Technology for Aging in Place - Aging In Place Technology Watch

Technology for Aging in Place - Aging In Place Technology Watch
Technology for Aging in Place
2012 Market Overview
May 2012
Laurie M. Orlov
Principal Analyst
WHO SHOULD READ THIS REPORT?
This report, revised in January, 2012, is a market overview with a single purpose: it is
intended to describe the need for and the current market of technology to help aging
adults live full lives in their homes of choice. As such, it is relevant to:
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Vendors within or considering entry into the Aging in Place Technology market of
baby boomers and seniors
Social networking sites targeting baby boomers or seniors
Continuing Care Retirement Communities (CCRCs)
Assisted Living Facilities (ALFs)
Senior housing developers
Home care agencies
Geriatricians
Hospitals and integrated service delivery networks
Government agencies and policy makers
Geriatric care managers
Naturally Occurring Retirement Communities (NORCs),
Virtual Villages
Intentional Communities
Caregivers, seniors, and family members
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AGING IN PLACE: AN EXPECTATION AND A TECHNOLOGY MARKET
“Before the tech revolution, the village took care of you. Now we will have an electronic
village.”
Eighty percent of older people today live in their own homes.1 Not surprisingly, the
majority of them would like to stay there – and if they move, according to the AARP, it
will be to another private home.2 The desire to live at home will dominate the minds of
baby boomers, in 2011 becoming seniors (age 65) at the rate of 10,000 per day, and will
reshape the markets that provide products and services to them.3 Further, in the 2011
housing market crisis, many who would move to more appropriate homes cannot.4
Within that context, aging in place reflects the ability to successfully age and remain in
one’s home of choice, whether it is a private home, condo, apartment, or group home.
MetLife published a vision in 2010 called Aging in Place 2.0 that reinforces why the
technology to enable this is so important now – versus years from now.5 That’s because:

Successful aging means independence. Nobody wants to think about becoming old
-- but improved medical treatment and growing life expectancy has resulted in the 80plus becoming the fastest growing demographic.6 When asked what’s important for
successful aging, seniors rank as the most important: ‘being in good health, having
the ability to do things for myself, having friends and family there for me, and feeling
safe and secure.’7 And studies have shown that older persons who live independently
have more positive self-esteem than those who are institutionalized.8

Cost of long-term care is daunting. MetLife has pegged the average cost of an
assisted living facility (ALF) apartment in the US in 2011 as $41K/year, with nursing
homes at $85K/year.9 Meanwhile, their cost projections show an ALF cost that is
growing to $51K by 2015.10 Unlike nursing homes, which can be covered under
Medicaid, more than 90% of assisted living costs are paid out of pocket.11 The ability
to keep paying for ALF care depends on availability of long-term care insurance,
sizable savings, or proceeds from the sale of a home – all three jeopardized by late
2011from a weak economy, falling value of assets, or inability to sell a home.
Otherwise, seniors may have to move to Medicaid-eligible nursing homes.

Care capacity will reach crisis proportions. As people age, the numbers of chronic
conditions and related care requirements grow. And for a variety of reasons, including
cost and availability, care of the aging population has already begun to migrate from
nursing homes to assisted living and increasingly to home-based care.12 But it is very
clear from age-related trends that there will not be enough caregivers to help them age
at home if need care. This care gap is a result of convergence of a growing senior
population, increase in life expectancy, looming healthcare issues, and a relatively flat
population of younger women -- still the source for primary home care, assisted
living, and nursing home aides (see Figure 1).13
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The looming crisis of care
Cost of
care ???
$51K/year ALF
Projected in 2015**
55 million age 65+
Potential caregivers:
Women aged 25-44***
39 million age 65+
$40K/year for ALF
2010*
2010
2015
* Source: MetLife 2010 Market Survey of Long-Term Care Costs
** Source: AARP State-by-State Long Term Care Costs
2020
***Source Healthcare for Healthcare Workers
Figure 1
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
Technology capabilities exist now – and seniors are willing. First and foremost,
technology to help age in place is at its most available and lowest cost to date. It is
the first time that platform adoption of cell phones, game units, PCs, tablets, high
speed Internet and video is enough to merit the tentative but steady entrance of new
and existing vendors. Next, baby boomers, the majority of adult children, own more
tech than any previous generation. Because of their access, today is the first time we
can connect multiple generations of families with each other -- and with their care
providers. What’s more, studies show that seniors and caregivers are interested, but
not necessarily aware of what exists (see Figure 2). A consolidated look at Pew
Research findings from 2011, however, indicates that seniors are not significant users
of communication technologies, especially the latest tablets and smart phones (see
Figure 3-a and Figure 3-b).
Awareness and potential use of home
technology devices among 65+
Personal Emergency
Response Systems
84%
54%
Alarms on doors and
windows
65%
57%
40%
Activity monitor
60%
24%
Electronic pillbox
Sensors to detect falls
29%
22%
25%
Internet Monitoring
w/provider communications
0%
Aware of
Would Use
44%
34%
20%
40%
60%
80%
100%
Derived from AARP Healthy @ Home 2.0 2011
Figure 2
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Older adults and Internet
technology (Pew Research 2011)
Category
All
Boomers (5064)
Seniors
(65+)
Comment/
Example
Online
79%
78%
42%
% of all adults
Use search
daily
59%
52%
37%
% adults
w/Internet
Use video
sharing site
71%
54%
31%
View YouTube, %
adults use of video
Seek Health
info
59%
58%
29%
% adults
w/Internet
Social network
61%
47%
26%
% adults
w/Internet
Figure 3-a
Older adults and online
technology (Pew Research 2011)
Category
All
Boomers (5064)
Seniors
(65+)
Comment/
Example
Have cell
phone
85%
85%
58%
% all adults
…Smart phone 35%
24%
11%
% all adults
Internet calls
24%
19%
18%
% all adults
Have E-Reader 12%
13%
6%
% all adults
Have a tablet
8%
8%
2%
% all adults
Have mobile
health app
9%
6%
5%
% adult cell phone
users
Figure 3-b
What Does It Take to Successfully Age in Place?
More than 25%, 10 million seniors, of those aged 65+ live alone.14 Many of the adult
children of today’s oldest seniors worry with good reason about their parents – and struggle
with them over whether they should be living on their own. And the National Institute for
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Nursing Research states that “one third of informal caregiving occurs at a distance with
family members coordinating provision of care, maintenance of independence, and
socialization for frail elders living at home.”15 What do these families need?

