Part Three in the PCAST Series: Spurring Social Engagement and Connectivity for Older Adults – It’s About More Than Tech

As we age, it becomes harder to maintain our social connections.  Families move, friendships change, loved ones pass away and we become less physically mobile.  While this is not a new phenomenon, we have never had more technology at our fingertips to allow us to stay connected.

The PCAST report makes a number of recommendations for the federal government to enact policy changes that facilitate leveraging technology to increase social connectivity among older adults:

• Create a national plan to ensure broadband Internet access for all older Americans

• Ensure that older adults are included in negotiated agreements for federal telecommunications approvals

• Develop a plan to support accessible technology training centers for older adults

These policy suggestions are important, but even if we solved all the technology issues that prevent older adults from staying connected, they would still suffer from isolation and reduced social engagement – technology isn’t enough.

In addition to technological solutions and efforts designed to improve the technical literacy of older Americans, we need to find innovative, meaningful ways for their local communities to tap into their skills and expertise.  Older adults are a huge resource for communities to build intergenerational bonds that allow them to pass on their expertise and wisdom from decades of experience to younger generations.

Technology is absolutely an enabler for older adults to have increased social engagement and sustained connectivity to their friends and family.  But it should not be a substitute for face-to-face, in-person human interaction.  In the future, the most innovative solutions and programs will use technology to facilitate more of these in-person connections and help them scale across communities around the nation.

COMING SOON:  Part Four in the PCAST Series: Technologies to Support Cognitive and Physical Changes

Part Two in the PCAST Series: Innovative Technologies and Disruptive Business Models in Hearing Loss

Hearing loss is a complex topic that is tough to adequately capture in a blog post.  Consider this post a primer on the key facts and associated regulatory and market issues as well as the barriers to consumer adoption of hearing loss solutions.

An October 2015 PCAST report on hearing loss laid out the following grim facts on hearing loss:

• 25% of adults between 60 and 69 years, 50%+ in the range 70-79 years, and almost 80% of those older than age 80 have difficulty hearing – that is almost 30 million people in the U.S.!

• The average person has been having trouble hearing for 7-10 years before they get it checked out

• Untreated hearing loss is statistically associated with higher risks of social isolation; depression; dementia; falls with injury; and inability to work, travel, or be physically active

• Only 15-30% of Americans with hearing loss seek out and use assistive hearing technologies

• Hearing aids are prohibitively expensive - the average price of just one hearing aid in 2014 was $2,363, with premium models costing nearly $3,000

• Hearing aid components are estimated to cost less than $100 to manufacture and produce

• Medicare rarely covers the costs of hearing aids so consumers typically pay out of pocket

• The stigma associated with wearing hearing aids is another major barrier to adoption

• 12-18% percent of the 3 million hearing aids sold in the U.S. each year may end up not being used due to poor fitting and other adoption challenges

Innovation in the hearing industry – both for product features and business models – has been lacking.  This is due to a number of factors:

• The industry is highly concentrated with just 6 hearing aid manufacturers dominating 98% of the global market for the last 15 years

• Distribution channels and reliance on audiologists to diagnose and treat hearing loss (who are incentivized to sell select brands) have reduced consumer choice by creating barriers to access multiple brands and models

• Some states require in-person sales and prohibit mail and Internet orders, which can be more affordable and convenient

There are a number of steps that the government and industry can take to improve treatment of hearing loss and adoption of hearing aids and devices.

• Run marketing campaigns and public service announcements to reduce the stigma associated with hearing loss and aid in prevention – Identify celebrity endorsers and promote free earplugs at loud events/activities (i.e., concerts, spin studios, etc.)

• Promote hearing testing early and often – Certify and market hearing aid tests and make them accessible online or via smart devices. Provide incentives to primary care physicians (PCPs), other providers and employers to recommend and perform hearing tests (currently very few PCPs conduct hearing tests)

• Relax regulations on FDA requirements for medical evaluations to purchase hearing aids – The FDA currently requires that consumers undergo a medical evaluation to purchase any kind of hearing aid. Relaxing this requirement and allowing consumers to purchase basic hearing aids over the counter may allow consumers to better treat and self-manage their hearing loss

• The Federal Trade Commission should work to promote more consumer choice – Nearly 80% of hearing care professionals bundle diagnostic and treatment options. Not only do many patients not use all the services in a bundle, but it also prevents them from comparison shopping for better options. The FTC ended such bundling practices for eyeglasses in 1978 and similar changes to bundling practices for hearing care will provide more consumer choice.

