Care Show China: a Glimpse of China Senior Care Industry, by Anita Jiang, edited by Robin Roth and Alisa Rodriguez

Screen Shot 2016-03-03 at 9.11.24 PM
Care Show China, one of China’s most influential senior care industry conferences, created enthusiasm among the approximately 70 guest speakers, 50 exhibitors, and 2000 professional visitors from 20 countries, who gathered at Shanghai World Expo Exhibition & Convention Center from August 25th to August 28th. Care Show China Conference & Expo’s 3rd annual event was informative and well attended.

Care Show China and China Aid are the two most influential professional conferences in senior care industry in China. Care Show China is organized annually by UBM, a company that provides a trade platform through conferences. These events help integrate “international concepts and local operational experience” and build an “international B2B platform for China senior care industry.” This two-day conference brought together representatives and experts from various areas, including government agents, long-term care providers, investors, consulting firms, and consumer product companies. This summit offered a glimpse of the current senior care industry in China from multiple perspectives such as design and planning, workforce management, and IT solutions.

Among those leading the opening ceremony were Margaret Ma (Managing Director of UBM China), Xieshu Zhang (Chairman of Shanghai Social Welfare Association), Shiming Lv (Vice President of China Federation of Disabled Person), Clive Allcorn (Assistant Director of British Consulate General Shanghai), and Chen Xiaodong (Mayor of the People’s Government of Rugo Municipality). After addressing the economic challenges faced by seniors living in rural regions, Qingchun Yan (China National Committee of Aging) urged private-sector investment in senior care. The Chinese government encourages these ventures.

Weiguo Zong (Deputy General Manager of Zhejiang Vanke Dignified Life Senior Center Management) classified the senior care industry in China into three stages. “Now the senior care industry in China is still in its Bronze Era (2010-2020), which is characterized by descendants’ orientation and the demand for medical treatment and nursing. It will mature in the Silver Era (2020-2030) and reach Golden Era after 2030, which will be marked as a combination of luxury assets and personalized services,” stated Zong. Vanke, the primary sponsor of Care Show China, is the largest residential developer in China. Recently, Vanke has developed its first senior paradise living community, which includes Charmwood Apartments, a nursing home, a training school, and neighborhood care. This series of senior paradise products incorporates healthcare and nursing, along with social bonds created within the community to develop a more socially supported senior living community.

Victor Yuan, (Chairman of Horizon Research Consultancy Group and CEO of FEIMALV) classified business in this industry into two types—venture and professional. Venture businesses generally control a large amount of capital and land, and develop rapidly within a conventional Chinese model. Professional businesses require expertise and specialization, and develop at a slower pace. According to Yuan, “We are expecting the emergence of a third type which builds on these two types.” Mr. Yuan holds an MPA degree from Harvard Kennedy School and runs FEIMALV, the first organization in China, which provides professional management support for the start-ups.

On August 27th, the conference continued on two tracks (Track A and Track B). Track A focused on Business Model and Design & Planning. For instance, PRP Architects LLP from UK, Shiga Design from Japan, Independent Management Group from Australia, and Greentown Yile Education Investment Management in China presented their designs of senior communities. Workforce management and the scarcity of professional caregivers were commonly addressed in these demonstrations.

Track B focused on Operation Management/Smart Technology. It began with an innovation competition, which was initiated by Senior Service Informatics Development Committee of China Association of Social Welfare, Shanghai Technology Elderly Service Center, and local media in April 2014. The innovation ranged from medical devices (such as acupuncture) to training sessions. The training sessions were run by a group of senior citizens with an average age of 72. These volunteers provided training sessions to seniors on health and biology related topics, such as depression. This project received the highest score. During the competition, 10 out of 18 pieces were selected by 40 senior consumers and experts to enter the final competition in this coming October. Winners will receive financial support and mentorship to test their products and services for market reaction.

