Five Covid-19 Technology and Health Blog Posts from April 2020

The title should not surprise.  The month of April had only one subject – no matter where you looked or what you read. Covid-19 and its impact and implications, starting early in the month following event cancellations, travel bans and stampedes, telehealth insurance changes and senior living visitation lockdowns. That was followed by a collection of companies offering free services for use of their technologies in the context of an increasingly isolated older adult population in senior living communities, nursing homes and at home. But it was a conundrum: so many of those older adults lacked access to or knowledge of technology, let alone the ability to acquire it, learn how to use it or participate in family Zoom sessions. In case you missed them, here are five Covid-19 blog posts from an April that was unlike any other:

Covid-19 – Technology changes accelerate – some a work-in-progress. Note the wave of announcements of 'free' tech services and sea changes. Numerous companies popped into my inbox in the past week with announcements of a period of free access to remote care/engagement technologies. Note the other ‘temporary’ change of reimbursement for remote (even telephone) visits, now fitting into the concept of telehealth. The ‘tipping point’ of telehealth is here – and tipping with a suddenness that is unnerving for overstretched vendors and most notably, difficult for providers who may lack the equipment and/or processes to deal with patients remotely, despite the risks to themselves with in-person interaction. Read more.

Side-effect: Covid-19 Should Close the Remaining Older Adult Tech Gap. The older adult coronavirus statistics skew toward oldest. There are more than 69 million people aged 60+ in the US. The oldest adults that appear to be at greatest risk dying from Covid-19 are not those of a specific age, but those in the oldest age ranges, particularly with 'underlying conditions.' From the CDC released April 8: Rates of hospitalization (4.6 per 100,000 of population) during the month of March indicated 13.5% of those hospitalized were aged 65+. And 90% of hospitalized patients identified through COVID-NET had one or more underlying conditions, the most common being obesity, hypertension, chronic lung disease, diabetes mellitus, and cardiovascular disease. The US statistics do what nearly all US data analysis does – 'older adult' equals 65+. But look at South Korea (in an article intended to make millennials nervous), the death rate in Covid-19 patients ages 80 and over was 10.4%, compared to 5.35% in 70-somethings, 1.51% in patients 60 to 69, 0.37% in 50-somethings. Read more.

Tackling Covid-19’s social isolation of seniors – one tech at a time. Saving seniors from Covid-19 means worsening isolation. In an article in the NY Times, Paula Span’s title said it all: Just What Older People Didn’t Need: More Isolation. The article attempts a number of references to mitigation, including the use of GrandPad in two Pace programs. These are compelling, but the overall story is about the oldest on the wrong side of the Digital Divide, which is notable and particularly pitiful in settings like nursing homes, Note in the Johns Hopkins Covid-19 guidance about nursing homes, at the very end, authors acknowledge the risk of social isolation and make a few (lame) recommendations. These do not include, unfortunately, providing usable technologies to connect isolated seniors with families. What might they be to help with loneliness? Here are six that businesses and non-profits serving older adults should provide for each of their constituents. Please nominate another six -- especially consider those with dementia. Read more.

Covid-19 and Senior Living’s growing use of tech. Seniors and technology – change is in the airwaves. In ways that could not have been anticipated six months ago, the technology marketplace (sellers and buyers) for older adults is accelerating in interest level and adoption. And that is likely an understatement. Following the reimbursement changes after in-person visits disappeared and numbers of visits exploded, firms with telehealth tech are finding a one-year-pipeline potentially compressed into one month. The odds are, not confirmed yet, that Wi-Fi deployment, donation of tablets and online video tools, will all be accelerating in the time of Covid-19, which will be confirmed in a future survey. Consider five intriguing examples – please send or comment with others if you have them. Read more.

