Heard about “Blue Zones?” | They’re places where “people live much longer than average.”
This Time Magazine article begins, “Global life expectancy averages out to 71.4 years. That means, of course, that some parts of the world see much shorter life spans, while others enjoy far greater longevity.
“Five places, in particular, fall into the latter category. They’re known as Blue Zones —named for the blue circles researchers drew to identify the first one on a map — and they’re home to some of the oldest and healthiest people in the world. Dan Buettner, author of The Blue Zones and The Blue Zones Solution, told TIME why residents of these places live so long—and how you can steal their habits.”
Blue Zones “are Inspired by the world’s longest-lived cultures, we help you live longer, better.”
AN OPINION: “Older adult finances and future senior housing options are out of sync” – Aging In Place Technology Watch
Rant on. A sad tale – reading the lament about the numbers of seniors who will not be able to afford assisted living in 10 years. The report is from NIC – the National Investment Center that provides research to the senior living industry. The upshot – 54% will be unable to pay the $60,000 average annual cost of assisted living (make that $93,000 in Washington DC), even if they sell their home. If one member of a couple is still living in the home, the number rises to 81%. According to the study, 60% of the population aged 75+ will have mobility, cognitive impairment or chronic conditions that would characterize them as good candidates for assisted living services and settings – but will not have the savings to enable them to move in.
There are some problems with this study’s message to the industry. First the affordability gap of assisted living and the population that could benefit. This has been a statistical fixture forever (move in age of 85 noted in 2012 and again in 2015). What has changed, if anything, is life expectancy. For those aged 65+, living into the late 80s or even the 90s is increasingly likely. Looking at life expectancy lasting to mid-to-late 80s combined with average savings for those aged 75+ of $16,025 for a couple with no children, it is no wonder that the steady state penetration of assisted living remains stuck at 10% of the likely population, at least according to the industry. According to NCAL, seniros stay 22 months on average, before moving to skilled nursing. With assisted living occupancy at 85% being attributed to over-building, but one might also posit that price-plus-life expectancy keeps even the willing and interested at home.
Consider the operating margin of 34% and the real cost – can tech help? This industry has been a real estate investment play from the very beginning. One executive interviewed for the NIC study observed, reluctantly, that margins could be compressed to create more affordable options, perhaps by building on less expensive land. Hopefully not from robbing the pay of CNAs who do the real hands-on labor – their average pay of $11-12/hour nationwide can’t be pushed down much further. Maybe high-end food choices could be trimmed, the lobby furniture more modest, or the long-shot on operational costs, noted in the Health Affairs the study: “Technology is already driving innovation. The implementation of an ever-expanding panoply of high-tech solutions such as artificial intelligence, voice technology, smart phone apps, smart sensors, and telehealth can help improve quality of life, and care, while reducing costs.” Right.
The margin question is about people — how to need fewer or boost pay to recruit. The staff-to-resident ratios may, in some states, already be too thin to handle assisted living memory care residents. For families of a resident, that means supplementing the $60K annual cost with the hidden cost of needed private duty home care aides (same hourly rate). For many, that additional cost may drive families elsewhere, to nursing homes or back home. But the real problem will limit expansion of assisted living is a shortage of available workers — for assisted living, skilled nursing and home care. Where to recruit this low-paid workforce in a high employment time, competing with wage levels of Walmart and McDonald’s? Finally, will we read the same lament in 10 years about the large population of now-aged boomers who cannot afford assisted living? Count on it. Rant off.
Have you heard about “age-friendly places?”
How much do you know about the “age-friendly world?” Perhaps the place to begin is to get some background insight into the World Health Organization’s initiative.
“A key strategy to facilitate the inclusion of older persons is to make our world more age-friendly. An age-friendly world enables people of all ages to actively participate in community activities and treats everyone with respect, regardless of their age. It is a place that makes it easy for older people to stay connected to people that are important to them. And it helps people stay healthy and active even at the oldest ages and provides appropriate support to those who can no longer look after themselves.”