Products were also introduced during this conference. For example, Bromme Cole (President of Hampter Hoerter Healthcare) presented an app called “ihuhuhu” as a tool to improve workforce performance and customer satisfaction in elderly care service. A representative from Shanghai Haiyang Group introduced its CBO model to build an intelligent platform of senior services.

Panel discussions were held on areas of primary concern such as strategy to survive in this industry, the integration of health care and social welfare, and the application of digital technology in health and well-being. During the end of the expo, the panel discussion on digital technology aroused heated debate among the panelists and audience. The panelists included Hanzhang Wu (Director of Shanghai Technology Elderly Service Center), Lanning Tian (Director of Senior Service Informatics Development Committee of China Association of Social Welfare), Hans Ding (CEO of VSI IntelTech), Rui Zhang (Senior Consultant of UNIS), Nan Xi (Regional Business Director of Shenzhen Belter Health Management and Analysis Technology), and Vincent Yang (Founder of Zionchina.com). Even though the panelists had differing opinions about the role of digital technology in senior care, they all expected cooperation from diverse backgrounds to inspire future innovation.

Screen Shot 2016-03-03 at 9.10.54 PM

Traveling and Mobility Issues for Older Adults, by Alisa Rodriguez and Robin Roth

The number of travelers in the older Baby Boomer population is growing. According to a 2012 Metlife study, Oldest Boomers, 66-year-olds “[are] not necessarily working till they drop.”  While a Gallup poll reports that older boomers make up approximately one-third of the American workforce, Metlife states it is also true that over half in this age group are retired The 2012 U.S. Census reports that “since 2007, the median household income declined for all age groups, except those 65 and older.”  Today’s older baby boomers are a growing population for the travel sector.  Older adults are not only living longer and healthier lives than their predecessors, they also have the finances to enjoy it.

 

Who is travelling?

Dr. June M. Fisher is an 82-year-old San Franciscan, is deeply involved with health, safety, and aging issues. Dr. Fisher is an internal medicine physician, specializing in occupational health since 1978. She is currently a senior scientist at the Trauma FoundaScreen Shot 2016-03-03 at 8.49.12 PMtion, San Francisco General Hospital. Dr. Fisher founded and heads the Training for Development for Innovative Control Technology Project and The Muni Health and Safety Study, which reflect her research foci on health and safety in user-based design.  As an outstanding mentor and contributor to ageless design (Stanford Center for Longevity and Aging 2.0, respectively), she is currently working with CITRIS, UC Berkeley on an analysis of environmental factors affecting mobility in the aging population.

 

Dr. Fisher has travelled extensively throughout the United States and abroad, sharing her research relating to product design and development of safer technologies for home care nurses. She always tries to book a few extra days in her trips to explore local art and culture. However, with each passing year, travel becomes more challenging for June because of the physical limitations she has developed. The requisite walking, public hotels (even handicapped access rooms), and mobility demands have slowed her down prematurely, as far as she sees it.

 

Is “handicap access” really for the disabled?

During our interview with June, she cited several areas that were lacking support for people with mobility issues. She said that when businesses in the United States are compliant with the Americans With Disabilities Act, and advertise as having “handicap” access, the implemented solutions are often really not at all practical for the disabled. “The legal box is checked off,” she said, but these legal guidelines may not truly address the needs of the disabled.

 

How were her challenges dealt with?

When June chose a hotel room online, which claimed to have access for those with mobility issues, she arrived to face challenges that were often met with impracticable solutions:

  • The height of the bed was too high, and she could not climb on to the bed.  At one hotel, the manager addressed this issue by bringing a narrow and very small stepstool into the room for June to use.  The stepstool only created a newer problem – June was not able to balance herself on a stepstool that had nothing to hold on to.
  • The sides of the bathtub with shower were too high, and June could not climb into the bathing area. At another hotel, June was not able to safely enter the bathtub because there were no safety bars on the walls of the bathtub and the sides were too high. The manager instead offered her a walk-in shower with no rails to hold on to.