Nursing home transparency needs more than Covid-19 case-counting. No understatement, these are very difficult times for nursing homes. First off, thousands of residents have died, and news media organizations are now obsessed with counting and re-counting, totaling up the numbers (more than 10,000 as of today) and then counting some more. So many of the 1.5 million residents of nursing homes were already very frail people, needing help with 3 or more ADLs. 72% of residents are women, most are age 85+, and as noted, 'many also have only a small group of family and friends for support.' Yet there are people who should know better lined up to bash their performance at managing this virus: "If there was any type of senior-care facility that should have been most equipped to manage the COVID crisis, it should have been skilled nursing facilities,” said Brian Lee, a former Florida long-term care ombudsman who currently is a member of an advocacy group called Families for Better Care." Read more.

category tags: 

covid-19, Seniors, Aging, senior living

• 

from Tips For Aging In Place https://www.ageinplacetech.com/blog/five-covid-19-technology-and-health-blog-posts-april-2020

Nursing home transparency needs more than Covid-19 case-counting

No understatement, these are very difficult times for nursing homes. First off, many residents have died, and news media organizations are now obsessed with counting and re-counting, totaling up the numbers (more than 10,000 as of today) and then counting some more. So many of the 1.5 million residents of nursing homes were already very frail people, needing help with 3 or more ADLs. 72% of residents are women, most are age 85+, and as noted, 'many also have only a small group of family and friends for support.' Yet there are people who should know better lined up to bash their performance at managing this virus: "If there was any type of senior-care facility that should have been most equipped to manage the COVID crisis, it should have been skilled nursing facilities,” said Brian Lee, a former Florida long-term care ombudsman who currently is a member of an advocacy group called Families for Better Care." Right.

Closing the gate, now that the chickens have left. With all the publicity about terrible conditions in the nation’s nursing homes, states and the federal government are galvanized into some self-protective and resident-protective actions. In fact, the latest is an effort across multiple states to grant them immunity from Covid-19 civil lawsuits because of a 'shortage of PPE' – unlikely to have been stockpiled just-in-case prior to this wave of publicity. Meanwhile, a wave of nursing home ‘transparency’ directives emerges from CMS, the nursing home regulator. Most important? Identifying which nursing homes had Covid-19 cases. Add to that, state-by-state, the National Guard is being brought in to disinfect nursing homes or assist with Covid-19 testing.

But what is the standard of care and how is it measured? With such visibility, consider that none of these articles are examining how nursing homes are measured. Consider the business structure of nursing homes – 70% of them for-profit, many also under-staffed and under-supplied, and not just with PPE. Multiple of these owners also own the supplier companies that deliver goods and services that also contribute profit to the owners.

Measure – and we can see. At the same time, a recent survey underpins the staff shortages and problematic infection control procedures. Some nursing homes (including my experience) are well-run – it would be useful if the rating system revealed that. At the moment, CMS’ five star rating system has a now-updated annual inspection process to check off whether nursing homes meet the individual elements that make up the rating. This AHCA observation was that the revised Five Star system would cause a slip in ratings, which would lead to consumer confusion, etc., etc. None of that change nor subsequent noise about nursing homes reflects the current Covid-19 nursing home nightmare.

So where is tech-enabled transparency in all of this? There are numerous reasons why nursing homes help families who otherwise could not provide adequate care. Technology-based changes could help with the management, family visibility/oversight, and tracking of quality in between inspections. Take the current data sets about Covid-19 infections, add complaints and other items well-documented over time. Combine staffing information, aggregate information about health status of residents, and create predictive analytics about where future issues may emerge. That could help families assess and management do a better job. Add tablets for residents and support camera-enabled tech for family chats, and wearables to better monitor health status. Identify volunteers who would check in online with residents that lack families, even willing to come in (when that's feasible) to be proxy family council members.

category tags: 

Seniors, SNF, senior living

• 

from Tips For Aging In Place https://www.ageinplacetech.com/blog/nursing-home-transparency-needs-more-covid-19-case-counting

Covid-19 and Senior Living’s growing use of tech

Seniors and technology – change is in the airwaves. In ways that could not have been anticipated six months ago, the technology marketplace (sellers and buyers) for older adults is accelerating in interest level and adoption. And that is likely an understatement. Following the reimbursement changes after in-person visits disappeared and numbers of visits exploded, firms with telehealth tech are finding a one-year-pipeline compressed into one month. The odds are, not confirmed yet, that Wi-Fi deployment, donation of tablets and online video tools, are all accelerating in the time of Covid-19, which will be confirmed in a future survey. Consider five intriguing examples – please send or comment with others if you have them:

Aegis Living’s new Youtube channel pilot, Aegis Live. “Three times a week, an in-house production team delivers programming directly to residents’ computers or mobile devices as a supplement to the provider’s Covid-19 normal activities schedule. And, the Covid-19 crisis is highlighting some advantages that small-home communities may enjoy, in being able to maintain a greater sense of normalcy in day-to-day activities.” Learn more at: Senior Living News.

