To Reach Seniors, Tech Start-Ups Must First Relate to Them

Oct 27, 2015 · 117 comments
billsett (Mount Pleasant, SC)
I particularly agree with the comments saying that tech developers need to involve actual "seniors" of different ages and conditions as well as professional caregivers and geriatricians. I'm in my early 70s and can see great potential benefits from well designed tech innovations to help support the aging-in-place movement. Developers wlll need a better understanding of the health issues and mental and physical needs of people as they age and cope with end-of-life issues. Start by discovering what the needs are, then design the products and tech, not the other way around.
Saco (Amsterdam)
My mother has Alzheimers and does not know what day or season it is, so I tried to find a calendar clock for her. To my amazement the only ones available are very expensive non-adaptive mechanical ones. So my point is: not only do the developments fail, but silvertech also seems to pick the wrong products to develop or not the most needed ones. I'm very sure - being an engineer myself - that development of a cheap tablet like dementia clock would be quite easy.
BCY123 (NY NY)
As I slip over the edge and reach retirement I have thought about what technology has really done to help in my day-to-day life. As a scientist, I adopted technology and used it wholeheartedly during my career. But now I'm less concerned with technology and more concerned for my wife and I that the heat goes on, the water runs, the lights work, I have something to eat, and I can speak to people. For all the costs of designing and implementing and installing this technology, we could pay someone a good wage to come to my house and help me get the things I really need. And it would be much more pleasant.
Lainie (Lost Highway)
As I continue to think about this article - it seems that prioritizing company "culture" (video games! free food! being fun and weird and quirky!) over user experience and customer needs is a problem throughout the tech industry.
margaret orth (Seattle WA)
We need far more of this is kind of thoughtful technology reporting.

One reason so many of these devices are being developed is that cs departments are far better funded than most others.

Altruistic young people are looking to do good work, with funding, so turning to technology. In addition, they want technology to help people.

But the environmental (tech waste) and social impacts, the impacts of this sort of gadgety approach are ignored.

As a society we need to examine how our human capacity, our brain power is being used. Much is going into well-intentioned meaningless technology junk.
Lee43 (Rochester)
The official help line for Social Security is 1-800-772-1213. If you are calling that number and get one digit wrong you are very likely to be connected to some company that specializes in selling seniors one of these hi-tech gadgets you write about. Ususally the spiel goes something like this..."You will be connected with Social Security in a moment, but did you know we are now offering a free (some period of time) trial of our (hi-tech gadget for seniors) and simply by pressing 'one' we can ship you one right away.
Yeah, I fell for it. My remaining supply of marbles wasn't sufficient to immediately reject the offer, but I did send the box back unopened a few days after it arrived. They did manage to nick my Visa card for nearly 30 bucks.
SA (Kansas)
My 45+ year old friend, who is a developer, recently interviewed at a tech company in TX. They flat out asked her how she would manage working with all the youngsters there since she's, well, um, not young herself. I wonder if we had more older workers in tech, would this mismatch of what that sector thinks elders need and what elders actually need still be such a problem? Maybe it wouldn't be so drastic.
Lainie (Lost Highway)
I am in my 50s and I work in a tech start-up with a mostly very young staff. Our typical customer is middle-aged (though our product isn't health-related) and I often see a lack of understanding of what the customer wants vs. what's fun for the young techies to work on. My colleagues are wonderful young people, and very smart, but not all are capable of empathizing with or appreciating people who are their parents' age or older. I'd love to see more older people in our company who could advocate for our middle-aged or older customers.
Anonymous (New York, NY)
Those who need help the most are the older adults with cognitive impairment. Most tech developers do not understand that no matter how simple, tech without personal care will not help. Persons with dementia cannot learn to use these devices. The developers need to take advantage of the skilled and experienced geriatricians who know theses truths all too well
dennis divito (Virginia)
"Developers, she said, aren’t taking advantage of geriatricians’ expertise." or families and the elderly.

Therein lies the problem.
Helping Hand (Grand Rapids, MI)
I agree that technology will provide recent retirees with better options going forward than their parents had, because technology has been a part of their professional and personal life for a long, long time. As a person responsible for the care of a 96 year old dementia sufferer, I don't know how technology of any sort can help. I have seen simple, life-long tasks become impossible to complete. If tech keeps people in their homes longer, I'm all for it. At some point, whether inside the home or in a memory-care facility, dementia sufferers need human oversight and care--and lots and lots of patience.
It's me, Margaret (New York)
Caveat about the alert systems: You note that Consumer Reports has looked at them, but, while I used Consumer Reports to select an alert system for my 88-year-old mother-in-law, I had a bad experience with the one that I selected. Suffice it to say that, among other things, I wondered whether the company was trying to take advantage of an elderly person by springing hidden costs on us. Moreover, the company was so incompetent when it came to delivering the device that my mother-in-law concluded that we should not use that brand. She pointed out that if they couldn't get the easy part (delivery) right, she was concerned that they would muck up in an emergency. We cancelled the delivery, but they (belatedly) delivered anyway. They claimed we wouldn't be charged, but then we got a bill. Based on what happened to us, I urge caution in using Consumer Reports to select a home alert system or perhaps simply before using the company that we had selected. (I wonder whether Consumer Reports tried having the devices sent to private addresses or whether the companies knew that Consumer Reports was scrutinizing their performance.) It is possible that our experience was an anomaly, but there were so many mess-ups that it did not feel that way. Philips Lifeline talked a greet game on the phone, but they failed to measure up repeatedly.
D. H. (Philadelpihia, PA)
TRIAL AND ERROR Right now, what you get for a senior family member will be based on your perception of what would be a good match, possibly without enough information. What is also required is a willingness to accept the senior's level of functioning as well as new needs and challenges as they emerge.

My brother told a story about one time that our father was found in the bathroom unconscious with dangerously low blood pressure. The problem was, fortunately, rectified with a pacemaker. But when asked why he didn't use the alert, my father said that he didn't want it to get wet while he was showering. That says a lot about the judgment that he had at that point in time, which, like it or not, meant that he probably could not use the alarm device reliably. That's a lot for family members to accept and work with. But there's definitely a great market out there for people who understand what's going on with seniors and want to help them get appropriate devices to make their lives more convenient.
Stuart K (Los Angeles)
I run a product design and innovation consultancy that’s been developing medical products for 30 years. Much of our work has involved products for the elderly (hearing aids, ventilators, etc.).