 

Airports were also full of obstacles for those with mobility issues.  Some of the issues June experienced were:

  • Wheelchair attendants were often late.  June cited times where she waited for over an hour for a wheelchair attendant to come and take her to her connecting flight.  There was no direct number June could call to check on the status of when she could expect her wheelchair attendant to appear.
  • Communication between gates of connecting flights was difficult.  During one of these delays with a wheelchair attendant, June requested communication be made to the gate of her connecting flight to let them know she was on her way.  Unfortunately, the communication between the gates of her connecting flights was not completed and she ended up missing her flight.

 

Airports and hotels were not the only places ill-equipped to address mobility issues.  June experienced challenges at museums, restaurants, and with public transportation.

  • Handrails are poorly designed.  Many handrails are not designed with functionality in mind.  They are either too slippery or too wide – making them ungrippable with one hand. Though the business may have been compliant with the American Disabilities Act, “the inspector may not have been an ADA person because the rail was not placed properly,” she said.
  • Elevator access can be one block away from front entrance.  When June visited a museum and asked for elevator access to the 2nd floor exhibit, she was directed to an elevator at the end of the building – one city block away.

 

June offered some suggestions to address some of the difficulties she has during her travels.  Here are some of the things June would find helpful during her travels:

  • How high are the beds in the hotel rooms?
  • Does the hotel have walk-in showers or safety bars in the bathtub?
  • If climbing steps is necessary to access the hotel lounge or other hotel areas, how many steps are there?
  • If elevator access is far from the main entrance, how many steps away is it?

 

As older adults continue to travel more, technology can be used to address their unique challenges while traveling.  Many, like June, are interested in being informed about exactly what solutions for their particular obstacles are, from transportation to buildings. If technology could provide this type of information for older adults, traveling would be much easier.

 

Brazil’s first mobile health ecosystem is presented at Aging2.0 São Paulo, edited by Alisa Rodriguez

Text and photos: Simone Jardim, edited by Alisa Rodriguez

pic1 pic2

More photos here

On Tuesday, 9/30, Antônio Nogueira Leitão and Simone Silva Jardim, hosted Sao Paulo’s Aging 2.0’s monthly meeting at the Hub Paulista. Guests included entrepreneurs, researchers from academia, gerontologists, and professionals in communication and marketing. Immo Paul Oliver, co-founder and CEO of the startup CareNet Longevity, prompted a lot of excitement and questions when he presented his new product, the Klip.

The startup CareNet Longevity was inspired by the current 2014-15 Stanford Design Challenge, sponsored by the Stanford Longevity Center in partnership with Aging 2.0. CareNet Longevity’s focus is creating products that allow people to live healthier and longer lives through small actions and behavioral changes.

Pioneer in Brazil: Oliver talked about this year’s debut of the Klip, the first mobile ecosystem for health monitoring in Brazil. The technology consists of a body sensor, weighing less than 12 grams, which with the Carenet Longevity app (for IOS), monitors and encourages users to maintain an active lifestyle and healthy life.

“The Klip makes the user be the author of their quality of life, with real-time monitoring of daily activities. For example, the distance traveled, mileage achieved during a run, calories burned, and the bioactivity of the body during sleep. Our application presents it in a fun way, to engage the user with their own health.”

Information more accessible: Today, wearable devices like the Klip biosensor are increasingly gaining importance among consumers worldwide.

“These devices gather information that, in the past, people could only get in a doctor’s office or laboratory. They are the gateway and the best way to demonstrate what is possible with a device. We also realize that the Brazilian consumer is more open to this type of product,” said Olivier.

The Klip biosensor costs $199 (less than $100 USD) in the CareNet Longevity store. The application for monitoring information is available for iOS in the App Store.

Next meeting Aging2.0 SP: The next meeting of Aging 2.0 São Paulo is scheduled for October 28, 7:00 pm. Our guest will be Edilson Osorio Jr., founder of an online market, that provides in-home products and services for the elderly.