Better communication. Seniors living alone and away from informal caregivers are
at risk of cutting themselves off or being cut off from others – whether due to hearing
loss or inability to leave their homes.16 Their long-distance family members struggle
to know what’s going on -- and healthcare providers offer few mechanisms for
communication. The result can be frustration and unplanned moves closer to family,
into independent or assisted living facilities.

Improved safety and monitoring. Many seniors struggle to take care of themselves,
to accomplish activities of daily living (ADLs) due to mobility issues or worsening
dementia. And many homes are danger zone of stairs, rugs, and bathing and cooking
hazards. As a result, 31% of people age 65+ suffer a fall that permanently affects their
mobility – whether it involves adding a cane, walker, or wheelchair to their lives.17
Even with hazards removed, remaining in the home in which they fell can be
frightening.

Greater focus on wellness and prevention. Seniors are too often forced out of their
homes or into greater levels of care as a result of hospitalizations.18 Depending on the
nature of the resulting illness or complication, doctors determine if living safely at
home is still feasible. And hospital discharge processes push most seniors into rehab
and permanent moves to assisted living or nursing homes, when with proper support
they might be able to function at home. The Federal “Money Follows the Person”
program launched in 2005 is now rolling out through the states and can help transition
nursing home residents into the community -- with appropriate levels of support.19

More opportunity to participate in society. But becoming frailer at home shouldn’t
imply a hard stop for contributing to life outside the home. In a recent study by
AARP, 34% of senior responders reported limits on basic physical activities, two in
five reported low vision or hearing impairments, and fifteen percent reported
problems learning, remembering, or concentrating.20 But at the same time, 66% felt it
was very important to stay involved with the world and with people, and 57% said it
was very important to continue to learn new things.
Aging in Place Spans a Triangle of Relationships
A critical enabler for aging in place is a working set of relationships and communication
between seniors, their families (both caregiver and long distance) or proxy caregivers, and
providers of services to seniors and their families. This triangle of relationships should be
reinforced with smart use of technology, but today suffers from weak or no connections: too
ad-hoc, too phone- or paper-based, too labor-intensive, and too narrowly conceived (see
Figure 4):
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Aging in Place depends on connected relationships…
Seniors
Family &
Caregivers
Providers
…Not well connected today
Figure 4
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Seniors. It’s true that baby boomers will skew the population distribution and change
they way we age, beginning in 2011 when the oldest began turning 65. But already there
were over 39 million seniors over the age of 65 at the end of 2010, 13% of the US
population.21
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Family & caregivers. Family caregivers often take an interest in and provide some sort
of oversight to seniors – either spouse or parents – in fact, as many as twenty-five percent
of families today care for someone outside the home.22 In a recent survey of caregivers
who use technology, two-thirds believe that web-based and mobile technology would be
helpful to them, although perceived cost was often noted as a barrier (see Figure 5).23
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Greatest Potential
(Helpful, Low Barriers)
Moderate Potential
(Helpful, HighBarriers)
)
100%
%very or somewhat helpful
Personal health record tracking
75%
Symptom monitor and transmitter
Caregiving coordination system
Medication support system
Interactive system for physical, mental, and leisure activities
Caregiver training simulations
50%
Video phone system
Caregiving decisionsupport tool
Passive movement
monitoring system
Caregiving coaching software
Transportation display
Helpfulness (
Caregiver mentor matching service
25%
Least Potential
(Less Helpful, High Barriers)
0%
25%
50%
75%
Barriers (% prevented from trying by any barrier)
Figure 5 (Source: eConnected Family Caregivers January 2011)
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Providers of services. Those with direct contact with seniors and their families include:
social services, hospitals, doctors, nurses, councils on aging, assisted living, and home
care organizations. This is the weakest technology link in the triangle, though it may have
the greatest potential for keeping seniors in their homes. Today 51 percent of doctors in
small offices, for example, have electronic medical records (EMR), a minimum for
sharing personal health record (PHR) information from seniors or with families, and twothirds or more in larger practices do so.24 EMRs include the basic diagnosis and drug
information at hospital discharge (often to a nursing home/rehab), yet as of 2007, only
41% of home and hospice care organizations use EMR.25
TECHNOLOGY FOR AGING IN PLACE TODAY – ENABLED RELATIONSHIPS
Successful aging and remaining at home can be substantially improved today by simply
sharing information and creating linkages between participants. Consider this scenario made
possible with technologies that exist and can be mixed, matched, purchased or used today.
The scenario (see Figure 6):
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A day in the life: Tech-enabled relationships
Long-distance
Family
Senior living at home
•Passes doorway motion sensor
•Puts on PERS watch
•Receives cell-phone
medication reminder call
•Gets a video call from grandkids
•Requests transportation pickup
•Participates in online hobby forum
•Attends a distance learning course
•Makes the video call
•Shares trip photos
•Sets up family tree
Healthcare
Providers
Family/Caregivers
•Updates personal health record
•Preloads ePill canister
•Sets med reminder schedule
•Configures notification phone list
•Receives home-related alerts
•Updates personal
health record
•Writes ePrescription
•Checks downloaded data
from wearable cardiac
monitor
•Answers e-mail question
from senior
Figure 6

Senior living at home. Margaret, an 88-year-old widow, lives alone in a senior housing
development in Florida. She rises in the morning, passes a doorway motion sensor that
remotely updates a security system, configured to alert caregivers if it is not activated by
a specific time. She puts on her mobile personal emergency response system (mPERS)
watch, receives a call on her cell phone or land-line that reminds her of a morning
medication, presses a button on the 7-day pre-loaded pill canister, takes her pills and
indicates such on her phone. Later that day, she receives a videophone call from her
grandchildren in Pennsylvania and tells them a bit more about her family history for their
ancestry project. She goes online to request a transport pickup to take her to the senior
center, and then checks in with her favorite online hobby forum through her easy-to-use
computer. At the senior center she participates in an exercise session or class. When she
arrives at home, she calls in to a telephone-based course.

