From specialized tablets to flat-panel TVs to smartphones, operators engage residents in new ways while trying to lower caregiving costs.
By Eric Taub
As a close family relative neared the end of her life eight years ago, after living to almost her 101st birthday, she said that she had only one regret: never getting to meet some of her great-grandchildren.
Living at the opposite end of the country, meeting them was no longer a possibility. But I had a laptop, and I could Skype. A quick call to the kids’ parents gathered them in front of the computer and, in a few minutes, this elderly woman, born before radio was even a product, got to see and speak to the great-grandchildren she would never meet.
What this person did was an early example of using a digital device for social connectedness. A standard MacBook enabled her to communicate with her family in a way that was unimaginable for someone born when horses still competed with cars for space.
That was eight years ago, before FaceTime existed and Twitter was just entering the consciousness of tech-savvy Americans.
These two apps have now become must-haves for Millennials. But for the elderly, social interaction with loved ones, and the communities in which they live, continues to be a challenge.
Breaking down walls
Despite the large offerings of daily activities, assisted living residents often suffer from loneliness and depression, unwilling to leave their rooms, or unable to see once-close relatives and friends who now live far away.
At the same time, senior living communities must deal efficiently with the day-to-day needs of their residents, including distributing and collecting menus, encouraging residents to go to activities and making sure they show up, setting up phone calls with friends and families, arranging transportation, and other labor-intensive requirements.
The question is, can they accomplish these key tasks in a less costly manner?
To open the digital world to the elderly while providing a significant return on investment to owners, a slew of products have been developed that companies claim can easily break down social isolation.
These products help people communicate, learn what’s happening in their communities and automatically keep caregivers aware of any problems that their residents may encounter, ranging from a dangerous fall to the need to change a lightbulb.
The best tools to use remain a subject of debate. Some advocate the use of specialized tablets, while others say computers are all that is needed. And one company argues that both are completely wrong.
“There’s not been a lot of market research done in this category,” says Laurie Orlov, industry analyst and owner of the website Aging in Place Technology Watch. “I hear the grandmother syndrome: ‘She fell down, so I’ll invest in a product that would prevent that.’”
As Orlov notes, computer tablets, popularized by Apple’s iPad and Microsoft’s Surface, have offered the promise of opening the digital world to seniors, but for many, they’re simply too complicated to master.
“For the very old, tablets are useless,” says Orlov.
Scramble for smart solutions
In an attempt to change that, a number of companies have modified the standard tablet interfaces to make them more user-friendly. The question is, can they be made senior-friendly without minimizing their customers’ interests and capabilities?
“No one wants the dumbed-down thing; they want the iPhone. An iPad is pretty easy to use once you figure it out,” says Katie Roper, vice president of healthcare strategy and partnerships for Home Care Assistance, a San Francisco-based provider of home care services to three countries.
Touchtown, one of the industry behemoths, offers elder care facilities a package of tablet-based apps, including dining menus, games, chat, and calendars, and a TV channel that runs in a loop.
In addition, digital signs can be placed in common areas alerting residents and potential customers to the day’s activities and meals.
Residents access features on a tablet using a simplified interface. To make the events they see attractive, staff can create events on the product’s desktop portal, illustrating activities by choosing from a set of hundreds of images. For example, type “yoga” and the user is presented with a range of yoga pictures that can accompany the calendar event.
Touchtown, based in Pittsburgh and used by 250,000 residents, sees its product suite as a superior marketing tool. Prospective tenants and their family members can be given access to the apps to see what activities and clubs are offered, and how many residents share their loved one’s interests. At the same time, staff will know which areas of the site the prospective customer is accessing and can address those interests directly.
“If using Touchtown can increase occupancy by just three residents per year, that could mean an additional $150,000 in revenue,” says Ted Teele, CEO of Touchtown.
CareConnect, a competitor, has recently allied itself with InTouchLink, and now combines limited interactive TV services with tablet and smartphone-based apps, a VoIP phone service, and satellite TV.
The company resells both Dish and DirecTV services to more than 20 communities, representing 60,000 residents. As with most of its competitors, residents can send and receive photos, e-mail, and phone calls, and access the Internet using a tablet.
Its unique feature: an in-house tech “concierge” physically available on a property from two to five days per week, helping both residents and staff use the product and various services, from Facebook to Skype.
Telikin believes the answer to increasing engagement and decreasing isolation is an obvious one: make standard computers easier to use. The company sells PCs with modified user interfaces, ranging in price from $800 to $1,080.
Every resident doesn’t need one, as each unit can handle up to 25 unique users, each with its own account, allowing communities to keep their costs modest by equipping only common areas with the machines.
The modified interface enables residents to use Facebook, Skype, and e-mail. If they get stuck, an adult caregiver can remotely take control of the machine, helping them to solve a problem.
While most of its 90,000 units are sold to individuals, the company says the machine’s ability to attract new tech-interested residents, while reducing the number of help calls to in-house IT staff, will provide a good return on investment.
“We see residents fighting over the Telikin, while Dell PCs just sit there, unused,” says Nancy Allegrezza, the company’s director of sales.
New entrants emerge
In addition to a handful of established players, a number of new startups are attempting to gain interest from assisted and independent living operators.
Cubigo, founded in 2011 in Belgium, now with offices in the United States, has re-imagined a tablet interface as offering features designed as “cubes;” one distinct app enables residents to see and choose upcoming meals, with any additional fees for special foods automatically entered into a resident’s billing account.
