IT Can Help Patients Age in Place - But They Must First Understand It

IT Can Help Patients Age in Place - But They Must First Understand It

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Photo: Seated is Stanford's Dr. V.J. Periyakoil. Standing (left to right) are New America Media's Paul Kleyman, the Institute for the Future's Richard Adler and UC's David Lindeman.

SAN FRANCISCO -- The United States is at a juncture of a “perfect storm” – a burgeoning elderly population, chronic diseases and a shortage of caregivers, observed a long-time health services researcher in the field of aging and long-term care.

But most people like to age in place, and rapidly evolving technology is allowing many of them to do that, said David Lindeman, PhD, director of health at the University of California’s Center for Information Technology Research in the Interest of Society (CITRIS).

Health and wellness technologies, he said, “help older adults engage in their own care.”

Nearly 84 percent of caregivers with internet access go online to access information about a particular treatment or disease, medications or health insurance, according to a recent report by the Pew Research Center.

Lindeman was a panelist at a two-day workshop on health information and technology presented here Oct. 13-14, by the Association of Health Care Journalists. “Will health IT help an aging population?” was the topic of his workshop.

Other workshops included such topics as growth in virtual medicine, challenges insurers face in the changing landscape of health care and closing health disparities with technology.

$117 Billion Business By 2020

Health IT is being embraced by providers, caregivers and elders themselves, turning it into a lucrative business. By 2020, experts say, the geriatric market will grow into an estimated $117 billion business.

Panel moderator Paul Kleyman, who directs the ethnic elders newsbeat at the online news service New America Media, noted that exciting as the developments in the field of internet-based technology are, “they can be challenging” for the aging population, many of whom have not grown up with it. That holds true for their unpaid caregivers, as well -– generally friends, family members or neighbors-- who have not learned how to use them.

In his presentation, Lindeman concurred with this observation. That’s why it’s important, he said, that the tech world be mindful that the geriatric devices they develop could be intimidating for the users.

“We need to have older adults in the loop as we design technologies,” he said. “It’s critical that the end user helps us shape technology.”

Companies such as Apple overlook the aging demographic and target their devices toward young people, Lindeman said -- even those that could help seniors.

IT "Angels in the Floorboards"

A plethora of high-tech devices meant to make the lives of older adults more secure and comfortable are on the market. Some of them can help even long-distance caregivers. For example, home sensors, including some that can be imbedded as “angels in the floorboards,” can alert caregivers when a senior has fallen. Another device can remind Mom to take her pills.

Panelist Richard Adler, PhD, a Distinguished Fellow at the Palo Alto-based Institute for the Future, is currently working on a project called “Caregiving 2031,” exploring tomorrow’s eldercare technology and

He also has helped develop the Avenidas eldercare nonprofit’s Generations Lab. Located in Silicon Valley, it aims to create a program to help older adults learn the technology of the devices designed for them.

But along with technology, he said, when dealing with the elderly population, there “has to be one more component -- a friendly helping hand.”

"Low-Tech, High Touch" for Patients

Panelist V.J. Periyakoil, MD, who directs Stanford University’s Palliative Care program at the School of Medicine, and works extensively with minority communities, has adopted a “low-tech, high-touch” approach in dealing with her geriatric patients.

“You have to be in love with the older adults, not in love with the technology in order to help them,” she said.

In working with her patients over the last 15 years, she said, “the most common emotion they express, especially near the end of their lives, is regret over a wide range of issues involving family and friends.”

To help them get it out of their system, she has them write a “Last Letter” to their loved ones, encouraging the patients to be as candid as possible. Periyakoil used a compelling Power Point and video to illustrate her presentation.

With guidance from seriously ill patients and families from various racial and ethnic groups, the Stanford Friends and Family Letters Project has developed a free template in eight languages for a letter that can help people complete seven life review tasks: acknowledging important people in their lives; remembering treasured moments; apologizing to those they might have hurt; forgiving those who might have hurt them; and saying “thank you,” “I love you” and goodbye.”

This approach, she said, is a chance for people to let go of grudges.

One of her patient, identified only as F.D., wrote: “Dear family and friends: I realize that my illness may be causing you some distress. You are working hard to support me and care for me in addition to all the other roles and responsibilities you have. Let me start by saying that I am very grateful to you for your loving care and concern. Your support is helping me cope with my illness.”