An analysis of healthcare-focused survey data revealed that 34% of the entire US adult population is now digitally inclined, and interest among the senior-aged is surging. While preventing infection with Covid-19 prompted many Medicare-aged adults to schedule telehealth physician visits, there are other reasons that adults aged 65+ are more willing than before the pandemic to utilize technology-based healthcare services. From reminders to take medications to disease-specific health education – and individual wellness checks to answering patient questions – the use of wearable devices and digital healthcare platforms by the elderly is significantly growing.  

Due to the potential for improved overall health status, senior care facilities and Medicare providers (including Medicare Advantage providers) are focusing more attention and resources on this trend. As of 2021, at least one in five nationwide healthcare leaders reported that their organization/practice offers remote patient monitoring. Described below are some of the different digital approaches to improving senior health status that are being embraced by senior caregiving facilities and clinicians, as well as by more healthcare payers. Diverse ways that digital healthcare delivery approaches can reduce costs are also discussed. 

Digital health education as a chronic disease management tool

The American Diabetes Association notes that 29.2% of all adults aged 65+ in the US have diabetes. Even more have a condition termed pre-diabetes that – with lifestyle changes – may be controlled such that progression to full-blown diabetes (Type 2) does not occur. Since obesity is highly linked to developing diabetes, digital wearables can calculate both the total calories consumed in the food eaten and the reduction in weekly caloric intake needed to lose a targeted amount of weight (in pounds).   

While Fitbit and similar fitness trackers can aid in enabling a plan for weight management or loss, other types of digital wearables are more focused on aiding people diagnosed with prediabetes or diabetes to understand their daily glucose (blood sugar) intake from the foods eaten – so can promote both weight loss and lowered glucose intake. Moreover, they can include a “chat” feature to answer questions about caloric and glucose content in a specified amount of a desired food item, so that the individual can decide whether to consume it or not. 

Other chronic disorders such as heart disease and Chronic Obstructive Pulmonary Disease (COPD) can also require major lifestyle changes. By utilizing a wearable that offers digital health education, the afflicted person can learn how to better manage a newly-diagnosed condition or acquire informative reminders if a medical provider’s instructions are forgotten. 

Medication management: How digital platforms and digital wearables are useful

Many senior-aged people take more than one prescribed medication each day. Two of the most common are cholesterol-lowering medication and antihypertensives (that control blood pressure). More than four in every 10 elderly people take at least five prescription drugs per day – which is a three-fold increase as compared to 20 years ago. Although this has enabled many to live “better” and enjoy a far longer lifespan, it can also be confusing for these people to keep track of all of their daily medication. Therefore, more intensive medication management by the individual (or that person’s personal caregivers and medical providers) is needed to reduce medication intake mistakes.  

For adults aged 65+ residing in assisted living facilities as well as alone, recognizing negative effects from skipping a medication or accidentally taking more than the prescribed dose can be problematic. Meanwhile, elderly people with early dementia (such as early Alzheimer’s Disease) can tremendously benefit by a digital device that provides real-time reminders of which prescribed drug to take and when to take it.  

Furthermore, patients with a history of nonadherence to their medication can benefit from a digital call from a member of the healthcare team (or even a nurse care coordinator from that person’s insurance plan) to ensure that the needed medication are being utilized. (This is particularly useful for a senior-aged person with a past history of stroke prescribed a daily blood-thinning drug to prevent another stroke, but who forgets to take the drug due to forgetfulness resulting from the stroke.) 

Wellness and safety checks to relieve stress on caregivers

Around 28% of community-dwelling senior-aged adults live alone, and that number sharply increases after age 75. According to Harvard University’s Joint Center for Housing Studies, the number of people aged 80+ who are living alone is set to soar to an estimated 10.1 million by 2038. “Slip and fall” accidents are the most frequent causes of bone fractures and death in adults aged 65+, and over 800,000 are hospitalized annually due to a fall-caused injury. One of the most common reasons is waking in the middle of the night to use the bathroom, and then losing balance due to suddenly standing up from a lying-down position with resulting light-headedness. 