Family/caregivers. Margaret’s adult daughter Irene lives an hour away and visits weekly
and takes her to doctor’s appointments. In consultation with her mom, she configures the
medication reminder schedule and uses a website to set automated check-in phone calls
while she is at work. Before taking her mom to the doctor, she ensures that her mom’s
personal health record is up-to-date and sends an e-mail question to the nurse. Irene and
her mom have agreed that she and home care aide Julie will receive only exception-based
alerts about her mom’s comings-and-goings and medication use.

Long-distance family. Other long-distance adult children of Margaret’s are alerted in the
event that Irene or Julie is unavailable. These family members use internet-enabled video
calls, e-mail, chat, and phone conference calls to stay in touch with Margaret between inperson visits. They send photos through e-mail that Margaret receives via fax – others
could use an e-mail appliance, printing mailbox or print from a senior-friendly PC.
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
Healthcare providers. Margaret’s primary care nurse practitioner, Suzanne, knows her
and her family – and makes sure that referred specialists and her primary care doctor
have the most up-to-date electronic health record. The health center where Suzanne
practices is up to date with the latest EMR systems and online prescriptions, using it to
communicate directly with Margaret’s nearby pharmacy. Margaret has a history of
cardiac problems and with the help of caregivers is regularly checked with home-based
diagnostic devices whose data is transmitted to the doctor’s office as needed.
Four Aging in Place Technology Categories Have Emerged
The above scenario is not a vision for the future. It is feasible with technology available
today, – listed separately in Appendix I and further discussed at www.ageinplacetech.com.
These technologies promise to help tighten and grow care provider relationships, improving
the ability to age more successfully, remain at home longer and more safely, and better
weather change over time (see Figure 7):
Four aging in place technology categories today
Email, Chat
Games, video,
Cell phone,
Smart phone,
Tablet,
PC, Mac
Home Safety and
Security
Security system,
PERS, mPERS,
Webcam
Fall detection,
Activity monitor
Communication
and Engagement
Telehealth,
Health and Wellness
mHealth,
Medication mgmt,
Disease mgmt,
Fitness
Learning and
Contribution
Legacy,
Lifelong learning,
Online education,
Volunteer, work
Figure 7

Communication and Engagement. For baby boomers and younger, life is
unthinkable without e-mail, chat, web surfing, Facebook, Smartphones, video games,
Skype, and texting. Yet the majority of seniors over the age of 75 are for the most
part unaware of these 24x7 ways to be in touch and in the know.26 And further, many
older people are intimidated by tech like PCs and complex cell phones. But they need
to stay in touch. Simplified tech -- like Cisco’s Valet wireless router or easy-to-use
cell phones from Great Call or Just5 or well-lit and customizable Android, Apple¸
or BlackBerry smartphones can make these experiences feasible and gratifying.
Once online, seniors and their long-distance grandchildren can chat, video chat or
enjoy reading books together through a video book-reading service like Readeo.
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
Safety and Security. The ability to remain in one’s home depends first on whether
the home is free from obstacles and dangers – and whether those risks are addressed.
Homes can be attractively retrofitted and become barrier-free by a Certified Aging in
Place specialist (CAPS).27 Further, security systems from ADT, mobile personal
emergency response systems like MobileHelp or LifeStation, or PERS with passive
fall detection from Philips, sensor-based home monitors (Care Innovations
Connect, BeClose, WellAWARE, AFrameDigital and GrandCare) could help
monitor and reassure seniors and caregiver.

Health and Wellness. The risks associated with obesity and lack of exercise only
worsen with age, so it’s no surprise that WiiFit has become so popular with boomers
and seniors. 28 The 2011 introduction of Microsoft Kinect has made a splash among
prospective commercial application developers – more will follow in 2012. For
chronic disease management, vendors like Intel, Bosch or Ideal Life offer systems
for remotely monitoring chronic diseases like diabetes or congestive heart failure.
Over time, integration of these with health systems’ EMR will become standard.

Learning and Contribution. In 2006, Joseph Coughlin of MIT’s AgeLab applied
“Maslow’s Hierarchy of Needs” to Aging in Place.29 He noted that once the basic
needs of communication, safety, and health are addressed, people have both the need
and capacity to read (on a Kindle or iPad, for example) and learn, stay active in and
knowledgeable about society, contribute to it through volunteering and likely
continued work, and leaving a legacy of stories, not just money, for those who love
them. Seniors can sort among online programs and auditable courses found at sites
like SeniorNet.org, New York Times Knowledge Network, Dorot University
without Walls or look for work on RetirementJobs.com or RetiredBrains.com.
Family and Professional Caregiver Links Overlay Categories
Family, professional caregivers and their clients are beginning to expect that they will, along
with the senior, participate in the use of technology categories (see Figure 8).
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Four aging in place technology categories today
Email, Chat
Games, video,
Cell phone,
Smart phone,
Tablet,
PC, Mac
Home Safety and
Security
Security system,
PERS, mPERS,
Webcam
Fall detection,
Activity monitor
Communication
and Engagement
Family and professional
Caregivers
Telehealth,
Health and Wellness
mHealth,
Medication mgmt,
Disease mgmt,
Fitness
Learning and
Contribution
Legacy,
Lifelong learning,
Online education,
Volunteer, work
Figure 8

Family members have growing expectations for connectedness. Today, picture
sharing, social networks, video chatting, and text messaging are the mainstream
mechanics for families – who will succeed at including aging parents in the loop of one
or more of them. And when home monitoring and PERS devices are purchased, family
members may be both the purchaser and rule configuration administrator for who to
notify about what pattern changes or emergency alerts, with or without a call center
intermediary. Vendors like eCareDiary and Connected Living offer portals for family
caregivers and seniors to share information, Caring.com and Care.com provides tools
for caregivers. Coro Health offers capability to configure music and spiritual content for
seniors with dementia.

Professionals, health, GCM, and companion agencies – will link in families. When a
national Geriatric Care Management organization trains its staff to use Skype to connect
clients to families, it’s a sign that professionals believe they must link families into their
process.30 These offerings will likely not be revenue generators, but rather added to
standard home health systems to enable providers to update all family members at once,
much in the way that CaringBridge enables families to provide patient updates on a
private website, rather than spend an hour or more on the phone each day providing
status.
Requirements for Aging in Place Technology Market Success
Across all these categories, a number of common requirements are emerging that will grow
in importance as the market grows. Customers will demand products that are as attractively
designed and easy to use as a game or tablet, ubiquitous as a cell phone, and as extensible as
a PC. For this market to further mature:
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
Technologies must be more intuitive. easy-to-use, and well-supported. Most people,
at every age, have a laundry list of frustrations with technology. AARP’s survey about
seniors and technology asked responders if they were concerned about the availability of
customer service reps. No surprise – most said yes. Service (online, telephone, remote) is
an essential ingredient in a go-to-market strategy. And ease of use means ease of setup.
Remote or zero configuration and exception management will be a major part of the
offering – or doom the product to failure. And focus groups and home trials reveal greater
technology resistance than any ‘what-if’ surveys.

