In this article: Introduction Aging at home • Assessing Our Ability to Live Independently: ADLs and IADLs • “Emerging Technologies to Support an Aging Population” Smart and AI technologies for aging at home • Smart home technologies • AI-powered companions and robots • Medical Monitoring, Smart Emergency Contact, and Transportation Older adults and technology
Smart home technologies have great potential to support aging in place, promoting independence, autonomy, empowerment, and social inclusion.
Moreover, smart homes and AI-enabled technologies have arrived at a pivotal time in which population demographics are shifting and the cost and potential need for senior care is growing.
The United Nations projects that the number of people aged 65 and older globally will be 1.58 billion (16 percent of the world's population) by 2050 and 2.69 billion (24 percent of the world's population) by 2100. The number of Americans aged 65 and older is projected to be 82 million by 2050 (23 percent of the U.S. population) according to a January 2024 report by the Population Reference Bureau (PRB). Meanwhile, according to U.S. care management and home care services provider, Arosa, while there were seven prospective caregivers for every person aged 80 and older in 2010, by 2050 that number will have shrunk to three.
Just as the percentage of the population that is older is increasing, the caregiver demographic is shrinking, leading to widespread concern that the demand for senior care will outpace the available number of professional and family caregivers.
At the same time, however, understanding of what older adults are capable of is also changing. Not only are older adults as a group remaining healthier and more able later in life. With an average life expectancy that has more than doubled since 1900 – increasing from 32 years to 71 years as of 2021 – conventional understanding of “old” or even “older” is also changing.
The prevalent use of the age of 65 to mean old can be attributed to something called the “old-age dependency ratio.” Developed in the twentieth century and used by governments to this day to analyze the sustainability of pension systems and to assess other demographic challenges posed by aging populations, this index has more to do with the age of retirement than chronological or biological aging. It is now widely recognized that one-size-fits-all terms like “elderly” - once commonly used to identify a person aged 65 years or older (and now generally considered pejorative )- or even the more acceptable terms like “senior,” don’t adequately reflect the range of experiences that the process of aging comprises. A 1992 study published in the Journal of the American Geriatrics Society exemplifies this, classifying older adults into the young old (60 to 69 years), the middle old (70 to 79 years), and the very old (80 years and older), as does a more recent 2021 Wall Street Journal article, which titularly reported that, “In Aging Japan, Under 75 Is the New ‘Pre-Old.’”
As humans live longer, healthier lives, the concept of aging is starting to better reflect the wide range of experiences and capabilities that aging comprises.
Aging may be an inevitable process, but it is less and less viewed as a monolithic one.
This is not only true in terms of older adults’ ability to perform fundamental activities required to care for themselves and live independently.
This is also true in terms of older adults’ willingness and ability to use and master technology.
Have we arrived at a serendipitous moment?
Let’s consider growing old while remaining independent (at least mostly) and how to age at home with the help of smart technology.
Aging at home
For some of us aging at home may be a financial necessity, with the high cost of retirement communities and assisted living facilities beyond our reach. For others it may be a choice borne from a desire to remain in homes and communities that are familiar and valued. Maybe, for most of us, it will be a combination of both.
Regardless of the specific reason, a sizeable majority of older Americans are expressing the desire to remain in their own homes as they age.
According to a 2021 survey by the American Association of Retired Persons (commonly known as the AARP), 77 percent of adults aged 50 and older reported wanting to "remain in their homes for the long term." This number, the AARP reports, "has been consistent for more than a decade." The AARP projects that by 2050, there will be 48 million older adults who want to remain in place, up from 34 million in 2023.
Aging at home, however, may ultimately entail the need for some assistance.
Assessing Our Ability to Live Independently: ADLs and IADLs
A person’s ability to live independently, in safety and with a good quality of life, is often assessed using criteria known as the activities of daily living.
The activities of daily living (ADLs), an umbrella term developed by the American physician Sidney Katz in 1950, describe a set of fundamental abilities required to care for oneself and live independently.
Basic ADLs (sometimes also called physical ADLs) include the ability to walk independently; feed oneself; dress oneself; bathe, groom, and maintain dental hygiene; use the toilet appropriately and control bladder and bowel function.
Instrumental activities of daily living (IADLs) encompass more complex thinking and organizational skills relevant to living independently in the community. IADLs include activities such as cooking, driving, shopping, communicating via the telephone or computer, managing finances, managing medication, and keeping up with housekeeping chores and home maintenance.
ADL and IADL checklists, such as the Katz Index of Independence in Activities of Daily Living and the Lawton Instrumental Activities of Daily Living (IADL) Scale, are used by healthcare providers and state and federal assistance programs.
Though how much, when, and in what ways will vary from person to person, eventually, as we age it is expected that we will experience some form of physical or mental decline. This may also be accompanied by more complex health needs and increased susceptibility to chronic medical conditions and diseases.
While most of us will remain completely independent or largely independent well past the age of 65, at some point we are likely to require some age-related help. (As the saying goes, it beats the alternative … right?)
