The Business of Aging

Where to Live When We Get Old. Help!

The Wall Street Journal Sunday does a great job at covering a variety of "elder" care topics week to week. This week's topic was Woes of 'Continuing Care' Centers.

The article provides not so much a critique on CCRCs (continuing care residential community) but things to consider when researching them, determining if they are the right option for you (or your loved ones) and how to go about selecting one.

The same WSJ Sunday has another article (from their sister magazine SmartMoney) titled Picking a Nursing Home which gives some good advice on finding and evaluating nursing homes. 

We have many options on where to live as we age - right? (I'm not talking geography)

Well, sort of but not really. The big four include:

1. Stay in your house/condo/apartment and as your needs increase bring in hourly help for meal preparation, assistance with activities of daily living, companionship, etc.
2. CCRCs
3. Assisted Living
4. Nursing Homes

Other options include cohabitation (dad moves in with the kids) and the really interesting (and sometimes bizarre) trend of co-operative arrangements.

While I am a huge proponent of aging in place (at home) I am aware that this option may not be for everyone - by their choice or otherwise - e.g., it is not a realistic option when your caregiving needs become too much for one or even two people to manage (the final stages of Alzheimer's).

One problem I have with the senior care marketplace is how representatives from each housing option seem to market their products as if their option (i.e., assisted living) should be the ONLY option you consider. 

Selecting a "place" to age is complex. So many factors go into it - personalities, physical and mental health needs, family dynamics, money, etc.  And people usually transition from one option to another. They start out at home, move to assisted living and then maybe to a nursing home. Making these "where to live" choices requires a lot of thought, preparation and research and unfortunately a lot of families don't put enough effort into it - or are unable to.

This is why I see a growth in truly "independent" services that educate families and individuals on the various senior housing options and guide them through the evaluation and selection. A buyer broker if you will that has no ties to any particular option nor takes placement fees or commissions from chosen options.


The closest we have to this type of service today for the masses are employee benefits like work-life or EAPs but most individuals in the country do not have access to such services. Another option is geriatric care managers (probably the best option) but they are expensive (up to $100 an hour) and not everyone can afford them. Then you have the Administration on Aging which is wonderful but like many government agencies providing support to the public it is understaffed and quality of support is inconsistent.

Maybe a solution is a type of supplemental insurance product geared toward evaluating and selecting caregiving options as we age.

I don't know but I do know there is a huge business opportunity for anyone who can figure it out.

Now if we can just pay for it once we do make the decision - but that's another topic.

Telecare: Packaged Technologies to Help Peope Age in Place. Very Cool.

An article from the Asian Leader titled "Home care service using technology launched"   discusses how technology can be used to help people age in place. Nothing really new (in terms of technologies) are discussed but how they package the technologies is what's interesting.

The packaged services are called "Telecare". In fact, there is an association dedicated to the concept in the UK - its called the Telecare Services Association. In their words:

"…..elecare is as much about the philosophy of dignity and independence as it is about equipment and services. Equipment is provided to support the individual in their home and tailored to meet their needs. It can be as simple as the basic community alarm service, able to respond in an emergency and provide regular contact by telephone. It can include detectors or monitors such as motion or falls and fire and gas that trigger a warning to a response centre staffed 24 hours a day, 365 days a year…."

The West Sussex county council  is an example of how one community is implementing Telecare equipment, enabling their  residents to continue living safely and independently in their own homes and communities. The equipment can raise an alert to a call center, monitor a person's wellbeing and environment and trigger a warning if this changes, and can provide immediate feedback to help with memory problems. It is hoped the equipment will prevent hospital admissions and support residents discharged from hospital to return home safely.