Utilizing a wearable digital device to dial for assistance in the event of an emergency is just one way that an elderly person who has fallen can obtain immediate aid. Another is a periodic call from someone (to ensure that the elderly person does not need immediate aid) in the form of a wellness and/or safety “check”. Through the capacity for periodic contact from a paid caregiver, family member, designated friend, or healthcare provider, prevention of a worsened healthcare outcome for the senior-aged person can be enabled. Likewise, it can also alleviate the anxiety and fear on the part of loved ones as to the health status and/or safety of that senior-aged person. 

The federal Agency for Healthcare Research and Quality (AHRQ) in 2020 reported that preventable hospitalizations among adults as of 2017 cost the US $33.7 Billion, and such hospitalizations occur most commonly among senior-aged adults. Therefore, insurance companies and healthcare organizations/facilities alike (as well as the patients themselves) are bearing preventable costs that digitally-initiated wellness and safety checks may curtail. 

Focus on Dementia: The importance of digital wearables to support patient functioning

An estimated 6.5 million adults aged 65+ in the US were living with Alzheimer’s Disease as of 2022. That number is expected to triple by 2050 (and one in three seniors is living with some form of dementia by the final year of life). Since dementia is highly associated with failure to take medication as prescribed, “slip and fall” accidents, and preventable hospitalizations, it is also linked to the overall increased cost-burden on the national healthcare system.  

When Alzheimer’s Disease is diagnosed at an early stage, interventions to promote cognitive functioning (such as engagement in online “brain health” games and programs) can be initiated to help prevent the afflicted individuals from experiencing a more rapid decline in cognitive functioning than otherwise. As noted in an article in Frontiers in Neurology in 2020, lifestyle modifications and enhanced social support may delay the need for nursing home care, while also reducing the patient’s overall healthcare costs resultant from living with dementia. In particular, involvement in visual art-making activities has been shown to improve cognition and relieve anxiety in people with Alzheimer’s Disease (and other forms of dementia), per a medical research article in Cochrane Database Systemic Reviews. 

Physical fitness and health status: Changed insurer attitudes toward fitness wearables

Reducing healthcare costs is a persistent issue for private health insurance companies targeting the senior-age demographic, as well as the US Centers for Medicare and Medicaid Services (CMS). Since physical fitness has been linked to both preventing numerous chronic diseases and decreasing the rate of age-related bone loss (osteoporosis), coverage of the cost of fitness trackers has been embraced by an increasing number of health insurers, as described by AARP 

Meanwhile, a Fierce Healthcare article in 2022 reported that Humana is using wearable fitness tracking devices it distributed to enrollees to track data on their chronic conditions in order to encourage embracement of healthy behaviors. Likewise, United Healthcare in 2023 is rolling out a financial rewards program for its enrollees using provided wearable digital tracking devices who meet their daily exercise goals (or other healthful activity goals). 

By utilizing the data obtained from health-related digital wearables, insurers are better able to predict (and adjust for) upcoming year costs related to preventable chronic disorders. (While Medicare does not specify technological devices or wearables in its coverage language, it does cover “medically necessary” Durable Medical Devices [DMEs) – so it is likely that more digitally-driven DMEs will be covered in future years.) Meanwhile, a Health News article in 2023 suggests that current coverage of digital wearables as an added plan benefit (such as a fitness tracker or personal emergency alert system) are far more likely under Medicare Advantage plans. 

Digital wearables, telehealth, and teleconferencing

Talking to a clinician as needed is a way that patients can stick to action plans for recovery at home following different types of surgeries (and also action plans for addressing early symptoms of disorders that require medical attention). For example, patients that are recovering at home following hip or knee replacement surgery – and are participating in post-surgery Physical Therapy (PT) sessions – may benefit from initiating a video call with their physical therapist to boost the likelihood of daily performance of the prescribed exercise regimen.  

Since mental health can affect overall health and well-being, it is also a way that clinicians can remain abreast of their patients’ mental health status. Especially for patients with cognitive impairments, being able to talk to someone via a digital device can improve compliance with medical (and allied) provider recommendations for maintaining overall health. 

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