Let's Collaborate.

Fall show season in the long-term and post-acute care industry has come to a close. As someone who has diligently attended many aging services-related conferences over the last 20 or so years, I can report that one stood out among the usual suspects this year—the Aging 2.0 OPTIMIZE conference.

In fact, I had anticipated the conference for some time, having heard about it from colleagues and given its promise to marry innovation and aging. For the most part, it did not disappoint: there were many new and enthusiastic entrepreneurs eager to show off their innovations and win over investors and customers. With about 900 attendees, the feeling of the conference was energetic, perhaps because many of those in attendance were relative newcomers to our relatively small aging services ecosystem.

Unfortunately, too many of the exhibitors—all of whom I’m sure have good intentions—had made what I believe were incorrect assumptions about what or how their inventions would aid older adults. In some instances the name of a gadget or software platform was condescending, ageist even. In one example, a service for elders and their families seemed to make an assumption that the users would have positive reactions to a robotic, Siri-like voice making phone calls to them. In another, a “simplified” tablet would make technology accessible easy for old people (those 50+). Being a member of that demographic, I wasn’t clear what problem this solved for me (I love my tablet).

For the uninitiated, Aging 2.0 is a San Francisco-based organization that “connects, educates and supports innovators through community, events, startup programs, and content.” You may be familiar with the local Aging 2.0 chapters that host pitch events for senior facing startup companies in search of investors.

On display in the main meeting room of OPTIMIZE were some 60 exhibitors. The majority of them were in a startup phase, hoping to attract funding for their innovations.

Some highlights of the conference for me:

1. UZURV: A transportation reservation services app “created to enhance the on-demand riding and driving experience.” The app works in conjunction with existing on-demand transportation services like Uber and Lyft, allowing riders to make advanced reservations with the driver of their choice. The company was at Aging 2.0 seeking capital to expand its services into the senior living niche. The appeal to riders is that it’s customizable—the user can filter drivers in a variety of ways: by vehicle, amenities and special services; by driver profiles; and by sending requests to favorite drivers they know and trust. In doing so, the company hopes to appeal to elders and their caregivers because it “improves the quality, safety, and accessibility of on-demand transportation.” 

   My take on it: Since UZURV is already in 60 or so cities it’s a no-brainer to make the expansion into senior living, although rollout strategy will be extremely important. However, the company will have to work with Lyft and Uber, which could present some challenges.

2. FibriCheck: Created by a Belgium-based company, FibriCheck is a screening and monitoring software that detects arrhythmias in patients. Whenever a patient feels symptoms, FibriCheck can immediately record the heart rhythm using their phone camera function, which is the coolest thing about the technology—it requires only an index finger on the smartphone camera.

   My take on it: It’s incredibly user-friendly. What’s not to like about its simplicity? It has already been deployed in Belgium but the technology could face some challenges getting into the U.S. market. Of note: FibriCheck was also the conference’s Audience Choice winner.        

3. Cariloop: A service that provides comprehensive “coaching” via phone or video chat for loved ones of older adults whose lives been turned upside down by an event that requires myriad medical, legal, and financial assistance. The company also organizes medical records and other important information into a secure portal that allows for “easy storage of important files and ongoing collaboration” with a coach. 

   My take on it: Since Cariloop contracts with companies to benefit their employees, their services are sort of like having an employee assistance plan and a geriatric care manager all rolled into one. I like this no-wrong-door approach.

There were a number of other innovative and clever creations that I’m sure will be successful in the longevity economy. But for those that don’t have a handle on what elders really need and want, I hope they will consider spending more time with elders and designing with them—not just for them. 

In just a couple of weeks, Quantum Age Collaborative will head to the Aging 2.0 OPTIMIZE conference in San Francisco, where we expect to find some highly innovative individuals, organizations, and companies navigating their way through the opportunities presented by the longevity economy.

I am particularly excited about one individual on the OPTIMIZE agenda, Jennie Bucove, founder and CEO of Furnished Living, a company with a new line of furniture “that addresses the needs of older adults and people with Alzheimer’s disease and other dementias.”

What’s most intriguing about the products is that they seem to be highly person-centered. I was able to catch up with Bucove recently to get some more details about the company, as well as a sneak peek of her talk at Aging 2.0 before she gives it on Thursday, Oct. 13.

Like many entrepreneurs in the senior living space, Bucove spent much of her career climbing the corporate ladder before her father’s health began to decline and he had to move to a long-term care center. “The home was lovely and extremely helpful to my father,” says Bucove, “but when I visited him I noticed that once he sat down in the chair in his room he couldn’t get up out of it.” As a result, Bucove says she often had to help him get up.

