JUNE 21, 2016 • Technology is slowly becoming a welcome addition to seniors’ lives, enabling independence and “aging in place.” • Many seniors prefer to remain in their homes in later life, even if they are unable to care for themselves. • The most common type of disability among seniors in the US and the UK is difficulty with mobility. • New technologies and innovations are helping fulfill various needs that mobility-constrained seniors may have, and enabling them to lead a better quality of life. • Robotics and smart homes are helping address seniors’ physiological, social and safety needs, while virtual-learning platforms and social networks are helping fulfill their social and self-esteem needs. The Silvers Series III: Technology for Mobility- Constrained Seniors DEBORAH WEINSWIG MANAGING DIRECTOR, FUNG GLOBAL RETAIL & TECHNOLOGY [email protected]US: 646.839.7017 HK: 852.6119.1779 CHN: 86.186.1420.3016
• New technologies and innovations are helping fulfillvarious needs that mobility-constrained seniors mayhave, and enabling them to lead a better quality oflife.
• Robotics and smart homes are helping addressseniors’ physiological, social and safety needs, whilevirtual-learning platforms and social networks arehelpingfulfilltheirsocialandself-esteemneeds.
The Silvers Series III:
Technology for Mobility-
Constrained Seniors
D E B O R A H W E I N S W I G M A N A G I N G D I R E C T O R ,
F U N G G L O B A L R E T A I L & T E C H N O L O G Y
d e b o r a h w e i n s w i g @ f u n g 1 9 3 7 . c o m U S : 6 4 6 . 8 3 9 . 7 0 1 7
H K : 8 5 2 . 6 1 1 9 . 1 7 7 9 C H N : 8 6 . 1 8 6 . 1 4 2 0 . 3 0 1 6
Agingbringswithitmanychanges,oftenincludingdisabilityduetofrailtyorillness.Whilesomeseniorsareabletocareforthemselvesathome,othersexperience conditions that constrain their mobility or leave themhousebound. In the US and the UK, the most common disability amongseniorsisconstrainedmobility.
Despite the prevalence of disability, there is an increasing preferenceamong seniors across the globe to “age in place” by remaining in theirhomes through the later stages of life instead of moving to institutions,eveniftheyneedhealthcareorassistancewitheverydaytasks.
Given many seniors’ preference to age in place and their high rates ofmentalandphysicalchallengesduetomobilityissues,companieshavebeendeveloping a range of technologies that cater to this population’s needs.Innovative products and services are providing seniors with assistance inmobility and everyday living, helping them keep in touchwith family andfriends, learnnewskillsor teach them toothers, andpursuehobbiesandfindcompanions.
Developments in robotics and smart homes are addressing seniors’physiological, social and safety needs, while creative virtual-learningnetworks are helping them learn new things and share their ownknowledge.Meanwhile,socialnetworksarehelpingthemfindcompanions,thushelpingtomeettheirsocialandself-esteemneeds.Suchtechnologyisnotonlyenablingmanyseniorsaroundtheworldtoliveindependentlyforlonger,butalsoenhancingtheirqualityoflife.
THESILVERSSERIES
The eraof thesilvergenerationhasarrived.Silvers,or peopleaged65andabove,aredrivingahugelydisproportionateshareofconsumer-spendinggrowthinmanykeyregionsglobally.Insomemarkets,theyaredrivingnearlyallsuchgrowth.Thistrendwillcontinueforthenext20years,anditisbeingfueledbytworelatedforces.Thefirstisdemographics,asthesilver population is growing considerably faster than other age groups are. The second is economics, as silvers hold adisproportionateshareofwealthglobally.
