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Design for Aging – Learning from Other Cultures

by Jeffrey P. Rosenfeld, Ph.D., Environmental Gerontologist, and Professor-Parsons School of Design, and Brookdale Center for Healthy Aging

Thinking Cross-Culturally About Aging-in-Place

A different language is a different vision of life.

Federico Fellini, film director & scriptwriter

We are eager to learn from other cultures, but usually not when it comes to making our homes safer or more age-appropriate. Our food preferences are another story. We don’t hesitate to stock our kitchens and cupboards with the ingredients we need for a healthy Chinese stir fry or Turkish couscous.  If only we were as willing to think cross-culturally about aging in place.

We can learn a great deal about home safety from the housing, home-furnishings and design options offered across the world, especially in other nations with rapidly aging populations. Aging in place is a more creative process than it has ever been before.

The beauty of globalization is that it gives us a world of options for designing our homes. To paraphrase Burger King, we can truly “Have it our way,” as we prepare to age in our homes. I learned this lesson well   when Wid Chapman and I were writing Home Design in an Aging World.

Backstory: Home Design in an Aging World

Architect Wid Chapman and I decided to write a book to make cross-cultural comparisons of environments where people age-in-place: everything  from apartments, detached and semi-detached homes, to traditional farmhouses, communes, and high tech dwellings. In 2009, we surveyed homes and home furnishings available to older people in seven of the world’s most rapidly aging nations: Japan, Sweden, China, Brazil, Israel, the United States, and India. By the year 2009, all 7 of these nations were being reshaped by what the Japanese call The Silver Tsunami, and what we describe as The Age Wave.  We decided to do a comparative study of design and architectural responses to global aging.

This led to the publication of  Home Design in an Aging World (NY: Fairchild, 2010).  The book remains one of a handful of cross-cultural comparisons of architecture and design for aging-in-place.

Chapman and I have asked how architecture and design respond to kinship norms. How is aging-in-place shaped by Hindu kinship, which is strongly patriarchal and multigenerational? Or by the sensibilities of Sweden, where fertility is quite low and people typically live in nuclear households?

As environmental gerontologists, we were curious about the impact of age-related norms on aging-in-place. For instance, would aging-in-place be discouraged in Brazil, one of the world’s most youth-oriented societies.  And how about Japan? Unlike Brazil, Japan, is a gerontocracy where elders and old age are honored, and where pride of place in their children’s homes is enjoyed.  What is the impact of the high U.S. divorce rate and small family size on our own architecture and design for aging-in-place?

Chapman and I focused on both Western cultures (USA, Israel, and Brazil); and also on cultures where non-Western architectural norms and traditions are still in play (Japan, China, and India).  What follows are some examples of how constructed environments and local technologies interact with social norms to affect the experience of aging-in-place.

Vernacular Design

Learning from other cultures involves appreciating that there is often a mix of traditional home design – what architects call “vernacular design” – and cutting-edge technologies such as robotics. New technologies, combined with strategic changes in homedesign, are making it easier than ever before to age in place. People on the cusp of retirement can build upon new technologies to create everything from home offices to home care for a variety of chronic illnesses.

What follows is a very brief look at “lessons” drawn from other cultures, ranging from low-tech/high-touch to high-tech/low-touch,  and from ancient to post-modern.

Japan: Living Close To The Floor

There is an old Japanese saying which goes, “May you live and die on tatami.”  This refers to the bamboo mats which cover traditional Japanese homes from wall-to-wall. Home-furnishings in traditional Japanese homes are low-slung or actually on the floor. The futon is perhaps the most familiar example of this approach to home-furnishings. Low, traditional Japanese home furnishings are ofchigaidana-chofu-mori-residence-bigten moved from room to room as needed. This occurs on the tatami mats which cover the floor of a traditional Japanese home.

The floor-based Japanese design aesthetic features low-slung furniture and futons for sleeping that make any home safer. Apart from reducing falls, floor-based lifestyles enhance strength and balance. My sources tell me that even the most contemporary homes in Tokyo or Osaka contain a “Japanese Room” with traditional tatami mats on the floor, and Tokugawa detailing throughout.

Apart from being reverent about its past, Japan is also a world leader in technological innovation.  Japanese homes often contain a mix of products and technologies that hark back centuries, as in the case of traditional tea-sets or futons, and also look ahead to a robotic future. For example, there is a growing number of Japanese households with robotic pets – mostly dogs.

Futurist Timothy Horynak (2006) claims that the interest in robotic house pets reflects Japan’s passion for incorporating the newest of technologies with time-honored canons of Japanese design and home life. Robotics is the product of digital design and innovation. Tatami dates back centuries. That they exist together in some Japanese homes is a reminder that Japanese proudly mix tradition and technology. This may be the new face of aging in place in Japan and elsewhere in the world.

Brazil: Universal Design Begins at the Front Door

Brazilian architect Sandra Perito, from Sao Paulo, has designed Senior Housing that is intended to prevent domestic accidents, especially falls (Rosenfeld and Chapman, 2012). Perito  routinely adds a built-in table on the front porch or entry to a home. Perito makes sure that this Entrée Table is as close to the front door as possible. In apartment buildings for Brazilian Seniors, she does much the same.

The idea behind Perito’s Entrée Table it Seniors a place where they can place packages, bundles, or a purse while searching for their keys. The inspiration came from a elderly woman from Sao Paulo who lost her balance while rummaging through her purse in search of her keys. Perito adds this reminder: her table also functions as a grab-bar for additional balance while locking or unlocking the front door.

Scotland: Why Smaller is Better When it Comes to Refrigerators

On a trip to Scotland many years ago, I visited a number of homes in the Scottish Highlands where people either had very small refrigerators, or no refrigerator at all. Those without refrigerators kept perishable items in their cellars.  The climate in the highlands is such that the home’s basement is always cool enough to put perishables for a day or two.

