The technologies that could transform ageing

At the start of the summer, Paula Tinkler was ready to take her career in a new direction. This may not be unusual – but the speed with which she was able to make the transition was. Within a week, she was shadowing a carer in Workington, England. Within a month, she was working as a carer herself.

Not only was her training rapid – it also took place completely in her own home. “I began the recruitment process by e-mail and completed my assessment online, which was followed by an interview and training process that was entirely digital,” she says.

She did this through a UK-based company called Cera Care, a “tech-enabled care provider” that doesn’t own or operate any care homes. It allows families to arrange and manage home care for their relatives using a digital platform that finds a match for customers from a pool of available caregivers. It also uses Uber to ferry patients back and forth to hospitals for appointments and an on-demand delivery service to fetch customers’ prescriptions from pharmacies.

The firm has raised over £20m ($26m) in investment since its inception in 2016 and delivers around half a million home visits every month, Tinkler’s included.

New, nimble models like this one may grow more necessary in coming years. Nearly one in five EU citizens is over 65 years of age, a figure expected to grow rapidly in the coming decades. A similar pattern is seen around the world. Globally, the world’s population of over-60s has doubled since 1980 to around a billion. It will double again by 2050.

In the face of this looming challenge, new models will have to be devised to allow older people live healthy, independent lives. And Cera Care is are far from the only company developing assistive technologies that can keep elderly people living independently and healthily.

Top of the range hearing aids, for example, now contain fall detection as a safety feature. An undershirt studded with sensors was key to the functionality of Alfred, a virtual butler developed by the EU to engage with older people and lead them through daily balance and exercise tasks. The Lean Empowering Assistant or Lea, meanwhile, is a robotic walker which also serves as a virtual assistant and even dance partner.

Global greying

Underlying the need for all of this, of course, is the fact that we are growing old.

“One in three people born today will live to 100,” says Ben Maruthappu, Cera Care’s chief executive and co-founder. “For the industry, the challenge is that as the market grows, the workforce is limited. Demand is outstripping supply – we don’t have enough care homes for everybody.” Not only that, he says, but most people prefer to get care at home than to move residences.

Cera also developed Martha, a virtual assistant that helps caregivers in their daily routines. “Martha has evolved to meet the needs of our clients and care workers,” says Maruthappu. “It started off as a chatbot that care workers could go to for advice. Now we have an interface that provides nudges and recommendations to the carer, based on previous information that has been gathered on clients that they are servicing.”

In 2019, the company partnered with IBM to trial the installation of Lidar sensors – more often seen on self-driving vehicles – in people’s homes. The sensors collect data on how much residents move about the home, and most importantly can alert carers if the resident suffers a fall. “It’s 24/7 support, rather than only when carers are there,” says Maruthappu.

Cera’s overall goal, says Maruthappu, is to predict and prevent hospital stays – the most resource-intensive element of care and one that contributes gravely to morbidity.

However, notes of caution about the use of AI have been raised. In 2018, the Nuffield Council on Bioethics, an independent medical advisory group, published a briefing note on the use of AI in research and medicine, noting the potential for reduced transparency in clinical decisions, concerns over patient privacy, and an increased possibility for social exclusion.

Ageing well

Although it’s generally accepted that we are living longer, that is only half the story. While the number of people reaching 80 years of age has increased greatly in the last century, the number reaching 90 or 100 has not increased in same proportion. The reality is that while we live longer, those extra years aren’t necessarily spent in good health.

As the average age of the population rises, more and more of us will be troubled by the chronic effects of osteoarthritis, diabetes, obesity, stroke, heart disease, respiratory illness and neurodegenerative diseases such as Alzheimer’s and glaucoma.

If your lifespan is the total number of years you live, your healthspan is how many of those are spent without chronic illness. And healthspan is something everyone is keen to extend. In its 2019 industrial strategy, the UK government, for example, launched a “grand challenge” of adding five years of healthy life to each of its citizens by 2035. Meanwhile, Google’s secretive Calico (a contraction of “California Life Company”) has spent the last seven years and $2 billion (£1.5b) researching treatments “that enable people to lead longer and healthier lives”.

