"I don't know what to do anymore. Please help me"
"I can't do it anymore. My husband has late-stage dementia and my children live far away. I just don't know what to do anymore. Please help me." Wow, that hit home. I looked up and saw an older woman sighing with frustration at the health-care counter. The woman at the desk was doing her best, but didn't really know how to help. I was sitting in the waiting room, watching it all unfold. For some reason, I couldn't stop thinking about it. Is this vulnerable group of people being left behind? Are we expecting them to be too self-sufficient? Are we doing enough to help them?
Technology back in the days
When I first started working with FocusCura in 2003, the world was relatively simple. iPads and iPhones didn't exist and technology was reserved for cool youngsters and nerds, not for senior citizens. That's why a lot of people called me crazy when I came up with the idea of using technology to help older people maintain their independence. But I did it anyway. And the senior citizens loved it, as you can see in the video below (made in 2004, Dutch).
Technology today
Things are very different today. Technology plays a dominant role in the lives of young and old alike. We use computers, smartphones, and tablets for everything. In fact, our devices are the first thing we see when we wake up and the last thing we see when we go to bed.
Last year, 86% of Dutch people used a smartphone (source: Dutch Smartphone Users report by Telecompaper). The majority of this growth was found among older people, given that most young people already used smartphones. "Smartphone use among people in the 65-80 age bracket increased from 9% to 63% in 2016"In fact, smartphone use among people in the 65-80 age bracket increased from 9% to 63% in 2016.
This doesn't mean everyone is downloading the latest apps and features. Although an increasing number of older people are starting to use technology, there's also a group of vulnerable older people who aren't exactly tech savvy. In fact, 1.2 million seniors don't use the Internet at all because they have no network connection (source: WijSr, a magazine by KBO-PCOB).
Self-sufficiency and technology
Technology is playing an increasingly important role in our lives and is therefore becoming a determining factor in our ability to remain self-sufficient. However, there are a lot of vulnerable people who don't understand these advancements - like the woman in the story above - and are afraid to ask for help. They are limited in their ability to take care of themselves and manage their lives. In many cases, the children live far away or have no interest in caring for their parents. It's important that we don't forget these people. And we aren't: ten thousand nurses, caregivers, and volunteers are committed to helping this vulnerable group every day.
At home with dementia
I recently had the opportunity to shadow a dementia case manager at a health-care organization Cordaan in Amsterdam. Case managers help old people with dementia and their relatives, such as husbands, wives, and close family members the entire time that person lives at home. We work closely with them to develop new technologies to support this vulnerable group of dementia patients using smart sensors, so they don't have to move to a nursing home if they don't want to (or can't due to long waiting lists).
Together, we biked around Amsterdam visiting several clients. One of those clients was a couple and the wife had severe dementia. The husband was faced with a tough decision: put her in a nursing home or keep her at home. Their daughter was there too and I had so much respect for how they handled the situation. They explored all of the possibilities and thought long and hard about ways to avoid this difficult decision. "The last thing you want is to have your own wife committed," he explained to me. The case manager and community care services were extremely supportive. "The last thing you want is to have your own wife committed."
We visited another older gentleman that day who lived alone. He was vulnerable but very happy. He was eager to share his stories with us, no real connection between them. He didn't know a thing about technology. He was still coming to terms with the passing of his wife. As we were walking out the door, he explained that his children were worried about him. They all live far away and don't really know how to help.
Technology to alleviate concerns
I was very impressed that morning and it really got me thinking. All of these people have their own challenges and problems, but were extremely happy with the support of the community care services and the case managers. To them, self-sufficiency was about as abstract a concept as technology. Although, that's not entirely true with respect to the latter. Lots of people asked me to explain what FocusCura does. So I told them about partnering with health-care institutions to help vulnerable people live at home safely and independently.
These people in particular, who didn't really understand technology at all, were the ones who encouraged me to continue. While the sensors may be too late for them, they would have certainly made life easier. It also would have been nice to stay in the comfort of their own home for dementia check-ups, instead of having to take their partner with them to the hospital.
Plenty of work to do
This day made me realize all the more how important technology is. While it may not help dementia patients directly, it does give them the opportunity to enjoy the personal attention of their own warm, loving, and dedicated caregivers.
I don't want to be a doomsayer, but the statistics don't lie. With the number of health-care users on the rise and a shortage of health-care workers, our problem won't be a lack of budget in the future. The real problem is a lack of qualified nurses, caregivers, and case managers.
The clever use of technology can provide support to these caregivers in helping their clients. In this way, we can help them maximize their limited time so they can also focus on offering personal and warm care. After all, they're the ones who know the type of care someone needs and when they need it.
How great would it be if they could use smart sensors to check on their clients and take immediate action when something goes wrong? And how comforting would it be for the client's children to be able to check on their parents using a handy app? "Almost everything we want is possible in our health-care system. We just have to do it!"
We still have a long way to go and there's still plenty to do and develop in terms of health-care technology. As great as the commercials are, it's extremely challenging to develop technologies that perfectly address the needs of users, be they health-care providers or clients.
We also have to reform our health-care budget system if we want to achieve this. We don't even have to replace the current rules and regulations with new ones; in fact, I believe that almost everything we want is possible in our current health-care system. We just have to do it, which requires courage on all sides: health-care providers, insurance companies, and businesses. If they create the room for health-care providers to determine their own care methods, we can make good on our promise!
It all comes down to one thing: the people.
Of course, the gadgets, robots, and new technologies are super exciting, but they really play a minor role. It's all about the people who use these technologies: the case managers who trust that these devices will be their eyes and ears; the caregivers who know that the smart sensors will alert them if something goes wrong. "Technology has to be extremely user-friendly"
Of course, this extends beyond the technology used in dementia care. The same applies to telemonitoring for COPD and heart failure, whereby patients send their measurements to their health-care providers. Technology plays an important and welcome role for this group as well. It does, however, have to be extremely user-friendly and many times it also requires a detailed explanation from our technicians. But when I hear how happy patients and caregivers are and how much calmer they feel, I know we're on the right path.
Extra help for an extremely vulnerable group
Is eHealth only suitable for independent, trendy, and healthy people? Or for people with a strong social network? Absolutely not! We can't forget the extremely vulnerable group of people, like the older woman at the health-care counter. They deserve special attention and help. After all, they're the ones who will benefit most from the support of modern technology.
Not necessarily from the technology itself, but from the warm and personal attention of caregivers who are always at hand. This personal care can continue to exist for all those who need it in the future!
*The situations were modified slightly for privacy reasons, without sacrificing the essence of the story.