To echo what Paula and many commenters have written here, I believe most of today’s products for seniors are failing. They’re problematic, poorly thought-out (for example, walkers that require adding tennis balls to the feet for stability), stigmatizing (the average person suffers from hearing loss for 7 years before finally “caving” and getting a hearing aid—because they don’t want to be stigmatized as “old"), and sometimes they just don’t work at all.

The underlying problem in most cases is that product developers simply don’t take the time to understand their target users. They create a technology and simply hope that they will be able to force fit it into people’s lives. But what they don’t understand is that aging is complicated. It’s an emotional process. Products have to address seniors’ physical needs, sure, but what about their cognitive, emotional, and social needs? My company just published a "visual whitepaper" on design and aging that addresses these very questions—I hope those reading will find it valuable: http://kartendesign.com/8428/outsights-vol-2.
jim (boston)
What goes around comes around. I wish all of my fellow seniors would take a break from complaining about those dang youngsters and their gosh darn technology and consider exactly how inconsiderate we were at that age of the tech challenged older people in our lives. I was a young man during the changeover from typewriters to word processing to full desktop computers. I saw a lot of people, only 15 to 20 years older than me, who could not adjust. People who had been masters of their domain were now old and in the way and those of us who are now facing the same thing were the ones sneering at them. I'm not advocating for generational insensitivity - just asking for a little perspective. We did the same thing we are now complaining about and one day a new, younger generation will do it to today's whiz kids.
george (Princeton , NJ)
My parents spent $600/year for several years on one of those pendant-actuated monitoring devices, but never realized that it only worked when the pendant was within range of the central device - in other words, only when in the house. Now my mother keeps her cell phone (a "dumb" flip phone) in her pocket at all times; she knows that she can get help by pushing "9-1-1" (or "0") no matter where she is. And it's a lot less expensive!
Mr. Robin P Little (Conway, SC)

There is no squaring this circle of assisting seniors/disabled people via technology. The only real answers are in human interventions, I.E. personal assistance, such as having a home-health care aide visit the senior. Such interventions are exactly what the Silicon Valley companies attempt to avoid because human beings are the most expensive part of the supply chain, and the most likely to have a mind of their own about what is needed in a situation.

When a person gets to a time in their life where they are unable to fully care for themselves, there are almost no technology solutions which will solve their problems. In this sense, microwave ovens may be one of the most useful low-tech items in a senior/disabled person's home. Such technology is what geeks call a 'solved' problem. There is no more technology needed in its development, and no more money to be made in working with it, hence no interest in it from tech people.

In most cases, machines are no substitute for people. Monitoring is only one part of personal care. It is when things go awry that human intervention and judgment are needed. If someone isn't taking their medication, discovering why this is the case calls for someone asking them about it.
Rabble (VirginIslands)
I tried and tried to find a portable player with actual, visible and grabbable knobs for my father, who suffered with macular degeneration. He could have been listening to his favorite opera and country western CDs while in the nursing home, but everything I found was sleek and unusable: black-on-black. Dumb dumb dumb.
Petie (MD)
All the hi-tech gadgetry in the world cannot come close to providing the level of care and oversight that vulnerable elderly need. Out elders are not a product on a factory assembly, there is no one-size fits all solution for the wide-ranging list of challenges they face. The problem is that there is not enough $$ invested in affordable, human-delivered care and not enough family support to make sure our older years are safe, secure and free from needless worry, loneliness and suffering. Keep your devices. Give me a human hand to hold, a caring person to talk with me.
Mary B (Massachusetts)
In section A of today's paper there is yet another article on the impact dementia sufferers have on medical cost of their care. Those cost are not impacted by gadgetry, but are born by family members who provide the hands on care required of a degenerative neurologic condition. I have no doubt that young, clever technologists would find the prospect of changing that Depend ( the gadget has signaled needs changing) just too icky. The actual challenge here is knowing the limits and or blessings of gadgetry and to focus instead on expanding Medicare home care benefits so everyones' dignity has a chance to endure.
Catharine (Philadelphia)
Just about every article and comment refers to the need for "family" caretakers. The new generation of elderly - those now in 60s and 70s - will often have no family nearby and increasingly no family at all. They're targets for abuse. Tech won't help.
Armando (Stiletto)
There's are large differences between clinical systems and consumer facing apps. Silicon Valley focuses more on consumer apps. Care providers need clinical systems to help them assist and treat multiple chronic conditions. real people, aided by systems, are the best delivery method.

perhaps someday there will be a useful convergence
Laura P (New York, NY)
AARP is working on this issue as well, running a series of studies with healthcare innovation lab HITLAB to see which technologies caregivers of seniors need, want and use. The findings are intended to stimulate the growth of caregiver-oriented technology products that meet the usability parameters of their older users. From an economic POV, caregivers of the elderly are a huge untapped market - start ups need to start paying attention!

More info here: http://medcitynews.com/2015/10/aarp-is-doing-a-deep-dive-of-caregiver-te...
B Dawson, the Furry Herbalist (Eastern Panhandle WV)
If an elder is storing an alert pendant in the 'fridge or you can't find a landline phone easy enough for someone to dial then maybe you should question just how independent these folks truly are.

It's one thing to provide gadgets for aging folks are interested in tech that will extend their active lives but quite another to wire up the elderly with passive devices and fool yourself into thinking that means you are there for them.