Olderhouseholdstendtobewealthier,whenmeasuredbytotalassets—whichisunderstandableandinevitable,giventhatmostpeopleaccumulateassetsovertheirlifetime.Whatismoreinterestingisthedisproportionategrowthinthewealthofseniorhouseholdsseeninsomecountries.Thistippingofthewealthbalancefromyoungtooldhasbeenfueledbychangessuch as the degradation of job security and opportunities, and the erosion of compensation and benefits for youngerworkers.Theimpactoftheeconomicdownturn,whetherthroughgovernmentausterityorprivatesectorcutbacks,appearsonlytohaveamplifiedthisdisparity.
Weliveinanagewhenmostofusarealmostalwaysdigitallyconnected—either to other people or to some form of media, such as online videocontentormobileapps.Althoughseniorsaretypicallylesslikelythanotheragegroupstousenewtechnology,theconnectionsitcanprovideareevenmore important for them than they are for younger people, as theirmobility problems may prevent them from living an active life andinteractingoftenwithothers face to face.Manynew formsof technologycan keep housebound seniors in touch: for example, smartphones andtablets allow instant connectivity between people who wish tocommunicatewitheachother,puttinglovedonesandfriendsjustaphonecall(oremailorchatmessage)away.
In senior care, technology has found numerous applications that not onlyenableseniorstogetfasterandmoreimmediateassistancewhenneeded,but also help them lead a better quality of life. As we showed in ourprevious reports in the Silvers Series, wearable devices can help seniorsmonitortheirownhealthandhelpcaregiverstrackthewell-beingofthoseintheircare.Thesedevicesalsofulfillsafetyandsecurityfunctions,helpingcaregiversandotherstrackthewhereaboutsandactivitiesofthewearer.
Source:Shutterstock
This is the third report in our Silvers Series. So far, we have looked athealthcaretechnologyandhomecareforseniors.Inthisreport,weexaminethetechnologythatisenablingseniorswhoaremobilityconstrainedduetophysical or mental conditions—those who are housebound or otherwiseunable to lead fully independent lives—to remain connectedand rely lessontheassistanceofothers.Suchtechnologyisslowlybecomingawelcomeadditiontoseniors’lives,enablinggreaterindependenceandaginginplace.
Thefollowingsectionsofthisreportconsidertheconditionsthatmayleadto seniors becoming housebound or mobility constrained, the kind ofphysical and emotional needs thatmobility-constrained people have, andthetechnologythatiseitheralreadyonthemarketorisbeingdevelopedtohelp silvers who have mobility issues. Our discussion of the potentialofferedbynewtechnologiesfocusesonfivethemes:
We define silvers as people aged 65 and above, and the Silvers Seriesexamines the impact this demographic has on various industries andservicesandontheglobaleconomy.
Beforewelookatsomekeyfigures,itisworthnotingthatmajorstudiesonthis issue by theWorldHealthOrganization (WHO) and national statisticsofficesaretypicallyconductedinfrequently,sothelatestavailabledataareoften from several years earlier. Nevertheless, they provide the bestavailableindicatorsofprevalence.
The WHO’s 2011World Report on Disability cited a key figure from theorganization’s last World Health Survey, which was completed in 2004:15.6% of the world’s population that year had a moderate to severedisability. That equates to about 650millionpeople, given that the globaladult populationwas approximately 4.2billion in 2004.About 248millionpeopleaged60andoverhadadisabilityinthatyear,weestimatefromthesurvey, equivalent to 38.1% of all disabled adults. The survey found thatdisability prevalence among seniors in lower-income countries was muchhigherthaninhigher-incomecountries(43.4%versus29.5%).
Figure1.GlobalDisabilityPrevalenceRates,2004(%)
Participants in the WHO’s survey were asked to score their difficulties in functioning. Theaverage score for all these groups—those reporting extreme difficulties and those reportingchronic diseases—was around 40, with a range from 0 (no functioning difficulty) to 100(completedifficulty).Therefore,40waschosenasthethresholdpointbetween“disabled”and“notdisabled”forallsurveyrespondents
IntheUSin2014,about36%ofthoseaged65andover,orapproximately15.5millionpeople in thatagegroup, reportedexperiencingsomekindofdisability.Themostcommontypeofdisabilitywasmobilityorambulatorydifficulty,experiencedby23.0%ofseniors,or3.6millionpeople,accordingto the American Community Survey (ACS), conducted by the US CensusBureau.
