Examining Ireland's strategy for aging in place

PRIME – November 2013 By Gary M. Kaye Chief content officer, In the Boombox I recently returned from Ireland, where I spent 10 days looking into that country's efforts to promote an Ageing In Place strategy. I found that while they are supporting the development of some new technologies, at its heart the national strategy is a grass roots effort. For five years, Intel Corporation, joined by University College of Dublin and several hospitals had sponsored a research center known as TRIL. The acronym stands for Technology Research in Independent Living. Later, Intel's part of the effort was transferred to Care Innovations, the joint Intel-General Electric health care venture. During the roughly five years that TRIL was in operation, it conducted some breakthrough efforts in several area including home monitoring for chronic populations such as those suffering from Chronic Obstructive Pulmonary Disease (COPD), and the use of tablet computers to reduce social isolation. But perhaps the most promising research came in the area of falls prevention. The rough estimate is that every fall that results in an injury costs an average of almost $10,000. That includes hospitalization, rehabilitation, and caregiving. There have long been predictive tests to indicate the likelihood of falling. But those tests could only be administered in a hospital or laboratory setting with some pretty sophisticated equipment. TRIL was able to build sensors and a smart phone application around an industry standard test known as Timed Up and Go, or TUG. In that test a patient gets out of a chair, walks down a hall, comes back and sits down. Then the process is repeated. Researchers at TRIL found that by using this test, along with several other measures, they could predict the likelihood of a future fall within 80 percent accuracy. And if you know you're likely to fall, there are a number of measures you can take to help prevent it. Simple procedures such as sitting up for a minute before getting out of bed, installing a hand hold near the bed, using a night light, and making sure to use the handrail when climbing or descending stairs can all lessen fall risk. The cost of falls-proofing a home might be a couple of hundred dollars at most. The potential savings from not falling would be in the thousands, regardless of whether you measure that cost in Euros or Dollars. But the real issue becomes deploying this new low cost technology so that it can be in the hands of gerontologists, clinicians, and other medical practitioners. Even here the cost savings are tremendous. Instead of requiring thousands of dollars' worth of expensive equipment, all the doctor needs is a set of sensors attached to the patient's legs and back and a smart phone app. This should be a slam-dunk, right? Wrong. In the end, the new technology belonged to Care Innovations, which opted not to bring it to market. They have now licensed the technology to some of the original researchers from TRIL who are working with Enterprise Ireland (the equivalent of the U.S. Department of Commerce, only on steroids), and University College of Dublin to bring the system known as QTUG to market in the course of the next one to two years. One of the people I got to meet with in Ireland was Kathleen Lynch, whose title is Minister for Older People, Mental Health, Disabilities, and Equality. It was Lynch who spearheaded the current government effort to devise the Ageing In Place Strategy, of which so-called Silver Tech is but one (relatively minor) component. But while Lynch's group developed a wonderfully comprehensive program, she admits that because of Ireland's fiscal crisis, there's little money to invest. She acknowledges that investing a modest sum now is likely to produce huge payoffs in terms of cost savings for medical care down the road. But because there's no money, she's constrained in what she can accomplish. To help enable the strategy without investing money they don't have, Ireland is increasingly turning to non-governmental organizations such as the Ageing Well Network to accomplish its goals. This is a grass roots organization that is helping to create a program of Age Friendly Counties and Cities. In community after community across Ireland, they are bringing together public and private agencies to create a complete program to help seniors live better and live longer in their own homes. Among the steps they've taking is to team up with the national police to become more aware of elder abuse. They are working to give increased support to caregivers so they can get some time off, even an occasional weekend away from their duties. They are working with community outreach groups to reduce social isolation, a significant problem for Ireland's rural farm population. And they are working with local transportation authorities to make sure that seniors have access to public transportation when they need it to take them where they need to go. They are even trying to help redesign the infrastructure by modifying sidewalks with more curb cuts, and installing median strips so seniors can more easily cross busy streets. In short they are stepping up to do through a coordinated volunteer effort that which the government is only talking about. They say that talk is cheap. Unfortunately, in many places, talk about aging is all that's happening. In Ireland, they're proving that while talk is cheap, there are plenty of ways to take significant action that are pretty cheap as well. Gary Kaye is the creator of In The Boombox (www.intheboombox.tv), the first website to cover technology from the Baby Boomer perspective. Kaye has been covering high tech for more than 30 years with outlets including NBC, ABC, CNN and Fox Business. He is a regular contributor to AARP and other websites on issues regarding the nexus of technology, seniors and baby boomers.