“Mobility,
Housing, & the Workplace” Panel
Presented by
Jeffery Pike, Senior Technical Specialist, Ford Motor Co.
Panel Co-Chairs:
Jeffery Pike (Ford) and
Margaret Stineman, MD (University of Pennsylvania)
A. Orienting Questions (Charge to Group)
1. What are the mandates for the application of
technology to the challenges of aging in the U.S.?
a)
Mandate:
-
demographic
imperative and with it the increasing dependency ratio
-
reduction
in healthcare and long-term care costs via the health
-
promotion,
health maintenance and enhanced independence
-
autonomy
b) Scope of technological
applications
-
Mobility
as it is reflected in transportation systems and community environments
-
Housing
as a platform and social participation
-
Workplace
strategies to maintain and support the older worker and caregivers
2.
Mechanisms that are currently working well and those that are not?
-
physical
accessibility of public building is increasing
-
increasing
awareness of elderly issues via organizations like AARP
-
increase
in dollars for research on age-related chronic disabling conditions
-
benefits
of Medicare in improving the health status of older Americans
-
technologies
have been developed for creating accessible homes, workplaces and
transportation, but the infrastructure is not sufficiently developed to make
these technologies available to older persons (this is a result of inadequate
education, delivery and distribution systems as well as payment systems)
-
Nat’l
Association of Home Builders working with AOA to promote home modifications
-
Visitability
ordinances in some parts of country --i.e. Atlanta
-
No
centralized availability of technology-related information and/or services for
older population
-
Failed
transportation infrastructure for persons who can no long drive placing
economic strain on older persons with disabilities and their families
-
Inadequate
safeguards for protecting older drivers and others
-
ADA
doesn’t incorporate accommodations for sensory, cognitive and endurance-related
disabilities
3. What research is needed in the areas of
mobility, housing and workplace?
-
Need
research to identify the elements of UD in the physical environments of home
and workplace and transportation systems
4. Are there technology transfer opportunities
that are currently being overlooked?
5. Are their collaborative opportunities that
are being overlooked?
6. Given the discussion on the mandate,
mechanisms that work and don't work, research needs and opportunities, what are
your recommendations to policy makers in areas of expertise?
Future
Initiatives need to be sensitive to heterogeneity among older population.
Also
need ongoing public education regarding age-related changes.
Need
more translation research
Need
Nat’l initiative on fall prevention -- in homes and transit (Universal Design
applied to furniture)
7. What can we do right away to make a
difference and what overarching stretch-goals do you think nation should
accomplish 10 years out?
1.
Need strategies & technologies to promote social participation and
interaction, citizenship (includes choice & engagement) and cognitive
vitality
Metric: increase health maintenance
behaviors
Metric: reduce healthcare costs & nursing home placements as
measured by tracking, control
groups, demonstration project
2. Need universal design of Home, Workplace and
Transportation Systems -- technologies need to be intuitive and expanded beyond
mobility to include sensory & cognitive issues.
Mechanisms:
-
guidelines
-
standardized
-
provide
incentives
-
remove
roadblocks
-
promote
education
3. Need systems for independence in Transport &
Home Environment
-
Transportation
for Life -- Public, Private &
Paratransit
-
Enhance
safety of elders using automobiles &
security of elders using transit
-
Increase
availability of paratransit for elderly & disabled
Metric: monitor # of older drivers, death rates of
older drivers, & usage at all levels
C. Raw Data from Brainstorming
-
Extend
driving years, use of personal transportation and independent living in the
home by 3-5 years. (the transportation component of this goal/recommendation
has ethical implications -- i.e., make sure this does not lead to higher rates
of accidents).
-
Need
to develop and use technology to support and enhance the person and as tools
for successful aging and not as ends in themselves.
-
Because
of increasing numbers of elderly and declining birth rate need to foster
technologies that reduces the need for caregivers and personal assistance
services.
-
Universal
Design of homes, transportation systems and workplaces should meet the needs of
90% of people
-
Standards
exist but developers don’t know about them
-
Appropriate
technology
-
Government
needs to promote universal and appropriate design for people
-
Need
Universal Design rating systems available to consumers -- i.e., like Bobby
system
-
National
policies to address education and feedback loops for users, providers, voc.
rehab. specialists, payers, and developers
-
Nat’l
initiative on fall prevention -- in homes and transit
-
Need
more integration of industrial, electric engineering, computer science, and
behavioral sciences in the operation of technology
-
Funding
-- removing barriers to getting access to technology
-
Integrate
standards for mobility aids in homes & transport -- i.e., communication
across systems that develop homes & mobility and transport aides
-
Need
multi-discipline forums -- across academia, gov't, and industry -- to achieve
mobility integration
-
Need
to fund cost effectiveness studies of new technologies
-
Better
design standards for public spaces
-
Universal
access to web which could have applications for scheduling services, safety,
transportation
-
Need
National initiative for universal access for seniors to software & hardware
-- i.e., natural language standards for operating devices
-
Need
R&D to develop standards for different segments of elderly population to be
able to use existing technology. Some argued that WWW Accessibility Project has
already done this for the Internet -- others disagreed.