Philip B. Stafford, author of  Elderburbia: Aging With A Sense of Place in America offers the following advice:  It is best for older people to have small refrigerators.  It has nothing to do with household size, he says.  Very simply, people with small refrigerators must leave home more frequently to do their grocery shopping.  The small refrigerator is an antidote to isolation.

France: Smart Home-Technology 

Beginning in 2013, Paris-based Netatmo has been developing a line of user-friendly Smart Home devices.  By “user-friendl3y,” Netatmo means that their technology provides feedback when and where their user is. For example Netatmo’s home security camera, “…detects and reports in real-time if someone lurks around your home, a car enters your driveway, or your pet is in the yard.”

User-friendly technology provides feedback at home, and also when the user is at work or on vacation.  The user can be far from home and rely on Netatmo’s personal weather station to keep track of  the weather at home. The personal air-quality sensor does the same for levels of air-pollution in and around the house.  The product line also includes a Smart thermostat and a Smart security camera with facial recognition. As more people opt to age-in-place, Netatmo provides the technology for safety and security.

Singapore: Robotic Home-Exercise Coach

In 2015, Singapore company RoboCoach, Inc., introduced  a robotic “exercise coach” at five of Singapore’s Senior Centers. The RoboCoach has a smiling face and appendages  that mimic human movements.  The robot has been developed to teachSeniors  a range of exercises while offering verbal encouragement and support.103266869-robocoach-1910x1000

According to The Guardian, the company predicts that RoboCoach will become a popular fixture in many of Singapore’s Senior Centers and Senior Living Facilities.  The goal is to enable the elderly to lead more independent, fulfilling lives.

“…The android with metal arms and a screen for a face is already leading sessions and will roll out its services to five senior activity centers across the city-state this year.”

Infocomm Development Authority of  Singapore (IDA)

China:  The World’s Earliest Example of Universal Design

BMEHED Elderly Salar man on Kang bed-stove with his granddaughter, Xunhua Salar Autonomous County, Haidong, Qinghai, China

Aging-in-Place, More Global Than Ever

Going forward aging-in-place will mean combining renovation and innovation: changes to the constructed environment of home, and the installation of  technologies which will make living at home safer and easier.  That said, it is as important as ever to respect the role that culture plays in making a home safe to age in place. As technology becomes a more important part of this process we must:

  • Consider how culture shapes the relationship between “private space” and “public space” in and around the home
  • Respect cultural traditions that shape the spaces where people cook, eat, sleep, and toilet. Designers and gerontologists should be mindful of how age, sex, and marital status all shape the form and function of a home
  • Understand the symbolism and social meaning of color in the architecture and design for every culture.

References:

About the Author: For the past 10 years, Dr. Rosenfeld has been researching the interplay of ethnicity, aging, and home design. He is currently looking at home design and community-building by Brooklyn’s “New” ethnic elders from Korean, India, Pakistan, and Guyana. Along with architect Wid Chapman, AIA, he has written Home Design in an Aging World (Bloomsbury, 2010), and UnAssisted Living (Monacelli Press, 2012).

Dr. Rosenfeld is also currently working with the research arm of New York Methodist Hospital in Park Slope, Brooklyn.  He is looking at ethnic differences (incidence and prevalence) of serious geriatric falls in the home.  The goal is to better understand how ethnically-themed design contributes to ethnic disparities in home injury. Dr. Rosenfeld has been on the adjunct  faculty at Brookdale Center since May, 2015. He can be contacted through Parsons School of Design at Rosenfej@NewSchool.Edu; 347-249-4014.

Destination Singapore: Restoring the Joy of Eating

By Ani Grigorian, with Jeff Rosenfeld

In a single century, we have extended human lifespan by 35+ years. At the same time, technology has evolved to the point where we can now communicate instantaneously across oceans, benefit from software which coordinates care and manages health.

We have even created robots which sense emotion and even lead group exercises.   Not only are we living longer.  We are living better!

It’s no wonder that technology and innovations that serve our aging communities are such a hot-topic. The Ageing Asia Innovation Forum, hosted this year in Singapore, brings-together professionals, inventors, and problem solvers from all over the world.  During this meeting, they had the opportunity to sample a new line of food products: Health Food Matters. The founder, Grace Gan, calls it a functional food product because it is intended for people who have feeding issues.

Gregorian was one of the few environmental gerontologists in attendance at these meetings. By and large, the Forum brings designers, inventors, and product-developers together.

On exhibit was a plethora of products and designs meant to make life more comfortable, and nutritious for people with feeding issues.  In other words, people who need help feeding themselves, or who need to be fed.

screen-shot-2016-10-22-at-11-06-07-pmGrace Gan, a native Singaporean, developed this line of functional food products in response to the older people in her own family. The product line is called Health Food Matters, with the subtitle, “Restoring the Joy of Eating.” It is steadily gaining popularity across Singapore, perhaps because it does make eating a more joyous and dignified experience for consumers – and their caregivers.

The original market for Health Food Matters  was older adults, and people living with a disability.  Gan at first marketed exclusively to care centers and retirement residences across Singapore.

Gan, a speech therapist by training, had spent a lot of time working with patients in Singapore’s care-centers.  She was frequently present when meals were served, and she noticed that food-preparation, serving and eating were fraught with stress and tension.

Even more important, Gan noticed that feeding was as stressful for the caregivers and wait staff, as it was for patients who were being fed.

It is familiar that the sense of taste begins to dull as people grow older, affecting the ability to taste, smell and savor food.  This is true even for people aging-in-place at home, where there is more control over what is on the menu, and how it has been prepared.   In care settings, the dulling of taste buds is compounded by loss of control over menu, and dining conditions.

To compound matters, many older adults in institutional care live with neurocognitive disorders that cause dysphagia, a nutritional disorder characterized by difficulty swallowing, malnutrition and dehydration. Malnutrition and dehydration, in turn, contributes to other conditions such as bed sores, infection and hypoglycemia.

