Mature Market Experts Gem of The Day: Serving Aging Populations with Remote Monitoring Technologies

42-17073549 telehealth mature market experts

Mature Market Experts: more mature market news and stats more often – Serving Aging Populations with Remote Monitoring Technologies – Estimates by the U.S. Census Bureau expect the population of Americans aged 65 and older to increase by more than a factor of two between 2010 and 2050 [1]. At the same time estimates of healthcare expenditure increases between 2007 and 2017 show an increase to nearly 20% of GDP in this period [2]. These estimates were made prior to the recent financial crisis that began during the Fall of 2008. Further compounding this increasing demand and the concomitant increase in costs is the availability of allied healthcare professionals. Some studies [3] identify the likely decrease in the number of physicians entering any number of key specialty areas, including cardiology (20% decrease by 2020), geriatrics (35% of current demand met today), rheumatology (38 day average wait for a new appointment), and primary care (on the verge of collapse). Those of us who are baby boomers are on the leading edge of this demand and, in order to mitigate and minimize the cost impacts on our children, it is our challenge and responsibility to innovate and meet these challenges without passing along unnecessary burdens to our children and grandchildren.

For most of us, aging means more frequent and severe afflictions. Taking care of our health by improving diet, exercising, and maintaining an otherwise active lifestyle is essential to ensure a high quality life. Even with increased vigilance chronic ailments can affect us later in life, brought on both by our genetics and consequentially due to the lifestyles we’ve led in our youths. Ailments such as dementia, coronary artery disease, Alzheimer’s, myocardial infarction, congestive heart failure, macular degeneration, osteoporosis, hypertension, chronic obstructive pulmonary disease, diabetes, and others take their toll. Managing chronic diseases is costly from a logistical perspective in terms of time and money. However, even more to the point, effective and quality oversight of patients with chronic ailments requires regular review, screening, and monitoring of patients. This is further complicated by the need to serve patients who lack the means or are physically incapable of leaving their homes for extended periods. Telehealth and remote monitoring are a means by which a case manager—an individual assigned to oversee the care of chronically ill patients within a home-health setting—can review patient information on a regular basis (for example, daily) and support both the patient and the primary care provider. Furthermore, Intensive care units and emergency departments are becoming more crowded. Individuals with insurance are going to EDs because they cannot find satisfaction in terms of prompt scheduling with their gatekeepers (family practitioners). The quantity of individuals with chronic ailments is on the rise (stroke, CHF, diabetes, COPD, etc.) This is in part due to the fact that people are living longer. At the same time the Medicare and SS systems will not be able to sustain the growth in population over age 65. This means that working individuals will increasingly bear the financial burden for us “boomers.” As a result of increased longevity and the fiscal challenges, the retirement age will increase.

So, what do we do? Well, several things: first, technology in the form of remote data collection, reporting devices and software will become more prevalent: glucometers, BP cuffs, spirometers and associated software will be more readily available for direct communication with personalized electronic health records. If the purpose of a typical visit is to take BP and diabetic assessments, this can be handled most by collecting data at the point of care (home) and transmitting to the physician’s office for assessment. Such also applies to nursing and assisted living facilities. Next, the technical infrastructure required to transmit and store these data will be required. Paying for this infrastructure could come from a number of sources. One possibility: most everyone nowadays has access to cable television. Cable companies could offer devices that integrate with existing modems to collect and transmit data to the FP, together with complementary emails to next of kin (e.g. “Your mother’s BP as of 8:10 this morning was 145/89”). Other technologies that can be used to evaluate and monitor chronic ailments such as macular degeneration can further reduce costs by providing video cameras at point of care whereby ophthalmologists can review retinal changes without requiring an elderly individual to be transported at expense and time to a hospital or office. In addition, support for remote consults via VoIP and video can be supported over the same network. This empowers the remote provider with the ability to interact with the patient All of these technologies are in use in remote pockets around the world today. But, they will become more prevalent. These technology implementations will reduce costs and provide for more personalized care in comfortable settings (homes). Of course, nothing takes the place of the tactile hands-on. But, for routine visits the above will be invaluable. In terms of the software technologies, personalized medicine will become the norm (eventually). Telehealth will be key. But, also, support for automated workflow in the acute care environment will need to be augmented. This means fully integrating all data into the enterprise HIS.

 The U.S. Department of Health and Human Services through its Office of the National Coordinator for Health Information Technology published operational scenarios focused on providing key information to assist in harmonizing standards on the implementation, certification, and policy implications for robust remote patient monitoring [4]. Included in this assessment are requirements on interacting with personalized health records and enterprise health information systems. The approaches to advancing remote monitoring include both seamless communication from medical devices at the point of care (i.e., in a patient’s home setting) and with a case manager and primary care provider both through electronic transfer, storage, and display of health information and remote video and audio interaction with patients in the same home health setting.

