Millions of older adults will develop dementia over the coming decades. The middle-agers who assume responsibility for this older generation face a looming concern: how can we keep our parents safe and at home? Can technology help make this possible?
If we read the popular press on this, the Internet of Things will carry part of the load of caring for our elders. New, in-home smart systems will reduce caregiver stress through electronic surveillance, allow doctors to get real-time insights into the health of our loved ones, and improve their quality of life.
Teams of clinical, economic, security, and technical experts are now at work on a new form of “assisted living.” The model patient in her home will have passive environmental sensors (the stove turns itself off), medical devices, wearable technologies, and interactive apps connected to her body and bed, floor and door frames, collecting a fast-moving stream of data, a “velocity challenge.”
Such “living labs” are already deployed and being evaluated. These new “trusted patient homes” will require a new kind of workforce of healthcare practitioners, not only persons who can read the new dashboards but also technicians who can maintain the sensors. But will these new, technologically sophisticated homes really tackle the core problem? At the moment these homes feel, to us, like new sites of isolation. They remind us of a surveillance state, albeit one that aims to preserve health.
Yes, we will all have more data. Yes, we might better understand the physiological patterns of persons living with dementia at scale. But can we really improve the quality of lives of our elders with dementia and their families with easy-to-follow audio instructions piped in over speakers? Will a daughter feel safe leaving her mother alone at home in this surveilled new world?
The world of continuous monitoring will bring new challenges. And the technology by itself will not be the full solution. Somewhere we have to figure out the role that old-fashioned social networks, humans checking in on humans, will play, and how technology can help augment, not replace, the role that caregivers play in maximizing quality of life for those who can no longer look after themselves. That will require a serious examination of the role of work and obligation, borne by those in middle age, and how this can fit in with the increasing responsibilities that they will inevitably bear as the population ages.
We need space in the public conversation for this too.
Warmly,
Michael Stein & Sandro Galea
What We Need to Talk About When We Talk About Health | Thrive Global
The midterm elections are over and the results are in many ways unclear. The vote was expected by some to deliver a decisive verdict either endorsing the direction of the country as led by President Trump or repudiating this course with a dynamic “blue wave” of Democratic victories. The actual result was more akin to a split decision. Republicans expanded their control of the Senate, while Democrats made significant gains in the House of Representatives, winning control of that body. With each side plausibly claiming a “win,” it is nevertheless a win tempered by uncertainty.
The 2018 Midterms: A Public Health Takeaway | Dean's Note
In my last Dean’s Note, I argued that health was on the ballot in the 2018 midterm elections. This week, health won. From climate change, to gun control, to health care, the issues that shape health were at the heart of campaigns across the country. Soaring voter turnout showed the power of these issues to mobilize millions of people in pursuit of a healthier world. Even more encouraging is how many candidates won on platforms that are good for health—from commonsense gun safety reform, to universal health care, to a willingness to address climate change. Arkansas approved a ballot measure raising the minimum wage by 29 percent over three years, a move which will help about 300,000 workers in the state access the resources they need to be healthy. Washington state approved a ballot measure to raise the legal age for buying assault rifles. Florida approved a ballot measure restoring the right to vote to more than 1 million former felons, allowing them to participate in the political process that shapes their health and the health of all. These are just a few of the changes ushered in by the election, changes with positive implications for health.
Invest in Health, Not Death | Thrive Global
We all die and, despite some fanciful aspirations to the contrary, we will all keep dying into the future. Our daily routines keep us closed off to this fact. Death’s inevitability suggests that we should keep it in our sights as we think about the public’s health. There are three areas which might fruitfully draw our attention.
The Public's Health: Invest in Health, Not Death | Public Health Post
We all die and, despite some fanciful aspirations to the contrary, we will all keep dying into the future. Our daily routines keep us closed off to this fact. Death’s inevitability suggests that we should keep it in our sights as we think about the public’s health. There are three areas which might fruitfully draw our attention.
Once we accept that we are going to die, how we spend our money and our time on the business of health begins to shift. At core we should aspire to die healthy. That means focusing our energy on creating a world that maximizes health, not one where we invest our resources into the last few months of life, aiming to fight death at all cost. This would represent a radical shift in how we think about our limited health investment dollars. Perhaps death can help focus our mind on living better, on the conditions that we need to create to generate health, rather than asking serial medical specialists to tackle symptom after symptom until we die.
The 2018 Midterms: A Public Health Takeaway | Dean's Note
In my last Dean’s Note, I argued that health was on the ballot in the 2018 midterm elections. Last night, health won. From climate change, to gun control, to health care, the issues that shape health were at the heart of campaigns across the country. Soaring voter turnout showed the power of these issues to mobilize millions of people in pursuit of a healthier world. Even more encouraging is how many candidates won on platforms that are good for health—from commonsense gun safety reform, to universal health care, to a willingness to address climate change. Arkansas approved a ballot measure raising the minimum wage by 29 percent over three years, a move which will help about 300,000 workers in the state access the resources they need to be healthy. Washington state approved a ballot measure to raise the legal age for buying assault rifles. Florida approved a ballot measure restoring the right to vote to more than 1 million former felons, allowing them to participate in the political process that shapes their health and the health of all. These are just a few of the changes ushered in by the election, changes with positive implications for health.
Health Is on the Ballot This Week | Dean's Note
This Tuesday, the US will hold its midterm elections, when voters will choose their representatives in a range of local and national offices. These offices include governorships, seats in the US House of Representatives and Senate, as well as in state legislatures. Some context, for those who may be unfamiliar with how these elections work: During the midterms, one-third of the US Senate and the entirety of the US House of Representatives are up for election. The elections are called “midterms” because they occur near the middle of a president’s four-year term in office. Compared to presidential elections, voter turnout in midterms has typically been low, but there are signs of higher turnout than usual this year, perhaps reflective of the increased political engagement we have seen in the US since the last presidential election.
Vote Health! | Fortune
As we approach the midterm elections, it is clear that health is a core priority for American voters. A Gallup poll taken earlier this year found that “the availability and affordability of health care” topped the list of Americans’ concerns. This concern seems to have been sharpened by Republican efforts to repeal the Affordable Care Act, a move which would result in the loss of coverage for millions of Americans.
It is also reflected by the growing enthusiasm for adopting a system of single payer health care. Such a system was once prohibitively controversial in the US, but, paradoxically perhaps due to the uncertainty of the ACA’s fate, Americans now seem increasingly open to a system of truly universal health care. Over half of Americans now support such a system, and many Democratic Congressional candidates have endorsed it. The upcoming election will help determine whether we chart a course towards single payer, with significant ramifications for our country’s health.