Substituting techie gadgets for in-person care by family members is the solution for those who would rather use their thumbs and have remote relationships than be care-givers. It is a sad statement about priorities.
Margo (Atlanta)
thoughtless design of electronics is hurting independence - that's a big problem I see.
Someone with macular degeneration can get around familiar surroundings OK - but you should notice that the display on the theromstat is in dark gray on a light gray background - hardly anything to think of unless you can't see it. I know someone who just flips the circuit breaker instead of fiddling with a thermostat he can't see.
The old microwave may be ugly, but the new microwave with thin green stick number display and tricky controls is unusable.
The elderly may want a flip phone because it's familiar and easy to use, but they can't see the tiny display numbers very well.
I thought it was bad when BellSouth reduced the font in the paper phone books just as I was starting to need reading glasses, but I now realize what my parents are having to deal with and it's a lot worse.
Ann Conway, PhD (Gardiner, Maine)
To me, this is sort of a no brainer...I think technology people need to talk to actual human beings instead "if we build it you will come. “ I am hearing impaired, a sociologist by training and have worked in public health education for many years. I think technology developers could really take a leaf from public health in terms of linking with partners (such as Area Agencies on Aging) to ask real people what they want. Many products are oriented toward addressing disabilities, such as the sensory impairments that increase with age, but their design process does not meaningfully include people with disabilities. Ignorance of the target population was exemplified in a call I was on a few months ago where the leader of a technology challenge said there were 20 million people with disabilities in the US. There are 78 million—many of them boomers and older! This ignorance of the market is very shortsighted.
New technology offers a concomitant opportunity to provide health education--but that needs to be cognizant of both the disability and health literacy concerns many older people face. For example, I tried one brand of an online, cheaper hearing aids, but you could barely read the type on the brochure (much less put the batteries in easily, but that’s a universal problem). If startups partnered with organizations/people outside their sphere, their products would be more successful.
Uga Muga (Miami, Florida)
I guess the young tech geniuses don't have useful contact with their grandparents, great grandparents and other older relatives who could provide exposure to that world's lifestyle needs and desires.
GaryB (SiValley)
No one, young our old, wants reminders that "they're a loser". The older adult might have once been a captin of industry, doesn't want a diaper wetness monitor sending reports to his/her children. So, dual use tech is better.

One example is Japanese toilets. They are now a swank high class item, but they also might solve a problem for older people who may be unable to wipe themselves. Yet buying such a toilet says you are "cool" and on the cutting edge.

Complex devices are generally a result of bad design -- make it easy for anyone to use. Speech recognition will probalby help.

My 98 year old father is sharp as a tack but nearly deaf and so people speak to him like he's an idiot. It is still almost impossible to get a good speech to text system. Why doesn't facetime or google hangouts allow a real time transcription ability. They have the tech, but are run by 25-35 year olds who just don't have this problem that probably 1/4 of our population has. Oi vey.
S D Kamm (NE Ohio)
The Google Hangouts app has had a real-time speech-to-text transcription feature for a few years now. Just tap the microphone button on the message keyboard. Compose your thoughts, then speak clearly and deliberately.

Hope this helps.
RitaLouise (Bellingham WA)
Weighing in one more time. Simplicity is the operative word. However, our youth has already moved far and beyond that! They were brought up in a tech savvy world. We had to embrace it in our mid years. Some did, some did not. However, what I have found is that email with my family, ability to find answers to my questions on the internet, and access to TV programs (I do not have cable, opted for an aquarium instead) is part of our lifeline to stay in touch as our lives narrow down. No night or freeway driving. Family supportive but far away. I use our library intensively. I can put books on reserve, check content, the list goes on. It really comes to being able to be a part of the world left to us. Some of us are social, others not so much. So, for me it comes to: reliable internet/email servers, a good program for writing the few letters I need to, internet security, scanning ability for recipes and knitting patterns. You see? It is all over the map. But to my mind, simplicity and help are two absolutes here. Keep it simple and tell us where to find help and support when we run into problems. Not an easy challenge when the rest of the world is on a roll for the newest and the greatest in technology. However, just to keep us in the loop in a fundamental way is priceless.
common sense (Seattle)
I am certainly not elderly - and I know I would purchase more electronic equipment if the manufacturers and marketers were adept at explaining to me exactly what each new generation of whatever can do for me.

Mostly I hear a babble of acronyms, and numbers that really do nothing to identify any reason to listen further. So all in all, I save tons of money, and somehow manage to get thru my medium high tech very profitable working day.

Meaningful communication is a failure from many tech companies.
Taoshum (Taos, NM)
This just amazes me... all these techies working to solve our problems... and at the same time, almost every week we get an update for windows that causes as many problems as it solves. Now they want to load us up with Windows 10... how many articles can you find in 5 minutes on Google talking about the issues and drawbacks as well as the "improvements". It scares me to even think about pushing the "Enter" button to start this update. If there's anything techie we need it might be something that will last for a few years without any big changes! And, when it does get changed, the update works without lots of extra work on our part. I guess we will switch from Win7 to 10 at some point but we are not looking forward to it at all.

Here's another improvement to consider: Put the light switch on every car in the same place; as well as the windshield wipers; as well as the HVAC controls; as well as the emergency brake and door locks... how hard could that be? Every car has move this stuff to a new location, why? Actually you could apply this same logic to lots of appliances, TV's, etc... for example, how many computers would you sell if you changed the keyboard layout every month? You could probably save millions in tech support if some of this stuff were standardized.

If you really want to change something of benefit, change to the metric system.
swp (Poughkeepsie, NY)
Sure a living person could do more than a machine, but often they don't. Especially in areas that are drug infested and isolation means the elderly are perfect targets for predators combing the medicine cabinet for free drugs. Much of the home care industry is privatized and there is little regulation or supervision.

The elderly person may have a very poor relationship with their children and those are the people who society expect to bridge the gap. Maybe instead of simply asking the elderly what they want, society should be aware its an app or nothing. Sure there are services for the very poor, but an elder has to exhaust their saving before public service kicks in. That means elder suffering from dementia and savings are eagerly announcing their vulnerability to every telemarketer and charity that brightens their day, There have been a few high profile cases of very wealthy elder abuse.

In the most ideal circumstances the family is making extraordinary personal sacrifices to help Mom and no one will ask them what they need. Relying on the kindness of strangers is a poor answer to the isolation of old age.
Denise Brown (Chicago)
Thanks so much, Paula, for this article.

For me, I am concerned for a few reasons:

1. The amount of money wasted to develop new technology we won't use is staggering. That's money that could be used to really help individuals who care receive and the family members who provide that care.
2. The amount of "new technology" that enters the marketplace which simply duplicates what's already available is really frustrating. I can't tell you how many apps to manage care schedules exist when most family caregivers will simply use a Google calendar. Why would I learn new technology when I already have a stable, free and easy one?