• Leverage innovative technologies to reduce the cost of manufacturing and improve convenience – Use 3D printing to create custom earbuds and configurations; develop “hearables” (wearables that assist with hearing to offer things like forgotten names (via face recognition), health alerts (Fitbit equivalents), and navigational information (indoor and outdoor GPS)); and utilize computational power to make assistive devices more effective

• Withdraw FDA’s draft guidance on Personal Sound Amplification Products (PSAPs) – PSAP devices, which aren’t defined as hearing aids, serve many of the same functions as hearing aids and have experienced greater innovations and cost reductions than traditional hearing aids. The FDA does not regulate PSAPs as they do hearing aids; however, in 2013, the FDA drafted guidance that would thwart PSAPs’ ability to truthfully market claims that they assist with hearing amplification. Such guidance will seriously stymie PSAPs’ ability to reach consumers, their business model and their efficacy in treating hearing issues.

In short, there are a number of complex societal, regulatory and market forces that make consumer adoption of accessible, affordable and attractive hearing solutions very challenging.  It is time for the public and private sector to work together to do what is best for the consumer and address our nation’s growing hearing problem.

PCAST Series on Independence, Technology and Connection in Older Age: 4 Changes Affecting Older Americans

In March 2016, the President’s Council of Advisors on Science and Technology (PCAST) issued a Report to the President on Independence, Technology and Connection in Older Age.  The report identifies four significant changes affecting older Americans and examines how technology and the government can play a role in supporting these changes.

1.    Hearing Loss – 25% of adults between 60 and 69 years, 50%+ of adults 70-79 years, and almost 80% of those older than 80 experience hearing loss.  That’s 30 million Americans affected today!  Hearing loss is linked to other issues – increased social isolation, dementia, depression and risk of falls, and reduced ability to work, travel and be active.

2.    Loss of Social Engagement and Connectivity – As people age and become less mobile, it can be increasingly challenging to maintain social connections.  Technology has the potential to address this issue as seniors increasingly utilize the Internet, smartphones and other innovations, but adoption is uneven due to varying degrees of technical literacy as well as socio-economic barriers.

3.    Cognitive Change – As we age, cognitive decline is inevitable.  Not only can this create challenges for daily living, but it can also make older adults victims of financial fraud and exploitation.

4.    Physical Change – Like cognitive decline, our bodies physically deteriorate as we age, causing other limitations both for aging in place and maintaining our health and quality of life.

PCAST provides 12 cross-cutting recommendations for the federal government to spur technological innovation to support aging challenges in these four areas. While the private sector is already tackling these issues, there have been less obvious synergies between private sector innovations and government programs supporting technology and aging.  This series will address each of these four areas and examine PCAST’s recommendations and private sector innovations and how both stakeholders can work together to address these important issues on aging.

COMING SOON Part Two in the PCAST Series:  Innovative Technologies and Disruptive Business Models in Hearing Loss

What Axl Rose Can Teach Us About Aging

This past weekend, I had the pleasure of attending one of the unlikeliest reunion tours in rock history – Guns N’ Roses.  I had high hopes for the show, but low expectations. The band was notorious for bad behavior – often starting late and sometimes abruptly ending shows early, even causing a riot in Montreal in 1992 when Axl Rose stormed off the stage after just a few songs.  Moreover, the two main stars – Axl, 54, and Slash, 50, – had an infamous feud and had not shared a stage together for almost 25 years.   

The tour was off to a shaky start, with Axl breaking his foot at his first show in Vegas in April.  I was a bit skeptical if the tour would still be in existence when the Washington, D.C. concert rolled around in June.  Thankfully, the show made it to D.C. and it was one of the best shows I have ever seen, surprising fans and critics alike. 

Two days before seeing the show, I was in Silicon Valley attending The Boomer Venture Summit, a conference on aging and the Longevity Marketplace.  With aging on the brain, I started thinking about how Axl’s performance was illustrative of so many stereotypes and perceptions people have about aging and what it means to be old and past your prime.

