Monday, November 23, 2015

To Reach Seniors, Tech Start-Ups Must First Relate to Them

Daily, breathless announcements arrive in my inbox, heralding technology products for older adults.

A “revolutionary” gait-training robot. An emergency response device said to predict falls. A combination home phone and tablet system that “transforms how older seniors connect with and are cared for by their loved ones.”

Daily, too, I hear tales of technology failing in various ways to do what older people or their worried families expect. I hear about frail elders who remove their emergency pendants at bedtime, then fall in the dark when they walk to the bathroom and can’t summon help.

About a 90-year-old in Sacramento who stored his never-worn emergency pendant in his refrigerator. About a Cambridge, Mass., daughter who has tried four or five telephones — not cellphones or smartphones, but ordinary landlines — in an ongoing effort to find one simple enough for her 95-year-old mother to reliably dial her number and have a conversation.

Which scenario represents the likelier future for senior-oriented technology? It depends on whom you ask.

Entrepreneurs are hard at work developing platforms, apps, sites and devices meant to help older adults manage their health, live independently and maintain family and social connections, all laudable goals. Let’s call their efforts silvertech.

Until a few years ago, “the whole tech world wasn’t sufficiently focused on this enormous opportunity,” said Stephen Johnston, a co-founder of Aging2.0, which connects technology companies with the senior care industry. “It’s changing quite rapidly.” He estimated that 1,500 silvertech start-ups had arisen globally in the past three years.

A couple of recent developments have intensified American entrepreneurial interest, said Laurie Orlov, a business analyst who began the Aging in Place Technology Watch blog in 2008.

Last spring, a start-up called Honor, which matches older adults with vetted home care workers, raised $20 million in venture capital from prominent Silicon Valley investors. “That gave all kinds of organizations hope for market potential,” Ms. Orlov said.

In addition, Medicare has begun to broaden the kinds of remote health monitoring — a.k.a. telehealth — that it will cover, though so far only in rural areas or in a pilot program for accountable care organizations. Eventually, remote monitoring will be “the way people will stay out of emergency rooms and nursing homes,” Ms. Orlov predicted.

Yet Mr. Johnston, whose organization convenes pitch events for silvertech developers, acknowledges that “there have definitely been a few missteps, and there haven’t been too many huge wins yet.”

As a geriatrician at the University of California, San Francisco, Dr. Ken Covinsky often hears from Silicon Valley tinkerers with big ideas. He has become something of a skeptic, as he pointed out in a post for the GeriPal blog last month.

“It’s incredibly well meaning,” he said in an interview. “But there are assumptions that are at odds with the problems our patients and families are facing.”

Tech people seem enamored, for example, with the prospect of continually monitoring older people using sensors that transmit information on when they get up, leave the house and open the refrigerator (or don’t).

Aside from the question of whether older adults appreciate such scrutiny, Dr. Covinsky suspects that an hour or two a day from a skilled home care worker (one paid more than minimum wage, he added) would do them more good.

“They don’t necessarily need someone to know when they open the fridge,” he said. “They need someone to make or deliver a good meal.” (...)

Design will play a crucial role in how useful consumers find any of these products, but it presents tricky questions. Do you come up with something specialized for older adults? “You don’t want to be handing smartphones with shiny glass to people with Parkinson’s disease or hand tremors or macular degeneration, and say, ‘Have a nice day,’ ” Ms. Orlov cautioned.

Yet with some exceptions — the Jitterbug phone, for instance — products aimed purely at older adults have often faltered. Sometimes they’re too complex, or too difficult for those with dementia, which is a lot of people.

Or users may balk because the devices become an uncomfortably constant reminder of incapacity. Technology isn’t always the solution to a problem.

by Paula Span, NY Times |  Read more:
Image: Luc Melanson