While an aging global population might be good news for the health of our planet, it presents a number of challenges for seniors and their families worldwide. From growing economic pressures to widespread loneliness, a society largely populated by the elderly poses difficulties we have not yet faced on such a significant scale. Of course, the most important concern brought up by an aging population is how we will care for our seniors. With over 80% of American seniors set on aging in place -- but few equipped to do so --, technology will play a major role in managing this crisis. Thankfully, encouraging seniors to age in place with the help of home tech could actually save money across households and government agencies. It could also benefit the environment, improve the health of seniors and offer peace of mind for their families. Integrative approaches to home health, sustainable initiatives and ethical treatment are all incredibly important to all of us at Living Deep. As such, we will delve into how we can best support our planet and protect our population as it ages. In this article, we will discuss how smart home tech can support Americans as they age in place and how we can all benefit from their health and happiness. Follow below to learn more about challenges facing our seniors in honor of Older Americans Month.
What an Aging Population Means for All Generations of American Society
According to Andrew Meola in a January 2021 article for Business Insider, the US population is aging rapidly, bringing with it a whole host of issues. Meola writes that by the year 2030, “every Baby Boomer will be age 65 or older, which means that 1 out of every 5 U.S. citizens will be of retirement age.” Because of this swift increase in our elderly population, Meola expects there to be “far more demand than supply of healthcare in the future,” increasing care costs for everyone. Because the Baby Boomer, Gen X and Millennial generations had fewer children than did the Silent and Greatest generations, “older people are projected to outnumber children for the first time in U.S. history.”
Thus, the onus to care for elderly adults will fall on a younger and smaller population than ever before -- a mixture of Gen Y-ers and Gen Z-ers. Meola explains that “as the adult population ages, the old-age dependency ratio (the ratio of older adults to working-age adults) will also shift,” placing pressure on the economy. Fewer people will be available to care for our elders just as fewer people will be engaged in the workforce. As of 2020, there were “3.5 working-age adults for every retirement-age person but by 2060, that ratio will drop to just 2.5.”
Challenges Posed by an Aging Population
Our rapidly aging population poses many challenges. First, many of today’s seniors live with one or more disabilities. According to the UN, worldwide “more than 46 per cent of older persons – those aged 60 years and over—have disabilities.” The CDC reports that -- as of 2018 -- disability affects “about 2 in 5 adults age 65 and older” in the United States. Mobility disability is most common amongst older adults, followed by “cognition, independent living, hearing, vision, and self-care” disabilities. Seniors with disabilities often require some degree of in-home care or assistance, paired with regular trips to specialists and primary care doctors. However, while many elderly Americans require some level of care, the majority prefer to age in place -- forgoing assisted living facilities.
Second, the Baby Boomer generation -- which now represents almost 72 million Americans -- had children later in life and birthed fewer than the generation preceding them. Because of this, the children of seniors and the elderly are often in the beginning or middle of their careers when their parents begin to need help at home. Those who cared for previous generations were largely approaching retirement when their elderly parents started to require assistance. As such, the Silent Generation, Baby Boomers, Gen X-ers and Millennials are all burdened by a rapidly aging American population. Home tech can both help seniors age in place on their own and take pressure off their working age adult children.
The Future of Aging is In-Home Care
Seniors and Elderly Reject Nursing and Assisted Living Facilities
Clusters of COVID-19 infections and deaths in nursing homes across the country contributed to an intense incline in the number of older Americans who would prefer to age at home. In the past more older Americans were inclined to move into assisted living facilities. However, whether older Americans would prefer to age at home or to age in a facility is of little consequence. This is because the US no longer has enough licensed spaces to accommodate our aging population and those it does offer are much too costly. According to the National Center for Assisted Living, there were only 28,000 assisted living residences in the United States as of 2018, able to house only one million people in total. As of 2016, there were only 15,600 nursing homes operating in the US, accommodating only 1.7 million people.