Not in This Lifetime

The Guns N’ Roses tour was so improbable they called it “Not in This Lifetime”.  No one expected Axl and Slash to move on from their tumultuous past and play together.  And there were doubts about whether they would even still be any good.  These guys were old enough to be AARP Magazine cover stars.

This “not in this lifetime” mentality is something that persists as many people age.  We start to believe that there is no way we could do that thing we used to be good at 25 years ago.  Furthermore, society encourages this thinking by glorifying youth over encouraging thought around what our second act might be later in life.  Axl can teach us all not to buy into this mentality.  If Axl and Slash can play on a stage together for 40,000 fans and sound incredible after feuding for nearly a quarter century, then the rest of us can also feel inspired to continue doing the things we once loved as we age.

Fat Axl

Axl was a tremendous talent in his prime – he has been named one of the greatest singers of all time by Rolling Stone and would’ve been inducted into the Rock and Roll Hall of Fame, had he not turned it down.  Guns N’ Roses’s recent concert proves Axl still IS a tremendous talent – his voice still has impressive range and his performance was fun and energetic. 

Despite having his voice and signature dance moves in tact (the Snake Dance!), numerous memes, articles and Facebook posts ridiculed his bloated appearance while simultaneously praising his surprisingly successful performance.  Just among my friends, I saw emails and social media posts saying “Fat Axl rocks” and “Long live Fat Axl.”  No one is more horrified from these images and posts than Axl himself – he’s even trying to get unflattering pictures of him removed from the Internet.

Axl, like the rest of us, is not immune to the ravages of time, despite all the resources at his disposal.  The ridicule he has faced for his looks and weight gain, despite his remarkable, enduring talent, is all too common in American society.  Unfortunately, society places so much value on youth and beauty that we end up disrespecting older adults rather than celebrating and honoring them for their accomplishments and continued vitality.  Axl is no exception.

The Second Time Around

Typically, most rock ‘n’ roll bands hit their peak when they are younger.  It’s hard to keep up the energy, looks and talent through decades of hard living.  That makes what Guns N’ Roses did even more special – they made it look better the second time around.

Compared to their youth, where they were unpredictable and difficult, they seemed to be running a well-organized tour.  They were prompt and played for nearly three hours and seemed to genuinely be having fun.

With age comes wisdom and maturity that can make reviving something from your past even better than it originally was.  Let this be a warning to people who tell themselves they are too old to do something – it may not be the same as it was the first time, it may be even better.

Gen X Who?

Gen X, also considered America’s neglected middle child (and my cohort) is often overlooked by marketers and, well, pretty much everyone. Gen X is significantly smaller than the two generations it sits in between – Millennials and Baby Boomers.

Yet Axl and Guns N’ Roses demonstrate that Gen X is big enough to matter (and can fill up stadiums).  Gen X is the primary audience for Guns N’ Roses and other 80s hair bands, 90s grunge and early rap.  They also have other distinct tastes beyond music, as well as a higher median income than their parents did at their age.  So the lesson here is Gen X still matters – even if we aren’t as big as the generations that surround us.

The Takeaway

While Axl seems like an improbable guru on aging, he can teach us all a few things – never say never, appreciate talent over beauty, reunions can be better than the original and Gen X matters.  As he said in 1991 on Dead Horse from Use Your Illusion I:

I met an old cowboy

I saw the look in his eyes

Somethin' tells me he's been here before

'Cause experience makes you wise

3 Things You Should Do Before Engaging in Business Development

Through my work, I see many organizations that are eager to build strategic partnerships and sell their products and services to more customers.  While most organizations can agree that they want to pursue new distribution channels, alliances and customers, fewer have done the necessary pre-work required to make such business development efforts successful.  As a result, these organizations often spin their wheels, resulting in an inefficient use of time and money and less than impressive results.

After working with organizations to grow their businesses for the last 15 years, I have observed three key activities that can prevent this inefficient use of BD resources and promote meaningful results, impactful strategic partnerships and increased revenue.

1.     Do Your Research – Conducting market research is key to understanding the landscape and the trends that could impact your organization’s ability to grow.  Such research can include market scans, introductory conversations with prospective partners, and talking with with potential customers to understand their needs and preferences.

2.     Determine Resources – There is always an upfront investment that occurs when pursuing new business.  Your organization should determine what that investment should be – how much time, money and human resources are you willing to commit to this effort? 