“Emerging Technologies to Support an Aging Population”
Building on the ADLs and IADLs described above, the NSTC report identified basic activities related to managing nutrition, hygiene, and medication; cognition; communication and social connectivity; personal mobility; transportation; and access to health care “as being critical to individuals who wish to maintain their independence as they age” and identified emerging technologies including sensors, apps, and even robots, which could positively impact these areas, assisting older adults in aging at home.
Since the report’s release, momentum toward employing smart home technology to enable older adults to maintain their independence and age at home has continued to grow.
Research programs such as CHART (Collaborations in Health, Aging, Research, and Technology) at the University of Illinois at Urbana-Champaign are “developing home-based technologies to make life easier, safer, and more interesting for older adults.”
CHART’S flagship research facility is the McKechnie Family LIFE (Living in Interactive Future Environments) Home, which opened in January 2021. The McKechnie Family LIFE Home is a model contemporary home furnished with the newest smart appliances and digital assistants including several robots and serves as a lab for testing home technology innovations.
And while indices like the “old-age dependency ratio” treat aging as a worrisome economic problem, lately entrepreneurs have begun to view aging as an economic opportunity.
Citing the AARP, the landing page for the USC symposium notes that the "50-plus population accounted for half of global consumer spending ($35 trillion) in 2020, and by 2050 this figure will reach nearly 60% ($96 trillion)."
Many of the products and services discussed at the symposium were what is known as “Age Tech,” the moniker given to technological solutions for aging-related challenges, technologies which increasingly include smart appliances, IoT devices, wearables and robotics.
In 2019, Dominic Endicott of 4Gen Ventures estimated the Age Tech market, which he also termed the “longevity sector,” at $1 trillion dollars, projecting it to double to $2 trillion (presumably in the near future, though he did not give a date).
The Age Tech market’s growth further underscores how increasing focus on aging in place has sparked a surge in interest in technology that helps older individuals live safely and independently at home.
Smart and AI technologies for aging at home
Smart home technologies
Smart home technology refers to the combined use of internet-connected digital devices, sensors, and machine learning in a residential setting. This technology is capable of gathering and utilizing information about a physical surrounding and its occupants to enhance their living experience. Unlike basic home automation, smart home technology integrates the Internet of Things (IoT) – a system of interrelated physical objects like sensors, processors, software, and other technologies that communicate and share data with other devices and systems via the internet or other communication networks.
Smart home devices and ecosystems provide the same benefits of convenience, safety, and enhanced functionality to older adults that they offer to any adult. The key difference is that for the latter, they may be a luxury or a novelty, while for the former they can provide enhanced functionality that facilitates independent living.
A smart home device is a standalone piece of hardware that connects to the internet and can be controlled remotely, usually via a mobile app. Examples include smart thermostats, smart lights, smart locks, and smart speakers. These devices often have built-in sensors and use data they collect to operate automatically or provide useful feedback to the user. On the other hand, a smart home ecosystem refers to a collection of smart home devices that are interconnected and work together seamlessly. This ecosystem is usually controlled through a central hub or a single app, allowing the devices to communicate with each other and coordinate actions. For example, your smart lights can be programmed to turn on when your smart lock is unlocked. The key difference between the two is that a smart home device operates independently, while a smart home ecosystem involves multiple devices working together in a coordinated manner to create a more integrated and automated home environment.
For instance, smart home sensors that communicate and share data with apps or other devices can control a variety of functions to enhance convenience, safety, and efficiency, including, but not limited to, lighting, temperature, and security.
Contact sensors, for example, use a magnetic switch to detect the manipulation of an object by capturing when two magnets are in proximity to each other. When the magnets are far apart an alarm is activated alerting a resident that a door remains open and needs to be shut.
Motion sensors, sensitive to infrared light emitted by the body, can detect the presence of a person in a room. Motion activated lighting, for example, can then be triggered to automatically illuminate dark rooms and hallways improving safety at night and reducing the likelihood of trip and fall accidents.
Comprehensive systems, such as whole-house security systems like the Ring Alarm Pro, serve more purposes than just notifying you of burglaries or other illegal activities. Such systems can be equipped with sensors that alert you when a door or window remains open, cameras that inform you of the arrival and departure of a caregiver, and smoke detectors that warn you of overcooked food in a pan. Additional features of these systems can include sensors that detect motion, water, or breaking glass and panic buttons. All these features can be managed through a single application, eliminating the need for multiple apps to receive notifications or access various devices. The self-monitored Ring Alarm Pro retails for $300 dollars
Smart home systems enable elderly individuals, including those with cognitive challenges, to remain in their homes safely for an extended period. This feeling of security extends to family caregivers, as they can use the same sensors described above to oversee the activities of their loved ones at home, if necessary, tracking their loved one’s successful compliance with the Activities of Daily Living (ADL).
AI-powered companions and robots
Increased loneliness and social isolation are detrimental to health and increase the risk of mental illness, obesity, dementia, and early mortality.