-
Different
segments of the older population require/need different technology applications
and interventions -- i.e., When we talk about UD for new housing we are talking
about the “young -old” of those 65 years 75 or 80; whereas when we talk about home
modification for existing homes we are talking about the “oldest-old” of those
85 and over.
-
Need
to distinguish between guidelines and standards -- i.e., Design guidelines vs.
requirements for end standards.
Standards are mandated and guidelines are voluntary. Consensus of the
group was for guidelines.
-
Need
technology in support of maintaining choice and independence
-
Use
positive language to describe Universal Design
-
Principles
of Universal Design need to go beyond mobility to include sensory standards
-
Need
to simplify technology for use by elders
-
Age
appropriate training and learning techniques
-
Expand
criteria for reimbursement from medical necessity to include what is
functionally necessary to support independence and active engagement
-
Need
to develop measures and indicators that are not stigmatizing
-
Create
positive education messages -- e.g. Be a smart consumer; make your house
supportive of an active lifestyle, safer, more convenient and more encouraging
of independence for all ages.
-
The
home is a social platform for maintaining active engagement. Technology needs
to be developed for person to be actively engaged as a citizenship -- e.g.,
attend Town Meetings and participate in city council meetings remotely
-
Develop
universal infrastructure for emergency and maintenance of adaptive technologies
necessary for mobility, transportation, caregiving and independent living.
2. Mobility/Transportation-Specific Ideas
-
Present
information to drivers in improved format
-
Need
better paratransit systems with infrastructure
-
More
voice-based vehicle interface
-
Develop
age-neutral driving test
-
Because
rate of traffic accidents among elderly is projected to double in coming years,
like to see “cocoon built around older drivers to protect from accidents.”
Could also apply to falls
-
Real-time
assessment of operator status (fatigue, alcohol) and automated adjustment or
accommodation --
-
Larger
and more visible signs and obstacle radar
-
Mobility
management need real-time “where, when and why” information to the user
-
Better
scheduling systems for paratransit and other services -- so elderly know about
delays and when to expect services
-
Paratransit
for small, rural areas & suburban areas
- Address risk adverse behavior and technology implications; an insurance issue; address risk management
-
Mobility
management system: e.g., all of Denver buses have GPS that can identify rider
in advance-- most advanced system in
the country, has the highest usage of public transport by PwD
-
ITS
-- Intelligent Highway Systems -- not yet safe
3. Housing-Specific Ideas
-
Benefits
of UD for all environments -- houses, automobiles
-
Barriers
mean more than walking
-
Research
is needed to identify common barriers and formulate standards to remove
barriers
-
Compatibility
of new technology with existing homes --impact of increased use of
technology in the existing homes of
elderly -- acknowledges that it is hard to move elderly to new homes (telemonitoring
, video-monitoring)
-
Integrated
service and need systems -- that monitor diagnostic information,
-
warning
systems, and delivery of services
-
Home-based
Health monitoring systems to support health maintenance behaviors &
activities (i.e., taking prescriptions)
-
Shift
to non-institutional long-term care system --more community and home based
-
Establish
national caregiving network -- to connect caregivers to recipients
-
Informal
service exchanges among seniors -- use seniors as a resource
-
Use
Internet to provide health counseling in the home
-
Security
systems -- Dick Tracy type wrist watches
-
Need
Public education re: currently available building designs
-
Need
rehab standards for adaptive re-use of existing housing
- Home as a platform for social participation & for maintaining one’s sense of personal control and choice --e.g., Extending/Maintaining opportunities for participating in civic life -- i.e., city council and town hall meetings
-
Discount
on homeowners insurance for Universal Design
-
Universal
Design guidelines need to be established nationally that are voluntary, based
on performance rather than the dictation of design.
-
Develop
mechanisms for certification
-
All
houses build by government should be Universal Design; whereas builders need to
make a certain % of other housing meeting Universal Design criteria.
-
Need
to have a consumer report for Web pages that certifies them by Bobby-standards
4. Workplace Specific Ideas
-
Make
the workplace senior friendly
- Workplace guidelines need to address more than mobility -- also noise, lighting, signage, and strength, working memory requirements
-
Need
to address transportation issues related to getting to and from work
-
Need
to plan for the diversity of workplace environments -- not all office-based
jobs
- Need to re-train for 3rd age employment; Dangerous trend is that corporations are not investing in training as too expensive; requiring workers to train themselves.
-
Need
adequate training for high tech service providers
-
Need
employment related policies that support caregivers -- Family Leave Act doesn’t
apply to ongoing caregiving, rather designed for acute and traumatic illness or
health events
-
Security
Issues are big at home & workplace