 Technology is not the silver bullet, but those described above are key enablers for remote health monitoring. Of course, the use of technology carries with it the implication that sufficient underlying infrastructure exists. This is not always the case in remote areas of the country. Satellite, cable, and fiber optic technologies are fairly extensive within the continental United States, but pockets and regions exist in which this is not the case. Therefore, a combined effort to extend the communications infrastructure must continue together with a unified effort to standardize and train and “in-service” individual care providers on these technologies must occur. One of the best mechanisms for enabling this is through the local hospitals and their satellite clinics.

[1] Source: Population Division, U.S. Census Bureau, August 14th, 2008; Table 12: “Projections of the population by Age and Sex for the United States: 2010 to 2050 (NP2008-T12)”

[2] Cinda Becker, “Slow: Budget Danger Ahead,” Modern Healthcare, March 3rd 2008.

[3] “Recent Studies and Reports on Physician Shortages in the U.S.,” Center for Workforce Studies, Association of American Medical Colleges, August 2007.

[4] “Remote Monitoring Detailed Use Case,” U.S. Department of Health and Human Services, Office of the National Coordinator for Health Information Technology, March 21st, 2008.

So, how long do we have? Well, the sooner the better. Successful telehealth and remote monitoring programs exist throughout the United States and worldwide today. We should ensure that our elected representatives direct healthcare expenditures towards several specific areas to promote growth and alignment to meet the objectives of remote monitoring. These include continuing alignment on electronic personalized health records, expansion of our underlying communications infrastructure, and promoting common standards of communication among these records so that, regardless of location, a patient can communicate his or her information to any physician and allied health professional within the country. In summary: common storage, homogeneous communication, standardized formats.

 
 
 
 

 

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Gardening and Exercise: Healthy Aging for Older Adults

CBR003130 mature market gardening

Mature Market Experts: more mature market news and stats more often: Gardening and Exercise, Healthy Aging for Older Adults – More often than not, the outdoor environment of a senior ‘retirement’ community is ignored and people focus on the attributes of a building’s interior. However, the activities that can be offered on the outside of a building are almost limitless, constrained only by the imagination, and not by a person’s age. We should encourage people to explore how the exterior environment can provide avenues for older adults to participate in physical activities that benefit them in many different ways. The stereotype, unfortunately, that older persons over the age of 65 are for the most part ill, dependent, mentally incompetent, unproductive and unattractive is alive and well. Nothing could be further from the truth, and fortunately this is changing thanks, in part, to the “Baby Boomers.” In actuality, those persons aged 65 and older represent one of the most diverse population segments, with everyone aging differently. While some of the oldest cohort (85 years and older) are frail and experiencing multiple chronic conditions, others are active and rate their health status as “good”.

In order to encourage older adults to exercise, active lifestyles need to be created in and around senior residences. Ultimately this will result in greater independence in the daily lives of a majority of the older adult population. There are a great number of programs—such as bike riding, hiking, birding, canoeing, etc.—that can be implemented to encourage older adults to become more involved in the outdoor environment.

Among these activities, one of the more personally rewarding programs is gardening. Gardening is the number one leisure activity in America, today. Studies have shown that many people 65 years and older are interested in gardening as a hobby. Everyone has had some interaction with gardening, whether it was tending to a house plant on a fire escape, blueberry picking along the side of the road or sharing fresh grown vegetables from the garden with family and/or friends. The percent of seniors interested in gardening and related activities has increased significantly over the past years and the number is expected to continue to increase as the “Boomers” age. That generation is more inclined to expect organic vegetables, health foods, and other natural products as part of their daily living.

There are reasons why gardening should be a natural part of a senior living community. It is a highly visible hobby in which everyone can participate, either passively or actively. And there is always one person that is a ‘resident expert’ who has had previous gardening experience and can lend advice. If a person has never experienced the joy of raising a plant, they can be encouraged to start small and build up gradually. The senior can begin with one tomato plant in either a container or in a small garden space. What person has not delighted in raising and ultimately sharing a fresh grown vegetable from their garden with family and/or friends?

Development of activity programs can be designed to meet the various needs of the seniors. Higher-functioning individuals who are physically active will be able to participate in a wide range of activities. Gardens can be located on-grade or at ground level, in order to take advantage of the larger growing areas. There can be minimal costs associated with the construction of smaller raised planting beds. Seniors residing in Assisted Living Residences may require a higher level of support. There can be garden spaces for Community Gardens located throughout the complex. However, there should be provisions for raised planters located closer to the residence. This will enable seniors who utilize wheelchairs and walkers to experience the joys of gardening nearer to the building. And seniors who are not able to actively participate can watch from windows or on a porch.