Towards an Age-friendly world [World Health Organization]
“A new report on the WHO Global Network for Age-friendly Cities and Communities reviews achievements since the founding of the Network in 2007, challenges and how to overcome them, and together with its Affiliate programs, outlines steps to guide action over the next decade. Eleven accompanying case studies from members of the Network around the world examine local age-friendly programmes in depth.”
What is an “age-friendly world?
The March 24, 2019 LNP – Always Lancaster carried a special newspaper supplement entitled Progress 2019. A story about The magazine-sized insert
Scan of the article in LNP – Always Lancaster‘s Progress 2019 special insert. Click on the image to enlarge.
The American Association of Retired Persons [AARP] also has its AARP Network of Age-Friendly States and Communities.
In Pennsylvania, these are AARP’s Age-Friendly Communities:
- Allegheny County: Joined: 2015 | Population: 925,521 | Survey | Action Plan
- Lancaster: Joined: 2018
- Lehigh County: Joined: 2018 | Population: 360,685
- Northampton County: Joined: 2018 | Population: 299,791
- Philadelphia: Joined: 2012* | Population: 1.58 million | Survey | Article
- Pittsburgh: Joined: 2015 | Population: 305,700 | Interview | Survey | Action Plan
- Swarthmore: Joined: 2017 | Population: 6,194
- West Chester: Joined: 2016* | Population: 18,968 | Action Plan
Constance: assures personalized, one-on-one conversational check in service for seniors.
Lancaster, PA – March, 2019 – Integrated Platform Services LLC today announced a new subscription check-in and reporting service for families of seniors who live independently. The service, named Constance™, targets the families of the 87% of Americans over the age of 65 who, according to AARP, would prefer to live on their own.
Constance™ provides daily human interaction with seniors to check on mood, meals, medications, appointments, and more. The check-ins are used to generate electronic updates for family members — typically members of the “sandwich generation” who find it increasingly difficult to balance support for their aging parents with managing their own busy lives. With a focus on overall wellbeing, Constance™ addresses the most important factors impacting healthcare outcomes: early detection of medical conditions, care plan adherence, and social engagement.
The service is delivered by carefully selected and trained team who call each senior for a personalized, one-on-one conversation. Unlike other personal care services, the reports are immediately available to family members via a smartphone app on iOS and Android devices.
Families using the service have confidence that the needs of their loved one will be identified and reported, allowing them to continue living independently. Constance subscriber Suzette Mullen commented, “My sister and I look forward to getting the reports every day. The daily updates have really connected us as we navigate (my mom’s) care from a distance.” Members also look forward to interacting with the Constance Family Coordinators. A senior using the service, Patricia Roberts, recently said, “It made me feel very safe to know you were calling me this morning.”
CEO and cofounder Henry Yaeger commented, “We started Constance because we want to apply business solutions to a huge and growing societal challenge. Demographic shifts and longer distances are leaving families unprepared for the demands of supporting their loved ones as they age. Our service allows seniors to continue to live independently, while giving their families the comfort of knowing they are always being looked after.”
– news release
ABOUT CONSTANCE
Constance is a service of Integrated Platform Services LLC, a company based in Lancaster, Pennsylvania. Constance helps seniors maintain independence by facilitating communication between seniors, their family members, and others. The high-touch service is supported by a cloud-based, HIPAA-compliant platform that enables the Constance team to efficiently provide services, while native mobile apps keep family members informed. Constance is a Pennsylvania Link to Aging and Disability Resources partner entity.
“Nursing Homes Are Closing Across Rural America, Scattering Residents” – The New York Times
“Ramona Labrensz with a photo of her husband Harold at her home in Mobridge, S.D. When the local nursing home where he was living failed, Mr. Labrensz was transferred to another nursing home 220 miles away in North Dakota.” Credit Kristina Barker for The New York Times
by Jack Healy
“MOBRIDGE, S.D. — Harold Labrensz spent much of his 89-year life farming and ranching the rolling Dakota plains along the Missouri River. His family figured he would die there, too.
“But late last year, the nursing home in Mobridge, S.D., that cared for Mr. Labrensz announced that it was shutting down after a rocky history of corporate buyouts, unpaid bills and financial ruin. It had become one of the many nursing homes across the country that have gone out of business in recent years as beds go empty, money troubles mount and more Americans seek to age in their own homes.
