living longer and living better: technology and wellbeing ... · genx millennials post-millennials...
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Living Longer and Living Better: Technology and Wellbeing for an Aging Population
Lisa D’Ambrosio, Ph.D.Research Scientist
AuDacity 2019Washington, D.C.15 November 2019
MIT AgeLab | agelab.mit.eduL i f e T o m o r r o w
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New Demographics and New Demands
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Aging Is a Global Success Story
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Source: United Nations 2017.
2017 2050(proj) Growth
World 962.3 2080.5 116.20%
Europe 183 247.2 35.10%
NorthAmerica 78.4 122.8 56.70%
In millions
Number of People Ages 60+Population Proportion Age 60+
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When It Comes to Aging, Success Is Disruptive
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Americans Are Living Longer
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Life Expectancy by Generation in the US, at Birth and at Age 65
Born 1900 Older Boomers
Younger Boomers GenX Millennials Post-
Millennials
At birth 47.3 68.2 69.7 70.8 74.9 76.8
At age 65 77.0 78.9 79.3 80.2 81.9 82.6
Women 49.0 72.0 73.1 74.7 78.3 79.3
Men 47.0 67.0 66.6 67.1 71.4 74.1
Generational breaks by birth year: Older Boomers 1946-1955; Younger Boomers 1956-1964; GenX 1965-1980; Millennials 1981-1996; Post-Millennials 1997+Data sources: CDC https://www.cdc.gov/nchs/hus/contents2017.htm#015 and OECD (by gender) https://data.oecd.org/healthstat/life-expectancy-at-birth.htm#indicator-chart, for birth years 1950, 1960, 1970, 1988, 2000, and CDC for 1900 birth life expectancy; https://www.seniorliving.org/history/1900-2000-changes-life-expectancy-united-states/ for birth year life expectancy at age 65
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A Quiz
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October 4, 2019
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Category:A Salute to 8000
The $600 Clue:The M.I.T. AgeLab estimates that this period of your life will last
about 8,000 days – don’t run out of savings
A Clue
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WHATIS
THE NEW OLD AGE?
An Answer
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›A long time – nearly 22 years
›New opportunities to define and to redefine how we want to live as we age
›People may not be following the same paths – or have the same expectations – around aging and lifestyles as previous generations did
8,000 Days Means….
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Not Just Living Longer, But Living Better
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Hearing and Successful Aging
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Changes in Vision and Hearing
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0 2 4 6 8
No noticeablechanges
Within the past5 years
5 - 10 yearsago
10 - 20 yearsago
20+ years ago
Number of participants
Hearing
Vision
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› Vision› No limitations in shopping, household
chores, cooking, attending medical appointments, participating in community activities, or paying bills
› Some impact on ability to live independently
› Hearing› Significant impacts on social
engagement: almost half said hearing loss limited their ability to maintain social relationships with friends and family
Impacts of Changes in Hearing and Vision Differ
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› 51% of Americans over the age of 71 live alone
› 17% of Americans over the age of 65 are isolated1
› $1608 = Average annual increased health care costs of isolated individuals
› Social Isolation increases risk of cardiovascular disease, cognitive decline and premature death as much as obesity and other clinical risk factors like smoking
Hearing, Aging and Social Isolation
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“At many social
functions, I feel as if I am not there at
all.”
“If I am at a party, and I can’t hear a damn thing, I just
withdraw myself . . . I don’t even try to
listen to what anyone is saying, and it’s not a good social thing.”
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› Use of multiple different kinds of solutions› Hearing aids› Hearables – e.g., Bose Hearphones, portable amplifiers› Closed captioning› Visual or vibrating alarms› “Hacking” the home environment
› No solutions were perfect› Hearing aids expensive› Hearing aids didn’t always work well or as expected:
“Hearing aids make things louder, they don’t make things clearer, and by clearer I mean speech perception.”
› Lots of frustration
Solutions for Hearing Loss Are Not Optimal
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A Deeper Dive into Hearing with the Lifestyle Leaders
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Experiences of Hearing Deficits
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0
2
4
6
8
10
12
14
16
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Balance issuesincluding vertigo
Hearing loss in theleft ear
Hearing loss in theright ear
Tinnitus Other (pleasespecify)
None of the above
Freq
uenc
y
Diagnosis
Have you been diagnosed by a doctor or other health professional as having any of the following conditions?
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In Their Words
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Hearing loss is “like tryingto understand
in a foreign country.”
“You know when you have hearing loss it
doesn’t happen, ‘Boom!’ I probably
had hearing loss for several years. Ididn’t notice my
hearing was going worse, but it was
happening.”
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Social Impacts of Hearing Loss Are Profound
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“I live in a place where we have
dinner together, a hundred of us
every night in a large room. I couldn't hear.
My wife still can't hear in that room.”
“I'm very limited. I miss all the
nuances. I, God damn it, you can’t hear jokes when
you… So everybody's
laughing, and I don't know what the
hell they're doing.”
“People are not going to be socializing if they can’t hear easily. They just sort
of disappear into their apartments, and I think
that’s a shame. I just realized
it’s tending to make me isolate myself because this
[my apartment] is theplace I hear best, with a
hearing aid in, the headphones on, watching
television.
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Hearing Has A Negative Effect on Activity Engagement
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“You start to feel leftout of things. Your hearing starts to
control what you do or don't do; what
you look forward to or don't look forward
to.”
“I can’t do the things that
you’re supposed to do when you
get old.”
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Hearing, Safety and Security
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"As it is now, I leave my
apartment door unlock[ed]; friends worry, [but] I do not hear knocks so [it]encourages [them]
to come in and check.”
“Fire alarms can be scary, and the older
youget, the scarier they get. I was not able to
hear, a few years ago. Twice, I
couldn't hear, and a friend woke me up in
bed.”
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Impacts of Hearing Assistive Technologies
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0
2
4
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10
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16
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Psychologicalwellbeing
Relationshipswith other
people
Sense of safetyand security
Memory andconcentration
Physical health Financialwellbeing
Energy level orhow tired youfeel everyday
Freq
uenc
y
Domain
Has made it better
Has not affected itat all
Has made it worse
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But Why Do Only 75% Use Assistive Technologies?
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A Framework for Understanding Technology Adoption
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Source: Lee & Coughlin 2014
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› Those who had adopted and regularly used a device that worked effectively for them were unlikely to stop using it
› People were more likely to say they had stopped using a device if it did not meet their expectations: uncomfortable, did not work as well as expected
› Design issues affect use: wires + manuals, batteries and poor fit
Functionality Key to Continued Use
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Big, Beige and Boring Is Out
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Experiences of Stigma Varied
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› “The craziest thing–here’s what the problem
is, everybody is vain, and they want to have
hearing aids that nobody sees, but what the hell of a difference does it make if you’re 70, 80 years old, if you
have a hearing aid? Doesn’t make a damn
bit of difference, so you shouldn’t care about it.”
– Male
“Of course it felt like anything that's new,
and I couldn't get comfortable with it…. I felt like somebody
else was lookingat it..” - Female
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› Access to hearing technologies is not seamless
› Cost of hearing aids can be high, even if there is some subsidy
› Getting assistive devices that work and fit properly can be an onerous process› Transportation is required to go to different
appointments and fittings› Referrals to different specialists and
multiple fittings are frustrating› Trouble-shooting on one’s own is daunting
Delivery Factors Matter a Lot
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1. New expectations among new generations of older adults extend
to their abilities to hear and what they think the technologies
should be able to do for them
2. Adoption of hearing assistive technologies takes place in a
broader framework of adoption
3. Future service and delivery models for hearing assistive
technologies will be different
Three Implications
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