The second-most-common type of disability was independent livingdifficulty,experiencedby15.2%of thegroup.This refers todifficultywithrunning errands, such as shopping or going to the doctor, alone. Somerespondentstothesurveyreportedexperiencingmorethanonedisability.
In the UK, meanwhile, more than one-quarter of silvers have reportedchronic health problems related to their muscles, bones, heart orcirculation:
• AccordingtotheUK’s2007GeneralHouseholdSurvey,27.3%ofpeopleaged 65–74 and 33.3% of those aged 75 and over reportedexperiencing long-term conditions that affect the musculoskeletalsystem.Theseincludejointpain,arthritisandosteoporosis—whichcansignificantlyaffectone’smobility.
• Conditionsaffectingtheheartandcirculatorysystemwerereportedby27.7%of those in the65–74agegroupandby30.1%of those75andover.
• Chronic problems related to other conditions, such as respiratoryproblems,werefar lesscommonamongthosepolled.However,takentogether,theyweresignificant,indicatingthatasizeableproportionofseniorswereenduringlong-standinghealthissues.
While some people with disabilities may be able to carry out certainactivities of daily living on their own, they may need assistance fromcaregiversortomodifytheirhomestomakethemmoreaccessible.Asweshowlater,thesetwotraditionalmeansofassistancehavebeenjoinedbyaseriesoftechnologicalinnovationsthatareallowingdisabledsilverstoleadmoreindependentlives.
AGING IN PLACE TREND PROMPTS DEMAND FOR INNOVATIONSTHATENABLEINDEPENDENTLIVING
In-homecareisbecomingmoreprevalentamongthosewhohavelong-termhealth conditions. Aswe noted earlier, seniors are showing an increasingpreferencetoageinplace—toremainintheirownhomesandreceivecarethere,insteadofmovingtoaresidentialinstitution.
In 2013, therewere approximately 4.6million senior long-termcare (LTC)recipients,whoneededeither institutionalcareor in-homecare, inthe10countries for which the OECD reports such metrics. A majority of theseseniorsarelikelytohaveexperiencedsomeformofmobilityconstraint.
ChangesintheproportionofseniorsreceivingLTCineitheraninstitutionorathomein2000versusin2013(latestavailabledata)showthattherewasaconsiderable shift in the countries examined by the OECD. In fact, thechange in the average proportion of seniors receiving in-home care wasmore significant (a 6.2-percentage-point increase) than the change in theaverageproportionofseniorsreceivinginstitutionalcare(a1.8-percentage-pointdecrease).
The average is of 10 OECD countries (Finland, Germany, Hungary, Japan, Luxembourg, theNetherlands,Norway,Sweden,SwitzerlandandtheUS)thatreporteddataontheproportionofseniorsaged65andolderwhowerereceivingeachformofcare.
Source:OECD/FungGlobalRetail&Technology
TheNeedsofSeniorsWhoAreAginginPlace
Asmoreseniorsage inplace,manywillbe living independently.Theymaynotalwayshaveaccesstoassistancewhentheyexperiencedifficulties,suchasan inability to runerrandsduetoamentalcondition,an inability todoregular household chores due to limitedmobility, or an inability to be associallyactiveastheyoncewere.Severalstudieshaveindicatedthatbeingisolatedinlateragecanhaveadetrimentaleffectonaperson’smentalandphysical well-being, and increase the risk of developing further healthconditions.
Withpeople’sneedsvaryingaccordingtotheirlifestageandcircumstances,healthcare organizations, social groups and innovators have createdproducts, services and activities that can serve the unique needs ofmobility-constrainedpeople,andsofacilitatetheirinclusioninsociety.
