Addressing the “Silver Tsunami” in Asia with Technology

Some Context

The United Nations predicts that Asia’s population of people over 65 will increase by a whopping 430% through 2050. Economies in Asia are maturing, social and economic trends are improving, but Asia is ageing significantly. An ageing population could lead to a steep drop in the size of Asia’s workforce and sharp increases in public spending on pensions, health care and long-term care in the coming decades, according to a recent World Bank report. Disruption of Asia’s demographics is creating disruptive economies as we’ve seen in the US and other nations. As such, disruptive technologies will emerge to meet changing demographics and socio-economic needs, and this is no less true in the health care/elder care industries.

Rapid ageing is partly a result of the region’s sharply growing economies, improving healthcare eco-systems, higher life expectancies and large declines in fertility rates, with a growing number of countries now well below replacement levels, the World Bank report says.

Around Asia, the rate of ageing varies. The wealthiest countries, including Japan, South Korea, and Singapore, have already become “growing gray nations,” with populations over 65 being 14 percent or more, on average, of their populations. Developing countries and more middle-income nations, such as Indonesia, China, Thailand, and Vietnam, are ageing quickly too. The last group, including Cambodia, Laos, Myanmar, the Philippines, Timor-Leste,Papua New Guinea, and the various Pacific Island countries, are still very young, with an average of four percent of the population older than 65. However, fast ageing will happen in the next few decades in these countries too. Therefore, considerable focus on caring for Asia’s elderly will be required throughout the world’s most populated region.

Relying on family support in old age, which has been a tradition for hundreds of years, is decreasing in a number of countries throughout Asia and will increase over time. In Korea, for example, fewer than 30 percent of elderly people live with their children. In China, 43 percent of those ages 65 to 80 live with their children, down from two-thirds in the early 1980s. Many elderly people are left in rural or suburban areas with young children to care for, as their adult children move to urban areas in search of better paid jobs or a more lively lifestyle.

Indeed, most older people in the region depend on their own work, instead of family and state support, as their primary source of income. A large share of people work well into their 70s, even in more wealthy countries such as Japan and Korea, but working is especially a necessity for rural residents without pensions. Baby boomers will be the “new aged” in 2030 to 2050. They will be more educated and independent with larger disposable incomes. There will also be more people that are single — both women and men — as a percentage the population that will be living independently or with partners and friends.

Transforming Ageing in Asia to “Ageing in Place”

People of all ages in Asia expect that governments will play a bigger role in supporting them in their old age. For example, one way is by providing care for the frail and incapacitated, How countries meet these expectations will be a key social, economic, and political challenge in the coming years. Unlike countries in other regions, most nations in Asia have not built nursing homes or the long term facilities one sees in America, Europe, or Australia. And, we expect few governments will take this course as the massive funding required will not be available. Most importantly, however, in Asia, putting one’s parents in a third-party private, or government-run home is not the honourable thing to do.

To be successful in addressing seniors’ health care and independent living needs, governments must transform healthcare systems into a model focused on primary care, with improved care management across all levels of the healthcare eco-system, efficient care delivery, and better prevention of noncommunicable diseases. Healthcare systems will also need to address diseases of old age, such as dementia, and develop long-term care policies that combine traditional family support with strengthened community- and home-based care systems. Assuming one can simply go into an old-age home at a certain point to address primary care needs or long term diseases, is not a likely outcome for most people, particularly in Asia.

What, therefore, can people do to care for an ageing population who will not enter nursing homes, will not live with their children forever (if at all), and are living a lot longer? Increasingly, home care where the elderly can continue to live independently, is seen as the most viable option on a long-term basis in Asia for several reasons:

  • Allows people to remain independent in their own homes, which results in a much higher quality of life.
  • Offers the full spectrum of services at home ranging from assisting with daily activities (shopping, eating, grooming, etc.) to nursing support (wound dressing, medication reminders, physiotherapy, etc.) to full medical services, particularly for people with chronic illnesses.
  • Takes the burden off loved ones — particularly children — who need to work to support their families or may live far away.
  • Can be more cost effective for the middle income demographic because, if done well, private providers of home care services can offer flexible pricing and products and services tailored to each family’s needs — without breaking the bank for those needing it.

How can technology play a role in home care?

As the number of people who need home care continues to grow, shortages of qualified caregivers and registered nurses is becoming a serious challenge. In many cases, care agency directors are struggling to find dedicated and passionate staff who can fill the demand.

Meanwhile, a lot of existing caregivers are suffering from physical and emotional burnout. They must deal with the fatigue of commuting and the guilt of never feeling like they never have enough time for the people the are caring for or the resources they need to do their jobs effectively.

This can mean more time alone for the elderly, which can increase certain types of risk for some people. Here are a few potential consequences that can result:

  • Dangerous incidents — falls and other emergencies can occur when clients with limited mobility or dementia are left alone.
  • A lack of compliance to follow their medication, physiotherapy or dietary requirements can at times cause a patient/elderly to re-admit to a healthcare institution.
  • Health risks can occur when clients forget to engage in other self-monitoring activities.
  • Health complications — health complications can arise when in-home treatment is based on incomplete patient histories sent from hospitals and other facilities. Complications may also occur while clients are waiting to see busy specialists.
  • Patient loneliness — social isolation can cause problems when client time with caregivers is reduced.