In addition, Bucove noticed that her father’s bed was made with a plastic headboard that was not at all conducive to his mobility or safety. “His furniture looked like it belonged in a dorm room,” she says.

After talking with friends who’d had similar experiences with their parents and loved ones in long-term care communities, Bucove realized that there had to be a market for better furniture—furniture that would both optimize elders’ independence and heighten engagement with staff and family members. “It was a light-bulb moment for me,” she says.

Bucove soon began compiling a design team and launched a search for a manufacturer. The process was not an easy one, she says, but she eventually found the right group of people, which included renowned gerontologist Rosemary Bakker.

The next step was to find a place to put the furniture to use. In a serendipitous turn of events, Bucove met Mike Shmerling, founder of Abe’s Garden, a memory care community in Nashville, Tenn. Shmerling’s father had Alzheimer’s disease and had lived in multiple long-term care centers. “He had been kicked out of every facility because of his disease, so Mike decided to create a community on his own,” Bucove explains.

She credits Shmerling’s entrepreneurial spirit for being open to putting her furniture designs in his building.

“So I worked with Mike and his design firm to fine-tune the furniture before putting them into Abe’s Garden,” says Bucove. Since then, she says she has learned that the furniture is helpful in improving residents’ independence, enhancing engagement with visitors, and helping staff avoid injury, among other things.

Of the eight pieces of furniture designed and produced by Furnish Living, the supply cabinet and the night stand sound most promising to me. The supply cabinet has a magnetic cover that holds cloth and magnetic frames for photos. “It’s made so family members can take them down and look at them with their loved ones,” says Bucove. The door on the supply cabinet also has no handles and it uses a magnetic lock system so that staff need carry only one key fob to disengage the lock, when necessary.

The nightstand has a light that illuminates the floor in front of it so the user can see the floor in the middle of the night—thus reducing fall risks—and a dimmer so that it doesn’t keep sleeping residents awake but allows for enough light for a staff member to check in.

The Aging2.0 OPTIMIZE conference, which takes place from Oct. 12 to 14 in San Francisco, brings together senior care executives, tech companies, investors, and entrepreneurs from around the globe to experience the intersection of aging and innovation.

If you are interested in attending, the Aging 2.0 folks are offering a last-minute discount for those who register with this code: A2NETWORK.

I hope to see you there!

Hung on the door of Bill Clinton’s Little Rock headquarters and originally meant as some levity for fellow campaign workers, campaign strategist James Carville made the phrase, “The economy, stupid,” a battle cry for the 1992 Clinton presidential campaign that still resonates today.

Reasons often cited for the current stagnant economy of the United States include debt hangover from the housing bubble, a slowdown of new technologies, and government over-regulation. A recent academic study from the National Bureau of Economic Research provides another explanation for the country’s lagging economic growth: an aging population.

“The fraction of the United States population age 60 and older will increase by 21 percent between 2010 and 2020,” says the study, which was coauthored by economists Nicole Maestas of Harvard Medical School and Kathleen Mullen and David Powell of the Rand Corp., a public policy think tank. “Our results imply that [Gross Domestic Product or GDP] growth will slow to 0.68% this decade and 1.28% next decade.”

A recent Washington Post article explained that from the 1950s to 2007, the U.S. GDP grew to about 3 percent per year. Since 2010, however, annual growth has averaged about 2 percent. Adding the paper’s dismal prediction of 1.2 percent annual growth lost to aging would keep the GDP at roughly 3 percent.

The rise of the U.S. population aging today is the result of a decline in the birth rate in the 1960s, which marked the end of the Baby Boom era, and the long-running decline in mortality rates. While it is becoming widely recognized (as highlighted in a previous blog) that Baby Boomers are a consumer force to be reckoned with, the new study paints a gloomier picture. Using 1980, 1990, and 2000 Census data and 2009-2011 American Community Surveys from the Census bureau to compare U.S. states with fast- and slow-growing populations, this study finds that states with the fastest increases in the elderly had the poorest economic performances.

The paper suggests that only one-third of the economic slowdown can be attributed to slower labor force growth. Curiously, the remaining two-thirds is due to reduced worker productivity—workers young and old have become less efficient. However, no clear reason is given for the latter finding. The paper postulates that the best workers may be leaving the workforce, despite other studies claiming that the most skilled older workers stay in their jobs longer.

Aging populations in other countries have produced similar results. Take, for instance, Japan, which has the highest percentage of people age 60 and older (35 percent), according to the United Nations. The aging of the Japanese population is due to its low fertility rate (about 1.4 children born to each woman) as well as its highest life expectancy (87 for women, 80 for men). In 2014, sales of adult diapers surpassed those of baby diapers. The country's economy is currently at a tailspin, with a GDP of 1.4 percent.

