Elderly Care is Broken – Can Tech Fix it?
“People across England are navigating a social care system that is in crisis. As our society ages, and more people rely on this system, it is vital that high quality services are in place to support people at the right time. “
Deborah Alsina MBE, Chief Executive of Independent Age
3.6 Million older people in the UK live alone, of whom over 2 million are aged 75 or over.
In the next 20 years, the number of individuals with complex care needs is projected to increase due to the increased amount of people now reaching age 85+.
This social care behemoth has both healthcare legislators and professionals scrambling for solutions to a problem that threatens to grow beyond control.
Between those developing technology specifically designed to help the older generations and their caregivers, and those who have adopted existing tech to meet the needs of those with extreme requirements, technology in social welfare and age assistance seems to be waiting for it’s moment of democratisation.
A Modern Solution to an Age Old Problem
“To Maintain a sustainable care system going forward, we have to increase the efficiency of the existing care service.”
Dr Cheiko Ikeda, Senior Assistant Minister for Global Health.
With an unremarkable exterior, Tokyo’s Shin-tomi nursing home, nestled between X & Y, has been shaping up for the shortfall of up to 380,000 care workers by 2025 with a modern solution.
Paro the furry seal cries softly while an elderly woman pets it. Pepper, a humanoid, waves while leading a group of senior citizens in exercises.
Robots run Shin-tomi nursing home and are flying the flag for technologies increased accountability in the social care for the elderly – a job typically seen as requiring a human touch.
For many in Shin-tomi, singing and dancing with Pepper, the humanoid exercise leader/karaoke robot, is the only time they can forget their cares and remember a time before retirement, before social care.
Despite steps by Japan to allow foreign workers in for elder care, obstacles to employment in the sector, including exams in Japanese, remain. As of the end of 2017, only 18 foreigners held nursing care visas, a new category created in 2016.
But, this innovation naturally comes at a cost.
Paro, the automaton designed to look like a friendly Canadian seal, took more than 10 years to develop and received about $20 million in government support, said its inventor, Takanori Shibata, chief research scientist at the National Institute of Advanced Industrial Science and Technology. About 5,000 are in use globally, including 3,000 in Japan.
“It’s potentially a huge market,” said George Leeson, director of the Oxford Institute of Population Ageing. “Everyone is waking up to their aging populations. Clearly robotics is part of that package to address those needs.”
Robotics is just one, albeit costly, solution that has arisen due to the shortfall of natural, devoted caregivers in social systems.
But other systems, that leverage current and emerging technology, are starting to proliferate and ease the burden on healthcare professionals across the globe.
A Damaging Stigma
“Older adults are often portrayed as tech-phobic. In our experience, that is far from the case. Older adults are very open to trying new technology.”
Erin Washington, Co-Founder & Chief Product Officer, Embodied Labs
Carrie Shaw, CEO and founder of Embodied Labs, remembers the moment she learned of her Mother’s diagnosis.
“My parents gathered my sisters, brother-in-law, and I in their room to tell us mom had been diagnosed with Early Onset Alzheimer’s disease, and that she had been told she had 5 to 7 years left to live. As the words came out of my dad’s mouth, he melted into body-shaking sobs.”
Following her Mother’s diagnosis, Carrie left college for a semester and took to the globe. Costa Rica, Peru, before finding the best escape possible, The Peace Corps, uprooting her life for 2 years to move to the Dominican Republic.
It was these 2 years working as a Health Education Peace Corps volunteer in the Dominican Republic that she fell in love the way visual communication tools have the unique potential to cross cultural, language, and education barriers.
Returning home, with a lifetime’s worth of experience condensed into just a handful of years, Carrie, tempered by her time as her Mother’s primary caregiver, saw the plight of caregivers and the aging services workforce. She founded Embodied Labs, an immersive education and wellness platform that deploys XR technology for professional and family caregivers and the older adults they serve, shortly after returning.
X Reality is a form of mixed reality environment that encompasses a wide spectrum of hardware and software, including sensory interfaces, applications, and infrastructures, that enable content creation for virtual reality (VR), mixed reality (MR), augmented reality (AR), cinematic reality (CR). With these tools, users generate new forms of reality by bringing digital objects into the physical world and bringing physical world objects into the digital world.
Embodied Lab’s use these systems to develop an “Immersive Training Platform” that gives a caregiver access to a “growing library of virtual experience labs that simulate key problems and situations facing older adults and their caregivers”.
This “Immersive Training Platform” is hoped to enable caregivers to provide better care, increase the interest in healthcare professions and improve patient-provider communication and relationships.
Erin Washington is Co-Founder and Chief Product Officer at Embodied Labs and sees integrated systems and immersive training as one of the most scalable options for continued, high quality social care.
“Currently, we see XR being the most impactful training solution out there, because it can be utilized to help our workforce learn better, faster, and retain that knowledge longer.”