When Grace Gan visited Singapore’s care centers, she noticed that it was common practice to thicken food with milk supplements.  The idea was that this would make institutional food more nutritious and more palatable.  But, in fact, Gan believed that the result was neither nutritious, nor palatable.  Milk supplements did not typically enhance appetite, or contribute to better health.

Gan developed Health Food Matters as a way to enhance appetite by making its functional food line taste more like familiar food, and have what professionals call, the “Mouth Feel” of eating familiar food.  In taste and texture, Health Food Matters has the taste and “Mouth Feel” of familiar food, but is much softer, and easier to eat.

Products range from porridges, side dishes, snacks and desserts to condiments and thickeners with a variety of flavors that serve different  functions. As an alternative to thickened fluids, apple ENA-charge fruit jelly for instance, supplement fiber while apricot fruit jelly supplement zinc and iron. Calcium sprinkles can be added to porridges or side dishes providing flavor, color, and extra vitamins which combat low appetite and malnutrition.

In addition to keeping patients in mind when developing functional food products, Health Food Matters has benefits for caregivers. Most important, it relieves them of many meal-related burdens: chopping and cutting food, feeding patients or assisting them when they feed themselves, and the perpetual chore of cleaning-up.

Portions tend to be small, but are densely packed with extra nutrients, proteins and calories. This achieves nutritional goals for patients, and gives caregivers an unexpected bonus. The Health Food Matters philosophy  also harmonizes with Singapore’s efficiency-driven culture:  Mealtime becomes more “Efficient.”  Less food is wasted, and less time is spent coaxing patients to eat. This resonates with local nutritionists and caregivers because Singapore is a culture which strives for efficiency.

One reason for the efficiency, is that this product-line is easily prepared. Caregivers simply submerge prepackaged food bundles in heated water. Nurses and care staff can focus on caring for residents rather than worrying about the viscosity and portion-size.

Products range from porridges, side dishes,  snacks and desserts, to condiments and thickeners with a variety of flavors that serve different functions. As an alternative to thickened fluids, apple ENA-charge fruit jelly for instance,  supplement fiber while apricot fruit jelly supplement zinc and iron.

Calcium Sprinkles, another of Gan’s innovative products, can be sprinkled over porridges or side dishes to enhance flavor, color, and nutritional value.   Caregivers tell Gan that the Calcium Sprinkles also make food look more festive and inviting.

Grace Gan believes that Health Food Matters will eventually be a welcome alternative to forced-feeding.  Thanks to this Singapore-based product, older people all over the world can one day look forward to enjoyable dining, in the company of family or friends.

Even now, local care facilities in Singapore residents report improved health outcomes  when they serve Health Care Matters, Inc. to patients and/or residents.   Caregivers also report minimal food wastage and easier clean up.  Residents enjoy Health Food Matters, Inc. that they often clean their plates.

Above all, Health Food Matters  makes mealtime into dining once again.  Health Food Matters restores dignity to breakfast, lunch, and dinner in long-term care facilities.  Eating can and should be a social experience, something which is true everywhere from Singapore to Seattle.

Singapore is considered to be a leader in applying cutting-edge, sustainable, technology to geriatrics. Technology-based interventions, such as robotics, are already making long-term care facilities more efficient.  Health Food Matters may be doing this for meals and mealtime in long-term care.

Singapore is a world leader in developing and applying technology to geriatrics. Health Food Matters has been proven to make mealtime a more efficient experience.  It may well be that this product-line can also make mealtime a more spiritual and social experience. For older people and people with disabilities. That would be the proverbial icing on the cake!

Contact:  Ani Gregorian:    animgrig@umich.edu

Jeff Rosenfeld:    Rosenfej@newschool.edu

 

 

Destination Tel Aviv: Entrepreneurship in Israel

Paula Adleman, with Jeff Rosenfeld, Ph.D.

Israel is no amateur when it comes to creating new and revolutionary products.  This powerhouse, nicknamed The Start-Up Nation, is now at the forefront of “The Business of Aging.”  VitalGo’s Total Lift Bed, developed by Israel’s Ohad Paz and Ofer Parezky, is one of the examples of this kind of revolutionary product.  VitalGo’s remarkable bed has already made life safer and easier for older people in Israel and many countries around the world.   

Upright Tilting Functionality

degreesThe Total Lift Bed (TLB) has a unique, “…upright tilting functionality” (UHS, 2015:1), which helps patients sit up, stand and start moving away from the safety of the patient’s bed.  This makes it a very therapeutic bed, thus making the TLB more than just a comfortable place to sleep. Click here to see a demonstration of Total Lift Bed.

One hospital in the US tested how the TLB worked for their patients.  They found that patients who were tilted up several times per day improved more in a shorter period of time, and more of them were able to go home than patients who were confined to bed and had traditional therapy (UHS, 2015:1). TLB’s unique functionality minimizes the risk of falling out of bed, and helps contribute to shorter hospital stays.

The Total Lift Bed is FDA registered and is used in Israel, USA, Germany, Austria, U.K, Switzerland, Italy, France, Australia and Norway. Some hospitals in the US include: The Cleveland Clinic, John Hopkins, Stanford University Hospital, Carolinas Specialty Hospital, Florida Memorial and various Veteran Affairs (VA) hospitals.

bed-recline

Seniors, whether in hospital or in their own homes, and regardless of whether they are in good health or not, have a higher risk of falling and becoming less mobile. Immobility then increases the risk of many health conditions and furthers the risk of falling and decline in quality of life.  The use of the bed   decreases this risk.

Many of the patients who have used the TLB have reported that, “This bed undoubtedly saved my life!” The hospital where the study was done found that the TLB “…improved patient-outcomes, the cost-effectiveness of providing care, and the satisfaction of patients and their families.” (UHS, bed-verticle2015:1).

Israel and The Business of Aging

Israel’s demographics make it an ideal marketplace for TLB.   In July of 2016, The Jerusalem Post estimated that 10.6 percent of Israel’s population, or 866,000 people, are now over 65.