“For Mr. Labrensz, though, the closure amounted to an eviction order from his hometown. His wife, Ramona, said she could not find any nursing home nearby to take him, and she could not help him if he took a fall at home. So one morning in late January, as a snowstorm whited out the prairie, Mr. Labrensz was loaded into the back of a small bus and sent off on a 220-mile road trip to a nursing home in North Dakota.”
Technology and home health care: a match?
We’ve been reading so much about advantages that aging persons can accrue with the introduction of emerging technology, we decided to list some of the articles.
Aging In Place Technology Watch shares this in today’s newsletter: “… it’s good to see that Envoy (concierge service for independent living), Kindly Care (home care agency), Caremerge (home care platform), and Seniorlink (care coordination) are in their same businesses from 2016 – and others from the period like Envoy and CareLinx received additional investment and moved forward.
“New Tech Options are Helping Seniors Age in Place – Systems that offer reminders and assistance are creating ‘monitored independence.’” – Scientific American
“Smart Home Technology Becomes a Must-Have in Senior Living” – Senior Housing News
A 2016 article | “Home care robotics market set to quadruple – The robots are finally coming home, but the undisputed category leader isn’t what you had in mind.” – ZD Net
“A Glimpse at Healthcare Technology May Give Signs to the Future of Home Care” – HomeCareDaily
“Where the Home Health Aide Shortage Will Hit Hardest by 2025” – Home Health Care News
“Remembrance of Things Past: Preparing for the Future of Aging” – GeriPal
The following is a guest post from Minakshi Raj (@MinaRaj91), 4th year PhD candidate at the University of Michigan in Health Management and Policy and Theodore Suh, MD, PhD, MHS, Clinical Associate Professor in Geriatric and Palliative Medicine at the University of Michigan and Medical Director of the Ann Arbor Geriatrics Clinic.
“In my parents’ home, one of our many photo albums is inaugurated by a photograph of me, in diapers, standing by my grandfather as he holds my hand. If panoramic photography had been available in the 1990s, we’d likely see my grandmother warning him not to let go as I might fall onto the wooden floor and develop a fear of taking my next step. In another, much thicker photo album, I’m taller and a decade older with my arm circled around my grandmother’s elbow as she leans against a walker supported by tennis balls to help her glide gracefully across the floor. As she clutches the walker, I can recall her saying, ‘Take the picture quickly; I can’t stand much longer’.’
“My paternal grandparents, married for over 65 years, had drastically different personalities, but both similarly desired engaging with friends, relatives, and even strangers.”
Get Moving With All of AARP’s Roadmaps | a six-part series features workbooks about housing, transportation, health services, community engagement and more.
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Book 1: Roadmap to Livability
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Book 2: Community Listening Session Workbook
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Book 3: Housing Workbook
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Book 4: Transportation Workbook
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Book 5: Health Services/Community Supports Workbook
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Book 6: Economic Development Workbook
“The Future of Retirement” – AgeWave
Age Wave conducted nine recent study reports in collaboration with Bank of America Merrill Lynch on the future of retirement. These reports were created by reviewing thousands of papers and datasets, conducting over 140 expert interviews and 43 focus groups, and surveying 50,000+ respondents. The nine reports cover a variety of topics regarding retirement, including family, health, leisure, and finances. All nine reports are followed by sample media coverage.
Click here to read this insightful and intriguing report.
“Real Seniors lack essential technology – who will make it happen in 2019?” – Aging in Place Technology Watch
by Laurie Orlov, Laurie Orlov’s Blog
When Pew stops tracking senior adoption, does that imply a market saturated? Rant on. Note this Fact Tank aggregation of technology adoption statistics (tech overall among seniors, last reported in 2016) – and the most recent data cited on Internet use, seniors were quoted in a 2016 survey, 44% of responders did not use the internet users. Of those that do, older adults aged 65+ said they had little to no confidence in their ability to use electronic devices to perform online tasks. Let’s think about their non-confidence (not broken down into the 65-74) and the 75+ who are the Real Seniors.