User Centered Design in the Aging Space, by Alisa Rodriguez

How does an entrepreneur who has little in common with their target market, best develop a successful product? Since the world of startup companies are, generally speaking, a young person’s game, innovators of products for older adults may have a distinct age gap with their end user. Coffee and Clicks is part of Aging2.0’s response to this challenge.

Over the past few months Aging2.0, a global organization on a mission to accelerate innovation to improve the lives of older adults around the world, has set up numerous focus groups between older adults and entrepreneurs and last Monday saw the first ‘Coffee and Clicks’ event in the Bay Area. The aim was not only to get feedback from end users about new products for the aging population, but also to get new inventors and young marketers to see the bigger perspective of making things better for everybody, including older adults. The event provided a raft of useful information to the startups who participated, and helped the older adults raise their voice in getting what they want.

In the case of products for older adults, these focus groups are particularly valuable because the innovators of these products are most often decades younger than their target user. Not only do older adults have concerns that they may not regularly reveal to the younger population, but they have generational behavior that shows where their flexibilities and limitations for new products lie. The consumers at this first event gave insights that could change the direction of the products presented. “The feedback [from the consumer panel] is very valuable… and appreciated,” said Jay Connolly, the founder of LiftHero, a transportation solution. It quickly became apparent that there is no substitute research for face-to-face feedback from someone who is actually in a body that is over 55 years old.

For example, one company was designing a stool for getting in and out of the bath that was functional but didn’t look like it was turning the home into a hospital room. The consumers were ready to help her understand what aspects of her product excited or concerned them. For instance, in adding functionality and style, the designer realized that some features of her stool, such as curved feet, set off physical safety alarms in the consumers’ minds, even though these features were not actually dangerous.

Laurel Tielis represented MagnaReady, a magnetic button shirt company that was founded by Mura Horton, after her husband came down with Parkinson’s at an early age. Those on the consumer panel who had experience with limited mobility were excited about the product, however, they also expressed a glaring concern for wearing magnets so close to the chest in the presence of a pacemaker or defibrillator.  Making things that look and perform, both safely and stylishly is a challenge for designers, however the rewards for those that get it right are likely to be significant.

Last, but not least, was LiftHero, which “brings the ridesharing revolution to seniors and their family members.” Jay Connolly, the founder, was given feedback that his current policy of having drivers who were screened, qualified, and trained to deal with seniors was hugely important to the riders. He further learned that displaying this type of driver and insurance information in the car would make the customer feel safer. The panel also expressed how they might want to know a little about their regular driver to prompt chat, or just for familiarity.

Stephen Johnson, co-founder of aging 2.0, talked further about creating a more “ageless design” mindset in innovation. “Two of the big things that are changing the world right now are exponential technology and the rapidly aging population,” he said. Making new products friendly to everyone, regardless of their age, was his message. For example, the font on restaurant menus could be large enough for everyone to read, or basic seating designs should comfortable (and high enough) for everyone, not just the agile bodied person. Technology and the aging community are two worlds that are dovetailing into “a fertile landscape for new ideas that will radically improve people’s lives.”

Some argue that user centered design is more time consuming for the amount of information that could be academically researched, or “genius designed,” but that myth was wholly disproven at this first event. The interaction between the inventors and the consumers was important for both parties during this iteration process. Not only is the time well spent for the innovator, feelings of usefulness and validation were apparent from the consumers. One woman piped up, “Forget the Coffee & Clicks, how about parties and wine? This is great!”

Technology Applied: Helping the Helpers of the Aging, by Alisa Rodriguez

It is so easy to find services that employ people to assist the elderly with heir daily routines, but why is it so difficult to find updated electronic and mechanical devices to assist with daily routines? There seems to be a gap in product offerings: Either there are services-only options that are a wasteful use of human interaction, or the offers are for a whole lot of unnecessary and overpriced stuff. The only products that try to integrate service and technology are working with very outdated technology (such as emergency response systems that require the user to press an alert button, which is not often doable by the person in need).