Another Cubigo cube enables residents to summon transportation (soon, via Lyft), see the day’s potential activities, ask for and track the resolution of room maintenance, and chat with relatives.
Communities choose which “cubes” they want to add to their service; adult caregivers can tap in to their family member’s account, to see what their parent is doing that day, whether they’ve attended a scheduled event, and whether there are any maintenance issues with their residence.
The company is convinced that communities will save money as Cubigo eschews the need for staff to deliver and pick up paper menus, activity calendars, and manually enter supplemental charges. The company is undergoing trials in the United States, and recently raised $4.6 million in capital.
GrandPad, another tablet solution, leases a specialized tablet for a monthly fee. Sporting its own version of a simplified interface, grandPad, like its competitors, allows residents to communicate with loved ones via voice, e-mail, and photos. The tablet can also be used to play Internet-based music and games.
A smartphone app allows family members to add names and phone numbers to the resident’s address book, and send photos and e-mails.
Recognizing that not all elderly individuals have Wi-Fi access, the tablet works via a Verizon 4G LTE connection. The user is notified when the tablet needs charging, which is done via a charging dock, not a cable.
What about price?
While a cellular connection adds convenience, it also adds to the price. The grandPad costs $75 per month, or $65.50 per month if paid annually. (Most companies in this space would not discuss pricing, as the fees are negotiable based on number of users.)
K4Connect is another tablet-based social engagement tool, but one that looks to add value by working with a wide range of connected devices, now commonly known as the Internet of Things, or IoT.
In addition to the standard communications apps, IoT devices such as connected thermostats, lights, and vital signs monitoring systems can be controlled by the K4Connect tablet. And one action can be programmed to trigger another. For example, a rise in tracked blood pressure could be the trigger to turn on a light.
The company has announced an integration with Garmin’s Vivofit 3 activity tracker, allowing the product to display heart rate, sleep, stress, steps taken and other vital signs on the tablet.
For those looking for the least expensive tablet-based solution to social engagement, Oscar Senior is an iOS and Android app that turns any iOS or Android tablet into a senior-friendly interface.
Once the app is downloaded, simplified tools allow the caregiver and resident to do the standard tablet tasks by just touching large square, colorful icons for weather, news, games, and other features.
The cost: nothing to the resident, and $1 per month to any individual who wishes to connect to the resident using the Oscar Senior smartphone app. The designated administrator can also remotely configure the senior’s tablet.
For some, a tablet is not the answer.
“A standalone tablet with limited family engagement tools will only scale so far,” says Stephen Johnston, CEO of Aging2.0, an organization dedicated to taking a fresh look at the challenges of aging. “You need to think of multiple platforms: tablet, TV, smartphone, and voice.”
“Older adults aren’t very adept at using tablets,” says Kian Saneii, founder and CEO of Independa. “They have trouble holding them for extended periods. And as they get older, they often forget to keep them charged.”
Independa takes a different approach, creating a social engagement platform using a standard flat-panel TV. It’s the one device that every senior already has, keeps on for extended periods of time, has used for decades and most likely won’t forget how to operate.
Independa’s menu of calendars, vital signs monitoring, photo and text sharing, and phone calls appears as an overlay on a regular TV channel. Caregivers, using the Independa smartphone app, program alerts that appear on screen and sent to themselves as well as the resident.
For example, if a resident suddenly gains an excessive amount of weight using a connected scale, that person’s caregiver will be immediately notified via text or phone call.
When residents are scheduled to take their medication, a scheduled reminder will drop down on top of regular TV programming. Once the senior reads the reminder, it can be dismissed using the simplified Independa remote.
LG, the electronics manufacturer and an Independa investor, embeds the Independa technology into all its commercial market TVs. Those who use other brands of TVs can use the Independa service via a small set top box.
“We’re a platform, not just an application, and the only company offering a completely interactive senior engagement solution using the TV,” says Saneii. “Independa uses the one technology that every senior knows how to operate, and we can connect a wide range of health monitoring and other sensors and technology services to our system.”
Voice: the next frontier
One technology waiting in the wings and about to impact all social engagement products is voice control.
Amazon’s Alexa, Apple’s Siri and Microsoft’s Cortona are already being integrated into automobiles, televisions, audio, and connected home products. Soon, their capabilities will impact the senior market as well, with developers arguing that a voice command is one action that few elderly forget how to perform.
Orbita, a Massachusetts-based startup, is targeting the senior market, looking to integrate its voice control technology into the type of products discussed here.
Using the Orbita system, conversational grids can be programmed by senior care administrators that allow the technology to recognize multiple responses to the same question. For example, a resident could say “I’ve not taken my meds,” or “I’ve not taken my drugs,” and still be understood.
“We will definitely integrate voice control into the Independa platform,” says Saneii. “In addition to providing our tools over a standard TV, controlling them via voice will be even easier.”
Telikin has limited voice control. Text to speech technology is enabled in apps that permit typing. Cubigo says voice control is on its roadmap, but the company is not currently working on any voice integration.
Touchtown “will consider whether there is an appropriate voice technology that could be integrated into our solution,” says Teele. However, “it isn't part of our near-term roadmap.”
“There’s a challenge asking an elderly person to do a paradigm shift,” says Roper of Home Care Assistance. “An elderly person will use a map, not a navigation app, on an iPhone. “We need to figure out how technology will add value to caring for the elderly.”