According to a recent UN publication: “For most nations, regardless of their geographic location or developmental stage, the 80 or over age group is growing faster than any other segment of the population.”   Global aging has thus created an international marketplace for the TLB in the world’s hospitals, rehab centers, and personal residences for people who wish to “age in place” in their own homes.  VitalGo’s marketing efforts are responsive to the fact that there is already a worldwide need for the TLB, both in hospitals and at home.  

 Aging-in-Place, With Dignity

Many seniors prefer to age-in-place (at home) whenever possible. Safety concerns, aging minds and decreased strength and mobility, along with increased risk of falling (especially getting up out of bed where many falls occur) can make aging in place challenging or unsafe. The chances of falling out of a bed, a chair, or down a flight of stairs increases with age, even for the healthiest of seniors.

One of the key goals in the development of the Total Lift Bed has been to help Seniors age in place with safety and dignity.

At home, or in the hospital, the TLB does most of the lifting that caregivers (whether they be trained professionals or loved ones) would ordinarily give. The TLB does not replace the human touch, but rather, enhances the ability of the caregiver to provide the healing touches needed, without the heavy lifting that leads to caregiver burnout and risk of injury. Additionally, being able to be raised smoothly and effortlessly enhances the quality of the mobility experience, without having to worry about hurting their nurse or loved one who is helping them to get up and move.

With the push of a button, whether at home or in the hospital, TLB contributes to mobility and self-confidence.  Hence, individuals, patients and caregivers (whether professionals or loved ones) are beneficiaries of the Total Lift Bed.

References

“Israel’s Elderly Population To Double By 2035,Statistics Bureau Says”   The Jerusalem Post, July 28, 2016

Carolina’s Specialty Hospital Evaluates The Total Lift Bed In Their Mobility Program”  Universal Hospital Services, 2015:1

For more information about the Total Lift Bed, see the Vital Go site.

Contact:  Paula Adleman:   Paula@Boomersurf.com

Jeff Rosenfeld :   Rosenfej@newschool.edu

Biosketch: Paula Adelman has an eclectic background and divided her time working in sports, raising 2 wonderful sons and helping the aging population. She has a business degree, with an emphasis on entrepreneurship.  She divides her time between the US and Israel. Paula is the founder of BoomerSurf.com, an American/Israeli based tech start-up. Through BoomerSurf, she is helping Boomers and Seniors manage computer, tablet and smartphone tasks online and through It improve their connection to family, friends and community.  For more information visit: BoomerSurf.com.

Destination Mumbai: Transforming Aging with Smartphones

by Ushma Mody, with Jeff Rosenfeld, Ph.D.

India’s economic boom has brought technology to the masses.  And no technology has been as transformative in India than the smartphone.  More affordable than the laptop or ipad, the smartphone has almost become a necessity in India.

Until about ten years ago, it would have been unheard of for lower-income Indians to own, or even have access to smart phones.  But by 2016, millions of Indian people had smartphones.  In fact, a 2016 survey of 70 nations worldwide found that India had the world’s second-largest number of smartphone users, exceeded only by China.  (Wikipedia, “List of Countries [N=70] by Number of Mobile Phones in Use”).

By 2017, the number of mobile phone users in India is projected to be 730.7 million, again the world’s second highest number after China. An estimated 10% of them, or 73 million, will be Indians aged 50+.  And nearly 10% of them will have smartphones (Forbes, “India Becomes the World’s Second-Largest Smartphone Market,” 3 February, 2016.)

India’s mature markets have embraced mobile phone usage with gusto.  Although people aged 60+ now comprise only 7.5% of India’s vast population, the percentage who are mobile phone users is higher than in younger cohorts of the population.

According to The Times of India, the percentage of mobile phone users aged 55+ had “…practically doubled between 2012 and 2013…rising from 5% in 2012, to 9% in 2013.” (Forbes, 3 February, 2016).  As India is reshaped by the Age Wave, smartphone usage will continue to rise. Without a doubt, mature markets will continue impacting on the development and marketing of smartphones.

The Business of Aging: India’s Age Wave Shapes  Smartphone Markets

During the past 6 years, the price of smartphones in India dropped steadily, which has both increased demand for smartphones, and encouraged the introduction of India’s first “Senior-Friendly” smartphone.

In October of 2014, telecommunications giant Mitashi began marketing the Mitashi Senior Smartphone AP103 (NDTV Correspondent, “Mitashi Play Senior Friend Android Smartphone Launched at Rs. 4,999” Gadgets 360, Oct 21 2014).  The AP103 was developed in response to India’s Age Wave, and was marketed aggressively to India’s  Seniors.  Among its selling points were:

  • The “SOS” Feature: In addition to standard smartphone features, such as internet, text-messaging, phone service and camera, the AP103 had an “SOS” feature, which allowed for rapid dialing to get help during an emergency; and
  • A “Senior-Friendly” Face: The AP103 offered larger font (by default), brighter colors, and larger buttons. This was supposed to make the AP103 is easier for visually impaired people to read.  Its larger buttons were said to be easier on arthritic fingers.

The AP103 was not well received by Seniors, however.  Sales were sluggish.  Complaints and criticisms went viral.  As early as 2014, the same year as the rollout, e-commerce websites were flooded with complaints and snarky reviews of the AP103.

For example, shortly after the roll-out in 2014, older people began complaining that the AP103’s microphone-system was faulty.  Even worse, there were complaints about AP103’s battery life.  According to comments and reviews on Amazon, battery-life was so low that the smartphone needed to be recharged more than once a day.

Worst of all, dissatisfied customers across India insisted that there was nothing especially “Senior Friendly” about the AP103.  The time was right for competitors to step-in.  A year later, in 2015, another telecommunications company did precisely that.