Embodied Labs’ work has been featured by the AARP, United Healthcare, Forbes, JAMA, and The History Channel and in July 2018, Embodied Labs won Grand Prize and a $250K award from The Bill & Melinda Gates Foundation’s XR in Education Prize Challenge.
More recently, at the start of January 2020, Embodied Labs announced it’s seed funding of $3.2 million led by Siegler Link Age Fund.
It’s clear that this visionary approach to senior care, using a combination of immersive tech and age-tech, is turning heads in the technology ecosphere, but there is still work to be done.
For Erin, the biggest hurdle integrated technologies faces in social care is the stigma around older generations and their adoption of technology.
Older adults are so often portrayed as tech-phobic and, although many would think this is simply an endearing characteristic of a generation born outside of digital innovation, when it comes to health care, this portrayal damages senior individuals access to connected networks when they’re at their most isolated.
“As wireless networks become more robust and the “internet of things” continues to spread, technology can be leveraged to create environments that lead to the best health outcomes for residents/clients and professional and family caregivers.”
But this problem is already embedded, as according to a 2018 survey, only one fifth of care homes have basic Wi-Fi, let alone the connectivity needed to deliver the XR systems that Embodied Lab’s have developed.
Addressing the connectivity of vulnerable communities will lay the foundation for innovation and ultimately enable better lifestyles for those most at risk but again. Despite healthcare technology coming on leaps and bounds, there will always be the problem of price. For all of this innovation comes at a price. A price that many simply cannot afford.
“When No One’s In, I Talk to Alexa”
The cost of residential care per week in England in 2019 was £655 per week without nursing care and £937 per week with nursing care.
These fees, varying across regions, have contributed towards what Deborah Alsina MBE, Chief Executive of Independent Age calls a “social care crisis”, with more and more people in the UK choosing to provide informal care to parents.
According to AgeUK, 38% of older people in England receive the help they need from family and friends, as opposed to 35% of older people who receive it through formal caregivers. This imbalance is predicted to continue to rise as the population ages and develops more complicated needs.
Technology in senior social care needs to be affordable, intuitive and fully accessible, not just to those who require the care, but for informal caregivers who, in some cases, may not be directly on hand to provide the care or company needed to fight one of the largest bi-products of a disjointed social care system: loneliness and isolation.
Although different concepts, Loneliness and social isolation are intimately related in their position at the very heart of the social care crisis.
In times like these, when we feel alone, it’s usually friends and family we turn to first and often this is where the transition to informal caregiver begins.
These informal caregivers, that are now being relied on more, simply may not have the time or resources to enjoy valuable face-time with their loved one.
And it’s here that many informal caregivers have found a solution in the form of Amazon’s popular Smart Speaker and other connected technologies.
University of Strathclyde’s Dr Graeme McLean, found that people could not help but make friends with Alexa, Amazon’s smartspeaker.
The university’s team asked more than 700 people online, who had been using their Echo for at least a month, about why they had bought one of the devices which cost up to £200.
The study found: “Voice assistants may serve as a means of overcoming loneliness in a household with fewer occupants.”
This approach, now backed by research, is being trailed by care-homes across England with one in four care staff saying their care homes use smart speakers such as Alexa or Echo to assist or entertain residents.
“Everyday we slide up and down the scale of impairment”
Whenever a new social care technology makes a breakthrough, eyebrows are always raised. How much will it cost? How many people will it actually be able to help?
In fact, If we were to pick one issue that underpinned the debate around technology’s place in senior care it’s cost, and, as a result, scale.
So instead of robotics or AR/VR, a growing portion of the community is looking to improving the accessibility of the technology that brings us all together – the web, and by extension, UX design.
UX design is big business, focusing on improving on platform experiences and reducing friction for customers using an app, service or website, professionals focused on this space have been growing and, according to IBM, for very dollar invested in UX a business will generate around $100 in return.
Within UX design sits Inclusive design.
Inclusive design is a design process (not restricted to interfaces or technologies) in which a product, service or environment is optimized for a specific user with specific needs. Usually, this user is an extreme user, meaning that this user has specific needs that are sometimes overseen with other design processes.
Robin Chrisopherson, Head of Digital Inclusion at AbilityNet believes that inclusive design is a way for brands and enterprises to meet the demands of consumers and cater for those with extreme requirements, like the elderly.
“We all slide up and down the scale of impairment on an almost hourly basis depending upon what we’re doing and where.”
The ripples of this inclusive design will be felt by the older generations, a sentiment mirrored by Robin.
“if an app or website is easy to use by those with extreme requirements, then it’s extremely usable for those without.”
Although not directly impacting the plight of the elderly and their carers, inclusive design will broaden access to key information and support. It isn’t farfetched to suggest that this would enable a better way of life for the elderly.