UsingpsychologistAbrahamMaslow’shierarchyofneedstheoryasabase,wegrouptheneedsofmobility-constrainedseniorsintofourthemes,onascale that runs frombasic survival to emotional satisfaction: physiologicalneeds,safetyandsecurityneeds,socialneedsandself-esteemneeds.
Figure6.HierarchyofNeedsforSilvers
Source:FungGlobalRetail&Technology
For new concepts, innovations and activities to become popular andsuccessful,theymustfulfilltheseneedsofelderlypeople,helpingthemleadnot only longer lives, but also better-quality lives. In the next section,weconsider how new developments are helping silvers lead better lives byfulfillingthesevariousneeds.
Advances in roboticsand the InternetofThings (IoT), and thewidespreaduse of social media, have contributed to the creation of solutions forseniors.Below,weidentifyfivesegmentsthatarecateringtosilversinnewways.
Thedevelopmentofroboticsforuseinassistingseniorshasbeensomewhatlimited to date, but there have been a few notable advances in terms ofroboticlimbsandexoskeletons,aswellasin“social”robots:
• Robotic arms and legs: SRI International, a nonprofit, independentresearch center, launched a venture called Superflex in April 2016.Superflex has developed a supportive robotic suit, essentially a softexoskeleton, thatcan fit snuglyoveraperson’sbodyandhelphimorher walk,maintain good posture andmove objects. It is designed toenablefrailseniorsanddisabledpeopletocarryouteverydaytasks.
JapanesecompanyCyberdyne is trialing roboticarmsand legs thatcanbefittedontoaperson/partofthebodythatisdisabledinordertoenablethepersontomoveindependentlyandcarryoutactivitiesofdailylivingontheirown.
A group of scientists from seven universities across the UK is working onsmart/robotictrousersandsocksthatenablemobilityinvulnerableseniorsanddisabledpeople.Thetrouserswilluseacombinationofbionics,reactivepolymersandartificial“muscles”tohelptheusermoveindependentlyandreducethechanceoffalling.
• Humanoidrobothomecareassistants:Jiboisbilledas“theworld’sfirstsocialrobotforthehome,”and ispositionedasaproductsuitableforelderlypeople.The robot can“see,hear, speakandhelp”andcanbeused as an emergency communication tool. Jibo also serves as acompanion,whichisappealingtomanyseniors,whooftentimesliveontheir own. The robot was originally an Indiegogo project that raised$3.7million.Jibo’sdevelopershavenowcreatedafull-fledgedcompanythathasattractedover$52.3millioninfunding.
Hondahasdevelopedahumanoid robot calledAsimo,whoseapplicationsrange from industrial uses—it can function as a warehouse assistant thatliftsandmovesheavyloads—tobeingahomehelper.Itisalsodesignedtohelppickupandstorethings,turnswitchesonandoff,andpushdoorsandcarts.
The Riken institute in Japan has also developed a humanoid robot, onewhoseprimary function is toassistdisabledandolderpeople.TheRobearnursing-carerobotcanhelpliftpeoplefromabedandplacetheminachairorinabath,andviceversa.
Mainstream mobile phones, tablets and computers usually come loadedwithsomanyfeaturesandapplicationsthatsomeseniorsfeeloverwhelmedby them. To better meet silvers’ need for technology solutions, somecompanies have developed hardware and software specifically for theseniorpopulation,allowingthemtoconnectwithothersaroundtheworldand view content that interests them. Notable players in this marketinclude:
• It’s Never 2 Late (iN2L): iN2L is a US-based company that providesseniors with technology—tablets, computers and televisions that arepreloaded with the company’s customized software—that is easy touseanduseful. Itssystem,consistingofhardware,softwareandothercomponents,isbasedontouch-screen,picture-basedapplicationsthatallow those with even limited computer experience to operate thedeviceseasily.
