The future of caregiving: ‘good deaths’ and, of course, robots – MarketWatch

Expect a caregiving environment rich in technology in the not-so-distant future. But along with that, therell be an emphasis on human connection to counter the devastating health effects of social isolation on older people.

In May, NextAvenue marked its fifth anniversary, but not with a look back. Instead, weve been trying to peer into the future for people 50 and older. We wanted learn how everything will change or not: living, learning, work, personal finance, health and now caregiving.

We received help on the caregiving front from three experts who have an eye on trends.

Demographically, well be facing hard realities in the next five to 10 years, says Ken Dychtwald, founder and CEO of the research and consulting firm AgeWave, and a 2016 Next AvenueInfluencer in Aging.

Therell be a handful of profound demographic shifts among them, a boomer generation with fewer children than their parents that will alter our capacity for caregiving, Dychtwald says. That will create great need and demand for alternate solutions.

The hope with the experimentation thats going on [now], is that well come up with better models that dont involve residential care for the disabled elderly in nursing homes, says John Haaga, director of the Division of Social and Behavior Research at the National Institute on Aging.

Technology will play a big role in helping people stay in their homes, says Laura Sands, professor at the Center for Gerontology at Virginia Tech and editor of a new journal, Innovation in Aging, published by the Gerontological Society of America. But well get more nuanced in our use of things like sensors and apps.

What I mean by that is that its not obtrusive. It doesnt violate basic principles of privacy and dignity, Sands says.

Those are the broad strokes. Now heres more on what our experts see as the future of caregiving in the next 5 years, 10 years and beyond:

Apps and online tools for family caregivers will be widely adopted, Sands says. Caregiving has already been inundated with tech gadgets. Whats been missing is a foundation of research and evidence to weed out the schlock from whats truly usable by older adults and their families and will lead to good caregiving or good health outcomes.

That evidence is more available now and tech tools known mostly in the research world will be entering the consumer market, Sands explains. She says: Theres really a lot of opportunity for entrepreneurs to use this evidence-based literature to start thinking about, How can I bring this into a cellphone environment?

Well be feeling the gap between lifespan and healthspan, says Dychtwald. Our health care system has done a pretty good job of keeping people alive longer, but not necessarily alive longer with health, he notes. Pair that with the demographics families with fewer children, families more geographically spread out and more women becoming primary breadwinners as well as having less capacity for the caregiving theyve traditionally done the lions share of and well be forced to redefine our goals, Dychtwald says. Instead of thinking only about how to improve long-term caregiving services and supports, well be looking for ways to prevent more people from needing them.

Well benefit at least a little bit from disease trends that are turning in the right direction, says Haaga. The worst fears about the growth of the population that has dementia and severe disabilities so far havent come true. Those populations are growing, but I think theyre growing slower than most people would have forecast 10 years ago, he notes. The percentage of the population developing Alzheimers disease is going down, Haaga says, but because the population of older adults overall is growing, the absolute number of Alzheimers cases is still on the rise.

Next-generation sensors will support caregivers and older adults who want to continue living at home, Sands says. Therell be better privacy checks to control who gets the information, she explains, and really deep thoughtfulness as to what is the information theyre collecting and why are they collecting it. Instead of gathering a massive amount of ongoing data about all of a persons movements in the house, for example, sensors will use logic checks built into their operating software to collect and store only the movementsthat seem like red flags.

Well get better at designing environments that dont prematurely drive people into dependency, Haaga believes. The universal design elements that make a home more accessible and user-friendly for those with physical limitations are one example of this. But Haaga is talking about community design as well. I predict that in 10 years, there will be no brick sidewalks in the United States. They will have been replaced by exposed aggregate that reduces fall risks, he says. He expects the car-centric suburban model of community planning to give way to plans that are more walkable and livable for nondrivers.

A good death will take priority over prolonging life, says Dychtwald. The social, emotional and financial costs of a stretched caregiving system will prompt us to look hard at our health care systems bias toward prolonging life even when prolonging it isnt what the dying person wants. Im not saying we should shorten peoples dying process unnaturally, thats a slippery slope, Dychtwald says. But many people will welcome a conversation about good deaththe idea of dying in a natural way without a lot of technology hooked up to you, in a comfortable setting, perhaps at home and not having it stretched out longer than nature would have it.

Mapping out highly individualized care pathways will become possible, says Sands. It will involvelayering together three things: 1) a persons genetic makeup and the tendencies that come with it for example, being a good or bad metabolizer of a certain drug; 2) metadata analyses of whole populations and the way specific health interventions tend to lead to certain kinds of outcomes and 3) apersons life and health preferences and goals.

The result will be the ability to predict just how effective a certain treatment will be in a patient and to make a care plan that the person is likely to stick with and benefit from. I think we have that opportunity in the future, but were still a ways off, Sands says, because it takes a lot of communication between technologists and clinicians.

Robots will share in caregiving, Haaga says. Not the high-touch and highly personal aspects of care, he adds, but for some of the physically difficult aspects of care. For example, we wont have to have home health care aides spraining their backs turning people over.

Haaga is also really optimistic about things like self-driving cars to help older adults overcome isolation and get out into the community. Dychtwald, on the other hand, has a different take and wants to see a driver in that car with the older adult.

Were going to have to become more comfortable with interdependence, Dychtwald says. Independence has been our goal for generations, and weve all learned to want our own houses, cars, bedrooms, TVs, phones and tech gadgets. But independence combined with aging creates a lot of isolation, Dychtwald says. In recognition of that problem, more of what we call senior housing, will be intergenerational in the future. Where families are scattered or dont exist, well create intentional communities like the village movement to stay connected, he says.

The thing about the Jetsons is they lived in a world with lots of cool technology, but what we liked was the family, Dychtwald adds. They were together in their bubble car.

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The future of caregiving: 'good deaths' and, of course, robots - MarketWatch