3.     Finalize a Strategy – Once you have a solid understanding of the market and have started thinking about the resources you are willing to commit, you need to incorporate this knowledge into a strategy. This strategy should define:

• Success – Determine the goals that the organization hopes to achieve through these BD efforts. Align these to specific metrics and milestones as much as possible.

• The Business Model – Define an initial business model, which can be iterated on over time, before engaging in formal partnership/BD discussions.

• Ideal Partners and Customers – In a world of limited resources, organizations should develop criteria for the types of partners and customers they want to pursue.

Taken together, these activities will contribute to more intentional, results-driven BD efforts and an efficient use of resources.  Without this type of planning, your organization is more likely to appear disorganized in front of potential partners and customers and have difficulty closing the right type of deals to take your organization to the next level.

Part Two in the Caregivers in the Workplace Series: 4 Caregiver Benefits Employers Should Promote

Thinking about offering caregiver benefits to your employees, but don’t know where to start?  Here are four benefits that can help your employees manage the stress, complexity and emotional and financial burden associated with caring for their loved ones.

1.    Employee Support Groups – As caregivers struggle to balance their career, families and other responsibilities with the task of caring for their loved ones, they often ignore their own needs, particularly around their mental and emotional health and well-being.  Providing a support group where employees can talk to other caregivers can be very therapeutic and offers a healthy release from their daily stressors.  These groups can also serve as a venue to share information and best practices that can help caregivers navigate a complex and fragmented ecosystem.

2.    Aggregated Local Resources – Nearly 85% of caregivers report wanting more caregiving resources.  Unfortunately, these resources and information for caregivers are extremely fragmented.  Additionally, many resources are at the local level, which can make it particularly challenging for caregivers who are providing care from a distance.  Organizations can provide great value to caregivers by aggregating local resources into existing EAP programs and including referrals to caregiver resources in the community.

3.    Discounted Products and Services – Caregivers often experience additional financial stress when caring for their loved ones and can benefit from discounts on caregiving-related services, including meal delivery, transportation, in-home paid caregiving, medication adherence and telehealth services.

 4.    Specialized 401K/Savings Plans – Many people do not adequately save for acute or chronic health problems that require caregiver support.  As a result, many caregivers and their loved ones face financial burdens that they did not anticipate.  Company 401K plans and advisors can provide retirement options geared towards caregivers, taking into consideration the often unexpected role that caregivers take on during their peak earning years.

Caregivers in the Workplace Series: 5 Reasons Employers Should Offer Caregiver Benefits to Employees

There are nearly 44 million caregivers in the U.S., the majority of who are also employed.  The typical caregiver is a female in her late 40s providing nearly 25 hours of care per week to her mother, for an average of 4 years (men are also increasingly taking on caregiver responsibilities). 

Not surprisingly, family caregivers carry a heavy burden as they try to balance their careers and their own families with the demands of caring for their loved ones.  This can have serious health, financial, emotional and professional consequences for the caregiver. 

Employers are also impacted by caregiving; on average, they lose more than $2,000 per year for each employee who is a caregiver. This loss is attributed to the costs associated with replacing employees, absenteeism, workday distractions, and a reduction in hours.  Employers have an opportunity to play a significant role in easing caregivers’ burden through benefits tailored to their unique circumstances.  

Here are 5 reasons employers should offer benefits to caregivers:

1.    Attract and Retain Women – Since the majority of caregivers are women, benefits designed for this group can help companies attract and retain women or those workers who are looking for a family-friendly work environment.  This can be an important differentiator in competitive industries like consulting, law and finance, where careers are particularly demanding and women may exit the workforce or defer a promotion, believing that they would not be able to juggle intense work demands with family responsibilities. 

2.    Reduce Health Insurance Costs – Caregivers often experience great stress and neglect their own physical and emotional health when caring for their loved ones, leading to increased healthcare costs. According to a MetLife study, employers paid approximately 8% more for the health care of caregiver employees compared to non-caregivers, potentially costing U.S. businesses $13.4 billion per year. By offering benefits that enable caregivers’ to more easily care for their loved ones, companies are helping caregivers take better care of themselves, which can lead to better health outcomes and lower costs.

3.    Increase Productivity and Reduce Absenteeism – U.S. businesses lose up to an estimated $33.6B per year in lost productivity from full-time working caregivers.  By providing access to resources, support and other benefits, employers can make it easier for caregivers to find services and solutions for their loved ones and, in turn, gain peace of mind that allows them to be more focused on their jobs.

