Uber for older

Sometimes referred to euphemistically as the “Silver Tsunami,” America’s population is rapidly aging. It is projected that the number of Americans over the age of 65 will double by 2060, growing to comprise nearly ¼ of the U.S. population. This demographic shift poses significant challenges, given the progression of chronic disease and disability that can accompany the aging process. While demographics may be shifting, the world that this aging population will inhabit is rapidly changing as well. Those who now find themselves in the over 65 population were born before the birth control pill was approved by the FDA, before the Internet was invented, and before the advent of commercial jet travel. Major technological shifts have shaped the lives, careers and health of these citizens. Well-designed technology, similarly, holds great promise as a tool for facilitating a healthier, safer and more independent life for these individuals as they age.

When surveyed, the elderly report a strong desire to age in place. 90 percent of those over 65 reported that they plan to remain in their current residence for as long as possible. Reasons underlying this desire to remain at home are varied, but include a desire to remain connected with friends, family and community organizations. Additionally, about one quarter of respondents reported they lacked the financial ability to move. Moving into an assisted living facility has significant financial ramifications. In 2014, the median annual cost for single bedroom apartment in an assisted living facility in North Carolina was over $35,000. A year of residency in a semi-private room of a nursing home cost almost $74,000. This cost is not just born by individuals. Elderly individuals who spend down their savings while in a nursing home come to have their care covered by Medicaid. Technologies that assist the elderly in remaining independent and family members in caring for the elderly at home can represent significant cost savings to individuals and society.

Technology that improves life for the elderly does not have to be technically complex to improve quality of life. One of the most common examples is a “Personal Emergency Response Service”—best typified by LifeAlert necklaces. Falls are responsible for 70 percent of the accident injury deaths among those 75 and older. Falling and being unable to obtain help can lead to dehydration, missing essential medications, and pain from injuries incurred during the fall. A simple and well-designed button gives many people the confidence to remain in their homes, knowing they could quickly summon help in the case of an emergency.

Novel emerging technologies also hold great promise. In August, Uber launched a fleet of self-driving cars in Pittsburgh. To many young adults the advent of self-driving cars is primarily a matter of convenience and the ability to avoid parallel parking indefinitely. However, for those unable to drive, these new cars could have a profound effect on quality of life. As anyone who has spent time with the elderly can attest, judgments regarding capacity to operate a motor vehicle can be touchy and unclear. Commonly, declines in vision, reaction time and memory occur insidiously, making a determination of capacity difficult. Much of American urban planning is predicated on having a car for transportation. In areas underserved by public transportation, the advent of self-driving cars could radically influence personal safety, reduce social isolation and increase the ability to carry out necessary tasks for independent living, such as grocery shopping.

New technologies also hold promise as a tool for supporting the caregivers, typically unpaid family members, who care for people in the latter years of their lives. Caregivers report significant emotional stress and neglecting their own health needs in order to care for others, often resulting in burnout. Technologies that can take over basic caregiving tasks, such as automated medication containers that alert a smartphone when a dose is missed or robots that help with lifting and bathing, can radically improve the quality of life of caregivers, and may prolonging the time that they can safely care for an elderly at home.

Like all technology, successful innovations for improving aging will depend on high quality human factors design. Poor design will fail to account for the declines in hearing, eyesight and mobility that accompany old age. For example, with a tremor a tap on a touch screen may turn into a swipe, rendering the device difficult to use. The MIT AgeLab has created a suit to help replicate the physical realities of old age, giving designers and developers a chance anticipate challenges and design better products. Another common pitfall is assuming familiarity with a given technology and failing to account for a learning curve. A device that may be second nature to a child who has grown up with similar technologies may prove deviously complex to a well educated adult lacking context.

While the population is rapidly aging, well-designed and novel technologies hold promise as tools to reduce costs of care and improve quality of life for the elderly and their caregivers. Success will be based on the use of these technologies to augment, rather than replace, supportive care from family and societal sources. Disruptive technologies have radically altered everything from the way we hail a cab to craft our social networks. Technological advances similarly hold promise as tools for creating an aging process that allows for greater independence, dignity and safety.

Lauren Groskaufmanis is a graduate student in the school of medicine. Her column, “the picture of health,” runs on alternate Fridays.