Technology for Home Care

The good news is there are plenty of new resources to explore in the form of home care and ageing in place technologies.

From emergency notification systems to videoconferencing platforms, home care technology helps clients retain their independence without sacrificing their safety. Many of these technologies have the potential to do more than improve the lives of individual users. When implemented correctly, they can help home care agencies provide better, quicker and more responsive care to a larger number of clients. Adoption of such technologies will vary, however, depending on the resources available and the technological savvy of home care agencies.

Telemedicine is one of the most talked-about types of medical technology, and with good reason. There are huge benefits to connecting patients with caregivers remotely. With the right digital videoconferencing platforms, caregivers can use phones and tablets to check in from anywhere, at anytime. While somewhat less personal, telemedicine does enable providers to offer more coverage to clients, even during off-hours.

The value of video contact is immense. Service providers receive visual confirmations that their clients are doing well. With some systems, they can send out and track reminders about medications and other activities. Clients get to see a friendly face. They get the opportunity to interact with caregivers in a way that’s more engaging than a simple phone call.

Videoconferencing can also be used when nurses are performing in-home visits and need to consult with outside specialists. For example, technology capable of capturing high-quality video can enable a wound care nurse to assess a patient’s wound remotely and advise her caregiver on how to treat it. As one can imagine, the possibilities are endless.

Wearable monitoring devices that track indicators of patient’s health, such as heart rate and blood sugar, can also help qualified health care providers get a more complete picture of what is happening with the overall health of home care patients.

Advances in telemedicine and remote monitoring are allowing home care workers to treat more patients, more often, all without the stress of constant commuting, and this could grow in Asia as the demand for home care in the region increases.

Emergency notification systems are one of the most widely-used classes of ageing in place technology. Given that an older adult dies from fall-related injuries every twenty seconds, it’s not surprising these technologies have taken off. Wearable devices that detect dangerous events and send out messages and calls for help act as lifelines for older people. These are just a handful of technologies relevant in the home care context but others are emerging.

What we’re doing at Pillar

As more and more older people with chronic health conditions are choosing to stay at home, or simply cannot live with their children, the number of companies that provide home care technologies is growing. With so many solutions to choose from, it can be difficult to figure out which ones will best serve the needs of Asia’s growing senior population. Our aim at Pillar is to transform home care in Asia by combining a full suite of services for the elderly that encourage independent living or address chronic/long-term medical needs, with technology that allows more people to gracefully live at home.

We are busy at work on technologies that meet the following criteria:

  • Intuitive, easy to use, and replicable in other markets — These days, older people are navigating social media with ease. So it’s easy to forget that many older adults still aren’t very tech savvy. When developing products that clients will interact with, we think how intuitive they are. Touch screens with clear visuals are a great example, and of course, larger fonts and screens so that older people can see them. The technologies we are working on for older clients will really be “un-technology,” in a sense, such that they won’t recognise it’s advanced “tech,” it simply gets the job done.
  • Compatible with other, more familiar technologies — Platforms and tools that can be accessed through widely-used devices (like iPads, iPhones, and tablets and laptops) will be more useful to everyone, including home care staff. It’s why we are building our leading-edge Pillar app, designed to ensure clients, their loved ones, and our caregivers can provide great care, book or extend services easily, and keep in touch.
  • Designed for family involvement — Technologies that enable a caregiver and client to interact and exchange information are even more helpful when the client’s family members can be included in the process. Adding new people for clients to talk to should be a simple process that anyone can do.
  • Capable of meeting communication and data collection and dissemination goals — Technologies that facilitate communication can serve other important functions, like collecting client data and generating useful reports that aide in the caregiving process, or provide information to offsite care providers such as doctors and specialists.
  • Able to monitor clients at home. Remote monitoring of older clients is becoming an important need, and it’s a service Pillar is developing. With the cost of on-site care growing, we are at the leading edge of structuring a number of technologies that will allow us to monitor clients in their homes, 24/7, check on wounds, monitor vital signs, report on emergencies, assist in fall and injury situations, and much more.

Many exciting products, services, and technologies are emerging to provide more effective home care for our elderly in Asia. Traditional health care and living situations for older people are changing. To keep up with a longer-living population we should adapt. In fact, we must adapt, if only to give back to the “Pillars of our families,” our parents, grandparents, aunties and uncles, for all they have done for us throughout the years. We hope you’ll join us on his important journey.

*Andrew Mastrandonas is the co-founder and CEO of Pillar, a home care service and technology company based in Kuala Lumpur, with staff in Singapore, Indonesia, Vietnam, and the United States..

+60 17 805 9677 (main line)

+1–202–361–3047 (Andrew — whatsapp)

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