Vendors must be capable of integration and extension. Many of today’s gadgets don’t
communicate – into or out of the home, but especially with each other. So a medication
reminder device is useful, but touches a tiny aspect of the whole person. Those who care
about seniors like Margaret must know that she has responded to the reminder and, if she
is willing to share, how her behavior changes over time. To provide valuable integrated
solutions, software will use common network standards to communicate to caregivers and
providers.

Costs to consumers must be affordable. As tech becomes more usable and useful,
consumers will look for ways to acquire it. This may occur through payers, but is more
likely through adult children and family. Higher income consumers will come to realize
that services associated with technologies like webcams and chronic disease monitors
that provide value are just as essential as cell phone plans, GPS services, cable TV and
many other monthly fees that are now part of their technology vocabulary.

Products must be available on widely adopted platforms. A growing number of
retirement communities are adopting Nintendo’s Wii; and cognitive fitness technologies
are making their way into both retirement and seniors’ homes. But too many interfaces
are confusing. So consumers may gravitate towards applications that work with ones they
already use, including Facebook. Even better, in the future, vendors will make it easier to
use personalized user interfaces across multiple devices, coined in a 2011 AARP report
as ‘Design for All.’31 Perhaps even a single device like a smart phone (or a TV) will drive
interaction and content, and other devices in the home will simply act as displays.
COMPETING PLATFORMS FOR AGING IN PLACE TECHNOLOGY
An aging in place technology platform battle is underway – vendors are deploying among:

Computer- and tablet- based. The PC and MAC – with unfettered access to the Internet
and multiple app formats – still offers by far the broadest access to technologies to help
seniors remain in their homes, whether it’s searching for health information from
MayoClinic.com, home retrofitting tips from AARP, or improving cognitive fitness with
Dakim or Posit Science. With the wealth of available PC/tablet applications comes
complexity, for some that may need to be masked with simplification interfaces like those
from new vendors Telikin, IntouchLink, or PointerWare.32

Wireless device, phone and tablet – smart or feature. Up next in today’s market,
expect that the wireless device, phone and web – at least 57% of seniors and 80% of
boomers own them. Good market penetration and simple operation is attractive,
especially for reminders, alerts, simple Internet search, texting, and even GPS location
applications. For baby boomers and their smart phones and tablets, targeted health apps
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for the iPhone (SugarTracker and BPBuddy), Android (FitSync and Absolute Fitness)
and Blackberry (DietCalculator or EmergencyInfo) are exploding and wireless devices
like FitBit, smart phones and their tablet counterparts like the iPad 2 or the Kindle Fire
will be an increasingly compelling mass-market information delivery platform, even
perhaps, as Eric Schmidt of Google predicts, eliminating PCs over the coming decade.33

Game platforms. There are 183 million active gamers today -- Nintendo alone sold 15
million game consoles in the US as of the end of 2010.34 As Jane McGonigal, author of
“Reality is Broken” notes: “Institute for the Future has shown that games consistently
provide us with the four ingredients that make for a happy and meaningful life: satisfying
work, real hope for success, strong social connections and the chance to become a part of
something bigger than ourselves.” Launched in late 2010, Microsoft’s Kinect, which is
gesture-based and recognizes the players, will enable multiple players to form longdistance competitive leagues. The Kinect platform and SDK for researchers with its
camera-eye’s view of players is already making inroads into health and fitness, especially
when the commercial SDK is made available.35

Televisions: CES 2011 brought an explosion of Internet-enabled TVs – and of course
theirTV set-top boxes. DVD players, Roku and now Amazon provide streaming videoon-demand and new Internet-enabled televisions could become an access point for senior
applications. As adoption of broadband grows, the TV may overtake the PC as an
interactive content medium for seniors and caregiving – GrandCare Systems is an
example of presenting senior-enabling software through a television user interface.36
ADVICE TO VENDORS TODAY: MOVE FROM PRODUCTS TO SERVICES
Probably the biggest issue that keeps more of today’s technology out of the homes of seniors
is the difficulty of marketing to both them (“We are not old!”) and to their afraid-to-interfere
adult children, while selling through knowledgeable reseller channels AND pricing right for
resale. Vendors and senior service providers can and must close that gap of awareness,
offering solutions for each stage of independence (see Figure 9). Vendors must find:

The right customer – baby boomers and their roles. But some marketers pick a target
audience that shares a common role – for example, Grandparents.com has identified a
shared role occupied by boomers as young as age 47 and built a high-traffic and
compelling website. And other role-based boomer sites like Caring.com and
OurParents.com offer aging in place vendors a ready audience of baby boomers with
shared interest in caring for their aging parents.

The real need – a service problem solved. Seniors and their adult children can’t begin
to imagine on their own what to do with sensor networks, web cams, or set top boxes.
Someone needs to tell them. Instead of offering point products out of context, vendors
should fit their offerings into solution descriptions, service provider relationships, and
senior support processes along the continuum of needed care. This includes a grasp of the
decision points that spike interest in a product. Finding an independent living assessment
on Philips’ Lifelinesys.com is a welcome surprise to boomers and seniors wondering if it
is feasible to remain at home.37
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Aging Status Changes May Require Different
Technologies
Home
Safety
Alarm system
Personal
Status
E-mail, phone,
Video, chat,
Text, GPS
Personal
Safety
PERS,
Fall
Detection,
Home
Monitoring
Personal
Medical
Status
Personal
Health
Medication
Reminders,
Dispensers,
Wellness
Guides
Independent
Chronic
disease monitors,
Online health
Communities,
Forums
Frailer
Time
Copyright Aging in Place Technology Watch 2010
Figure 9