Already being used at about 2,000 senior-living communities and insomehomes,iN2L’scomputershelpseniorssendemails,useSkypeandviewphotos froma single home screen that is customizedwithwhattheuserwantstosee.
iN2Lalso teamedupwithMicrosoft andSelfhelpCommunity Servicesto create a project called the Virtual Senior Center, which connectsseniors from around theworld through group video chats. Users cantalk about their common interests or attend virtual classes offeredthroughthecenter,whichhelpsthembuildtheirsocialinteractionandkeepsthemactive.
• ZoneV:ZoneVwasfoundedbyDr.PeterAshall,formerlyheadoftheVertu business unit at Nokia. The company plans to produce asmartphoneforpeoplewithlimitedeyesight,hearingordexterity.Itisnow in the final preparation stage, following three years ofdevelopment.
• 21KE:21KE isoneofthepopularcellphonemanufacturersonChina’se-commerce site JD.com. The company develops cell phones forseniors,andhasalreadyreleasedfourmodels.Thephonesby21KErunontheirownproprietaryoperatingsystem,CareOS,whichhasover65customized features catering to the needs of seniors. The companyreceived funding fromXiaomi,oneof the largestChinese smartphonemanufacturers, in 2015. The move will help Xiaomi capture thepromisingseniorsmarket.
• RealPad: In the US, the AARP (formerly the American Association ofRetiredPersons),anonprofitsocialwelfareagency,developedatabletcalled the RealPad that is specifically designed for silvers. The devicecomeswithpreloadedappsandlargegraphicsandicons,whichmakeiteasyforolderpeopletouse.
• Elderis: Elderis offers an interactive portal, accessible via smart TV ortouchpad, that is available for use in private homes and institutions.The company advertises that its portal serves most of the needs ofseniors, promoting well-being, comfort and prevention and helpingthem keep in touch with loved ones. Key features includecommunication(sendingandreceivingtext,email,photosandvideos),on-demand content (audio, video and neighborhood information),scheduling and notifications, and inactivity detection through sensorsconnectedinthehome.
VirtualLearning:LearningandTeaching
Several initiatives have been developed that enable seniors to continuelearning as they age. Still others help seniors teach other people throughvirtual learning centers, either from their homeor froma residential carefacility.
• TheSpeakingExchangeprojectwascreatedbyadvertisingagencyFCBBrasil and an English-language school called CNA to help the school’sstudents inBrazil connectwithAmericanretireeswhocantutor theminspeakingEnglish.Theideawasconceivedtohelpthestudentslearnfromnative English speakers,while giving the retirees anopportunitytoteachthroughsocialinteraction.
Source:Cna.com.br
• Senior Learning Network (SLN) is a membership-based program thatoffers courses to seniors virtually. Seniors can enroll in courses thatthey are interested in, and attend them from their home or from aseniorcenter.Theycanalsochoosetoconductclassesandsharetheirknowledgeorhobbywithothermembersoftheprogram.
SocialNetworks:CompanionshipandDating
Social networks are usually developed to connect people who may havecommon interests or to help them stay in touch with friends or othercontacts. Adjacent to the social network space are online platforms forcompanionshipanddating.While there isnothingtoexcludeseniors fromusing popular social networks such as Facebook, there are a number ofsocialmediaapplicationsthathavebeenspecificallydesignedforseniors:
• Stitchisanonlinesocial-networkingplatformthataimstohelpseniorsfind companions.Different frommost dating sites, it is not limited tosingles; seniors can use the site to find travel companions, groupactivities,dinnerdatesorromanticpartners.Userscanregisterforfreeand enjoy limited services or pay a yearly subscription fee for moreprivileges.TheserviceiscurrentlyavailableinEnglishonly,anditsusersaremainlyfromtheUSandAustralia.
• LaoLaoisaChinesesocial-networkingapptargetingseniors.Ithastwoversions,oneforseniorsandonefor theirgrownsonsanddaughters.The senior version helps seniors track their exercise, follow interestgroupsandsharephotoswiththeirchildren. Itaimstosolvecommonissues for seniors living in cities, suchas lonelinessandboredom.Theversionforsonsanddaughtersprovidesthemwiththeirparents’healthdataaswellasthecontentgeneratedbytheirparents.