Smartphone Wars: Competition For A Market-Share

In 2015, SeniorWorld launched a competitive smartphone called EasyFone, which was also intended for mature markets.  EasyFone had similar but more sophisticated features: An SOS emergency call button which texted for help along with telephoning; a battery which held its charge much longer; and a standing dock which doubled as a charger.  The goal of this last feature was to automatically charge the phone every time it rested on this stand, thus eliminating the need for Seniors to (re)charge the smartphone

Other features include the option of adding photographs next to the names and phone numbers of important contacts; also, larger buttons and fonts.  In addition, the EasyFone comes in brighter colors. Snappy colors, larger font, and the option of “photo calling,” or selecting phone numbers from the phone’s directory on the basis of a photo rather than a name) proved to be appealing to Seniors. Like Mitashi’s smartphone, this one is also inexpensive, priced at around $80.

screen-shot-2016-09-30-at-10-18-29-pm

There is also a SeniorWorld website (Indian-based).  Along with promoting the EasyFone, the SeniorWorld website offers a blog, healthcare self-testing options for older people, and even a “Hobbies” page which offers information on some of the most popular pass times of older people: Gardening, exercise, cooking and more.

EasyFone, along with the SeniorWorld website,  have been well received by India’s Mature Markets. People who had bought this phone for their parents report that they seem to be happy with the phone, and involved with the website.

Like so many Third-World nations, India is now experiencing a demographic transition.  Not only is India’s business world becoming more sensitive and responsive to the needs of the mature marketplace, the sheer size of that marketplace makes it more important than ever. The EasyFone is already being joined by new and more Senior-Friendly competitors.  Senior-friendly products such as this are ringing-in a new age for Smartphones, and a new age for India as well.

Contact:  Ushma Mody:      Ushmamody28@gmail.com

Jeff Rosenfeld:  Rosenfej@newschool.edu

References

Forbes, “India Becomes the World’s Second-Largest Smartphone Market,” 3 February,2016.

NDTV Correspondent, “Mitashi Play Senior Friend Android Smartphone Launched at Rs. 4,999” Gadgets 360, October 21 2014.”

NDTV Correspondent, “Five Senior-Friendly Phones Available in India, October 14, 2014.

The Times Of India, Seniors Ditch Old Tech, Call On Smartphones. November 7, 2014. Saritha Raj.

Wikipedia, “List of Countries [N=70] by Number of Mobile Phones in Use”.

Biosketch: Ushma Mody graduated with a Bachelor’s degree from Parsons, the New School for Design (New York), majoring in Interior Design. Her favored secondary subject was history – of art, design and architecture. During her time at Parsons, she was named to the Dean’s list, and also won the award for Outstanding Design upon graduating. She worked for Wid Chapman Architects in New York, post-graduation. She currently lives in India with her family, and will be a Masters student at New York School of Interior Design, beginning in the  Fall 2016, semester.  At NY School of Design she will focus on designing Sustainable Interior Environments.

Aging & Innovation in Other Cultures: Destination Cuba

This week’s installment features the work of Steve Minkin, and is edited by Jeffrey Rosenfeld, Ph.D. of Parsons School of Design. 

When the embargo is finally lifted, Cuba could become an emerging market for American companies concerned with the “business of aging”. The statistics are strikingly clear. Cuba has one of the oldest populations in the Americas, and demographic trends virtually ensure that by 2030 the country will be the oldest in the hemisphere.

Cuba today has about 11.1 million inhabitants. The percentage of Cubans living into old age is moving higher everyday. In 2015, one out of every five Cubans was reported to be above 60 years old. By 2025 the ratio is expected rise to 1:4. In less than 10 years 25% of Cubans will be over 60.

In 2030, less than 15 years from now, 30% of Cubans will have entered their 60+ senior years. Revolutionary Successes:  It is common demographic wisdom that healthy, educated societies have low birth rates. Pre-revolutionary Cuba was characterized by a stark contrast between the lives of the rich and poor with very little in between. The country was controlled by a dictatorial, mafia-connected, brutal and corrupt regime. The majority of the country was uneducated. Infant, child and maternal mortality was rampant.

From its inception the Castro government emphasized education and a system of free national health care. As a result, Cuba, although poor, boasts the highest literacy rates in the Americas and the lowest rates of infant, children and maternal mortality. By these demographic measures,  Cuba fares better than the United States and is demographically comparable with Canada.

Cuba only spends a fraction of what we do on health care, but average Cuban life expectancy is equal to that in the United States.

One reason for Cuba’s longevity rate, is that this island nation is a very safe place to live. There is virtually no gun violence, and drugs are not a major social and public problem. Education and health have had powerful impacts on the age structure of Cuba. Most Cuban women delay childbirth in order to continue their educations and careers. The Cuban demographic profile is nearly reverse of that of most other Caribbean and Latin American countries, where the age structure looks like a pyramid.  A pyramidic population  is a “Young Population,” which means there is a high fertility rate, and lots of kids. The pyramid-shape results from the fact that the mortality rate is very high. Most of the children in a “Young Population” will die-off before they reach adolescence.  As a result, the population narrows as the cohort gets older.

The Cuban age-structure is now comparable to that of other demographically aged nations, and not the younger Latin-American ones:  The Cuban population-base is narrow.  It “fattens” with the succession of years, because most people live longer than  ever before. Cuba’s population is aging, and along with that, a larger percentage of Cubans are approaching “advanced old age” (80+) than ever before.

cuba-grandpaThe Cuban government makes it easy to postpone having children. Family Planning is nearly free and medically safe abortions are easy to obtain. When children are born, the mother, or if the family chooses the father, is allowed one year paid leave. After that free childcare and nursery school is followed by tuition-free quality education, encompassing elementary and high school, university and professional schools. Physicians, engineers, scientists, as well as, teachers, artists, musicians, dancers and all other fields graduate debt-free. However, newly minted graduates enter a low wage job market that is still largely controlled by the state. As a result, many educated Cubans seek opportunities abroad as economic migrants in search of higher incomes. This partial brain drain contributes to the aging of the populations and creating a rift in the more comfortable patterns of elder care many Cubans have grown used to enjoying. In socialist Cuba, most families live in intergenerational homes or apartments that are owned free and clear of debt.

