Technology and Collaboration for Quality Aging

By Dr. Joseph Coughlin at MIT (Copyright 2010)

Editor’s Note: This is an excerpt of an excerpt, based on an original essay by Joseph Cough­lin, Direc­tor of MIT Age­Lab. Coughlin’s essay was part of Longevity Rules: How to Age Well Into the Future, a collection of 34 essays by leading longevity experts that help pol­i­cy­mak­ers and the pub­lic bet­ter under­stand the aging expe­ri­ence.

Aging is not for wimps. Liv­ing well takes lots of work, even if liv­ing longer is now com­mon­. Longevity cre­ates new tasks or “jobs” for indi­vid­u­als, fam­i­lies, professional care­givers and pub­lic agen­cies. Technology can help, but it’s just part of the answer. It’s too often dri­ven by those who are pas­sion­ate about inven­tion but lack inno­va­tion – that is, putting ideas to prac­ti­cal use. The ques­tions that should be asked by pol­i­cy­mak­ers, busi­ness and the aging com­mu­nity are:

  • What are the tasks & jobs that get more difficult as we age?
  • How tech­nol­ogy and col­lab­o­ra­tive part­ner­ships can help us accom­plish these tasks?
  • Where should society direct lim­ited resources to exploit tech­nol­ogy and enable indi­vid­u­als and fam­i­lies to live bet­ter, not just longer?

What are the jobs of longevity?

Source: A Maslow, Motivation and Personality (2nd ed.)

They look much like they did in our younger years but are now more diverse, com­plex, crit­i­cal, frag­ile, and out of our per­sonal control, as health declines. The long list of jobs begins at the very base of Maslow’s “hierarchy of needs” begin­ning with safety, secu­rity, food and shel­ter. Higher up in the pyramid are social engage­ment, con­tri­bu­tion and play. At the top is mean­ing and per­sonal legacy.

Stay­ing in our homes can become an extreme sport in old age. Con­sider the simple task of changing a light bulb once using a lad­der becomes a seri­ous haz­ard. So who can we trust to go into the home and do rou­tine main­tenance, clean­ing and repairs?

Meals become both exhaust­ing to pre­pare and lonely to eat. The basic tasks of shop­ping, trans­port­ing and “putting away” gro­ceries can become bar­ri­ers to independence, good nutri­tion, and even­tu­ally well­-be­ing.

Trans­porta­tion is taken for granted when we can drive, but it becomes a problem when it’s not avail­able. Especially for those in the suburbs or in rural areas where public transportation is scarce, the loss of mobility can mean the very connection seniors have to live is severed.

Man­ag­ing health becomes more difficult and com­plex­ with age. One dis­ease is tough enough, but man­ag­ing two or more becomes a full-time job, with mul­ti­ple doc­tors’ appoint­ments, main­tain­ing diets, adher­ing to complex med­ica­tion reg­i­mens, tracking symp­toms and trends, and com­mu­ni­ca­ting with clin­i­cians and insur­ers.

An Emerg­ing Care Gap

We are all responsible for own longevity, but as frailty and capac­ity decline, we often must rely on oth­ers. Who do we turn to? Often it’s a spouse, a part­ner or an old­est adult daugh­ter who becomes the coor­di­na­tion point to ensure that the house is clean and main­tained; food is pre­pared and eaten; trips are planned and dri­ven; and health needs and admin­is­tra­tion are met. Studies show that nearly one-in-five Amer­i­can fam­i­lies pro­vide over 20 hours a week of care giving to sup­port older loved ones.

The need for elder care is increasing rapidly. Another Baby Boomer turns 64 every seven sec­onds, but who’s to care for them? Boomers had fewer chil­dren; are more likely to be divorced; are most live in sub­urbs and rural areas where deliv­ering ser­vices is more difficult.

Pub­lic agen­cies and count­less vol­un­teer orga­ni­za­tions may not be able to meet the most basic of needs since they are often over­whelmed and under-resourced, short on bud­get, peo­ple, logis­tics and spe­cial­ized exper­tise.

Invest­ing in Com­pre­hen­sive, Col­lab­o­ra­tive and Con­nected Aging Services

The cre­ative use of infor­ma­tion and com­mu­ni­ca­tions tech­nol­ogy (or ICT) – including web-based appli­ca­tions, social media, mobile com­mu­ni­ca­tions (e.g., smart phones), and net­work and cloud com­put­ing – can greatly improve care for older adults. Busi­nesses should develop and pol­i­cy­mak­ers encourage the deploy­ment of appli­ca­tions and sys­tems that advance three prin­ci­ples: 1. com­pre­hen­sive access, 2. col­lab­o­ra­tive deliv­ery and 3. con­nected visibility.

1.       Com­pre­hen­sive Access — You are well and inde­pen­dent, until you are not. Few peo­ple plan, let alone can envi­sion, the day they will need sup­port with every­day activ­i­ties. Con­se­quently, the search for aging ser­vices is often after an event, such as a fall, accident or hol­i­day meal when fam­ily mem­bers “dis­cover” that a par­ent is not well.