While we do need a Consumer Reports to review the new technology, I wish advisors and incubators would stop the development of these duplicate, inefficient and impractical ideas before they become technology. We have enough experience with failures in this space to avoid them in the future.

And, if a company develops technology in the older adult and caregiving markets, let's make it a requirement that a percentage of their funding goes to help this marketplace. That percentage could go toward Meals on Wheels, respite programs for family caregivers. So, even if the technology fails, the funding of that technology still makes a difference.
CJ (Orlando)
I'm 62 with a 35 year old partner who works in a nursing home. For the right amount I would gladly advise a tech company. My number is xxx.xxx.xxxx. No seriously, if you want to understand your targeted market it probably makes sense to bring them in house.
Barbara Duck - The Medical Quack (Huntington Beach, California)
What do seniors get with Health IT, a lot of nothing. AARP creates a tablet for further dummy them down when in fact they want to learn. I help quite a few seniors with healthcare tech. What they are doing with Medicare Advantage i shoving drugs at them. Look at Express Scripts scoring them and us..senior patients who pay cash for prescriptions are now rated at Outliers and given non compliance ratings if they can't find enough data.

http://ducknetweb.blogspot.com/2015/07/patients-who-pay-cash-when-fillin...

Actually we are seeing the end of what has been known as Common Sense all over and CMS is so bad in just putting out data that scores everything and everyone. I don't blame seniors one bit for keeping their participation with tech to a minimum, as you can't trust those who write and sell proprietary algorithms to score everything under the sun, huge abuse.

http://ducknetweb.blogspot.com/2015/10/the-end-of-consumer-common-sense-...
Dawn Lybarger (Gulf Islands, BC, Canada)
The advice at the end rings so true, as does the whole article. I ordered 2 hi-tech docettes (pill organizers) and spent HOURS programming them for my Dad. They were supposed to flash a red light and beep at his morning/evening dosage time. Well guess what; even though I taped off the reset button and extra-labeled each pill compartment, within 2 weeks the alerts were going off at the wrong time and he told the nurse at his senior living facility he hated the thing. I reset them on my next visit, same thing happened. Now she reminds him most mornings when she sees him, and I phone him most nights to remind him to take the pills. He won; he gets more human contact this way, feels he's checking up on ME, instead of the other way around, and allows him to keep his role as Dad. He does like the technology of FaceTime, as he gets to see me (and I him, or at least the inside of his ear). So let's choose wisely with silver tech. And yes, be able to return it, with all that entails if you live far away.
Topflight (Los Altos)
Virtually every website is different meaning there is a learning curve to each and every one. Many are poorly designed by teenagers who cannot appreciate that small type size is a factor too for us oldsters. Then we get to the Iphone which has NO help functions and virtually every app is different. People must learn new applications via help from their friends whereas, once upon a time, software developers had to adhere to windows standards so they looked and functioned alike. Then we get to the ads which are literally killing the internet experience. Adblock worked ok until the special interests bought the company and infected it with their garbage.
In Europe, phones have a caller ID feature that forces callers to id themselves as SALES whereas in the good old USA no such protection is provided. Of course, we're exceptional (sic).
BG (NYC)
If only the tech people would come up with a way to get rid of the constant annoying sales robocalls that start with "Hello, Senior!!!"--I'd buy that. They don't respect the "No Call" list and they won't remove your name even when you make it clear you are not interested and will never be interested.
Neale (Los Angeles)
Can the numbers printed on my health card, my credit cards be larger ? There is lots of white space.
And those keypads with a security hood cause .my wrists hurt after i return from the market...
jim (boston)
The first step towards making usable tech is the banishment of tiny writing and tiny buttons.
alansky (Marin County, CA)
I wasn't aware that the high-technology industry was even trying to relate to seniors. It looks to me like virtually everything technology-oriented is aimed squarely at the younger generation. I have always been a big fan of Apple, for example, but the way they are pandering to the youth market nowadays is disgusting.
James Myers (Houston)
4 years ago I left life as a Silicon Valley geek to be a full time caregiver for my parents. 1 has since passed, the other is in early/moderate dementia with multiple health issues.
I had a great brain trust, but eldercare/Ageism is bias they find impenetrable.
"Youth dives the economy" "They can't learn the new tech, change will only come after they die off" "There's no money in old people" " Could you even imagine Johnathan Ive designing for old people?"
I've heard all that & more.
The valley can't even design interoperability in medical records to solve The Primary Tech Problem of geriatrics- managing the medical records mess, and the pills that go with it.
Mom has 17 dr's she sees at least once every 2 yrs. At her peak she was on 23 daily meds. Not Pills, mind you, meds.
People who spend the most time with the most elderly are women minorities, low education and pay, treated halfway between scutwork and babysitters.
SF geeks spend more on a cup of coffee than many elder care workers make an hour. Many if not most seniors have no interest in smartphones.
Dementia is exploding as a national epidemic almost like the Spanish Flu, none of the solutions will come from the Valley. It'll be a collection of dirty hacks & workarounds from flyover country, then Sand Hill Angels will try to pump cash and scale up, and they will fail.
There is no successful model in place.
Cosa (West Coast)
It depends on the senior. Some seniors have kept up with each generation of tech products. They do not need specialized products. Other seniors are best served by single-use devices instead of a device with multiple applications. It runs the gamut.