As a result, the Cuban family remains the most common source of support for the elderly. Cuban Seniors are culturally respected, and as required, they are cared for at home.

The government and/or the Catholic Church and other charities operate Casas Abuelos or so-called grandparents homes. These provide daytime recreational and cultural opportunities as well as meals, health and social services. The responsibility to ensure that elderly are not locked-in, ignored and depressed remains a community and governmental priority. Doctors and nurses and social workers regularly perform home visits. In the future the aging population will likely face new social dynamics as the economy opens up to private enterprise, which currently accounts for about 25% of GDP. Opportunities for buying and selling properties are increasing and  increasing numbers of mobile young Cubans are choosing to live separately or migrate in search of work abroad.

As more elderly people live alone, tools for remote care will become increasingly necessary, especially in families where the younger generation has moved overseas. Emergency alert systems will find a place and could readily be incorporated into the existing neighborhood heath care structure based on 24 hours on-call medical services. Such devices could become widely available following investments in building the necessary  technical and marketing infrastructures. The outdated US embargo, however, places US companies at a serious disadvantage. The Chinese, Canadians or Europeans are likely to dominate the field unless the Congress votes to end the embargo – the “white elephant” standing in the way of US-Cuban business opportunities.

Next week, Destination Mumbai, with  Ushma Mody. 

Contacts:  sfminkin@yahoo.com; rosenfej@newschool.edu

The Business of Aging: Aging & Innovation in Other Cultures

This week The Business of Aging kicks off an amazing series of articles from all over the world, curated by the very talented Jeffrey Rosenfeld, Ph.D. of Parsons School of Design. Join us each week as we highlight innovation from: Israel by Paula Adelman; Singapore by Ani Gregorian; Mumbai  by Ushma Mody; and Havana by Steve Minkin.

Edited by Jeffrey P. Rosenfeld, Ph.D.  Parsons School of Design, New York, NY

Overview:  It’s A Small World

Back in 1964, when I was still in my teens, I visited the World’s Fair, which was held that year in New York’s Flushing Meadows Park.  I’ll never forget my ride through the Disney Pavilion, on a journey celebrating the idea that “It’s A Small World After All.”

Visitors to the Disney Pavilion embarked on a magical journey to more than 75 nations. Visitors sat four-across in gondolas which each held about 40 people. Together we floated across Disney’s small world, serenaded by a farrago of singing, dancing  (robotic) children. Every nation was represented by children in national garb, who were merrily singing  “It’s A Small World After All,” in each of their native languages.

At the time, it had not dawned on me — and probably on most of the other people in our gondola — that those same nations could just as easily be represented by a chorus of costumed Seniors. Was this ageism, back in 1964?

In all fairness, this was a Disney production; and most of the world’s population was still under the age of 20.  It’s no wonder that back in 1964, most of us took it for granted that youth was the common experience that made it a small world after all. The social and demographic fact is that aging had not yet taken center stage.

its-a-small-world-disneyland

Inside The Disney Pavilion, It’s A Small World,  1964-1965 World’s Fair

More than 50 years later, the Disney lyric still rings true:  It is still very much a small world.  But it’s now a world which is  “Small” for different reasons. Today, ours is a world knit-together by two Master Trends that are compressing and unifying our social, technological and economic space. These are The  Silver Tsunami, and Globalization.

 

The Silver Tsunami, and Globalization:  Unifying and Compressing The World

It is familiar that the world’s population is now shaped more like a rectangle than a youth-heavy pyramid.  And now, more than ever before, the most influential ideas, technologies, products, and services for Seniors have gone global.  They flow worldwide, sometimes in a matter of hours. I am reminded, for example, of a Korean client of mine, living not far from Flushing Meadows Park, whose family was looking at ALF’s in Queens.  I recall that before they finally settled on one, they forwarded the information to Seoul, so that their Korean advisor could give them feedback.  They arrived at a decision within minutes of receiving his email from Seoul.  The most intimate and local of decisions had been shaped by our global connections.

What better place to celebrate this confluence of Aging and Globalization, than a publication like The Business of Aging?  This is a journal whose time has come.  It’s the voice of an economic sector that continues to be stimulated by The Age Wave, and energized by globalization.

What better way to acknowledge globalization than with a series called Learning from Other Cultures?

A Small World Then, and Now

The symbol of the 1964-1965 World’s Fair was the Unisphere.  Even the name underscored that this was one world, and a small one after all.  A glance at Figure 2 confirms that the Unisphere celebrated a world without national or political boundaries. The Unisphere was intentionally designed to make that very point.

unisphere_in_summer

 

There are no national or political boundaries on the Unisphere: 1964-1965 World’s Fair

Although it was created for the 1964-1965 World’s Fair, the Unisphere anticipated the impact of the Master-Trends being celebrated here,  more than 50 years later:  The power of the Silver Tsunami, and the emergence of global markets.  It is still a small world, but for very different demographic, economic, and social reasons.

Our 21st-Century Unisphere celebrates a world in which national and political boundaries are being eclipsed and reshaped by global forces.

Among the most significant of them are:

  • Rapid diffusion of ideas from West to East; and vice-versa;
  • “Floating Populations” which cross borders and boundaries permanently, seasonally, and                  voluntarily;
  • Educational exchanges, “Distant Learning,” and worldwide opportunities to study abroad;
  • The worldwide web, the now ubiquitous http://www , which turns 25 this year.
  • The acceptance of non-Western paradigms, such as Acupuncture, in Western medicine, and germ-theory in non-Western healing.

Together, these forces mean that ideas, innovations and products created in one corner of the world, can be available and accessible everywhere. This series, which is called Learning From Other Cultures,will be reporting on products, services and technologies which are very much a product of these global forces, and which promise to transform the lives and social worlds of older people.

For example, two of the future  installments in this series will focus, respectively, on a Senior-focused food-supplement from Singapore, and a Senior-Friendly mobile phone from India.  They, along with innovations described in other installments of the series, are part and parcel of a global economy built upon the needs and desires of older people.