Does that fear imply lack of training? Or too much media reporting about scams, breaches, and identity theft – most of which it is difficult to detect and nearly impossible to prevent? Who knows, since Pew appears to be largely done – after all, they note, 89% of Americans are online and they do not survey all questions each time. AARP published a survey last year that included responders in their 70s — we stay tuned for the next update.
Are those who should care about this not doing enough? Here are questions to ponder moving into 2019 for those whose job, business, or non-profit organization is explicitly to help seniors go online (you know who you are):
- For seniors, why is there a problem with non-use? Note the research from Michigan State cited in an AARP article: “Greater technology use was associated with better self-rated health, fewer chronic conditions, higher subjective well-being and lower depression.” The study also found that technology use reduced feelings of loneliness. And let’s not forget how many services can be discovered and accessed online, including scheduled food delivery, transportation requests, buying tickets and signing up for local events. And have we mentioned online banking, accessing Social Security information, buying savings bonds – oh, and then there’s healthcare access, including finding a doctor or benefiting from telehealth services?
- Are there still senior centers or organizations that do not have high speed internet? You know where they are – maybe they haven’t figured out the right source of grants, like, for example, Grantmakers in Aging? Senior centers are partially funded by the Older Americans Act – which also provides Meals on Wheels. But there is nothing in the Act (beyond partial funding of senior centers) that specifies professionally delivered training of seniors on technology use or supporting seniors in their usage. This is a policy change and it’s high time that the policy was changed.
- Why isn’t technology training of seniors required to be delivered by professionals? Is it because it is viewed as non-essential because it is ‘free’? The Geek Squad isn’t free, so why is there no magnanimous donor group focused on helping seniors who could fund a regular visit of several Geek hours to a library, senior center or other community center who could help individual older adults during designated hours with their devices? AARP pays for training it offers in its regional workshops, which is free to participants. Presumably organizations like OATS, expanding outside of NYC (but still reaching a small percentage of seniors), must use grants to pay trainers to do the offered training, which is free to attendees. This should be the standard of caring about seniors — offer professional trainers combined with free training.
- But you ask, so why isn’t ‘volunteer’ training good enough? Because at today’s pace of technology change, it can’t be. Read the list of Geek Squad services again. Or look at another nationwide competitor, HelloTech (ads bash Geek Squad) or Bask or many paid services in various geographies. You hopefully get what you pay for. Free training may be well-intentioned – and it is appropriate in stores of carriers who provide the connectivity. But it is very expensive to stay current with the myriad of always-shipping new devices and OS variations and upgrades, required to keep a device secure. Add the difficulty (and costs) of getting an operational router, high speed internet printing from multiple devices, streaming from devices.
- Smart phones for seniors: why can’t every Real Senior have one? And no, it’s not to read dumb text messages heads down and fall into a manhole – nor is it about the social media company that cannot be named. Smartphones are useful in so many ways that without one, day-to-day life and flexibility are circumscribed. GPS turn-by-turn directions, research about what’s nearby when traveling, renting a car, checking reviews before eating in a restaurant or checking into a hotel, for starters. And that doesn’t count emergency advice from WebMD or Mayo Clinic. So that brings me to:
- Why isn’t there a senior discount to get a smartphone? No, I am not talking about the cell phone plans. Senior discounts are offered in at least 180 categories. But what about 50% discount an iPhone or Galaxy S9 – to get them into the 21st century of their grandchildren, assuming that other infrastructure is available to help them (in-store training, upgrade assistance, and on and on.)
- When will everyone have a voice-activated TV remote? Voice-activation and control will surely be standard for smart TVs, but sites that cater to seniors aren’t sources for finding them. Nor is there any apparent interest in re-engineering older remotes to support voice input. Why not?
Baby boomers cross 73 in 2019, becoming Real Seniors in 2 years. They will likely live, on average another 10-15 years or more. For the next 18 years, the growth in the number of Real Seniors will continue. Shortages of in-home care workers are worsening, new, hopefully tech-enhanced services are already forming. Senior living firms, meanwhile, are over-expanding to accommodate them, hopefully in communities with high speed internet and WiFi access everywhere. For all of the Real Seniors to be, now’s the time to tech-enable their future, don’t you think? Let’s not keep having this conversation for the next 18 years. Happy New Year. Rant off.