Identify the right channel – it’s about an ecosystem and indirect selling. The right
channel depends on the complexity of the product and the target user. And less is more –
remembering that 20% of channel partners typically contribute 80% of revenues. Channel
utilization should primarily be indirect, either because of extensive reach, configuration
or local service needs. For example, PERS vendors like VRI or Philips market through
multiple regional service providers at local price points. Others will gravitate to a larger
and branded ecosystem from insurance companies or selling devices through senior
centers, home care agencies, or senior housing organizations.
Ten Steps for Vendors and the Aging in Place Technology Market
Find the channels that present products and services in the context that’s appropriate, whether
it’s AARP, ASA, or Silvers Summit at CES -- an annually occurring event that focuses on
boomers and seniors within this giant consumer product showcase.38 In addition, 2010 saw
the launch of a trade association of vendors – Aging Technology Alliance (AgeTek.org) –
that promises to further propel the market of technology for older adults.39 To those within
or contemplating entry into the boomer and senior market – here are 10 steps to consider:
1. Create a boomer-and-senior aware website. Mention the target audience by name:
“How this product can make seniors feel safer” rather than hoping prospective
customers will figure it out. Make the site is friendly to those with diminished vision.
Use IN2L’s example: provide a video of a pleased user that’s worth 1000 words.
2. Test usefulness with the target audience. So much of the R&D effort in technology
firms and university programs fails to produce a viable product. And vendors too
often jump in without confirmation that tech resonates. Consider relationships with
senior centers, area agencies on aging, or health centers.
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3. Narrow scope, but broaden messaging. Products that serve a narrow purpose can
still be described within holistic context as a day-in-the-life scenario, like Margaret’s.
Early on, seek partners with related products or service messages to make it happen.
4. Be wary of box obsolescence. Avoid being part of the back-room junk pile of
products-gone-by. Recognize the progressive nature of the service needs of the
consumers and pre-engineer extension (the tablet version, for example) and expansion
capability into the product.
5. Give away device and sell service. Device prices are a barrier to lucrative and longterm service to boomers and seniors. Yet many vendors have devices listed for more
than $100, beyond the price tolerance noted in survey’s like AARP’s.
6. Offer the free trial. Try with option to buy is such a time-tested strategy -- it is
interesting to see how rarely it appears to be used by vendors in this market.
7. Add related and useful value. Offer points and advice about problems faced by
prospective consumers – including links to criteria for assessing needs and services,
like a link to ‘20 questions for long-distance caregivers’ from the National Institute
on Aging.40
8. Add the community to the product. E-mailed customer testimonials are nice but
they are inadequate to build buzz from early success. Moderated communities (or
blogs with comment) can become product feedback living organisms.
9. Monitor reputation on consumer websites. Vendors should be wary about
deteriorating service reputation by regularly checking blogs, chat rooms, and forums - improving their responsiveness accordingly.
10. Cultivate members of other markets early. Be the first in your space to actively
seek out continuing care communities, geriatric care managers, home renovation
providers, assistive technology, and health care organizations.
HOW DOES THE AGING IN PLACE TECHNOLOGY MARKET EVOLVE?
The marketplace of products today is fragmented into a cottage industry comprised largely of
startups, challenged by both lack of awareness and a difficult economy. But with its
fragments assembled into an overall puzzle, this business for boomers and beyond represents
a conservative $2 billion market today.41 But potential business would be far higher if
marketers could reach the 14% of boomers that have expressed interest in helping their
parents. Between 2010 and 2020, based on growing boomer awareness and their own aging,
this market will grow to at least $20 billion and radically change as (see Figure 10): 42
Aging in Place Technology Watch
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How large is the market?
$20 billion…
•Games/Fitness
•Computers/Tablets
•Web cameras, TVs
•Cell, Smart phones
•Chronic disease mgmt
•Caregiving apps
•Home automation
•Mobility aids
•Vision, hearing tech
•PERS/Fall detection
•Fall prevention
•Car safety technology
•???
Growth Rate $
$2 billion
2010
2012
2015
2020
Time
Figure 10
1. Role- and need-based hubs will emerge and grow. Aging in place technologies are
beginning to gravitate towards hub-and-spoke portals, so dominant in eCommerce
evolution, that provide a lens into how roles (like caregiver, senior, and provider) relate
to needs (like home monitoring, and medication reminders). As hub-and-spoke portals
mature, they will offer concierge service for consumers to view and share information, as
well as to purchase targeted products and solutions. Consider role-based hubs like
Grandparents.com and Caring.com, and health need-based hubs like DiabetesMine
and PatientsLikeMe. Their partner spoke vendors (like Care Innovations, Great Call
or HealthHero) may advertise or even connect directly to these sites. In the future, some
platform vendors may become important as hubs, like MayoClinic, WebMD, and
MedlinePlus, for example, in healthcare, or Google+ or Facebook, building on its
growing boomer-turned-senior social network (see Figure 11).
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Role and need-based hubs will provide
the lens to Aging in Place services
Devices
Role-based Hub-and-spoke model
(Caregiver - Senior)
Example sites:
Example sites:
Caring.com
Shared
ParentGiving.com
Information
Grandparents.com
Products
Guidance
Services
MayoClinic.com
MedlinePlus
DiabetesMine.com
Need-based hub-and-spoke model
(Rehab at home)
Figure 11
2. Aging in place provider silos will overlap (home design, healthcare, services). In the
future, role or need-based hubs-and-spokes, with their caregiver- and senior-focused
lenses on need, will force convergence of aging-related categories. For example,
Assistive Technology (part of the healthcare market) overlaps with Healthcare – and
those in that market see little link to aging services. Service-based providers – like
assisted living, CCRCs, and home companion care all target the same senior, but in very
different and still largely tech-free ways. And markets that should overlap don’t: Home
care and geriatric care management groups are becoming interested in deploying
technology that could help family members know what’s happening with loved ones.
The home automation and custom installation market – filled with tech experts -- could
be an aging in place enabler, but currently is a separate small market (see Figure 12).
3. New developments and remodels will offer aging-in-place technologies. Some new
housing developers (including CCRCs and ALFs) pre-wire housing with broadband,
security monitors, and motion sensors – in addition to grab bars, wide doorways, and
alternative kitchen counter heights. As costs go down and housing demand restarts, other
senior housing options will be standard, upgrades or even pre-packaged retrofits.
Boomers will expect home networks, web cams, and voice-activated security for personal
emergency response – and aging in place vendors will leverage them to build more
sophisticated and connected applications. To reduce energy use, building codes will
mandate temperature and humidity sensors, including automatic reset of lighting and
temperature as home is entered or exited. Automatically lit pathways from bed to bath
will become standard as well.
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Aging in Place Market Silos Will Overlap
Home
Services*
Home
Automation
Healthcare
Home Design
Assistive
Technology
* Example services include:
Home care, transportation, geriatric care management, social services
Figure 12
4. Vendor standalone market entries will morph into solutions, designed for all.
Today’s high product prices and one-off innovations will be replaced with integrated
low-cost solutions; and the evolution of hubs (on- and off-line) will force vendors to find
customers through them. Unique functionality may garner adoption by the most tech
savvy seniors, but for the majority of the aging population, a consistent underlying
platform that is designed for all, not simply for the elderly, will be preferred.
Professional caregivers and health providers will use smoothly connected tablet/PC-smart
phone platforms to gain visibility, which will propel solution-aware vendor offerings into
mainstream usage. Local integrators, drawn perhaps from senior housing, electronics
dealers, or remodelers or home care, to travel the last few feet into the home.
WHAT CONSUMERS AND SUPPORT SERVICES SHOULD DO TODAY
Although this is still an early market, it is still a very useful set of products – and should be
explored now by seniors and their families, caregivers, and service providers. Helping
seniors and the-soon-to-be-senior be safer, connected, healthy and fulfilled is too important
to await market evolution and shakeout. And market awareness pressure results in better
products and services – and vice versa. It’s time to:

Assess family along a tech literacy continuum. Not everyone grows older in Silicon
Valley -- a newspaper letter quotes a senior subscriber who plaintively noted that
advertisers keep mentioning websites, not phone numbers. Even the Social Security
Administration recently stopped printing statements that can be viewed online. If your
family member sees the web or other tech as impenetrable, don’t give up. That’s why
there is still a market for one-button answering machines, easy-to-use cell phones, and
printing mailboxes. And providers are learning: new training of Geriatric Care Managers
(GCMs) offered by the University of Florida guides prospective GCMs in the use of
technology to support clients, especially long-distance caregivers, in their businesses.43
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
Research technology for today’s need with an eye to the future. Family members and
providers who observe that no technology is available to loved ones should be energized
into asking: why not – where is it? Yes, you should inquire about the availability of
fitness programs in an assisted living facility, but also ask about technology (like web
cameras for long distance family chats or wireless networks to enable use of tablets in
common areas) to improve safety or help engage family members into tighter connections
to a relative, and how the facility deals with increasing frailty.

Find a community of interest and support. Look online first for shared interests in
advancing the use of technology and related services for boomers and seniors. Demand
that nationwide and visible organizations, like AARP, WebMD or Caring.com, provide
more information on recent tech-enabled innovations and solutions. Find technical
support communities, local ‘Geek’ and ‘Genius’ squads that will service boomers and
seniors where they live as well as online. Push cable providers to add a local ‘geek squad’
service to offerings for a small recurring fee. If consumers elevate their expectations,
vendors and providers must listen.
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Contributors to earlier versions
Erin Kinikin, Editor
Susan Ayers Walker, Silvers Summit
Mary Furlong, Founder, Mary Furlong & Associates
Elizabeth Boehm, Principal Analyst, Forrester Research
Julie Menack, Author and Geriatric Care Manager
Sources
Center for Aging Services Technologies (CAST)
Continua Health Alliance
Members of AgeTek.org
AARP
National Alliance for Caregiving
Pew Research
MetLife Mature Market Institute
And many others who have provided guidance and insights over the past 2 years
About the Author:
Laurie M. Orlov, a leading tech industry veteran, writer, speaker and elder care advocate, is
the founder of Aging in Place Technology Watch, a market research firm that provides
thought leadership, analysis and guidance about technologies and related services that enable
boomers and seniors to remain longer in their home of choice. In addition to her years of
technology background and years as a technology industry analyst, Laurie is certified in
geriatric care management from the University of Florida, and has served as a long-term care
ombudsman in Florida. She is the author of other market reports, including ‘Calibrated Care
is Closer to Home’ and a 2011 AARP report on communication and engagement tech for the
50+ market. She is also the author of When Your Parents Need Elder Care (Authorhouse
2006).
In her previous career, Laurie Orlov spent more than 30 years in the technology industry,
including 24 years in IT and 9 years as a leading industry analyst at Forrester Research where
she was often the first in the industry to identify technology trends and management
strategies which have survived the test of time. She speaks regularly and delivers keynote
speeches at forums, industry consortia, conferences, and symposia. She has served as an
advisor to leading organizations like AARP, J&J and Philips and her blogs are featured on
numerous websites about topics related to boomers and seniors. Learn more at
www.ageinplacetech.com.
Aging in Place Technology Watch
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References:
1
http://www.aarp.org/home-garden/livable-communities/info-11-2010/home-community-services10.html
2
http://www.census.gov/population/www/projections
3
http://online.wsj.com/article/SB10001424052748704013604576104394209062996.html
4
http://www.kaiserhealthnews.org/Stories/2011/August/22/housing-crash-assisted-living.aspx
5
http://www.metlife.com/assets/cao/mmi/publications/studies/2010/mmi-aging-place.pdf
6
http://www.census.gov/prod/cen2010/briefs/c2010br-03.pdf
7
AARP [email protected] 2008 survey ranking by 907 65+ individuals
8
Lewis, Aging: The Healthcare Challenge, 2002
9
Costs shown are rounded up. Nursing home cost is for a private room.
http://www.metlife.com/assets/cao/mmi/publications/studies/2010/mmi-2010-market-survey-longterm-care-costs.pdf
10
http://www.aaltci.org/consumer/travel.html
11
As of October, 2011, Congress is evaluating cuts to Medicaid that would impact nursing home cost.
12
Number of nursing home beds, ALF, and CCRC flat, incremental growth curves. LeadingAge.org
13
http://hchcw.org/wp-content/uploads/2008/04/hchcw-women-fact-sheet.pdf
14
27% of 65+ live alone: http://pewsocialtrends.org/assets/pdf/752-multi-generational-families.pdf
15
Family Caregiver Alliance (http://www.caregiver.org/caregiver)