This small number has slipped over the last six years. With family members pulling their older loved ones out of nursing homes due to poor policies, high costs and inappropriate conduct, hundreds more have closed across the country. Senior contributor to Forbes Howard Gleckman explains in his March 2020 article “Why Are So Many Nursing Homes Shutting Down?” that nursing homes were shutting down long before the pandemic. Gleckman writes that “occupancy rates in skilled nursing facilities have been falling since 2015” due to “growing pressures from payors, rising costs [and] the need to replace old buildings.” Others have shut down due to “increased competition from other forms of residential care and shrinking demand from older adults who prefer to age at home.”
More Americans prefer to Age in Place Than Ever Before
The 2018 AARP Home and Community Preferences survey noted that “76% of Americans age 50 and older say they prefer to remain in their current residence and 77% would like to live in their community as long as possible.” According to the AP-NORC survey “Long-Term Care in America: Americans Want to Age at Home,” this number has declined in the last three years. The poll found that “88% of Americans would prefer to receive any ongoing living assistance they need as they age at home or with loved ones.” Only twelve percent of older Americans “want to receive care in a senior community or nursing home.” However -- according to AARP -- only 59% of those surveyed “anticipate they will be able to stay in their community” without changes to cost of living or home technologies.
Benefits of Aging in Place
Experts agree that aging in place -- whether in a home of one’s own, an adult child’s house or in a senior living community -- has many benefits for seniors and for society. According to the HUD Office of Policy Development and Research paper “Measuring the Costs and Savings of Aging in Place,” “programs that support aging in place may yield cost savings for families, government, and health systems.” The 2013 brief cites “recent research on home-based health programs” which suggests that “aging in place can yield potential cost savings at the individual, state, and federal levels.”
A Sustainable Future For Seniors
Benefits for seniors may include individual cost savings, boosted mental, emotional and physical health, improved quality of life and increased longevity. From a cost perspective, in-home care from a relative or from a professional caregiver is typically much less expensive than that of a live-in facility. The HUD Office of Policy Development and Research notes that “the median monthly payment for noninstitutional long-term care was $928 compared with $5,243 for nursing homes” between 2004 and 2007. Expenses at nursing and assisted living facilities are only expected to increase. According to HUD, between 2011 and 2012, “the average daily rate for a private room rose 3.8 percent, which exceeded the rate of inflation.” Furthermore, Medicare, Medicaid and other insurance services rarely cover the entire cost of nursing or assisted living facility care. On average, “out-of-pocket spending is much greater for institutional than for noninstitutional services.”
Emotional, Mental and Physical Health Benefits of Aging in Place
From an emotional, mental and physical health perspective, seniors able to age at home are more likely to preserve or improve their overall health. Seniors aging at home are more likely to seek out medical help due to lesser costs and greater availability. They are also more likely to feel fulfilled and connected to their communities. The ScienceDaily article “Aging in place preserves seniors' independence, reduces care costs, researchers find” references 2011 research conducted by the University of Missouri-Columbia to support this claim. Researchers at the University of Missouri-Columbia found that “‘traditional long-term care often diminishes seniors' independence and quality of life.’" However -- notes Professor Marilyn Rantz of the Sinclair School of Nursing --, “‘aging in place enables most older adults to remain in the same environment and receive supportive health services as needed.’” Aging in place affords seniors continued independence, a key element of mental and emotional health in older age.
The 2019 study “What does quality of life mean to older adults? A thematic synthesis” conducted by Karen M. van Leeuwen at the University of Amsterdam underscored the importance of independence to quality of life. Van Leeuwen and her colleagues surveyed 3,400 older adults living at home across eleven Western countries, asking about their perceptions of quality of life as seniors. Their survey found that older adults consider “being able to manage on their own” and “retaining dignity and not feeling like a burden” as key contributors to their quality of life. They also valued “spending time doing activities that bring a sense of value” and “feeling secure at home and living in a pleasant and accessible neighbourhood.”
A Source of Comfort for Families of Seniors
The benefits of aging in place are similar for families of seniors. These include reduced financial costs and increased peace of mind for the health and wellbeing of their loved ones. Children of elderly Americans have become increasingly suspicious of nursing homes and assisted living facilities in recent years. Their suspicions are not unwarranted, explained Chisun Lee and A.C. Thompson in their 2011 article “Gone Without a Case: Suspicious Elder Deaths Rarely Investigated” for ProPublica. Thompson and Lee reported on an investigation conducted by ProPublica and PBS’s "Frontline.” The investigation found that “the system to examine unusual fatalities often fails seniors, leaving them vulnerable to neglect, abuse and even murder.” A more recent WHO study conducted in 2020 found that “nearly 1 out of 3 of staff members admitted to emotionally abusing residents.” According to the research article “Elder abuse and neglect: an overlooked patient safety issue” by Janne Myhre et al, care managers at nursing homes often misunderstand cues from residents.