Accommodations for handicapped seniors should be incorporated into the overall design of garden activities in order to allow everyone to participate and feel a part of the program. Various levels of gardening can be introduced to encourage individuals to take part. Containers or raised planting beds are more easily accessed for people in wheel-chairs. Vegetable plants with brightly colored fruit and with a fragrance are good for the visually impaired. Ergonomically designed tools that are lightweight and have long handles make the job easier, especially for arthritic and wheelchair-bound seniors. Each person needs to experience his or her own unique sense of accomplishment. After all, the purpose of participating in an activity program is to promote better health, increase agility, maintain a sense of independence and feel better about oneself.

Gardens for special needs residents, Alzheimer’s and other memory-impaired patients, are another very specific level of programming. Gardens should be designed to meet the needs of the people at each stage of the disease. For example, plant material should be nontoxic for stage-three Alzheimer patients. Plants can be a wonderful tool for remembrance therapy. The tomato plant is widely recognized, has a very distinctive odor and the red fruit is attractive. Vegetables offer stimulation to almost all of the senses, therefore, they should be readily utilized in the garden.

The key to success in developing any activity program is achieving a level of motivation that stimulates a personal interest. There should be opportunities to interact with other people. We all like to meet friends in various settings. Education regarding the benefits of gardening can also be an important part of the program. Guest lecturers, how to/educational videos, magazine subscriptions, walking tours and classes can be part of the gardening program.

Individual goals should start small and be realistic. A person should not try to do more than they are able to the first few days. Moral support is also very important. Remind the senior of the benefits of physical activity and how participating will personally reward them. The same logic that motivates a person to participate in a group also motivates a person to pursue individual interests. Help the person set goals that can be achieved on a daily basis. Keep track of their progress so they can see the results of their efforts. Socialization, the enjoyment of nature and education all contribute to the success of any activity program.

Gardening involves many small tasks that encourage physical exercise. Bending, reaching, pulling, stretching are just a few of the movements that are required. A study conducted at Tufts University in Boston discovered a “threefold increase in muscle strength among frail, elderly nursing home residents aged 86 to 96 who exercised their legs on a weight machine over an eight week period.” (DiGilio1994) Seniors who have never been exposed to an exercise program continued even after the program has been concluded. They realized the importance of being physically active. As a result of their consistent efforts, they now have increased mobility, agility and energy and are experiencing increased independence.

The following list offers insight into just how beneficial exercise and physical activity can be:

• The risks of cardiovascular disease decrease dramatically
• Mental acuity increases, as more oxygen is available to the brain
• Proper weight is maintained
• Neurotransmitters are regulated, resulting in less depression and anxiety
• Digestion and gastrointestinal mobility is increased
• Flexibility and balance is improved
• Self-esteem is enhanced
• Individuals experience an increased emotional resiliency in response to life’s changes and losses
• A perception of positive health status contributes to an overall satisfaction with life

The ability to be outdoors and interact with nature also has been proven to have its own unique benefits. The natural production of Vitamin D occurs with exposure to sunlight. There are psychological benefits to interacting with the environment. Watching a beautiful sunset or experiencing the sunrise has a profound effect on mood and emotion. All of the senses are activated when you are outside. The smell of Lavender angostifolia (lavender), the sound of a bird’s song, looking at a chipmunk scurrying about for food, as well as touching the soft leaf of a plant such as Stachys byzantina (lambs ear) are all activities that excite the senses. Research supports the preceding findings and the results are significant.

It is also important to be needed. The act of gardening not only maintains a connection with nature, it creates a sense of dependency. When a senior raises a plant and is responsible for its care, that person develops a bond. Both need food, air, light and water as a basic minimum. A person also gains positive reinforcement from growing plants. We feel better about ourselves when we have accomplished a talk, such as growing a plant or harvesting vegetables.

Another indirect benefit of gardening is the promotion of quality sleep through natural means. Older adults suffer from a decreasing production of melatonin, the hormone that regulates sleep. Many older adults tend to get sleepier in the early evening, around 8 pm, and then wake up at 4 am. This can be very frustrating because it offsets normal routines and disrupts schedules. Daily activities and regular exercise regulates hormones and bright natural light resets our biological clock. Exercise promotes peaceful, uninterrupted sleep and diminishes episodes of insomnia.