• In the US, the Connected Living program leverages technology tocreate an environment for older adults in senior housing to enjoygreater social interaction. Itenables themtoconnectwith lovedonesand provides open access to community, educational and healthcareresources.Theprogramhassignedupover60,000usersin36USstatesoverthepastsevenyears.
• Telephonebefriendinggroupsinvolveindividualswhomaketelephonecalls to housebound seniors and engage them in lively conversation.These are usually conducted by local councils, support groups andcharitable organizations to help ensure that seniors are not isolatedfromsociety.
SmartHomes:AssistingIndependentLiving
Sensors and the IoTare findingnumerousapplications in senior care, andare particularly helpful for patients with dementia, who may need to beremindedtotaketheirmedicationorturnoffappliances.Smartdevicescanalsonotifycaregiversaboutseniors’safetyandwhereabouts.
Mostsmartdevicesinaconnectedhome,suchassecuritycameras,fridges,lights, thermostats and TVs, can be programmed to function in amannersuitable to theperson living in thehome.Theycanhelpkeepseniorssafeand reduce theirdependenceonassistance fromcaregivers.Productsandsystemsinthesmarthomesegmentinclude:
• Sensoralertsystems:CompaniessuchasLively,EvermindandBeCloseplace discreet sensors for wirelessmonitoring in homes. The sensorsallowadultchildrentomonitortheiragingparents,andtoofferhelpifneeded.Sensorscanbeattachedtoitemsassmallaspillcontainersandthecollecteddata is recorded inadigital log thatcanbe reviewedbyrelativesorcaregivers.
• Fully integrated smart home systems: AT&T’s Digital Life offeringincludesanalarmsystem,doorlocksandcamerasforthehome,andisdesigned to be simple enough to be used by those who are notespeciallytechsavvy.Inthefuture,systemssimilartoDigitalLifewillbeable tosyncwithwearabledevices that track thehealthconditionsofseniorswholiveinsmarthomes.
• Othersmartdevicesthatfunctionaspartofanintegratedsysteminthehome include Samsung’s SmartThings and Nest’s Thermostat. Smokealarms and compatible devices fromothermakers can also be set upand customized to help ensure seniors’ safety and allow them to livemoreindependently.
Moreandmoreseniorswanttobeabletoageinplace,toremain intheirownhomesas theyage,even if theyarenotable to care for themselves.The opportunities to serve this group are not confined to providing careservices. New technologies can play a significant role in raising thestandardsofeverydaylifeformobility-constrainedseniors:
• Robotics: Innovations in robotics are helping seniors bemoremobile,and care robots, such as Jibo and Robear, are providing them withassistancewitheverydaytasks.
• Virtual learning:Virtual learning centers arehelping seniors learnandshare knowledge through online classes, whether from their ownprivatehomeoraresidentialcarefacility.
• Social networks: Social and dating apps and online platforms createdforseniorsarehelpingthemfindromanticpartnersandcompanionsforactivitiessuchastravel,classesandhobbies.
• Smart homes: IoT devices and systems are helping fulfill a range offunctions for seniors living independently, reminding them to takemedication,providinghomesecurityandreducingtheirdependenceoncaregivers.
Technologiesdesignedforthesilversmarketcanbeparticularlyeffectiveataddressing the serious issue of social isolation that can arise from beinghousebound ormobility constrained. Such isolation has numerous effectson one’s physical, mental and emotional well-being, which can lead tofaster deterioration of health and result in illness. In more-developedeconomies,technologyisvirtuallybreakingdownthewallsforhouseboundseniors.Indevelopingeconomies,whereobtainingbasiccareandessentialneeds such as food, water and clothing is often more difficult, suchtechnologyisunlikelytobeusedtohelpthehouseboundinthenearfuture.