East Asian countries, such as China and South Korea are following suit. A recent World Bank report predicted that shrinking labor forces in these two countries will increase health and pension spending, as well as wreak havoc on their respective annual economies.

Europe’s economy is also not immune. A similar labor shortage caused by an increasing aging population in Austria, Germany, Greece, Italy, Spain, and Sweden will depress the E.U.’s annual growth by 0.4 percentage points from 2000 to 2025, states a study from the Organisation for Economic Cooperation and Development.

The World Economic Forum’s Global Agenda Council on Ageing predicts that over the next four decades, “rapid ageing of populations will be one of the most powerful transformative forces affecting society … This will have a significant impact in areas such as social welfare, public health and economic prosperity.”

As if it hasn’t been said enough—the aging of our population will have a momentous affect on all aspects of society. What’s more, aging guru Ken Dychtwald, PhD, may disagree with these studies’ conclusions, as a previous post in this space indicates.

Whatever the future holds, it’s important to be aware that an aging population will create a longevity economy that has the potential to be a tremendous asset to our society.

Businesses may have to pay heed to the adage, “listen to your elders.” According to a recent report from the worldwide management consulting firm McKinsey Global Institute, the 60+ age group will be one of the top three consumer groups to generate half of the global urban consumption from now to 2030.

The retiring and elderly in developed economies, along with China’s working age population and North America’s working age population, form a consumer seismic shift that will “reshape global consumer markets over the next 15 years,” the authors write in the April 2016 report titled, “Urban World: The Global Consumers to Watch.”

Reasons for the economic dominance of the elderly include the high number of baby boomers—the post-World War II generation that resulted from the largest spike in birthrate—entering the 60-plus age group as well as the growing number of those who are aged 75 and older.

Typically these consumers spend more per head than younger people. Although health care remains the main service that is purchased (In developed countries, a 30-year-old consumer spends on average $3,000 per year on health care, while a 60-year-old and a 90-year-old respectively spend annually $8,200 and about $35,000), this group also spends more than 40 percent on transport, housing, and entertainment, the report states.

For example, people over 50 bought nearly two-thirds of the new cars sold in the United States in 2011, the report states, adding that half of all Americans riding Harley-Davidson motorcycles are baby boomers.

The elderly increasingly want to “age in place.” As such, the authors claim that those aged 55 and older account for nearly half of the U.S. spending on home improvements.

Yet this population is not nearly as homogenous as previous generations. Several factors affect the buying power of this age group: retirement age, rate of divorce, spousal death, and the need for, and timing of, assisted living. While they will continue to spend on health care, this generation uses technology at rates closer to those of the 20- to 30-year-old Millennials, enjoys more active lifestyles and vacations, and spends more on good design and higher-cost items when their savings can support it, states the report.

While many in the 60-plus age group are wealthy, others have not saved enough to sustain their retirement. The latter may have to supplement their income by downsizing, renting out rooms, or taking out reverse mortgages, suggests the report. Many baby boomers are also delaying retirement.

According to the report, nearly 65 percent of U.S. baby boomers plan to work past the age of 65; of those, 62 percent plan to continue to work either to maintain income or health benefits, while the rest will do so because they enjoy their work.

This tech-savvy, resourceful, and energetic group is causing many businesses to rethink their consumer models and tap into the longevity economy.

“Companies in every sector—some of which have never been associated with the elderly—will need to prioritize this market as never before,” wrote the same authors in a recent Harvard Business Review article.

For insights on how you can tap into the longevity economy, engage with Quantum Age today.

Humans are living much longer than any other time in history, and according to a recent study this phenomenon will translate into a tremendous boon of volunteerism and charity—to the tune of an $8 trillion dollar windfall—for American society.

Aging guru Ken Dychtwald, PhD, and his colleagues presented the study’s findings in his keynote last month at the American Society on Aging’s annual meeting. Released late last year, the report reveals some remarkable findings about the generosity of older Americans. Titled Giving in Retirement: America’s Longevity Bonus, the study offers some food for thought for anyone who serves elders and plans to serve baby boomers.

The study found that over the next two decades there will be a surge in giving by retirees, leading to what Dychtwald describes as America’s $8 trillion “longevity bonus.” Behind this phenomenon, he says, are three factors: the wave of baby boomers moving into retirement (or something that may or may not resemble retirement), the rise in longevity, and the rather high rates of giving among this cohort.

So what’s the evidence behind his premise? Older Americans have more time, money and skills to contribute to causes they care about than younger adults. For instance, more people age 65-plus donate money or goods than any other age group, and they give the greatest amount—more than double that of younger adults.