Senior residences should be designed to meet the needs of older adults who want to use the exterior environment. Some residences may offer a walking path and/or a few benches. The plant material, exterior furniture and other amenities must be suited to a specific use by the older resident. Whether creating a new project or upgrading an existing residence, it is important to incorporate the professional expertise of a Landscape Architect and a Gerontologist. These two professionals need to be involved from the onset, along with the Architect and Engineer, in the development of a new residence. The Landscape Architect is experienced in the selection of a site, including the placement of the building in a location that enhances the views to and from the building, minimizing impact on the existing environment and presenting a realistic construction budget. The Landscape Architect understands how to create environments suited to a person’s specific needs and is experienced in the art of problem solving. Functional and aesthetic perspectives are equally important to the success of any building. The Gerontologist understands the aging process and how to meet the needs of a particular age group when designing a senior residence. The physical, emotional and social aspects of the aging person must be considered. The Gerontologist works with the staff to tie together the multiple needs of a person successfully “aging in place”. The psychosocial dynamics of stimulating a person’s interest and engaging them in an activity is very important. The Gerontologist and Landscape Architect are vital links to the success of a project and are therefore integral parts of a design team.

An exciting aspect of the creation of outside areas that stimulate physical activity is envisioning how these spaces will evolve over the coming years. In the future, residents who participate in various activities will not resemble the residents today. The Baby Boomers, many of whom are currently caregivers for their parents, will demand a different set of standards for themselves in years to come. They are an active, mobile, environmentally conscious generation that will face today’s challenges in new and exciting ways. Comfortable exercise outfits and sneakers will replace walkers and orthopedic shoes. Health food and environmental programs will become industry standards. These predictions help to challenge our imagination and keep us focused on how we will create the living environments we ourselves will expect tomorrow.

About the Authors: Nancy Norton Carman, M.A. Gerontology, CMC and Jack Carman, FASLA, RLA

Jack Carman, owner, founder and president of Design for Generations, LLC, has over 20 years experience as a landscape architect. He is a nationally recognized expert in the design of therapeutic gardens, particularly Alzheimer’s gardens and outdoor environments for senior living communities. http://www.designforgenerations.com/

Note from Tom Mann: Gardening is America’s #1 hobby. Guess who makes up the biggest percentage of gardeners?

Can Google make you smarter? Is the more you Yahoo, the better?

A new study suggests that searching online could be beneficial for the mature brain. A study  conducted by  Dr. Gary Small has been in all the news this week.  

 

Join us Wednesday evening  as Gary  discuss how your brain changes  using today’s  technology.

 

iBrain:  Surviving the Technological Alteration of the Modern Mind

 

Date:               Wednesday Evening, Oct 22, 2008

 

Moderator:      Jeff Zimman – CEO, Posit Science

 

Speaker:         Gary Small, MD, Director of the Aging and Memory Research Center, Semel Institute

 

Location:        Wilson Sonsini – 950 Page Mill Road, Palo Alto  

 

Time:               6:00PM Registration, Hors d’oeuvres and Networking

 

                        7:00PM Presentation and Panel Discussion

 

Registration:

$20.00 in advance on the website

 

$25.00 Walk-ins at the door (cash or check please, no credit cards accepted at door)

 

Here is the  buzz …   If you think our constant use of the internet, blackberry’s, iPods, text-messaging and video games have changed our lives and our children’s lives, here’s some breaking news:  Our frequent use of technology has not only altered our lives, it’s altered our brains.

 

Gary Small, M.D., one of America’s leading neuroscientists and one of the leading medical experts on memory and brain fitness, discusses the remarkable brain evolution caused by the constant presence of technology today, separating the digital natives – those born in the computer age – from the digital immigrants, those who discovered computer technology asadults.   Join us as Gary discusses:

 

·         Techno-Brain Burnout -psychological and brain stress from too much technological exposure

 

·         I Can Quit Any Time I Want — how we can, indeed, be addicted to, the internet, games, social networking ,our e-mail and more – Find out what happens in our brain when we see messages that we like.

 

·         Brain Gap – Technology Dividing Generations – gap between young digital natives and older adults.

 

Gary Small, M.D – Director of the Aging and Memory Research Center at the Semel Institute for Neuroscience and Human Behavior Dr. Gary Small is a professor of psychiatry at the UCLA Semel Institute and directs the Memory and Aging Research Center and the UCLA Center on Aging. He is one of the world’s leading experts on brain science and has published numerous books and articles. Scientific American magazine named him one of the world’s top innovators in science and technology, and he frequently appears on The Today Show, Good Morning America, 20/20 and CNN. Dr. Small has invented the first brain scan that allows doctors to see the physical evidence of brain aging and Alzheimer’s disease in living people. Among his numerous breakthrough research studies, he now leads a team of neuroscientists who are demonstrating that exposure to computer technology causes rapid and profound changes in brain neural circuitry.

