Agism and exclusion
A group of entrepreneurs, nurses and aged care reformists crammed into the first floor of RMIT’s Activator space in Victoria Street, Melbourne last Tuesday.
The event was called Rethinking Aged care Through Technology. The audience were looking for answers on how to reform the aged care industry. Long the Cinderella of healthcare, aged care is going through a transformation.
No one was left disappointed. The event, which was sponsored by STC, who run the MedTech’s got Talent quest was was full of challenges. The aged care sector demanded that technology meet elderly people’s needs, not the other way around.
The event was also celebrating 5 years of successful operations for the health technology Meetup group Peak 15.
Named after the highest mountain in the Everest Rangers, Peak 15 set it’s sights from day one on creating Australia’s most Powerful HealthTech Commercialisation and Mentoring Network. They have recently passed the 1,000 membership level, making it the 4th largest health tech Meetup group in the world.
Over the years, the most lively topics for Peak 15 have been Aged Care, FinTech, User Experience, Mental Health and Medication Adherence.
In terms of strained budgets and over crowded services aged care reform is the most urgent. The biggest roadblocks are structural problems like fragmented services and financial incentives that encourage over servicing and unnecessary hospital admissions.
At present, over 10% of Australia’s GDP (or A$170bn) is consumed by health costs. Nearly 25% of the Australian population are now over the age of 65.
Three guest speakers brought their very different views to the table.
Matiu Bush – Founder of One Good Street, Design Integration Lead at Bolton Clarke and Board Member Better Care Victoria
Cameron Van Den Dungen – Third Generation family member to work for Forty Winks and CEO of The Sleeptite program
Debra O’Connor – Deputy Director of the National Ageing Research Institute
The first speaker was Debra O’Connor. She raised a number of important points.
Aged care focused technology is exploding, with friend robots, home alerts and social media tools coming on to the market every week. However, entrepreneurs are often creating these products before spending time with the aged care industry and their customers, and finding out what their problems actually are.
Lack of two way communication through the creation and testing phase of tech development, between elderly people and tech companies means that many products risk being left on the shelf. The result is both customers and companies are missing out.
Sometimes the best solutions is the least sexy and most basic technology. An example Debra made was falls prevention products. Simple products like pressure mat alerts are often the most popular, because they simply solve a major problem. Falls are the leading cause of death in people over the age of 65.
The aging population is driving the need for structural reform. Currently 8.5 percent of people worldwide (617 million) are aged 65 and over. By 2050 this percentage is projected to jump to nearly 17 percent.
“There is a lack of communication between the aged care sector and elderly people, and technology companies wanting to produce products for them.”
Debra pointed out that across the globe, countries are facing these challenges with innovative solutions.
Japan currently has the worlds largest aged population, and have been developing robots targeted at the aged care market since the1990’s. 8% of nursing homes in Japan use lifting robots. Products under development include RoBear. Also popular are companion robots like Kirobo and Paro.
Australia has also trialled a companion robot for aged care called Matilda.
Some of the benefits of aged care technology include reduced social isolation, preventing falls, helping to manage chronic disease and making medication regimens safer.
Debra feels that current aged care technology can be categorised into the following categories – gaming and virtual reality to provide entertainment and relive memories, assisted living with home artificial intelligence and smart walking sticks, wearables, internet of things and falls alerts and telemedicine for home consultations.
She sees future challenges as –
- Re addressing the usefulness of aged health technology
- Integration of information across silos
- Addressing privacy concerns
- Providing technology education for elderly people
- The use of big data and analytics to drive better health care decisions
Matiu Bush, Founder of One Good Street, Design Integration Lead at Bolton Clarke and Board Member Better Care Victoria.
Like Debra, Matiu’s approach to aged care is based on his practical experience. He believes that ageing is not a disease to cure or a problem to solve, it’s a life stage to manage successfully.
And he also believes that older people need to be welcomed into the technology and startup community, which is currently highly agist.
He supports the clinical models of care are replaced with an open marketplaces of care where elderly people can buy the services they actually want.
He feels that the current Government policy of keeping people in their home longer is resulting in elderly people being isolated, widowers living in empty family homes. People need other people most of all.
“Ageing is not a problem to solve, it’s a life stage to manage.”
Matiu advocates streets of people being paid to care for older people – local hero’s doing most of the work and only connected with nurses when necessary
A doctor needs to be able to prescribed a poorly nourished patient to a local garden group that grow local veggies and keeps in touch, rather than a dietitian who orders blood tests then hands out packets of food
Just giving AI devices to lonely older people is not the answer.
Cameron Van Den Dungen third generation family member of Forty Winks and CEO of sleeptite.
His father was one of the founding member of FortyWinks, he has worked in advertising, journalism for racing cars….a range of jobs.
His family come from Holland. His mother ran local nursing home in the community.
His father was always an entrepreneur.
Cameron created a company called Sleepeasy, and found an engineer able to create smart mattresses – using nano technology able to give personalised data using haptic sensors.
Cameron met some researchers at RMIT – working on a wearable biometric devices- and now have a device on sheets, mattress covers medical grade, able to pick up heart rate, ECG, movement.
Cameron discovered that carers are overworked and stressed. A smart bed that can track patients vital signs will provide a safety net for nurses and carers.
One of the problems in healthcare is that there are many end users, nursing homes, patients, nurses, government, insurers etc
The company Hexoskin are providing biometric shirts using the same technology.
This product will eventually provide medical grade vital signs for aged care residents to keep patients safer.
The first question was, if you started out again, what would you do differently?
Deb – “I’d start with asking elderly people what they want, not trying new technology out on them. Ageism is real.”
Cameron – “I’d try to find a bigger bank balance because you burn through so much money developing new products.”
Matiu – “I’d try to change the health funding model. I’d get rid of funding in levels according to how severe people’s conditions are; high v low level needs. I’s flip it, put more money into early care to solve problems before they become unmanageable. I’d also replace the ineffective model of nurses driving around in cars, with local people paid to be carers.”
The second question was, what sort of tech do older people like?
Deb – “Older people love social media, communicating with family and friends.”
Matiu – “Simple technology is often perfect to solve a local problem.” He gave an example of a Facebook page connecting communities on a hot day, to encourage people to share access to air conditioning and stop older people dehydrating.
The third question was, what are the main things you notice when dealing with aged care providers?
Cameron – “There is a big disconnect between ground floor nurses and carers and board room management. Management is often out of touch with bedside nursing care.”
Deb – “There is no clear forward vision or forward planning in Australia. Telehealth not funded which limits it’s use in a large country with a small population.”
The fourth question was, we know the health industry is very silo based, what do you think would help to overcome this?
Matiu – “Be micro ambitious- pick one problem to fix.” He gave the example of district nurses driving around in a company car all day long just to ask people how they are, is a very wasteful use of resources.
Cameron – “Care standards are a big issue, they are ad hoc, fragmented, different providers are using different standards. It make creating a medical device difficult. Standards need to be uniform and national. Aged care companies suppliers needs clear guidelines to work with.”
In conclusion, there needs to be closer communication between engineers, entrepreneurs and aged care service providers.
Aged care technology needs to be focused on solving elderly people’s problems, not creating trendy electronic toys that just sit on the shelf because no one wants them.
The actual structure of healthcare needs to change, and this includes the way services are funded.
And finally, community focused services are cheaper, more effective and help create a sense of community, which is ultimately what everyone needs.
© Wikihospitals September 2018.