According to Myhre, managers “lack awareness of elder abuse and neglect, and that elder abuse is an overlooked patient safety issue.” This results in an increased “risk of [nursing home residents] being harmed and distressed.” Concern over the safety of ALF’s reached a fever pitch during 2020, when repeated COVID-19 outbreaks in nursing homes stunned residents and their families across the country. According to the COVID Tracking Project from The Atlantic, “about 8% of people who live in US long-term-care facilities had died of COVID-19” as of March 2021. Nearly ten percent of those who lived in nursing homes died from the disease. Given the threat of abuse, neglect and infection at nursing and other assisted living facilities, families often prefer elderly relatives to age in place.
An Environmental and Financial Boon for Society in General
Supporting seniors aging in place can also benefit society at large -- from government program cost savings to reduced waste and emissions. According to the HUD PD&R article “Measuring the Costs and Savings of Aging in Place,” promoting aging in place could “create systemic cost savings for the Medicare and Medicaid programs.” As we mentioned in our Into the Deep blog post “Multigenerational Living: Faster Alone, Further Together,” compound living can benefit the environment as well as aging seniors.
Environmental Benefits of Aging in Place
Natascha Kocker and her colleagues at the University of Wollongong outlined a few environmental benefits in their study “The environmental implications of multigenerational living: Are larger households also greener households?" Klocker and her colleagues found that “multigenerational family living presents unheralded opportunities to save energy, water, building materials and land.” According to Klocker, “households with more members typically consume fewer resources” and "generate less waste.” We explained in our article that this is because ”resources are shared rather than consumed -- or tossed out -- individualistically.”
The same may apply for seniors who live independently in senior living communities rather than in nursing or assisted living facilities. In recent years, green senior living communities have popped up all over the US -- focused on both independent senior living and sustainability.
Senior Communities Are Focused on Sustainable Living
According to the ASHA article “Senior Living Trends: Green Senior Living Communities,” retirement communities “across the country are actively moving toward reducing their carbon footprint in a variety of ways – both in infrastructure and practice.” Retirement communities that “go green” have actually been proven to provide “seniors with greater fulfillment, a higher sense of purpose, and improved mental health.” This shift supports the goals and priorities of seniors worldwide, many of whom are concerned about the environment. Some demographics of seniors are actually more concerned about climate change and sustainability than younger generations.
How Home Tech Can Help Seniors Age at Home
In the Forbes article “Three Trends In Senior Care That Offer Opportunities For Health Tech Companies,” Kal Vepuri writes that American seniors are becoming more and more tech literate. From automated blinds to wellness sensors, willingness to engage with tech amongst the elderly can dramatically improve their ability to age in place. Vepuri writes that “technological innovations like virtual assistants and connected devices [can] help seniors age in place, promote their independence and support caregivers.” With new advances each month, more devices will soon “allow a primary user’s loved ones to monitor details like diet, activity or medication adherence.” Such features can “features provide peace of mind to everyone involved.”
Three Examples of Smart Home Tech for Seniors
#1 Smart Home Devices for Security and Safety
Today, dozens of smart tech solutions can be found for the security and safety concerns faced by older adults. In her article “Today's Smart Home Tech Can Help You Age in Place” for AARP, Sarah Elizabeth Adler notes that low-tech options are still key. However, high-tech options like the integrated security systems offered by “ADT, SimpliSafe and Vivint” can ensure senior safety for many more years. Adler recommends one of these smart security systems that “can be managed with a smartphone app” or by conversing with a smart-speaker.
Other home tech for security and safety Adler suggests for older adults include “smart smoke detectors...leak-detection sensors...and video doorbells.” Smart smoke and carbon monoxide detectors can “issue text alerts and helpful voice instructions” if a fire or leak occurs. Leak-detection sensors -- combined with “automatic water shutoff valves” -- can prevent flooding and reduce growth of mold, mildew and other harmful bacteria. Electric stoves, heaters and other potentially dangerous devices can be equipped with sensors that shut off their power if the user is distracted or away from home.