Much attention has been given to medical solutions for this, for example drugs such as rapamycin and metformin, known as senolytics, which can purge morbid cells and rejuvenate the body – in mice, at least. Although as Judy Campisi – professor of biogerontology at the Buck Institute for Research on Aging in California, US, and cofounder of senolytic drug firm Unity – points out, far more prosaic options exist. “Optimising diet, exercise and social interactions helps a lot,” she says. “Providing intellectual challenges, engagement or other mental activities also helps.”

A question mark remains over who will provide that engagement and social interaction. As the total working population shrinks in comparison to retirees, there will be fewer people available to pay for care through their taxes – and fewer doctors, nurses, therapists and care workers to provide those services directly. The cohort of those in need will grow even while resources and health budgets constrict.

Providing a dignified elder life, then, means finding ways to do more with less. No wonder people are looking to technology to pick up the slack.

Mechanical mates

The 2018 Smart Ageing prize from UK innovation think tank Nesta, for example, was awarded to the Norwegian Komp, a one-button tablet aimed at elderly users. The stripped-down tablet is modelled on analogue televisions of yesteryear, and offers a simplified way to share photos and make video calls to family and friends.

For those in need of more regular contact than the occasional FaceTime, there are no shortage of robots queuing up to be your best friend in your twilight years. There’s Pepper, the diminutive android made by Japan’s SoftBank Group, which was seen entertaining guests at the Life 90 social club in Prague – “very stupid, but a great deal of fun”, according to one of those present.

A cuddly robotic seal pup named Paro is found in care centres the world over, mewing and wriggling as seniors cuddle it. The improbably cute Japanese “carebot” (to charge its batteries, it sucks on a tethered pacifier) is designed to be a therapeutic experience for dementia patients, many of whom are unaware that they are holding a robot and not a live seal pup, bonding with the robot as if it were a real animal.

And the EU-funded Enrichme project dispatched Tiago robots built by Spain’s Pal Robotics into the homes of elderly people. The large, squinting droids trundled after their charges, reminded them of appointments and medication schedules, ran through fitness routines and sought out mislaid items. But their companionship was rated as highly as their ability to track down lost keys. When the experiment ended, residents mourned the loss of their new friends, with one seen rearranging their furniture to fill in the empty space left by the droid.

Antonio Kung is CEO of Trialogue, an innovation technology company based in France. In 2016, he headed a three-year project to develop robots in conjunction with elderly people. The two models were Buddy, a cutesy “emotional companion” the size of a dog, and Astro, a sturdy walking assistant almost as big as an arcade cabinet.

The project visited care homes and spoke to residents about how the robots could better suit their needs. “We wanted to know, can we capture feedback from the users and provide a system that is closer to what they expect?” says Kung. “Surprisingly enough, there’s not much done right now on that.”

Kung’s research also hinted at the limits of what can be achieved with technology. While feedback on Astro was prosaic – the robot was too big, they said – Buddy was a different matter. “They wanted features that a human has – to understand them better, to be smoother, to have a voice conversation that works well,” says Kung. “They wanted it to be more human.”

At the end of the day, there is only so much social isolation that a robot can alleviate. These have their place as facilitators, says Kung, but at their core they are still toys, albeit useful ones. In his opinion, the breakthrough robot for elder care will likely arrive as an offshoot of a more mainstream product – one that’s good enough that everyone wants one.

Instead, it is the human connection that lies at the heart of our relationships. “I can say hand on heart that I absolutely love my new job, and it is incredibly rewarding,” says Tinkler. “Myself and other Cera Care carers in this area have had neighbours clapping outside of our houses, and we’re constantly being stopped on visits by people offering us cups of tea or to say thank you. I hope it inspires others to take up care as a career.”

The need for people like Tinkler has never been so acute. The US will need to recruit an estimated 2.3 million care workers by 2025 to keep up with demand, while Australia, will need 100,000. Other developed countries face similar shortfalls.

A tech-empowered workforce, trained online and partnered with virtual assistants, tele-present doctors, sensor-equipped homes and dependable companion robots is a future that is fast becoming a reality.

For a world that’s rapidly growing old, such a change can’t come quickly enough.

Source: BBC