The research also found volunteers over age 65 volunteer an average of 133 hours per year, compared to those ages 25-34 and 35-44 who volunteer an average 55 and 58 hours per year, respectively.

In addition, retired women—the predominant gender living in seniors housing—are even more likely than men to say retirement is the best time to give back (68 percent vs. 62 percent). More retired women donate (81 percent of women retirees vs. 71 percent of men retirees) and volunteer (29 percent of retired women retirees vs. 22 percent of men retirees) to charitable causes.

According to Dychtwald, those in the aging services field have a “unique opportunity to harness the wealth of talents, skills, and experiences of the boomer generation as they enter retirement and seek to make a difference.”

Dychtwald is right, and long-term and post-acute care providers are in a unique position to harness this moment in history. Consider the fact that living in a nursing home or assisted living community doesn’t mean you cannot give as a volunteer, as a mentor, or in another capacity. In fact, some providers already offer programs that engage their residents in very successful and purposeful volunteer programs, such as creating items to give to local underserved families, serving as mentors for nearby school children, or making crafts to sell at the community farmers market. It’s also good for you—physically and mentally.

The longevity bonus is also ripe fodder for innovators in the field who may be interested in developing solutions that further enable volunteerism for elders, as well as for providers.

What's more, there can be little downside to activities that have been shown to reduce depression and diminish chronic pain.

Sometimes the best solutions for improving quality care and reducing risk are decidedly low tech. Food for thought indeed.

Hospitals are out and community alternatives are in, according to Bill Thomas, MD, aging guru and Harvard-trained geriatrician, who was at University of Maryland Baltimore County recently to share his opinions on long term care, ageism, and the word “continuum,” among other things.

After declaring himself a nursing home abolitionist, Thomas was quick to note that he bears no ill will toward owners, operators, or others who work in such places—he simply wants to abolish institutional models of care.

This assertion is not a new one for Thomas, who had just finished his Age of Disruption tour of 35 U.S. cities. He began his career as a nursing home medical director in New York some 30 years ago, where he encountered poorly run facilities and painfully lonely and isolated residents. Since then, he has founded the Eden Alternative and Green House models of long term care, which eschew models that adhere to institutional dictates.

However you may feel about Thomas' views, he is a force to be reckoned with when it comes to holding sway among long term care professionals. His standing as an aging influencer (a title bestowed upon him by both www.NextAvenue.org and The Wall Street Journal) is undeniable. He is credited by most to be the founder of the culture change movement in nursing homes, and his many followers (nearly 7,000 on twitter and thousands between his Facebook page, blogs, and books) believe him to be a bit of a savior in the field of aging services.

The informal gathering enabled Thomas to wax extemporaneously from his “notebooks of thought” on topics such as aging, grief, and hospital care. Yes, that’s hospital care. The good doctor believes that the law responsible for Obamacare is doing a fine job of steering money away from hospital beds and toward outcomes.

How so? For one, he says the Affordable Care Act (ACA) is creating, slowly and imperfectly, “a movement away from a system where the money follows the bed to one where money follows the risk,” he says. What’s emerging, he adds, are populations of people that become enrolled in an organization or system that takes responsibility for those people and those outcomes (a la accountable care organizations).

“All of the sudden,” says Thomas, “heads in beds is not a winning strategy.” He confessed that he spent years of his career doing the best he could to make a flawed nursing home model work. “But now, provisions of the ACA are changing that far more than I ever did."

Connected to this issue, Thomas noted, is something known as post-hospital syndrome—when someone goes into a hospital and comes out much worse off due to a lack of movement resulting in loss of balance and muscle mass, among other things. 

“What happens in a hospital,” Thomas said, “is they treat a presenting complaint and when it’s been adequately treated, you are discharged. They don’t help you heal; the docs treat the numbers, and not the person.”

So, what is the antidote to this? Thomas posits the following: Move Eat Sleep and Heal, or MESH. He believes that hospitals and the entire health care system have been doing it wrong by focusing on chief complaints and diagnoses when they really need to focus on MESH.

“We spend billions of dollars where it’s virtually guaranteed that Medicare patients will not heal,” he says. “The slope [of decline] is of our own creation. We manufacture disability, frailty, weakness, and we create it on a massive scale.”

In short, Thomas says he would like to “free America’s elders from its hospitals.” The real conversation, he adds, is with the payers and with the people who will set up new and different networks that keep people out of hospitals.

The corollary to this, Thomas notes, is to “create a rich set of community-based alternatives that work for people. Get the people who are in hospitals out of hospitals, don’t put them in the nursing home, put them in a place in a neighborhood in a community where they can get MESH care,” such as their homes.

A future post will examine why Thomas wants to wage war on the word “continuum.”