4.    Prevent Talent Drain – Some caregivers find that working and caring for their loved ones is just too much.  Nearly 20% of employees leave the workforce earlier than planned to care for a family member.  Many of these employees are mid- to senior-level professionals in the prime of their career, which can leave big gaps for employers to fill. Providing additional support and resources for caregivers can prevent early retirements.

5.    Promote a Culture of Diversity and Inclusion – As companies increasingly look to differentiate themselves as employers of choice and brand themselves as innovators, they need to develop a diverse workforce comprised of different cultures, genders, races and viewpoints.  Providing benefits to caregivers should be part of an overall inclusion strategy to attract and maintain a diverse workforce. 

COMING SOON Part Two in the Caregivers in the Workplace Series:  4 Caregiver Benefits Employers Should Promote

Transportation for Family Caregivers – Driving Scalable Solutions

According to a 2015 joint research study between the National Alliance for Caregiving and AARP, there are 43.5 million caregivers in the U.S.  Caregivers are typically female, 49 years old, caring for their mother, work full- or part-time, and provide care for an average of 4 years.

Transportation is the leading activity caregivers provide

Transportation is the leading Instrumental Activity of Daily Living that caregivers provide to their loved ones.  Caregivers spend a lot of time in the car, driving the individuals they care for from appointment to appointment or social activities, picking up groceries and medicine and running other errands.  On top of this, many caregivers have children of their own and may also be shuttling them between soccer practice, friends’ houses, tutors and school.  This means the average caregiver can spend a lot of time acting as a chauffeur, which may test their capacity to be physically and emotionally present in other activities, such as work or spending quality time with the ones they are caring for and their friends and family.

Providing transportation solutions for caregiving is hard

Unfortunately, providing transportation solutions for caregivers and their loved ones is not an easy fix.  Standard transportation options like public transit and taxis often work well for the general population, but do not address the special needs of this population, which require empathetic solutions.  Few organizations have been able to bring scalable, affordable solutions to market in a meaningful way, as described in the table below.

 Despite these challenges, there are some existing, albeit imperfect, solutions

The solutions that exist today can be helpful for those who are aware of them and know how to leverage the resources in their local communities. That said, it is still challenging to find a consolidated source of transportation options, even with options such as Eldercare Locator, a finder tool that connects individuals to community resources and Ridescout, an app that displays a wide array of transportation options available locally.

The federal government has acknowledged these challenges as the U.S. Department of Transportation prepares to launch the National Aging and Disability Transportation Center (NADTC) in the fall of 2015.  The NADTC will have $2.5 million to provide technical assistance to improve the availability and accessibility of transportation options that serve the needs of people with disabilities, seniors and caregivers. 

In the meantime, private companies, public and non-profit organizations, and volunteers continue to test and try to scale a number of transportation solutions.

 We need to think differently to bring effective and scalable transportation solutions to market

We should leverage the learnings from the plethora of pilots and community efforts and identify public and private partnerships that will provide ample funding and consumer choice for different solutions. 

Through such partnerships we could design solutions, including:

• A national ridesharing service that provides extra assistance through for-profit, public and grant funding

o   Partnerships between the leading ridesharing companies and volunteer, public and escorted ride organizations that already have the expertise and training to deliver assisted/escorted rides

o   Collaboration between logistics and transportation coordination companies and escorted ride, public and volunteer organizations to leverage expertise on fleet management, greater coordination and transparency, and economies of scale resulting from centralized control of resources

o   Additional features – such as telephone and web requests – to make an older population more comfortable with the service

• An aggregator or finder tool to allow caregivers and loved one to access all transportation options available in their communit

• A nationally-recognized volunteer platform that allows caregivers and their loved ones to request rides and encourages volunteers to sign up

These solutions are not quick, cheap or easy.  But until we start thinking boldly and differently, we will be stuck waiting for business models to prove themselves out in the private market and communities and local governments to advocate for more funding.  Until then, caregivers will continue to juggle too much, causing them to miss work, lose quality time with their family and friends, and contribute to declines in their physical and emotional health.  At the same time, care recipients will continue to be dependent on their caregivers for transportation or risk becoming isolated and sick.  Given the choice, we simply can’t afford to maintain the status quo.