Learning From Other Cultures will be an ongoing series.  It will showcase the business of aging as it transforms people and cultures worldwide.

Coming installments will celebrate:

  • The Total Lift Bed-Chair, a therapeutic device from Israel, which actually rotates 180-degrees and helps patients to sit-up, without getting out of bed; reported from Israel by Paula Adelman;
  • Health Food Matters, A line of food supplements from Singapore, which offer tasty new options for people who are restricted to easily swallowed and digested foods.  Believe it or not, the product-line even includes vitamin-packed sprinkles; reported from Singapore by Ani Gregorian;
  • A Senior-Friendly mobile-phone from Mumbai, which permits automatic dialing based on the photos of people listed in the phone’s Directory (Ideal for people who easily forget names and phone numbers); reported from Mumbai  by Ushma Mody;
  •  An overview of Cuba’s Casas Abuelos, or Grandparents Homes, which offer the best of Senior Day-Care and Assisted Living; reported from Havana by Steve  Minkin; and
  • A discussion of worldwide developments in the design of products and services for Seniors; reported by Jeff Rosenfeld.

Waiting in the wings, and still in development, are articles on The Business of Aging in Athens, Tokyo, and Buenos Aires.  It is still a small world after all.

Why do we celebrate Grandparents Day?

National Grandparents Day is celebrated the Sunday following Labor Day each year. Marian McQuade made it her mission to educate young people about the contributions of seniors and their importance in the community. She encouraged young people to adopt a grandparent, not just to celebrate the day, but for their lifetime. By 1978, led by Senators Randolph and Byrd, a resolution was passed by Congress and the proclamation signed by President Jimmy Carter. Marian knew what she was talking about. She had 15 children and 43 grandchildren!

Grandparenting, as a lifestage, stands out as the most positive transition in later life. If you examine the lifestages that occur after the age of fifty, most have to do with loss. Many grandparents see it as a continuation of their lives and families, even after they are gone. Others see it as a “do-over.” As busy parents they may have spent less time than they wanted with their children, but as grandparents they are available and happy to be with their children’s children.

grandparent-econ-THUMBNow that the Baby Boom generation is becoming grandparents, the sheer size of the market is compelling. There are more than 100 million people over the age of fifty. By 2020, 80 million older adults will be grandparents. That is one in three US adults will be in this lifestage. For marketers the grandparenting lifestage represents a huge opportunity.

First, marketers have to overcome outdated stereotypes of grandmothers with buns and rolling pins, or granddads in rockers. With $400 billion in spending on goods and services, adults 55+ are outspending younger consumers two to one online. Becoming a first-time grandparent is a huge trigger for spending. Recent studies, however, show that spending remains consistent as a grandchild ages. This has been more true since the recession and the gradual recovery. Where once grandparents helped with “extras” like trips, cars and education, more than half report helping their adult children with the expenses of everyday life – tuition, clothing, insurance and more.

The majority of Baby Boomer grandparents are more educated than previous generations, and are still working, with no retirement in sight. With increased spending on their adult children, these grandparents are often providing some type of care for elderly loved ones as well. Hence the term “sandwich generation.”

As we celebrate grandparents the social impact of having older adults in the lives of children is undeniable. Margaret Mead said, “Somehow we have to get older people back close to growing children if we are to restore a sense of community, a knowledge of the past, and a sense of the future.” Now it is time to recognize the financial contributions as well and respect their role as dynamic consumers across nearly product category.

To learn more about today’s grandparents and their role in lives of their families, get your copy of The Grandparent Economy, available now on amazon.com.

The Un-Stuffing Of America: The #1 Business Opportunity Serving The Boomer Population

Reprinted from MediaPost Engage Boomers

It isn’t a technology solution. It is decidedly low-tech. It’s not a medical device, but it does ease suffering. And while we sometimes joke about hoarding, older adults are buried in stuff — the accumulation of a lifetime (or two). The resistance to letting go of it is an enormous issue for caregivers, senior living providers and aging in place experts. Of all of the issues of caregiving, this one is the gift that literally keeps on giving.

I profess my expertise. 

I come from a long line of near-hoarders. My grandmother, who passed away at 98 on our family farm, was a collector — antique furniture, dishes, books, family photographs, recipes … she had my grandfather’s college report cards squirreled away! And I had the task of helping to empty her home and prepare for her estate sale. (Read that as two truckloads of stuff making its way from Missouri to my very small Bay-area home — including her restored Victorian baby carriage — because who doesn’t need one of those?)

My mother, whose basement was nearly at intervention stage, had a fire and her house burned down. She lost everything, but continues to joke that she saved us from the work of going through that stuff. The positive outcome was that she and my stepfather moved to a very livable, beautiful home in an age-targeted community with plenty of features for aging in their home.

Caregivers & Professionals

In our research with family caregivers, it isn’t medication management or fall prevention that keeps them up at night, though they care deeply about those things. It is their worry over what to do with all of their parents’ stuff. The conversations with their parents can be as precarious as the “time to give up the car keys” talk. At a time in their life when seniors are losing friends, giving up hobbies and freedoms, their treasures are very important. The irony is that seniors believe staying in their homes as long as possible is easing a burden on their children. The reality is that it shifts the burden from the finances of long-term care to extended time and expense of wrapping up their affairs after death.

Senior housing professionals know that stuff keeps older adults from moving to homes that are better designed for their needs — both physical and social. Aging-in-place professionals and occupational therapists know the dangers all of the stuff creates in the home. Caregivers tell us that the aftermath of losing a loved one is so complicated by the dispensation of stuff that their mourning and grief is put on hold sometimes for several years.

The data is the stuff that companies are built on

Two-thirds of 18-34 year olds value experiences over possessions. They don’t value or want the stuff. And if HGTV is any indication, they are buying tiny houses with the storage capacity of a file drawer. That’s if they can afford to buy a home at all. Perhaps it’s growing up with the stuff that has created this desire for a simpler existence.