Holiday Retirement and MeMD. Holiday Retirement, the largest independent senior living provider in the U.S., announced today that it has provided telehealth access and services to the residents of Holiday’s 261 senior living communities. Holiday’s residents have access to MeMD’s national network of healthcare providers for treatment of urgent-care situations and other conditions in the safety of their Holiday home. Learn more at Holiday Retirement.

Eastmont Senior Living Disinfection Skybot. Eastmont Senior Living in Lincoln, Nebraska, recently rolled out two Skybots, robots that use UVC light to disinfect rooms - and help them in the fight against COVID-19. The light does not travel through glass. People, animals, plants, and TV screens are not safe with the UVC, but Door Movement Modules hanging on the door shut the system down if someone tries to go into the room. The equipment will not start if someone is in the room either. Plants can be removed and TVs can be covered with a sheet.” Learn more at SeniorDining.

Thrive Senior Living. "Thrive is looking to use telehealth to limit the risk of exposing residents and staff to coronavirus and other contagions, and free up team members to spend more quality time with residents. Smith acknowledged that telehealth can be difficult to implement in communities during shelter-in-place edicts, but Thrive expects to expedite the process in its communities as soon as the orders are relaxed in its markets. The company has also created a plexiglass separator called Clear Connection." Learn more at Thrive.

Zorabots in nursing homes. “Approximately 60 robots are being used in Belgium the government there has banned outside visitors from nursing homes in order to prevent the spread of COVID-19 among the vulnerable community. The robots were created by Belgian robotics software firm Zorabots. The company says that the spread of the novel coronavirus meant they had an excess of stock they didn’t know what to do with. That’s when they decided the best way to use their resources was to use that stock to help older adult communities. All of the robots so far in circulation have been donated by Zorabots and they say more are on their way.” Learn more at MSN.

 

category tags: 

robotics, Telehealth-mHealth-Voice Health, social isolation, covid-19

• 

from Tips For Aging In Place https://www.ageinplacetech.com/blog/covid-19-and-senior-living-s-growing-use-tech

Tackling Covid-19’s social isolation of seniors – one tech at a time

Saving seniors from Covid-19 requires worsening isolation. In an article in the NY Times, Paula Span’s title said it all: Just What Older People Didn’t Need: More Isolation. The article attempts a number of references to mitigation, including the use of GrandPad in two Pace programs. These are compelling, but the overall story is about the oldest on the wrong side of the Digital Divide, which is notable and particularly pitiful in settings like nursing homes, Note in the Johns Hopkins Covid-19 guidance about nursing homes, at the very end, authors acknowledge the risk of social isolation and make a few (lame) recommendations. These do not include, unfortunately, providing usable technologies to connect isolated seniors with families. What might they be to help with loneliness? Here are six that businesses and non-profits serving older adults should provide for each of their constituents. Please nominate another six -- especially consider those with dementia.

GrandPad. "GrandPad^® is designed with seniors in mind – the innovative device comes with features for connecting with loved ones, without the complicated features of other tablets. The large buttons and intuitive interface make the GrandPad a simple tablet for seniors who are ready to start video chatting and sharing memories with family and friends around the world. Built-in Wi-Fi and private data sharing family network." Learn more at GrandPad.net.

Claris Companion. "We believe that everyone (especially older seniors) deserve to be connected with friends, family and caregivers online – even if they’re uncomfortable using technology. We designed the Claris Companion tablet for seniors living at home so their family can connect with them socially using email and text messages, photos, and videos, while caregivers can receive alerts and monitor compliance with medications, treatments, and important appointments.” Learn more at Claris Companion.