Product developers over estimate the amount of time and effort most people are willing to spend learning anything new. If it is not exciting, obvious, easy and nearly effortless many people will just ignore it. There is so much on the market and so much poorly designed UI that even those of us who love tech ignore 99.99% of what is out there.
jane gross (new york city)
User-friendly technology may be better than no help at all. But what old people need and want is human companionship.....not robots. These devises are more likely popular with with their adult children, because if they can monitor mom they don't have to go visit her.
Sara (New York)
The tech industry shaped its brand and the supposed necessity of its products by positioning them as new, young, and "disruptive" (as though that's a positive thing to items working well). Now it has the problem that its members think of seniors not as a market to be listened to but as something like non-compliant domesticated pets, true "others." It's astonishing the lengths to which American tech and business in general wants to try to sell to people by forcing them into more and constant contact with machines. Spend your entire day inside a machine, lose your ability to understand people and their needs/wants.
A. Stanton (Dallas, TX)
I once ran a large overnight homeless shelter near Boston for homeless men and women. Close-by to the shelter, there were several blocks of apartments for low-income people, many of which were inhabited by seniors and disabled people, living alone, barely surviving off of Social Security or disability payments. Many of these people were in worse shape than the guests at my shelter, some of whom at least had the advantage of being young and healthy. Nobody visits these people. The neighborhood they live in is dangerous. Let's get them somebody who will knock on the door occasionally before we worry about the technology.
rfsBiocombust2022 (Charlottesville)
Having to take care of a toddler AND figure out dementia care for my mother at the same time in the same house, I can tell you there is not nor will there ever be an app or widget that will replace the simple need for assitance from another human being to DAILY help feed, change and engage human beings with such basic needs. Stop wasting money on gadgetry and the health care industry.
GCrow (Here)
When I'm an elderly man I'm just going to hobble off into the mountains and eat mountain lions
GiGi (Montana)
There is physician resistance too. My partner needs regular INR monitoring to determine warfarin dosage, but the physician, who is in every other way very competent and likeable, is reluctant to recommend a home monitoring device. These devices plug into a smart phone which transmits the data. My partner has tech-savvy, gizmo-loving me around to help with any problems. But no, he still has to go to the doctor's office, where they use just such a device.

Maybe it's a billing issue, in which case I don't understand why Medicare doesn't insist on home use of such devices if they save money.
Adele Lyford (Huntsville, AL)
It might be cheaper to buy your own monitor device if you have to drive long distances. Pleading excessive costs often moves doctors to work with you. Is there a second hand market for used but functioning monitors? Check pricing on-line and if you could qualify for a manufacturer discount. Wishing you good luck!
Cheryl (<br/>)
This certainly rings true. There is a race to devise devices that will sell to the enormous boomer generation coming "of age."
They can't manufacture and sell hands-on help for an hour or two a day; so they sell the idea that monitoring someone is the next best thing to being there. But it isn't. And while data is essential to research, simply collecting more and more of it does not solve real life problems. I am not sure, say, that realtime 24/7 blood pressure reading for an 87 yr old would significantly contribute to quality of life.

Designers/engineers need to attend to typical aging issues - less dexterity, tremors, fear of looking foolish, slower learning, more difficulty hearing - and what people most need and want. Just as I do not want a computer-internet linked house, or car, I don't want any more tracking than the NSA already provides, until I am ready for a lifeline type device, which could be easily worn and which served to answer and make limited phone calls, [not really a bad idea for single people period].

A pet peeve that I can't stop from harping on is the need for advanced. Easily adjusted, inserted, recharged hearing aids - at reasonable prices - which would assist so many, both at home and in nursing facilities.

Best way to define problems - spend time with geriatric specialists - and with their clients -- the "elders" and watch and listen.
sandrasizer (<br/>)
It must be driving the 30-something techies absolutely bonkers not to have come up with THE app[s] that will tap them into a huge, growing, and potentially highly lucrative market and make them zillionaires. But, as Gail Collins observed in her column today, "It’s not that age no longer matters, but that we’ve come to realize it hits different people in different ways. Some lose energy and focus, while others seem to get smarter and stronger. Justice Ruth Bader Ginsburg of the Supreme Court, at 82, does push-up routines with her trainer. Gloria Steinem celebrated her 80th birthday riding an elephant in Botswana." As it happens, I'll celebrate my 80th birthday riding an elephant in Nepal. The point that Ms Collins so perfectly makes, and what the wannabe entrepreneurs miss completely, is that we all age differently. "Silvers" may look like an easy mark, but thanks to our differences we are most definitely not, and designing apps for the relative few who need one particular thing or that addresses one particular failing is not what these techies are after.
April Kane (38.0299° N, 78.4790° W)
These same differences exist in younger people but not to the same extent.
marky (home)
One thing that's going to hold back the companies trying to bring products to the senior market (whether those products are well designed or not) is the fact that the only industry more ageist than the tech industry is the advertising industry. So, those companies' ad agencies don't have a clue how to create messages that resonate with mature consumers. There's a great web site on the topic of ad industry ageism called Revolutionary Old Idea (Google it) that details the many failures of the ad business to understand the significance of, or meaningfully reach, the $3 trillion per year mature consumer market.
Jpdragon (Seattle)
Family Caregivers most likely are "connected" -- I'd happily participate in a consumer panel online.
Abbe (Brooklyn)
I clicked the link for the Caregiver's Guide which led to a website. I did a search there, but could not find it. If anyone found it, please post a link.
Paula Span (NJ)
Abbe, you'll see the title of the Guide at the bottom of the web page. That's a clickable link to the Guide itself.
Carol Levine (New York NY)
http://www.nextstepincare.org/Caregiver_Home/Technology/
This link should work --if not, try the home page ---www. nextstepincare.org.
Carol Levine (New York NY)
I'm sorry you couldn't find the Next Step in Care guide. Here is a direct link: http://www.nextstepincare.org/Caregiver_Home/Technology/

If for some reason, this doesn't work, try the Next Step in Care home page--www.nextstepincare.org

Hope this helps.
bobinator60 (NY NY)
There are two issues you don't mention regarding silvertech:

1. silvertech is a shrinking market, and doesn't get the attention it deserves. people now in their 60s and over didn't grow up with technology, so they often have a hard time accommodating to it. But the younger generation of 40- and 50-somethings are much more technically adept, and they will bring their own technology into the their old age.

2. silvertech is not marketed to the people who will use it, but rather to the medical industry, caregivers, and family members. so an adult child who buys an emergency pendant cares more about price, how big the red button is, and how it attaches to the parent than they do about whether the device is designed to actually be usable.
Paula Span (NJ)
I can't agree with your first point, bobinator. Silvertech is about to become a much larger market as the oldest baby boomers turn 70 next year. They have a very different skill set than previous generations of older adults. But they (well, we -- I'm one) are very different from many of the designers and developers, so there still needs to be ongoing conversation about what we need, want, value and can pay for.
MMonck (Marin, CA)
I spent 25 years in tech product development and marketing, mostly market research, and decided to become a GCNS (geriatric certified nurse specialist) 12 years ago. My masters is in telemonitoring of CHF and my doctorate is in antipsychotic mortality with Alzheimer's.