I work with smart entrepreneurs who have brilliant ideas for apps and devices that serve older consumers, some more scalable than others. You want scale, consider this:

  • There are 50,000 storage facilities in the U.S. — five times the number of Starbucks. That’s 2.3 billion square feet.
  • 50% of storage renters are simply storing what won’t fit in their homes even though the average home size has doubled in that last 50 years.
  • Currently there are 7.3 square feet of self-storage for every man, woman and child in the nation. One in 10 Americans rents offsite storage. It’s the fastest-growing segment of the commercial real estate industry over the past four decades (New York Times Magazine)
  • 25% of people with two-car garages don’t have room to park cars inside them; 32% have room for only one car (U.S. Department of Energy)
  • The home organization industry, valued at $8 billion, has more than doubled since 2000 at a rate of 10% each year (Uppercase)

Services like moving, packing, estate sales and auction sites are fragmented and require time, trust, and oversight. Rarely are there services of social workers, gerontologists or care managers to start the conversations, provide resources or support family caregivers. But everyday there are millions of families are trying to figure this out. This is a service worth figuring out. (After I figure out which key goes to which storage unit.)

*Data aggregated by becomingminimalist.com 

The Hottest Start-Up Market? Baby Boomers

Reprinted and linked to: (CONSTANCE GUSTKE, New York Times)

Boris Mordkovich, a 30-year-old serial entrepreneur, had never considered developing products for the aging baby boomer market. One day, however, he saw that his parents had started using an electric bike that his brother Yevgeniy had modified for his wife and himself.

“Electric bikes are an equalizer,” said Mr. Mordkovich, who has also owned a software company and a small-business magazine. “They let the rider decide how much or how little they will pedal.”

This year, he said, Evelo, the electric bike company that he founded with his brother, will double its revenue to $4 million, and it is profitable. “There’s no shortage of potential customers,” he added.

The company is just one of many that are plugging into a wealthy slice of the over-50 demographic called the longevity market, whose annual economic activity currently amounts to $7.6 trillion, according to AARP.

 With an estimated 74.9 million baby boomers, according to Pew Research Center, the biggest market opportunity for start-ups is older Americans rather than hip millennials.  Keep reading . . .

Four Ways Your Wrong About Boomers

I am very proud to have received this great review from the National Association of Realtors for my book, The Grandparent Economy: How Boomers Are Bridging the Generation Gap. Following is the blog:

It seems everywhere you turn these days there’s some new diatribe against the generational focus of commentaries on society. It’s boomers attacking millennials attacking boomers… Heck, we even played an April Fool’s joke based on the trend a couple of weeks ago.

As someone who’s always bristled at generational stereotypes, I’m cheering those who are finally agreeing we need to stop playing the millennials vs. boomers card in the media (as no one talks about generation x anymore, that needn’t be halted of course). But as I was working on the upcoming feature for our May/June issue about how brokers are attracting the next generation of real estate pros, I found myself unable to avoid the term “millennial.”

Is your image of grandparents woefully outdated? Photo: bandini, Morguefile.

Are your ideas of grandparents woefully outdated? Photo: bandini, Morguefile.

That’s when I realized it has nothing to do with the terms; it’s the inaccurate stereotypes everyone should be finished with. And that’s why I really liked Lori K. Bitter’s The Grandparent Economy: How Baby Boomers Are Bridging the Generation Gap (Paramount Market Publishing, Inc., 2015). Not only is she seeking to help business owners and marketers better understand the boomer generation through the lens of grandparenthood using actual data, but she also busts a fair amount myths about boomers and grandparents in the process. Among them:

  1. Age and aversion to technology: Bitter says if you do an image search on grandparents in Google you’ll likely see “cartoon caricatures of couples with gray buns, sagging bellies and boobs, and canes… In reality, only 20 percent of grandparents are 75 or older.” She also points out that grandparents not only outspend other generations in traditional shopping environments, but they also “are outspending younger consumers two to one online… and they account for one in four mobile transactions.”
  2. Multi-gen housing as a temporary reaction to recession. Bitter, who was raised by her grandparents, points out that humans have been living with several generations under one roof since the beginning of civilization, and in many cultures around the world, it’s more common than it currently is in the United States. But as we become increasingly multicultural, it’s important to examine our biases and look at the facts: 2.7 million grandparents are raising small children on their own, and that doesn’t encompass the many who are sharing the task of raising children with the kids’ biological parents. She also points out that, far from being temporary, the trend will probably grow as people are living longer, and notes that grandfamilies occur in every area of the country and represent all income levels, races, and ethnicities.
  3. Midlife crises. Rather than fearing their advancing age, boomers are becoming less concerned with numbers as they mature. Bitter says this is the beginning of wisdom, or “the centered sense of the timelessness of all things.” She suggests thinking of marketing in the same way you might universal design: If you create something that can be used by anyone, it will be appreciated by everyone.
  4. The “Me Generation.” Bitter shows how the common trope of younger generations being full of themselves goes astray: All young people project that sort of bravado to a certain extent. “The images of self-entitled, self-centered, and materialistic boomers do not sit well, and the majority of those surveyed believe advertisers and reporters frequently get it wrong. From a developmental perspective self-involvement and materialism are features of a striving lifestyle typical of younger adults, which would be accurate for any generation, not just the Baby Boom.”

Though this isn’t a book specifically about real estate, Bitter includes numerous examples of housing communities that are successfully meeting the needs of this new batch of grandparents. And she clearly thinks highly of REALTOR® outreach to consumers: “Has an ad ever brought a tear to your eye? …Fast forward to the recent ads by the National Association of REALTORS® about the ‘American Dream of home ownership’ featuring a grandfather and his grandson. Mature consumers appreciate the art of a story well told.”

Now that’s a stereotype I think we can all live with.

Meg White

Meg White is the multimedia web producer for REALTOR® Magazine and administrator of the magazine’s Weekly Book Scan blog. Contact her at mwhite[at]realtors.org.