How to Choose a Smart Home Technology Security System for Senior Living
When determining which integrated systems to install in your home as you age, consider Alexandra Kalita’s advice in her article “Everything You Should Know About Designing a Home for Aging in Place” for Architectural Digest. Kalita writes that “mechanisms like front door locks, lighting, or thermostats that you can control with a smartphone can be easier to operate in advanced age.” However, seniors aging in place -- or their friends and family -- should consider “maintenance requirements [and] the risks associated with malfunctions.” Seniors should also think about whether such systems “can be operated on a device with a larger screen, like a tablet.” For specific products related to home security systems, consider the article “The Best Smart Home Devices to Help Seniors Age in Place” from Rachel Cericola at The New York Times.
#2 Wellness Tech for Health Monitoring at Home
In her article “Senior Care Homes Are Becoming High-Tech Medical Devices” for Slate, Emily Anthes writes that “it’s not tech-savvy millennials who are ahead of the ‘smart home’ curve.” Anthes explains that “our homes are becoming more intimately involved in our health care than ever before” -- particularly amongst seniors. Rather than tech-savvy Gen Z-ers, “it’s in the senior care community where scientists and engineers are putting all the pieces together.” It is in senior living communities and the homes of those who are aging in place where innovators are “experimenting with integrated health-monitoring systems that are truly turning homes into medical devices.”
Today’s Wellness Tech
Medication dispensers, activity-based sensors and fall detection pendants are all current realities of wellness tech. Marc Saltzman elaborates in his article “'Aging in place' tech helps seniors live in their home longer” for USA Today. Saltzman notes that “activity-based sensors around the home” monitor elder activity throughout the day, alerting caretakers or loved ones of unusual behavior or lack of movement. Some systems “report about changes in activity levels, sleeping and eating patterns, bathroom visit frequency and medication adherence.” Medication dispensers and fall detection pendants are designed for seniors “with dexterity challenges,” memory struggles and mobility issues.
Tomorrow’s Wellness Tech
Working with doctors and seniors, engineers have developed fall detection technology, wearable biometric sensors and more. Anthes writes that over the last few years, engineers have created “smart pill bottles that light up, chime, or fire off text messages when patients miss a scheduled dose.” Global companies like Google and Amazon have begun designing futuristic tech we might have balked at just a decade ago. They have engineered “smart mirrors [that] monitor our cardiovascular health by detecting subtle changes in skin color” and “patented systems that could prompt our smart speakers to order cough drops when they overhear a sniffle.”
In their 2020 paper “IoT Wearable Sensors and Devices in Elderly Care: A Literature Review,” Thanos G. Stavropoulos, et al discuss the future of wearable tech for seniors prone to or suffering from cognitive decline and physical illness. Stavropoulos writes that “wearables could soon emerge as predictive medical tools and digital biomarkers for [the] elderly.” This could enable “care at home, as well as pharmaceutical treatment by accelerating and optimizing clinical trials.”
#3 Virtual Assistants for Companionship and Connectedness
Lastly, virtual assistants and smart speakers can also aid seniors aging in place. Jennifer Pattison Tuohy explains in her article “9 Smart Home Devices For Aging in Place” for Dwell. Tuohy writes that “a smart speaker with a voice-activated virtual assistant...can be very helpful to seniors living alone—both as a tool and a digital companion.” According to Tuohy, “isolation among older adults [is] a significant problem, one that costs Medicare $6.7 billion each year.” For seniors living alone, voice assistants like Siri or Alexa can serve as “a kind of companion" when friends and family are away.
In addition to easing loneliness, smart speakers can also help with home integration. They can “connect to smart lights, sensors, switches, door locks, and many other gadgets, allowing a senior to easily control their home by voice.” Emerging virtual assistants like LifePod are a bit more proactive than a Home Pod, writes Tuohy. These types of smart speakers “can ask questions without needing a prompt from the user…[taking] pressure off a caregiver.” They can encourage seniors living alone to order groceries, call a friend or check in on a prescription.