Having had both feet in this issue, I can tell you that silvertech is fueled largely by an imaginary huge and profitable market of aging baby boomers and their families needing expensive smart devices.

But there is a mismatch of declining skill sets in the end user market, the most important being high cognitive function and engagement, in order to productively utilize these devices when they most need them.

And the critical period that they need them most is when they are at their most frail and cognitively challenged.

Case in point, my mother, when she was first diagnosed with CHF at 87, dutifully took her blood pressure (BP) and pulse at regular intervals during the day. She would bring those figures with her to her monthly cardiologist appointments. She was cognitively, as we say, intact. Very productive health care activity with a wrist BP cuff, pen and paper.

And I was involved in a CHF telemonitoring test project at the time. But I didn't think she could handle the device based on my experience with them. And yet she was the target market for CHF telemonitoring.

Guess what, my telemonitoring project was discontinued....and rightfully so.

P.S. Classic dementia indicator - devices in the frig.
KarinaK (Boston)
Excellent article and badly needed. A refreshing reminder to ask users what works for them - no matter how old they are. Hoping articles like this promote truly useful technology to keep people at home.
bodonnell (Chicago IL)
Why oh why don't these much-younger designers and developers meet and talk with seniors, their intended audience? Many senior facilities would be happy to serve as free focus groups if it meant getting devices they could actually use -- with simple, understandable directions and/or keyboards those of us who matured without smartphones and their array of apps would welcome.
Paula Span (NJ)
That's exactly what some developers are doing, bodonnell. Aging2.0, for example, is holding discussions and pitch sessions IN assisted living communities, where residents can give feedback on what works and what doesn't.
trudy (<br/>)
Because they think we're all stupid.
ejzim (21620)
They don't just have to relate to seniors, they have to value seniors, and realize that they, themselves, will grow old. Do unto others as you would have them do unto you, without profit as the reason.
Richard Green (San Francisco)
When I was in my twenties, I never had to wait in line for two days for the privilege of being one of the first to ge the newest iPhone (substitute any must have device.) Of course, there were no such toys. I will turn sixty-nine in January, and, now, I don't have to wait for the newest, best, monitoring device to inform hackers of the "Internet of Things" about the state of my slow inevitable slide toward senescence. Somehow, I will muddle through -- plugged in or unplugged.
r (x)
I'm a Luddite engineer who asks "Why do I need this?", answering most often "I don't." similar to the Times' writer who attempted automating his home. Pushing technology onto seniors seems more exploitative than helpful. Dr. Kernisan correctly advocates tapping geriatricians' knowledge and experience - an anathema to millennial starter-upers. There's a whole knowledge base of geriatric social workers and care givers that's being ignored.
Mill (South Lake Tahoe, CA)
I loved your term "Luddite engineer", along with your post. I don't know anything about engineering, but I bet those are the best kind. . . .
Larry (Stony Brook)
This is a good and on point piece. I would like to call attention to part of it which illustrates that the issues can be complex. Drs. Covinsky and Kernisan "groaned" and belittled the idea of an incontinence brief capable of assessing bacteria in urine of the elderly saying "It would just lead to antibiotic overuse." Perhaps that would be true, but the well known reality is that seniors with urinary tract infections ARE infected, but commonly do not exhibit symptoms shown by younger folk (such as pelvic pain or burning during urination). However, a common symptom in the elderly is dementia, which is all too frequently dismissed by medical staff as unrelated to the presence of a high proportion of the elderly with UTI and, as indicated by the quote from Dr. Kernisan, their dementias are not treated with antibiotics. Psychiatrists generally know the relationship between UTI and dementia, as do the nursing staffs in housing facilities for the elderly.
AliceP (Leesburg, VA)
Please, UTI infections are very easy to test for and putting some testing gear into every "Depends" sanitary product is really unnecessary.
Bbgods (brooklyn)
Our society spends too much time telling older adults what they need, and not enough time asking us what we need and want.
Kate johnson (Salt Lake City Utah)
Two comments... one that my 85 year old mother truly loves her Jitterbug. The other is that what stands in her way of adopting more tech items that would make her life better or easier is a reluctance to pay more for a better internet connection. Possibly partly because she's never really experienced how much better a fast connection can be. She's sharp as a tack, and would benefit from being able to watch Ted Talks, take classes from Counsera and the like, and so on, but without faster internet none of that will happen. Too bad....
Sara (New York)
Great gifts for the elderly often include things they consider luxuries - like subsidizing their internet connection. My parents constantly ask that we not get them more "stuff," just tickets to things that are life experiences or that pay for things they want, like a pool membership that they really don't feel they can afford in fixed incomes. Win-win: they get a gift they can really use and we get to be caring kids.
Peter (The belly of the beast)
Our local senior center has young people hold classes to teach seniors to use their SMART phones, Tablets, Social Media etc... They get community service credit for it. Maybe we need a special "Geek Squad" for seniors - that have been vetted/bonded and trained specifically to help seniors get more comfortable with tech. I agree with everyone who said tech is no replacement for caring people nearby. Sometimes I think adult children want to load us up with devices to stay in touch because they feel guilty they live so far away.
Adele Lyford (Huntsville, AL)
Can you get your mom a month-long trial from the cable company? Maybe even free?
Charles Raguse (Woodland , CA)
Amen. Indeed, the installation of a number of grab bars in all the appropriate locations, including the bathroom, could be more realistic in preventing falls than any remote monitoring device on the market .
Similarly, vis a vis the dementia and/or Alzheimer's complex, getting "lost" in driving, in one's own neighborhood, should lead to much more conservative use of an automobile, to, if need be, giving up driving.
At age 85 I still live in my residence, but I think constantly about adaptations that can help protect me from disaster, and accept the responsibility to implement them.
And as Dr. Covinsky has noted, visits an hour or two daily, or at least a few times a week,by a home care professional (of an age, I might add, who truly understands the elderly) trumps innovative technology hands down.
arian (california)
Newsflash: That trueplan(?) debit card--sending older callers to real people--WE ALL want real people, not automatons!
Smcs (New Orleans)
Safety with iPhone, iPad and Siri. If device is off , just shout out "Hey Siri". It awakes, tell Siri to call 911.
ejb (Philadelphia)
Why not just "Call 911!"? My Dad can't remember names, let alone an oddball one like Siri. Why should he have to remember a silly name to get 911?
A Goldstein (Portland)
I thought this article was going to skip mentioning the other very important way to connect with seniors electronically and that is by designing things like phones, computers and home appliances that truly enable the use of such devices by seniors despite physical and mental limitations. It's important to save lives by remotely monitoring older individuals but quite another to make their lives more connected and productive by enabling them to participate in the electronic revolution. That's a quality of life issue.
Chuck W. (San Antonio)
My 89 year old mom, legally blind, would love to spend more time on her computer. We are able to enlarge the text on books enough to allow her to read. The instructions to download books, apps, and even how to upgrade her computer are incredibly complicated. I have to admit that, at times, I have a difficult time trying to understand instructions much less trying to explain them to mom. It is heartening to read that there are companies trying to make life a bit easier for our seniors.
trudy (<br/>)
Chuck, there is at least one product, Dragon, designed to help the visually impaired use a computer. I am not familiar with it, but it's probably worth looking into for your Mom.