 

Jeff Zimman is the co-founder and Chairman of Posit Science. From 2003 to 2008 he served as President and CEO of the company. He now chairs the Board of Directors and focuses his full-time efforts at the company on strategic relationships and corporate development. For the past two decades, Jeff has been involved with healthcare, information technology, and consumer products companies in implementing strategies leading to successful funding, high growth, and liquidity. Jeff is a former Venture Partner of VSP Capital, a former Managing Director of Lazard, where he founded and ran the investment bank’s early stage advisory business, and a former partner of Cooley Godward, where he headed the corporate and securities practice in the law firm’s San Francisco office. In addition to running these high-growth service businesses, he has served on the boards of several start-up companies. Earlier in his career, Jeff was an award-winning newspaper reporter, covering business and technology. He earned his AB degree at Bowdoin College and his JD and MBA degrees at Stanford University.

 

Release by:

Susan Ayers Walker, Technology Journalist

www.aarp.org/learntech/computers/

Managing Director, SmartSilvers

www.smartsilvers.com/

(office)    650-854-1146

(fax)         650-854-1889

(cell)        415-265-1045

(skype)   wra7562

Mature Market Experts Stat of The Day: Biggest Fear?

Can games help keep your mind sharp?

Can games help keep your mind sharp?

A 2006 survey by the MetLife Mature Market Foundation reveals that the U.S. mature market fears Alzheimer’s and its accompanying memory loss more than heart disease, stroke, or diabetes. Among adults over 55,  tops the list of most dreaded diseases.

Think there’s a huge opportunity for memory fitness games like Mind Sparke?

How big is the fear? In 2005, Americans spent $109 million on ginkgo biloba, an unproven supplement used for memory enhancement.

Mature Market Experts Stat of The Day: Alzheimer’s

Wow, its 7:14 pm Eastern Standard time. I almost missed today’s Mature Market Experts blog entry. I’ve been on the road all day visiting some extraordinary clients. I have a very cool job. Anyway, since I started the stat of day, I haven’t missed a weekday entry. Since Cal Ripken Jr. is one of my heroes (his 2,632 straight games is a monument to work ethic), I raced home to get this one in:

What’s the mature markets biggest fear? Certainly, Alzheimer’s is near the top of the list. Currently, approximately 4 million Americans have Alzheimer’s disease. (National Institute on Aging)

By 2050, the number of Alzheimer’s patients is expected to reach 12 to 15 million. (National Institute on Aging)

In 2000, about 40% of Alzheimer’s patients were age 85 and over. By 2050, the number is expected to grow to 60%. (National Institute on Aging)

In 2050, Alzheimer’s disease is expected to affect 8 million people 85 years old and over. (National Institute on Aging)

 

Mature Market Experts Stat of The Day: The Costs of Care

What are the costs the mature market faces for care?

 

The average daily cost for a private room in a nursing home is $213, or $77,745 annually.

The average daily cost for a semi-private room in a nursing home is $189, or $68,985 annually.

The average monthly cost of living in an assisted living facility is $2,969, or $35,628 annually.

The average monthly cost of living in a not-for-profit Continuing Care Retirement Community is $2,672, or $32,064 annually.

The average monthly rate for assisted living facilities that charge additional fees for Alzheimer’s and dementia care is $4,270, or $51,240 annually.

To move into a community, individuals must also pay an entry fee ranging from $60,000 to $120,000.

The average hourly rate for a certified home health aide is $32.37.

The average hourly rate for a uncertified home health aide is $19.00.

Source: AAHSA, American Association of Homes and Services for the Aging

 

The national average daily rate for adult day care centers is $61.

The national average hourly rate for homemakers/companions is $18.

Source: 2007 MetLife Market Survey of Adult Day Services & Home Care Costs

Mature Market Experts Stat of The Day: U.S. Life Expectancy

Japan continues to have the highest life expectancy.

Japan continues to have the highest life expectancy.

 

The mature market just keeps on growing:

 For the first time ever, U.S. life expectancy has past 78 years

Japan currently has the longest life expectancy – 83 years

Heart disease and diabetes as a cause of death dropped by more than 5%

Death caused by diabetes also declined, placing Alzheimer’s as the country’s new 6th leading cause of death

Flu and pneumonia deaths dropped by 13 percent from 2005

On average, life expectancy for U.S. citizens improves by an average of two to three months every year (this year saw a usual increase of four months)

Source: National Center for Health Statistics, Associated Press