Future of Care

What is it?

“By 2050, 1 in 6 people in the world will be over the age of 65, up from 1 in 11 in 2019.”
United Nations World Population Ageing 2019

Our current system of social care is in crisis. Over-prescribed and under-funded, we aren’t equipped to deal with existing problems, let alone prepare for the pressures of an ageing population. The impact of pandemic on the elderly, and care homes, has been devastating. Funding and staffing problems that existed pre-COVID have only got worse. Our system of elderly care needs urgent reform to prepare for the considerable challenges ahead.

“Providing a growing older generation with a dignified and independent life means doing more with less – and governments and industry are looking to cutting-edge technology to help (Frank Swain, BBC)." Tech will play a central role in our care, backed by the recent influx of investment in ‘Age Tech’.

Why should I care?

It’s clear that our current system of care homes will be inadequate to support us all. Aside from that, the Baby Boomer generation expects more from elder care. Wealthier, more active and better connected, Boomers demand a deeper level of involvement in culture and society and they want living environments to reflect that.

Meanwhile, there will be a significant squeeze on the generations responsible for their care – the time-poor and cash-strapped Gen X's and Millennials. The problem of how to fund this care is looming, and the third sector will need to find ways to lead change while struggling with its own funding challenges.

But there is hope. If handled right, progress in tech could have a dramatic impact on health and wellbeing. The Internet of Medical Things is already enabling easier sharing of data and learnings between medical professionals and could pave the way to more effective prevention, revolutionising public health.

Technology Transforming Care

The pandemic brought telehealth to us all – phone and video consultations becoming a necessary norm. There’s more tech to embrace if we choose it. Cameras and sensors can help caregivers make sure elderly loved ones are safe and treated properly. Canary Care‘s wireless sensors let you monitor movement, temperature and door activity, while Snap40 is developing wearables that “monitor a vast number of health indicators and then analyse the data in real-time allowing early detection of the warning signs”.

The latest GPS devices can be ironed into clothes or inserted in the soles of shoes – their ability to locate someone who is lost or disoriented could be lifesaving. Personal alarms can locate someone in distress and alert emergency services. New hearing aids contain fall detection. Smart pill dispensers organise, schedule and deliver pills to patients, with models being developed that let doctors know when patients are taking their medication. Also in development, patches and implants could be the future of administering medication.

AI and virtual or robot assistants can be present and attentive when human carers can’t be. Care-bot prototype Martha evolved to give nudges and recommendations to carers, based on data gathered from clients, to prevent deterioration in health. ‘Personal assistant’ LEA offers support with daily activities, entertainment and keeping in touch with family, while Paro the cuddly robotic seal pup is “a therapeutic experience for dementia patients”.

But there are big questions about how we address inequality in access, issues of privacy and consent and the risk of dehumanising care. Peggy Hicks of OHCHR says: “We need to ensure that technologies are designed and deployed safely, which requires active participation of older persons in their development.” Takanori Fujita of C4IR Japan advocates Authorised Public Purpose Access, “balancing the interests of individuals, holders of data like technology developers, and society at large… using data for the public good – without letting that become an excuse to trample individual rights”

Referencing the health risks of social isolation, Sofiat Akinola of WE Forum believes “the biggest benefit technology can have on ageing and longevity is creating opportunities for people to connect.”

Changing Care Environments

One response to inadequate care provision in the UK has been to send relatives with dementia to Thailand. As Dr Caleb Johnson explained: “Thailand already has a long history of medical tourism and it’s now setting itself up as an international hub for dementia care”.

Leading the way in elder care are Norway, with a focus on preventive and primary health care, home-based care and independent living, and Sweden, where health and social care for the elderly are central to welfare policy and mostly funded by taxes and government grants. Singapore’s Agency for Integrated Care (AIC) is piloting Care Close to Home where “a registered nurse and health care assistants are situated in communities and provide health and social care to residents living in the area.”

The Hospital-at-Home trend will help seniors live independently for longer. New technology frees healthcare from hospitals and, as highlighted by Victor Dzau, allows people to “age in place and remain connected to their loved ones.” Maliha Hashmi of NEOM adds: “care will be everywhere. Multichannel health delivery will be built around the individual, providing them with greater self-agency and self-awareness”.

Disrupting the independent living versus care homes debate, “retirement villages offer a third option... they allow people the chance to continue living independently in properties that are designed to cater for their changing needs, they also provide a much-needed sense of community”. Karim Kassam of Optima Living believes “senior living communities are going to be tremendously attractive two to three years from now because of all of the innovation and investment that's going to be coming into the sector.”

Retirement communities are a growing industry, with Associated Retirement Community Operators (ARCO) making “a detailed plan to have 250,000 people living in retirement communities by 2030.” They have the potential to create jobs, cut costs of looking after people at home and, importantly, reduce loneliness and isolation. As the ILC points out, they could offer a good solution for Baby Boomers.

Multi-generation housing could answer the problem of rising house prices, the cost of childcare and elderly social care. We’re already seeing more young adults living with their parents. Recent studies have found that children mixing with older people “demonstrate improved language, reading and social skills”, while “increased social contact between the ages of 50 to 70 is associated with a lower risk of developing dementia”.

Funding Care

The private, public and third sectors have proposed a variety of reforms to our care system. Oliver Brown of Imosphere suggests “investing in short-term aftercare support improves independence and prolongs people’s ability to live at home, as well as removing or reducing the need for commissioned care”. The Dilnot Commission recommends “setting a cap of £48k on the amount people can expect to pay for care over their lifetime”. Learning from the pandemic, Caroline Abrahams of Age UK suggests “care needs to look and feel much more like a proper public service, as near to being free at the point of use as we can manage.”

David Alexander Walcott, Founder of Novamed, sees “opportunities for economic contribution through continued workforce engagement”. Now that older generations are more tech-literate, they have potential to work longer and more flexibly. Could continuing to work enable us to pay for our care as we age, or at least share the responsibility?