I decided a few years ago not to upgrade my computer. I know this is a security risk. But it's a lot simpler.
ejb (Philadelphia)
But not so heartening to NOT hear that they're trying to simplify menus, enlarge text, enlarge buttons and the space between them, and (in other than screen-based devices) give buttons shape and texture to allow people to distinguish buttons by feel.

My folks can barely use the phone, TV, bake oven, microwave oven, radios or CD players or any entertainment device any more - mainly because they can't read the labels, distinguish the buttons, or aim properly at tiny little things in pale fonts.
marticarroll (Amelia Island)
What we need is The Times or AARP to open a forum for ideas coming directly from seniors, their families, caretakers, health professionals, case managers, social workers. Almost everyday while caring for my husband I wished I had had a device, app, rehabilitative tool that did not yet exist or I did not know how to find. If the makers know what we need, we might get it.
Taoshum (Taos, NM)
That plus just plain simple stuff... easier to open peanut containers... I often get tempted to send an email to the CEO asking for a video of them opening their products and packaging.
trudy (<br/>)
As an older person, I think Dr. Covinsky really understand this situation.

I would like to point out that not older people are idiots, however as the young people in Silicon Valley seem to think.

My Doro PhoneEasy works well and I encourage seniors looking for a phone to consider it, it's cheap plans, and its AARP discount.
Andrew Makarushka (San Diego CA)
My wife and kids tease me about my Jitterbug phone, which I find easy to use. But I just wish the phone could somehow remind me not to forget it when I go out. Is there an app for that?
Charlie B (USA)
Even the most tech-savvy among us encounter glitches that, to the old are insurmountable. And then there's the loneliness.

Millennia of human experience suggest another idea: Establish multi-generational family households in which the very young and very old receive care from those in the middle.
A (Bangkok)
Charlie: Why not focus on helping everyone to be self-sufficient.
SC (Hartsdale)
How about including seniors in the teams that develop these projects? Yes, there are seniors who have 40 years of software development experience, keep up with the latest technologies, and are still great programmers, but are shunned by the companies which make software for seniors!
Paula Span (NJ)
Amen, SC.
Sara (New York)
Given current life spans, a lot of users will also be older women. That's bad news for an industry that can barely manage to include younger women and rarely designs with women in mind.
Jeffrey B. (Greer, SC)
Who, or what bot, wrote this fairy tale? And the publication is located in what part of Fantasy-Land at Walt Disney World-Disneyland, Inc.?

If you are not tech-savvy, no one has the time, nor the inclination, to spend with you explaining what you don't know, or are trying find out.

I'm very tired, and a little cranky at the tech industry today.
Tried to buy a tablet yesterday; bombarded with offers from teen-!@#$ who wanted to sell me what they wanted, not what I.
Finances? Young male wise guys, who have no patience for your questions, on anything you want to know more about. Guess they're much too busy getting their ...
If anyone says to me they want to help me from an organization that wants to "Make-Things-Happen", I am gonna' throw a bucket of water at them. No, not just the water; the dang bucket.

Same to you, Largest Investment house on the web.
Oh, it only took me 30-minutes to compose this; don't type gooder when I'm upset. (Gooder - Yeah!)
PNRN (<br/>)
Jeffrey,

I totally sympathize about techie kids not understanding the needs of seniors. They won't get it for another 30 years. But in the meantime,
this article got me researching assistive devices/programs for my patients.

I see that SC has a couple of resources you might want to check out. This link leads t SC Access, Aging and Disability Information.
http://scaccess.communityos.org/cms/

You can call 800-868-9095 to speak with an SC Access team member for any questions about the site. Maybe they have ipads you can borrow and try out. Or maybe they have other devices to suggest you try?

Anyway, good luck!
RitaLouise (Bellingham WA)
At 87, I can relate to this article. Fortunately for me, I have been 'in to computers' since the mid 80's. On the Internet for years. Yet, I find technology running roughshod over my attempts to keep up. That said, there will be a plethora of need to address seniors and the complexity of their support. One size does not fit all. The range of monitoring and attention ranges far and wide. Some are able to afford retirement living facilities. Others cannot afford it. These are the seniors that need the most assistance and affordable support. Seniors have contributed in many ways to the continuity of this country. Yet, seniors are 'disposable' as they are 'on their way out'. Admittedly, they drain some of the health care system. Given the needs monetarily to address disasters, fund our overseas allies, fund our education, infrastructure, and our very needy Veterans, we really need to take a long and hard look to our priorities. A quagmire at best.
L (NYC)
Ah, yes, the all-purpose catch-all term "seniors"! It covers people from 65 to 100+ yet the article is written as if we're a homogeneous group, and Luddites at that.

A friend who's worked her entire career with frail older people told me decades ago that emergency pendants are almost never worn as they're meant to be, so that's not news.

As a computer-literate older person, I don't like being tracked on my computer and I certainly don't want to be tracked by a security pendant that will inform others if/when I open the fridge! It's none of their business, frankly.

The article also is replete with stories about people who are NOW in their 90's, whereas over time a majority of older people will be quite familiar with computer use. Some of us have even studied programming and website development.