Telecare equipment enables vulnerable people to use technology, such as community alarm and pendants, fall detectors, movement sensors, medication dispensers and bed and chair sensors. But it can also help people communicate and stay mentally healthy. Examples of Telecare products may include:

• Bed and chair occupancy sensors
• Emergency caller buttons
• Enuresis sensors
• Epilepsy sensors
• Fall detectors
• Flood detectors
• Gas detectors
• Lifeline boxes and alarm triggers
• Passive infa red (PIR) detectors
• Property exit sensors
• Smoke detectors
• Temperature sensors
• Memory aids
• etc…………

Again, nothing new but the value is how they are all packaged together and delivered into the community. A benefit to ALL.

Anyone want to start a USA version of The UK's National Telecare and Telehealth Association? 

Intel's Impressive Aging In Place Technology

A Business Week article titled Intel Wants You to Age Gracefully, at Home discusses a new category of technologies designed to help seniors stay longer in their homes - and in the process save the health care system billion of dollars. 

One such product is Intel's Health Guide,  a device that let doctors monitor a patient's health remotely.

An excerpt from the BW article describing the technology:

"Each day after he woke up, he'd step on a scale and strap on a blood-pressure cuff that were attached to the Health Guide. The device collected his vitals and zapped them to his doctor's office. From there, nurse Marie DiCola scoured the data, and if she noticed anything amiss, she dialed up Lang and chatted with him over Health Guide's videophone."

Very cool.

Besides Intel (INTC), the aging-in-place market has attracted the likes of General Electric (GE), Philips Electronics, Honeywell (HON), Bosch, and dozens of technology startups.  I think Johnson and Johnson (JNJ) is also in the space.

Also mentioned in the article was an advocacy group that Intel and 400 other technology and health-care organizations formed called the Center for Aging Services Technologies (CAST). The group's mission is to fight to improve the reimbursement outlook for aging-in-place technologies.

A good newsletter to read to follow the aging in place technology market is aging in place technology watch.   - or this blog :-)

"Retrofitting" Suburbia for the Aging Population

At the 2009 Silicon Valley Boomer Venture Summit & Business Plan Competition there were a few start-ups competing in the business plan competition that intended to market products/services that would help seniors age independently in their own homes. Some of the companies proposed "retrofitting" homes to make them more senior friendly while others were focused on senior friendly technologies.

The idea of making our homes more senior friendly through both architectural design improvements and aging in place technologies is nothing new and lots of companies are investing in these areas.

But what about making our cities and towns more senior friendly?

A recent AARP survey showed 85% of individuals age 50-plus that they wish to remain in their communities for as long as possible.

A special section in the Wall Street Journal's Weekend Report (September 19th, 2009) was dedicated to "Making Suburbia More Livable" for the aging population. Or, as the intro to the story stated:

The nation's sprawling suburbs may have been a good place to grow up, but they're a tough place to grow old. 

(By the way, have you noticed the dramatic increase in stories dedicated to "aging" topics in the national media?) 

Ken Steele is the mayor of Fayetteville, Georgia and he is working to transform his community  into a "lifelong community" and suggests neighborhoods across the country need to do the same.

"Every small community has the same problem," says Mr. Steele, age 69. "We want residents to be able to age in place, to meet their needs…here, without having to move away."

The idea is to "retrofit" suburbia which involve taking a neighborhood or site within an existing town or suburb and creating a compact, walkable community—one with alternatives to single-family homes, such as condominiums or row houses. Older residents in large homes will have the option of downsizing and remaining in a community where they can access restaurants, shopping and other amenities and services on foot.

This is already underway in Lakewood, Colo. "The change is pretty dramatic," says Mike Rock, retired city manager of Lakewood who helped direct Belmar's development. "Buildings are pulled right up to the sidewalk; residential living is above the retail outlets. You don't expect to see this in a suburban setting.

"Many weekends, my wife and I don't use the car," he says. Movies, an athletic club, a coffee house and restaurants are all within walking distance. "I regularly see people who are 10 years older than me—and 30 years younger," he adds. "I like that. I like the vibrancy."

The entire Wall Street Journal article can be read here. It's a very interesting story.