Ageless Innovation. "JOY FOR ALL Companion Pets are designed to bring comfort, companionship, and fun to elder loved ones. Our interactive cats and pup are all about an ease-of-care and convenience that pairs with technology for the best possible experience. The pets can help calm anxiety and soothe those that are agitate, increase quality of life for those with dementia or who are socially isolated, and can improve behavior without the use of drugs." Learn more at Ageless Innovation.

GreatCall Jitterbug Smart2 and Link App. "The simple list-based navigation makes it easy to find what you need with large easy-to-read letters and numbers. GreatCall Link helps keep friends and family updated on your health and safety. After they download the free app -- and with your permission -- they will receive an alert on their smartphone if you call 5Star, let them know if the device is running low on battery, check your daily activities, and let them know your location." Learn more at GreatCall.

Echo Show. "Drop In is a feature that lets you instantly connect with an Echo device, including a contact's, as long as they have granted permission for you to do so. For instance, you can Drop In on any Echo device you own, or you can Drop In on a Echo device that your parents own. When you Drop In on an Echo device, the device's light ring will pulse green and then the device will bleep and bloop automatically connect. You will be able to hear anything within range of the device. Similarly, if you and your contact are using Echo devices with screens, you both will see anything within range of your devices." Learn more at Pocket-Lint. 

OneClick.chat. "Research funded by the National Institute on Aging (NIA) has shaped the design of our products, making them easy for older adults to use. Our aim is to help reduce social isolation in this population and mitigate the associated negative health outcomes. Our Live Video Events platform is ideal to connect older adults and caregivers for training, support, and social engagement. We are currently working with organizations in the longevity market to implement our research in real-world settings." Learn more at OneClick.chat.

category tags: 

social isolation, computers, internet and social networking

• 

from Tips For Aging In Place https://www.ageinplacetech.com/blog/tackling-covid-19-s-social-isolation-seniors-one-tech-time

Side effect: Covid-19 Should Close Remaining Older Adult Tech Gap

The older adult coronavirus statistics skew toward oldest. There are more than 69 million people aged 60+ in the US. The oldest adults that appear to be at greatest risk dying from Covid-19 are not those of a specific age, but those in the oldest age ranges, particularly with 'underlying conditions.' From the CDC released April 8: Rates of hospitalization (4.6 per 100,000 of population) during the month of March indicated 13.5% of those hospitalized were aged 65+. And 90% of hospitalized patients identified through COVID-NET had one or more underlying conditions, the most common being obesity, hypertension, chronic lung disease, diabetes mellitus, and cardiovascular disease. The US statistics do what nearly all US data analysis does – 'older adult' equals 65+. But look at South Korea (in an article intended to make millennials nervous), the death rate in Covid-19 patients ages 80 and over was 10.4%, compared to 5.35% in 70-somethings, 1.51% in patients 60 to 69, 0.37% in 50-somethings.

Fear and isolation permeate all 'older' segments. So even if a small percentage of older adults are likely to die of Covid-19, nearly everyone over the age of 60 (and their kids, grandkids) has read the 'This means you' guidance. For a state like Florida, where more than 26% of the population is aged 60+, these fear-inspiring percentages stop individuals cold in their well-spaced retail paths, cram the grocery lot at early shopper times; walking across the road to stay socially distanced, counted by spacing clickers entering Home Depot, as masks and face coverings proliferate. For the worried well, which includes nearly all, the panic has penetrated psyches, crafting a fear of encounter that may dissipate slowly even when the official lockdown ends. The result? Staying home will be a habit, past the point that it is a requirement.

As the retreat to home settles in, what does it mean for technology use? It would be nice to think that the oldest adults at home or in senior living are Skyping, Zooming, and FaceTiming away. And in the face of this lockdown, likely more technology may be used at home by older adults than is detectable in surveys. But it is unlikely to make a major adoption dent among the oldest and/or lowest income. Not much chance to mitigate the isolation from family in locked-down nursing homes or assisted living. The average cost of broadband in the USA is $60/month. An older iPad mini is $95 – the average smartphone was $528 last year. Using the most recent data, home broadband adoption drops off notably in the upper age ranges, down to 59% of the 65+, though surveying of the older age ranges is infrequent. AARP addressed the 70+ population with a few statistics recently, including 40% tablet adoption, and 62% smartphone adoption.