Ms. Span, you have used anecdotes that indicate that the older people involved are perhaps in severe mental decline: a man who "stores his never-worn emergency pendant in his refrigerator" and a woman whose 95-year-old mother can't use a regular telephone. This is hardly representative of the entire aging population! Give us all a little more credit, please.

And you buried what should have been your lede, namely that companies run by 25-year-olds are not likely to comprehend what people triple (or more) their age might need. Further, computers are NOT the answer to everything; as noted, human care & contact are often what's needed, and no device will provide that.
Paula Span (NJ)
Actually, L, the man who stored his pendant in the fridge did not have dementia. He had hung it on a magnetic hook on the side of the refrigerator, kept knock it off, so just stashed it inside. Because he didn't want it where it was designed to be: around his neck. The 95 year old had a phone designed with the volume control on the side of the handset, just where she habitually held it with her thumb, thus inadvertently turning the volume down while her daughter on the phone kept yelling, "Push the volume button!"

So these are not just age-related difficulties. They are also design/conceptual issues.

Over time, yes, we boomers will have greater technical skills than some (not all!) 80 year olds do now. But we will still want products that are simple and intuitive, that fill a genuine need. I don't know what all the buttons on my home phone, my cell phone or my TV remote actually do -- do you?
India (Midwest)
I'm 72 and living independently in my home. I attend pulmonary rehab 3 times a week with many men and women who are far older than I. Those who do best have family members who help them often, in some cases daily, or who can afford to hire live- in caregivers 24/7.

It's not easy getting old or more dependent, and I know the one thing I would like to hang onto is my dignity. A monitor of how often I open the refrigerator or use the toilet would pretty much do away with what little is left.

I love technology but do not believe it's the answer for the elderly. We need family and caregivers at home and often neither is going to happen.
April Kane (38.0299° N, 78.4790° W)
Sorry, I'd prefer a monitor than people being around and bothering me.
Sondra Weissman (Orange ca)
I am an 81 year old silver sneakers lady, who would like very much to participate in any consumer group about tech products, and I bet my husband (86) would also be a willing participant. Each of us was involved very early in the tech world but we are completely befuddled by today's environment. We could contribute well to both the user and the provider side. You can contact me at [email protected].
director1 (Philadelphia)
I am 70, have been involved with IT for a long time, my parents 90 and 95 have three main issues, sight, sound and mobility. User Experience analysis and testing are major processes to make any application / product workable.
JP Milton (Boston)
Nice to see recognition of the market opportunity, with less focus on remote monitoring and gadgets and more focus on services. So what kind of services? Those that facilitate human connection, convenience, and trusted supplier networks would make sense. So think Uber/Lyft, Angies List, hyper-local. Interesting to see the Lyft Ride Sharing sponsor as sponsor for Web2.0 events. Another benefit - employment opportunities for able seniors into getting 'younger next year'.
sjs (Bridgeport, ct)
The problem is that tech people are in love with tech (that's why they are in the field, after all) and they have an insatiable need to keep loading on options, choices, alternatives, etc. etc. that nobody wants or uses. Most electronic devices are so over designed, they are almost unable. It is not just old people. Most people only learn to do a few things on their devices and forget about the rest. Most people don't have the time or interest in learning all the options (this, by the way, is why so many people hate a new 2.0 of whatever they are using). I believe that a good deal of Apple's success is the promise of simplicity. They don't always achieve it, but at least they understand its what people want.
April Kane (38.0299° N, 78.4790° W)
Except how do I stop Photo from opening every time I start the new OS 10.11 system - I don't want to access it that often.
Taoshum (Taos, NM)
true enough but I'd love to get a pair of glasses with an adjustable focal length... light, low cost and self charging of course.
ring0 (Somewhere ..Over the Rainbow)
An important issue with these silvertech products is ease of use.
I note my finger nimbleness (and my patience!) decline with age.
This is especially apparent with Apple's mobile products.
Rich (Washington DC)
The issue of persons with dementia or sensory impairments is important because products that accommodate those needs could also be marketed for the large number of disabled younger adults. I am responsible for a family member with a head injury for whom current versions of Windows and Office are a minefield. I can turnoff some features but it requires a lot of research to find out about these, but even then something as simple as printing a document often leads to misunderstanding.
Jason Shapiro (Santa Fe , NM)
people attempting to create electronic apps and products for say people over 60 or 70 (yes, boomers are still a big market) need to keep three things in mind:
1. keep it simple and user friendly to operate;
2. make it useful, necessary, or fill a genuine and not a manufactured need;
3. make it dependable.
Older consumers are skeptics, not because they are too old and conservative but because they have lived long enough to have heard too many magical claims about too many products and have learned that cynicism is often the healthiest response.
ejb (Philadelphia)
4. Get it right the first time so you don't have to keep updating it.
5. Don't keep adding silly features that overwhelm the initial, useful ones.
Jackie (PA)
A "lending library" perhaps through the Dept. of Aging would be useful in trying products before buying. This exists for the disability community already as products are as diverse as consumers.
Cheryl (<br/>)
Creative idea.
ring0 (Somewhere ..Over the Rainbow)
Buy at a retailer who readily accepts returns. Target has never failed me in that regard.
Steve C (Bowie, MD)
I am a caregiver for a woman who fell and damaged her hips two Easters ago. She continues to deteriorate and is to a point now where walking is almost impossible and transportation involves the use of a wheeled chair.

She continues physical therapy with admirable determination but needs somehow to go beyond this to another step in both the examination and repair process.

All of the modern caregiver aids described in this fascinating column are dependent on two factors: the patient's acceptance of their need and the willingness to use them.

I cannot emphasize enough how important it is for these aids to be properly presented. Stubbornness is often present in the minds of afflicted elderly, or so I have found. This is a whole additional area of difficulty that must be addressed.

Elder care is a top order of business and sadly it deserves the attention of our
malfunctioning Congress: this does not bode well.
Eric (Sacramento, CA)
This is a "double" market. What seniors will buy for themselves, and what their children will buy for them trying to improve or maintain their quality of life. Seniors need a personal assistant that they trust and will use. Saving seniors from fraud (see recent issue of consumer reports) would be a great feature. The trick with AI and seniors is getting them to make it part of their lives.