16
http://research.gallaudet.edu/Demographics/deaf-US.php
17
http://www.cdc.gov
18
As of 2006, 38% of all hospital inpatients were individuals age 65+.
19
http://www.cms.gov/CommunityServices/20_MFP.asp
20
http://assets.aarp.org/rgcenter/il/healthy_home.pdf
21
http://www.census.gov/population
22
http://www.caregiving.org/data/04finalreport.pdf
23
http://www.unitedhealthgroup.com/news/rel2011/eConnected_Family_Caregiver_Study_Jan_2011.pdf
24
http://www.physicianspractice.com/blog/content/article/1462168/1933985
Aging in Place Technology Watch
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25
http://www.cdc.gov/nchs/data/databriefs/db45.htm
26
Only 33% of those 65-73 and 9% of those 74+ go online wirelessly (smartphone or laptop).
27
CAPS, National Association of Home Builders.
http://www.nahb.org/generic.aspx?genericContentID=9334
28
Eight-six percent of the American population is predicted to be overweight or obese by 2030.
http://www.newsweek.com/id/153309
29
Cathedral Builders Wanted, Coughlin & Lau 2006
http://agingsociety.org/agingsociety/publications/public_policy/previous.html
30
NY Times 5/27/2010 http://newoldage.blogs.nytimes.com/2010/05/27/screen-time-with-mom/
31
AARP.org
32
Today 23% of seniors use the Internet at least once per day. As boomers age, however, that number
will grow – 26% of today’s boomers are online more than 9 hours a week and 35% of those users
purchase products online at least monthly. www.forrester.com
33
http://seattletimes.nwsource.com/html/microsoftpri0/2014231113_mobile_world_google_ceo_says_t
he_phone_is_the_new.html
34
http://train2game.wordpress.com/2011/01/14/nintendo-sold-15-million-consoles-in-us-during2010/
35
http://weblogs.baltimoresun.com/health/2010/06/kinect_for_xbox_360_adding_a_l.html
36
http://grandcare.wordpress.com/2010/07/29/grandcare-2nd-article-in-new-york-times/
37
http://tech.yahoo.com/news/ap/20090123/ap_on_hi_te/high_tech_senior_living
38
http://www.silverssummit.com/
39
http://www.agetek.org/
40
http://www.nia.nih.gov/HealthInformation/Publications/LongDistanceCaregiving/
41
2010 market size was based on a combination of published market estimates, including the $295
million 2010 brain fitness market (SharpBrains), $1 billion PERS market, with $50 million (estimate)
of all privately held home monitoring companies and related security firms. PCs, software, cell
phones, smartphones, tablets, and video games, make up the remainder.
42
The PERS market has been forecast at an 11.6% CAGR through 2012,
www.marketresearchworld.net
43
University of Florida certificate program: http://www.distancelearning.ufl.edu
Aging in Place Technology Watch
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Appendix – Technology for Aging in Place
5/31/2012
Laurie M. Orlov
Example Vendors by Category with Example Price Ranges Derived from Vendors or their Online Sites
Aging in Place 2012 Technology Categories and Vendors (Example vendors)
Today’s market combines general-purpose technology vendors with a boomer/senior offering and
small specialist vendors solving more narrowly defined problems. For inclusion as a technology
to facilitate aging in place, the vendor meets two of these criteria (these are examples, not an
exhaustive list):
a)
b)
c)
d)
Incorporate messaging to and about boomers and/or seniors.
Boomers and/or seniors have broadly adopted the product.
Is available across the US, not just in a single region.
Be available free or for a fee, not only via insurance reimbursement.
Appendix – Technology for Aging in Place
5/31/2012
Laurie M. Orlov
Example Vendors by Category with Example Price Ranges Derived from Vendors or their Online Sites
Category
Subcategory
Purpose
Platform
Contact
Communication and
Engagement
Cost/ mo plus
Device
Example Price
range
Celery 2-way (no computer)
email
E-mail
Printing email
Appliance/
Fax
mycelery.com
$13.98 or
$139/hr plus fax
machine
Presto Printing Mailbox
E-mail
Printing email
Landline
Presto.com
$12.50/mo plus
$149.99
The Valet Easy-install
router
Wireless
router
Wireless
networking
Internet
TheValet.com/
$100
Just5 Simple Feature phone
Cell phone
Long battery
life
Cellular
phone
Amazon.com
$63 and up
Senior Value TracFone
Pre-paid No contract
Cell phone
Multiple
phones
Cellular
phone
TracFone.com
$9.99 and up
Great Call (multiple)
No contract
Cell phone
Cellular
phone
GreatCall.com/
$14.99/mo plus
$99.00
ClarityLife C900
Cell phone
Easy-to-use
cell phone +
services
Amplified
20db cell
phone
Cellular
phone
clarityproducts.com GSM carrier
/products/
plus $82.95
Hamilton CapTel
Multiple
devices
Free
service
HamiltonCaptel.
com
800i for $99
iPad
Tablet
9.7 inch
multi- touch
Tablet
Amazon.com
$491.99
Kindle Fire
Tablet
7-inch multitouch
Tablet/
eReader
Amazon.com
$199
Telikin Touch Screen
Computer
Touch
Computer
Easy to use
computer
PC
Telikin.com
$699.99
Captioned
telephone
services
Appendix – Technology for Aging in Place
5/31/2012
Laurie M. Orlov
Example Vendors by Category with Example Price Ranges Derived from Vendors or their Online Sites
Communication and
Engagement
Example Price
range
Acer Aspire One
Netbook
2.76 pounds
PC
Target.com
$248.99 & up
InTouchLink
PC Ease of
Use
Software
Monthly or
yearly
Senior PC
Software
IntTouchLink.com
$13.00/mo after
initial free trial
Connected Living
PC Ease of
Use
Software
Internet
Senior PC
Software
ConnectedLiving.
$9.99/mo
LifeShare
PC Ease of
Use
Software