Part­ner­ships between retail­ers and healthcare providers are helping to improve user aware­ness and access. CVS, Tar­get and oth­ers have already invested in retail clin­ics that pro­vid­e easy and con­ve­nient access to med­ical ser­vices. And Web-based tech­nolo­gies and online discussion sites (including our site, are connecting older adults and care­givers to information sources and online discussions. These resources are part of the solution since they prompt critical think­ing about today’s needs and tomorrow’s and facilitates information sharing.

2.       Col­lab­o­ra­tive Deliv­ery — Aging is too big for gov­ern­ment or busi­ness alone. Pub­lic agen­cies have a vast and inti­mate knowl­edge of aging but lack the technical expertise to provide solutions. Pri­vate firms have the tech­nol­ogy and know how to scale ser­vice and prod­uct deliv­ery, but they have lit­tle knowl­edge about aging. Col­lab­o­ra­tion between pub­lic agen­cies and pri­vate firms is required.

Retail­ers like Wal­mart have finely tuned sup­ply chains that make it pos­si­ble to source and deliver prod­ucts effi­ciently and in real time to stores within a few short miles of nearly 90 per­cent of the Amer­i­can pop­u­la­tion. How might these sup­ply chain effi­cien­cies be part­nered with aging ser­vices? Could food retail­ers, for example, be enabled by Web appli­ca­tions for older adults, fam­i­lies or aging ser­vices providers, and thus man­age both cus­tomized nutri­tional needs and ensure timely, trusted delivery?

3.       Con­nected Vis­i­bil­ity — Infor­ma­tion technology’s basic value propo­si­tion is con­nec­tiv­ity and com­mu­ni­ca­tion. The jobs of aging and care­giv­ing include the need to com­mu­ni­ca­te between providers, fam­ily mem­bers, pay­ers, etc. Com­mon plat­forms are needed, such as online apps that help older adults man­age the ser­vices they are receiv­ing.

Com­mu­ni­ca­tions between providers is often lack­ing. Med­ical spe­cial­ist “A” is not always in sync with spe­cial­ist “B,” “C,” the phar­ma­cist and the patient’s pri­mary care physi­cian. Ubiq­ui­tous and secure online tools are needed to engage clin­i­cians, patients and care­givers in col­lab­o­ra­tive deci­sion mak­ing for bet­ter outcomes.

Tar­get­ing Gov­ern­ment & Busi­ness Investment

The grow­ing demands of an aging pop­u­la­tion are a call to inno­vate. Tar­geted invest­ment in ICT, as well as col­lab­o­ra­tive inno­va­tion by both gov­ern­ment and busi­ness, will address the needs of older adults and their fam­i­lies. Done cor­rectly, ser­vices will pro­duce bet­ter out­comes and cost effi­cien­cies, and stim­u­late new mar­kets. Below are some guide­lines on how to invest:

  • Stim­u­late col­lab­o­ra­tive inno­va­tion. Invest in tech­nolo­gies and demon­stra­tions that fos­ter public-private part­ner­ships. Part­ner­ships should be based upon improved out­comes, as well as effi­cien­cies and a sus­tain­able eco­nomic busi­ness model.
  • Lever­age “big” sys­tems. Wire­less providers, cable com­pa­nies, electric util­i­ties, banks and large retail­ers pro­vide nearly uni­ver­sal access to every­one. They are con­duits into the homes and lives of older adults and care­givers. So, invest­ing in sys­tems and ser­vices that lever­age these “infra­struc­ture” com­pa­nies guar­an­tees access, scal­a­bil­ity and supe­rior processes.
  • Touch the user not just the provider. Sys­tems that improve the “effi­ciency” and cost of ser­vice deliv­ery alone may even­tu­ally ben­e­fit the pub­lic in the aggre­gate, but we age one at a time. Invest­ments in sys­tems and ser­vices that directly touch older adults are likely to pro­duce bet­ter out­comes and are polit­i­cally and eco­nom­i­cally sustainable.
  • Con­nect and dis­trib­ute exper­tise. The use of video conferencing can bring exper­tise to the user or patient. Addi­tional invest­ment should be made in using ICT to con­nect providers with each other and with life­long edu­ca­tion on best prac­tices and tech­nol­ogy in the full range of aging ser­vices (e.g., trans­porta­tion, home mod­i­fi­ca­tion, etc.).

BOOK: Longevity Rules: How to Age Well Into the Future

Joseph F. Cough­lin, Ph.D., is the founder and direc­tor of the Mass­a­chu­setts Insti­tute of Tech­nol­ogy Age­Lab. Based in MIT’s Engi­neer­ing Sys­tems Divi­sion, Cough­lin teaches pol­icy and strate­gic management. For information on the book that contains the full version of his essay, click on Longevity Rules: How to Age Well into The Future

For more info on the MIT AgeLab and their AGNES suit, see this New York Times article.

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