and “Medfolio” are examples of medication management systems. Both come with a dispenser. Caregivers load the pills for a week or month, which in some systems have individual chambers which can be locked until the day they are to be used. Systems provide audio/visual alerts, will phone your loved one, and then contact the caregiver if pills aren’t taken.
Questions to ask: Memory and dementia play a huge role in medication mishaps. A simple reminder may not be enough for a loved one experiencing memory decline. Also, if the pills are removed, that may not have been taken.
Brain and Physical Health (“I’m deteriorating”)
There are hundreds of applications available to promote and track health and wellness, as well as to maintain brain health (memory and focus). With fitness wearables, the number and sophistication of medical applications will continue to grow.
“Lumosity” is a free iPhone application with memory and brain performance workouts. “It’s Done” is a daily task tracker available on Android and iPhone for $2.99. You can customize the list, so ‘Turn the stove off’ and ‘Lock all the doors’ can be programmed and then checked off by your loved one. “Brainy App” is a free app on iPhone and Android that promotes brain and heart health (developed by Alzheimer’s Australia). “Spaced Retrieval Therapy” provides those with dementia a way to practice the memory of names and routines ($3.99, available on iPhone/iPad).
There are many fitness and nutrition tracking apps available, although you need to consider appropriateness for your loved one’s health status. Best to work with an occupational therapist or doctor.
Trends: You’ll be seeing more devices with added medical applications and more predictive sophistication. Devices will be able to detect hydration levels, monitor blood pressure/heart rate/glucose levels, apply medical history analytics to assess a patient’s health state (detecting possible stroke, diabetes issue, etc.).
A few examples of more sophisticated medical sensors include “Abbott Diabetes Care”, which was announced as an upcoming wearable glucose monitoring sensor requiring no finger prick. “BioSensics” provides medical tracking and condition assessment for cardio monitoring as well as for analyzing data on gait and balance. A doctor could use it to assess if a Parkinson’s patient’s therapy is helping out with their balance. “Alive Cor” has a mobile EKG device that works with a smart phone. “Livongo” has a diabetes monitoring device that connects directly through cellular, combining blood glucose level data, activity data and other assessments (how the wearer is feeling) to analyze their diabetic condition.
Engagement and Enjoyment (“I’m lonely and bored”)
There are literally hundreds of applications available on a variety of platforms, including: specialized TVs, PCs/specialized tablets, iPhones and iPads. Engagement applications can be a great bonding opportunity between older people, their adult children and grandchildren.
- “Skype” on iPhone/computer – free, voice/video calls, and share photos
- “Independa AnyTV” – let’s your loved one use the Independa television as a TV as well as a communications portal to video-chat, share photos, send reminder messages, etc. Controlled via a simple television remote.
- “Telikin computer” – a computer especially designed for seniors.
- “Bloom” – a device meant to encourage natural communication between grandparents and their families; a band worn by the loved one is detected by the device, which automatically turns on photos/videos and encourages communication.
- “Tyze” – share messages, stories/updates/photos among family/caregiving team.
- “Yesterday USA Old Time Radio” – old time radio shows (1920-1950), free iPhone/iPad
- “Virtuoso” – play the piano, free iPad
- “Getty Images” – 46 million images, search by topic (“flowers”), free
- “Pocket Pond 2” – feed koi and decorate their pond, free iPad
- “Slots Heaven” – gambling fun for free
Search for additional apps for your loved one’s hobbies and interests (music, gardening, and sports).
Caregiving Support (“I need help”)
If your loved one suffers from a particular disease, check out the official support organization for information, caregiving tools and caregiving forums. The Alzheimer’s Association, for example, has a wealth of info, daily blogs and caregiving forums. Apps that can help:
- “Caretaker” – prescription/medical record centralization, reminders, free
- “Unfrazzle” – care coordination app, to do list, journaling, iPhone, iPad, Android, free
- “Lotsa Helping Hands” – care coordination/task coverage by volunteers with calendar and blog, free
- “Balance” for Alzheimer’s Caregivers – care/medication coordination, $.99
- “Caregiver’s Touch” – document and share medical info/appointments/more $4.99 iPhone, web portal is $19.95/mo.
As we boomers age, vendors of all types are taking notice of both the implications and opportunities. More intuitive user interfaces are paramount, and as disparate devices are used for more and more confidential medical information collection, analysis and sharing; privacy, security and interoperability concerns need to be addressed.
Self-service medical portals will be offered, to remotely connect seniors with medical professionals from the comfort of home, and may incorporate fingerprint or retina verification for security and health privacy purposes. Robots will be utilized for a variety of medical care services, much like Paro (a furry robotic seal developed in Japan to be a “carebot”) is already used today as a therapy robot to comfort dementia patients.
Our aging population will indeed survive longevity by connecting with a new technological village of support.