Pre-config’d
software
Senior PC
software
LifeShare.com
$30/month
PointerWare
PC Ease of
Use
Software
Pre-config’d
software
Senior PC
Software
Pointerware.com
$8.00/mo
Coro Health Therapeutic
media service
Alzheimer’s
Care
Individual
music
therapy
Service
Corohealth.com
From $10/mo
per user
LifeLedger
Caregiver
support
Internet
Caregiver,
GCM
Lifeledger.com
$9.95/mo
eCare Diary
Caregiver
support
Internet
Family
Caregiver
eCarediary.com
Funded by
advertising
Caring.com
Caregiver
portal
Support to
family
caregivers
Web
portal,
directory
Caring.com
Funded by fees,
advertising
Care.com
Caregiver
portal
Support to
caregivers
Portal,
directory
Care.com
Funded by fees,
advertising
SilverPlanet
Portal plus
consulting
Boomer
portal
Resources,
directory
SilverPlanet.com
Consulting fee
Caregiver.com
Portal
Support
caregivers
Resources,
Events,
media
Caregiver.com
Funded by
advertising
Ankota Family Connect
Homecare
software
Info for
families
Suuport to
families
Ankota.com/ankota
-family-connect
Free to families,
health svc fees
com
Appendix – Technology for Aging in Place
5/31/2012
Laurie M. Orlov
Example Vendors by Category with Example Price Ranges Derived from Vendors or their Online Sites
Home Safety and Security
Example price
range
GreatCall 5Star Urgent
Response
Mobile PERS
Consumer,
Caregiver
Wearable
PERS
GreatCall.com
$14.99/mo
+49.99
LifeStation
PERS
Consumer,
caregiver
PERS
Lifestation.com
$26.95/mo
Independa
Smart
reminders
Consumer
Monitor
Platform
Independa.com
$19.95/mo
SilverFox Link
PERS, Twoway Alert
Consumer
Monitor
Platform
SilverFoxLink.
com
$24.95/mo
AframeDigital
Monitor
Remote
monitoring
Watch
plus
sensors
Aframedigital.
com
$69/mo plus
$499
Attentive Care Family
Caregiver Edition
Monitor
Remote
monitoring
Caregiver
Support
Caregivertech.
com
$58/mo plus
$198
Care Innovations Connect
Monitor
Remote
Monitoring
Tablet
Care
Innovations
$500 plus $3090/month
GrandCare
Monitor
Remote
Monitoring
Appliance
grandcare.com
$50/mo plus
$2000
Healthsense™ eNeighbor™
Home
monitor
Resident
Monitoring
Wifi
sensors
Healthsense.
com
$60/mo plus
$1300
WellAWARE
Monitor
Resident
Monitoring
Wifi
sensor s
Wellaware
systems. com
$125/mo plus
$250 activation
BeClose
Monitor
Consumer
Wifi
sensors
Beclose.com
$79/mo plus
$299
Sonamba
Monitor
Consumer
Cellular
Sonamba.com
$39/mo plus
$549.99
Philips Lifeline with AutoAlert
PERS with
fall detection
Consumer,
caregiver
PERS with
fall detect
Lifelinesys.com
Range $35 $59.00/mo
Mobile Help (Medical Mobile
Monitoring)
Mobile PERS
Consumer
PERS with
GPS
Mobilehelpsys.
com
$36.95/mo based
on annual
Appendix – Technology for Aging in Place
5/31/2012
Laurie M. Orlov
Example Vendors by Category with Example Price Ranges Derived from Vendors or their Online Sites
Health and Wellness
Example price
range
Dakim Brain Fitness
Cognitive
fitness
Brain fitness
program
PCinstalled
Dakim.com
$249
MindFit
Cognitive
fitness
Consumer or
senior center –
Brain exercises
Web or
CD
e-mindfitness.
$139.00 or
$149.00
Cognitive
fitness
Brain fitness
programs
PCinstalled
program
Positscience.
WiiFit
Exercise
Consumer:
Balance board,
fitness games
Wii
Amazon.com,
others
$90.00 plus
$272.99 Wii
Wii Sports Pack
Exercise
Senior center:
Wii Bowling,
Tennis, other
Wii
Amazon.com,
others
$42.99
My Fitness Coach
Exercise
Consumer:
Ability to chart
progress over
Wii
Amazon.com,
others
$31.20
Microsoft Kinect
Exercise
Gesture,
camera-based
Kinect
Amazon.com
$149.99
Philips Lifeline with
Philips Medication
Dispensing Service
Medication
Consumer: cup- Appliance
dispenser and based dispensing
reminder
Lifelinesys.
com
$75/mo plus
$85
installation
MedSignals
Medication
management
Consumer, 4
drugs,
instructions
Phone
Medsignals.
com
$15.00/mo
TabSafe
Medication
dispenser
Consumer,
senior housing
Appliance
Tabsafe.com
968.95 plus
$19.95
OnTimeRx
Medication
reminder
SMS, e-mail,
phone-based
Web or
software
Ontimerx.com
$9.95/mo and
up
MedMinder
Medication
dispenser
Consumer:
dispensing
MedMinder.
com
$39/month
Appliance
PositScience
com
$395-495
com
Appendix – Technology for Aging in Place
5/31/2012
Laurie M. Orlov
Example Vendors by Category with Example Price Ranges Derived from Vendors or their Online Sites
Learning and
Contribution
Example
price range
MyGrandchild.com
Games with
grandkids
Play games,
read online via
network
meetings
Internet
Mygrandchild.
com
$4.95/
meeting
Readeo Video Book
Reading Service
Books with
grandkids
Read books, see
grandchildren
Internet
Readeo.com
$9.99/mo
SeniorJournal.com
Social
networking
Boomers and
seniors
Internet
Seniorjournal.
com
None
Amazon Kindle
eBook
Reader
Download books
in adjustable
reading formats
Device
Amazon.com
9.99/book
$139-379
Barnes & Noble Nook
eBook
Reader
Download
books, color
Device
Barnesandnoble
.com
$9.99/book
$149-249
LifeBio
Legacy
Produce a book
based on
template
Internet
Lifebio.com
$39.95
Ancestry.com
Legacy
Create family
tree
Internet
Ancestry.com
$20.95
SeniorNet.org
Education
and Learning
Technology
training and
access
Internet
Seniornet.org
$40.00/yr
Dorot University
Without Walls
Education
and Learning
Telephonebased learning
Telephone
Dorotusa.org
$15/course
RetiredBrains.com
Education
and Learning
Directory of
online courses
Internet
Retiredbrains.
com
None
Senior Center Without Education
Walls (California)
and Learning
Telephonebased courses
Internet
Seniorcenter
withoutwalls.
org
None
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