I attended a UX conference the other day and spoke with a few sponsors about mechanical and electronic devices that may help the elderly stay in their homes longer, before having to incur the cost of assisted living. They seemed genuinely interested, and pointed me to community building or automated home systems.

While Co-housing or Intentional Community building is a very effective (and old within the human social system) way of ensuring the care of all members of a population, it can take generations to re-build in the United States. In a society like the US, we are not accustom to having our privacy invaded, and our care so directly dependent on other people. We are a society of individualists who value their independence. A collectivist model like Japan’s works well in Japan, and we would do well to be influenced by the advantages they enjoy, but our individualist society may need a different approach to caring for the elderly.

As the luxury of an automated home becomes more popular, we are seeing remote controls become more sophisticated. We have gone from “clap on, clap off” to phone apps that will ensure a securely locked and surveyed home, which can be observed and altered on command. The house will be warm, and the dinner cooking by the time you drive up to the door.  These seem like great alternatives for people on the go, and who need to be in tighter command of their living environments, but not everyone can use these technologies.

What about those individuals who are losing the ability to be in command of their environment? Can caretakers really program their living for them? What kind of control does that take away from the person in need? What about the caretakers that don’t want to be constantly monitored? How about embedded bio devices that send messages to caretakers when an individual’s body or location steps out of normal parameters? Where do we draw the like of independence for older adults, while keeping them in their homes as long as possible?

What other ideas do you have? How can they become available and affordable soon enough for the Silver Tsunami that is cooming?

“An Ounce of Prevention… “ by Alisa Rodriguez

It seems that the current solutions available to deal with the aging population are like putting Band-Aids on a bleeding artery. The socio-economic system in America is bleeding out fast, and we need to plan a surgical strike to deal with the upcoming problem.

How do we prevent some of the issues that come up with an aging parent? We seem to scramble when the problems related to aging become an issue, but we do not practice preventative planning as often as we should. Many children of aging parents and grandparents have the same challenges. They include the parent denying they are getting older, not realizing that dementia is setting in, the parent not wanting to go in to assisted living because they do not want to leave their home, and parents too shameful to admit they have been victims of elder-fraud. As my friend Samantha put it, “It seems like something we continuously realize only in retrospect.” We are taken by surprise every time.

The mechanical and technological devices that we need are not complicated, and should work with updated technology that incorporates biotechnology with practical use. They should include automated message sending to caregivers and doctors when the readings go out of a certain customized and preset parameter. The prevention of financial fraud of the elderly, banks must work directly with the caregivers and authorized panel to oversee transactions of a prescribed upper limit.

A peer review process to insure their accuracy and competence should vet these devices. This is not to eliminate all the options currently out there, but instead, to weed out overpriced, unnecessary, or ineffective riff-raff. The solutions need to be direct, and user friendly. Do you see any desirable, feasible, and viable integrated system out there right now to help keep the aging population in their homes longer?

Communication and Home Environment for Elders, by Alisa Rodriguez

Research on caring for the elderly in their homes has aimed to help alleviate the natural anxiety and increased work load felt by everyone involved. The research ranges from environment to personally embedded electronic devices. Here a re a few examples:

– Studies show that music and singing with or for a person with dementia can reduce communication problems and aggression toward the caregiver.
– In 6 focus groups, of staff and patients, and in-home and assisted facilities, spoke about a personally applied wandering device. All felt that the wanderer would eventually ignore the alteration device. They felt that it should be waterproof and easily turned on and off by the caregiver. Two-way communication was also a concern, as was camouflage of the device. (e.g., to look like a watch).
– Another study looked at medication compliance, using a live video or phone reminder. The first month showed no difference in adhering to medication schedule, but after six months, those who had live audio reminders had over 20% higher adherence to treatment.
– Another study gave an Alzheimer’s patient three phases of treatments, in hopes that a computer display would improve the patient’s memory and sense of identity. This relatively inexpensive technology was set up in the kitchen with photos, narratives and videos of the subject’s life. Eight varied psychometric tests measuring well being, communication, cognition and caregiver relationships showed that the ambient treatment alleviated general apathy and the decay of positive self-identity.