A significant adoption change will occur after the current crisis ends. The refurbished tech market is skyrocketing from Covid-19’s work-at-home mandate. Could the 2020 catastrophe be the catalyst to boost tech use up to 90% among all older adult segments, at home or in senior living, propelling adoption of telehealth forward for older adults? The senior living industry is under intense pressure as a result of Covid-19, with a precipitous drop in move-ins occurring and predicted. At the same time, the isolation of residents from families and even from each other in locked down communities has created a business opportunity for telehealth and remote care technology firms – with a spike in interest and demand. Vendors could use their unsold inventory from 2019 first half and donate it to senior living communities, senior centers and social services organizations. And telecom service providers could step up and discount – in partnership with device vendors – and the refurbished market. Why not?

[NOTE: If you receive this in email, click on the website directly at ageinplacetech.com to view other research and articles.]

category tags: 

covid-19, Aging technology, Boomer-Senior Tech Business, smartphones, cell phones

• 

from Tips For Aging In Place https://www.ageinplacetech.com/blog/side-effect-covid-19-should-close-remaining-older-adult-tech-gap

Covid-19 – Technology changes accelerate – some a work-in-progress

Note the wave of announcements of 'free' tech services and sea changes. A number of companies popped into my inbox in the past week with announcements of a period of free access to remote care/engagement technologies – including and in alphabetical order CareCentrix, CareTree, Ergo, Eversound, Outpatient, Ready Responders, VitalTech, and NurseCaller. If your firm is in the remote care/caregiving space (health, telehealth, engagement), please comment or email and I will add to this list. And our family doctor’s staff initiated an offer of a Facetime (or Skype or Hangouts or other choice) for a follow-up visit instead of going into the office. Note the other ‘temporary’ change of reimbursement for remote (even telephone) visits, now fitting into the concept of telehealth. The ‘tipping point’ of telehealth is here – and tipping with a suddenness that is unnerving for vendors and most notably, difficult for providers who may lack the equipment and/or processes to deal with patients remotely, despite the risks to themselves with in-person interaction.

Remote engagement technology is suddenly a must-have in senior living. This is the same senior living industry that was s-l-o-w-l-y implementing high speed connections and resident Wi-Fi for many years. But nursing homes, specifically? Well, as of 2015, only one-third offered free Wi-Fi to residents. In 2018 and 2019, infrastructure topped the list of investments for surveyed organizations, particularly multi-site campuses that might include nursing homes. Following the most recent no-visitors rules, it’s easy to imagine the accelerated ramp up in order to accommodate anxious families and also to support the use of telehealth for residents who cannot go anywhere and cannot be visited by doctors either.

Home health care and home care – what are they doing? It has looked like all Healthcare providers, including Home Health, were getting the same telehealth arrangement as physicians’ practices – so telehealth services could only be used to augment in-person visits/care. But since doctors are now being reimbursed as though the visit was in person, that has been clarified to enable Medicare reimbursement for telehealth during the ’30 day’ plan of care. Home care (companion or personal care) is typically paid for by families. And that does not seem to have any change in tech use, though it may just not be documented. Comments to the contrary are welcome.

Imagine a year from now – what’s changed in tech importance? Here are the first five things that come to mind: 1) Families will be ramping up the use of tech for their aging relatives, requiring improvements to user interface and availability of training; 2) Senior living will be nearing the end of deploying Wi-Fi to the resident unit; 3) Nursing homes will have a process if not an actual program to provide residents with at least temporary tech (loaner tablets?); Or the could move around a kiosk-style offered like that offered by iN2L that enables communication with families when none can enter a building. 4) The Medicare telehealth reimbursement equivalent to in-person visits will not be rescinded – and providers will have to accommodate the appropriate mix of in-person and remote based on health status and condition. 5) Changes may also impact staffing and make the care delivery structure in all settings more efficient – as it could long have been -- but no need until now.

Feedback is welcome, either through posted comments or to laurie@ageinplacetech.com.

category tags: 

Telehealth-mHealth-Voice Health, senior living, social isolation, SNF

• 

from Tips For Aging In Place https://www.ageinplacetech.com/blog/covid-19-technology-changes-accelerate-some-work-progress