Studies show that quality of life, according to the patient, is greatly dependent on self-esteem including respect, dignity and better interpersonal relationships. Technology can assist the lay caregiver during the early stages of dementia by taking the workload off the family and the overall health care system. One concern is that with more care automation may come disinterest in the patient. The opposite is true. Not only is more time available for social interaction with the elderly, but the patient becomes happier and less burdensome. The patient can perceive this from the caregivers, and this can boost self-esteem.

For or Not For Profit: How Do We Sustain Healthcare Innovation for the Elderly? by Alisa Rodriguez

Non-Profit

One interesting funding group I stumbled upon for healthcare innovation in California is the California Healthcare Foundation (CHCF). This foundation was created from the Blue Cross transformation to a for-profit business. The government directed Blue Cross to use their left over funding for its original purpose.

CHCF funds innovation in products, billing, integration of information, policy awareness, and law. Other private foundations include The Commonwealth foundation, for educational and institutional research.

Diverse Revenue Streams in Non-Profit

An interesting note was in Stanford’s Social Innovation Review. Curtis Chang argues that positioning a non-profit service or product as a product for all in-home elderly, instead of only low-income elderly, will allow possibilities from higher money sources, because it will appeal to all financing sectors. In addition to the “true” philanthropist, this type of branding will turn the heads of the more self interested entities.

A Hybrid with For-Profit

Though R&D has historically been either an expensive part of doing for-profit business, or considered a main objective of non-profit, a non-profit and for profit combination can also be an option. Issie Lapowski of Inc. magazine outlines some aspects of a bybrid model, and looks at current socially responsible entrepreneurship business configurations. A non-profit subsidiary can inform the for-profit with R&D in an exclusive contract situation, as long as conflict-of-interest boundaries set forth by the IRS are not violated, and an experienced business lawyer works out contractual and operational details. This type of relationship has been enjoyed by companies like IDEO and Mozilla, as well as many others. These companies created differentiated, and overall beneficial tax shelters, but the combination is not to be taken on lightly. This synergism can be tricky.

From Baby Boomers to Aging Boomers, by Alisa Rodriguez

The Baby Boomers are aging fast, living longer, and facing an inadequate elder care system… and they’re not going to take it lying down. These independent-thinking people created one social revolution, and know how to demand another. So look out because here they’re coming fast, will be staying a while, and won’t be happy when they see their current options at the old folks home.

BoomtownLiving is a forum where elder living gains the vitality it deserves; from innovation technology to all things that foster a richer experience in the second half of life. Technology and social innovations will help give the caregivers and older adults higher quality time to enjoy together. Quality time for elders on their own, with their peers, and with their loved ones gives everyone involved a better life.

———-

The lifestyle and culture of the elderly is beginning to change, both in assisted living situations and with aging in place, but not rapidly enough. As the independent-thinking baby boomers become the aging boomers, there will be more demand for “aging in place” (in their homes) and an active lifestyle. If forced by circumstance to an assisted living situation, there will be no more Lawrence Welk and bingo… the older community will require an updated list of options that could include having Rock ‘n Roll concerts and raves in the dancehall, interactive and community video gaming, access to video streaming, and better communications with their loved ones, to name a few.

The current trend just scratches the surface of what will be needed to keep these folks happy. Medical advances and other technologies are being created that will greatly extend the average life expectancy for all. Making sure our loved ones take their meds, or don’t wander is vital to their safety, but what about their happiness? What about their dignity and self identity that is silently slipping away? What are we doing about loneliness and boredom? Now that we are in it for a longer run, how do we fuel our very reason to live?

How can we protect and enable older adults to maintain a good, sustainable, and independent quality of life both physically and emotionally?