While all evidence points to having a human friend as the best solution, a growing body of research shows that companion robots and AI-powered sidekicks may help older adults stay healthy and active in their homes by lowering stress and loneliness.
Moxie, for example, is an AI-enabled play-based conversational learning robot designed to enhance emotional, social, and academic skills. Though Moxie is designed specifically for children aged 5 to 10 years old, the McKechnie Family LIFE Home is testing Moxie as an engaging and supportive companion for people of different abilities, limitations, and ages. The Moxie robot is widely available and retails for $799.00.
The animal therapy robot, Paro, is modeled on a baby seal. Paro was originally created to bring psychological enrichment to senior citizens with dementia but is being used more broadly to help people cognitive and developmental disorders and people suffering from PTSD and social isolation. The Paro robot is harder to come by than the Moxie Robot (which you can find on Amazon) and much more expensive, retailing for more than $7500.00.
Though not a robot in the strictest sense, ElliQ, an AI-powered companion designed to reduce loneliness and isolation for older adults, is a much more attainable option.
ElliQ, is described by its manufacturers as a simple an easy to use, offering “positive small talk and daily conversation,” mindfulness and cognitive exercises, workout videos, errand, appointment and medication reminders, video calling of family and friends, and notification of “loved ones if there is a need for support,” among other features.
ElliQ is available by subscription for $59.99/month but may also be available through local Area Agencies on Aging across the United States at no cost to eligible applicants.
Though not yet available to consumers, robots are also being evaluated as devices that provide aid as well as companionship.
At the McKechnie Family LIFE Home, for example, a “soft robot” is being evaluated for possible telehealth uses. Because it is able to reach places that a “hard” robot cannot, if a person suffers a wound in a difficult to access area, the soft robot can take pictures and send them to a telehealth provider.
Another robot being tested at the McKechnie Family LIFE Home is Hello Robot’s StretchTM which is able to reach up and down to pick up objects, assisting senior citizens with activities that can sometimes lead to falls.
Medical Monitoring, Smart Emergency Contact, and Transportation
Medical Monitoring
Biometric remote patient monitoring can alert physicians when biometric data is abnormal. Effective remote care, which is becoming more popular and, particularly in rural and underserved areas, more necessary, can minimize the need for in-office doctors’ visits. Proactive monitoring can help prevent medical emergencies and enhance general wellbeing.
With potentially complex medical conditions that require multiple medications, medication adherence can be a challenge.
AI-powered companion like ElliQ can set medication reminders and smart pill dispensers, though still being perfected, are designed to automatically dispense medication according to a pre-programmed schedule helping patients manage their medication intake, reducing the risk of drug interactions, and ensuring that the correct dosage is taken at the right time.
Smart Emergency Contact
Emergency-contact systems often involve wearable electronic gadgets that offer round-the-clock surveillance and might incorporate fall detection features.
An example of a wearable smart emergency-contact system is the Apple Watch SE which can detect falls and even certain cardiac events. The watch can make and take calls, send help automatically, and can provide emergency responders with medical information, such as blood type, ECG stats, and medications.
Smart speakers equipped with emergency-alert functionalities can also function as emergency-contact systems.
Transportation
As part of the PRISM study, researchers are developing “user-friendly instructional support for transportation apps” to help older adults, particularly individuals with cognitive impairments, use transportation services like Uber more easily and successfully.
Older adults and technology
The COVID-19 pandemic highlighted the essential role that even basic technology can play in lessening loneliness by enabling older adults to stay in touch with their loved ones. Many older adults who saw no value in owning a computer or mobile device now recognize the benefits.
Nonetheless, and despite the growing Age Tech market, a common misconception that older adults don’t or won’t use technology persists.
Studies point in the opposite direction, however.
Data gathered by the AARP and the Pew Research Center conclusively shows that older adults (at least in the U.S.) are adopting and using technology in growing numbers, reports The Gerontechnologist, a site dedicated to elucidating the intersection of tech and aging.
Citing The Gerontechnologist founder, Keren Etkin, a report by financial news website, The Street, noted that Americans over 50 own, on average, seven devices, most of which are being used daily.
But while the stereotype “that older people can’t cope with technology or that they only want simplistic designs” is being challenged writes the APA in aforementioned 2021 article, “Optimizing tech for older adults.”
A major challenge for the Age Tech industry is not to simply design technology to address challenges of aging but rather to design technology that reflects the desires and interests of the users themselves.
“Many technology companies, for example, forge ahead with designs that they think would benefit older adults without understanding the differences in various age ranges or consulting potential users” writes the APA.
On the other hand, the role that thoughtfully designed technology can play in facilitating independent and at-home aging is becoming increasingly clear as is the fact that older adults are welcoming it.
K. (“Kristen”) Powell is a technical writer and ghost writer for a firm that represents advanced degree STEM professionals, many of whom work on the cutting edge of AI and robotics. While fascinated by the research and the high-tech innovations she learns about through her professional life, in her personal life Kristen seeks simplicity and a welcoming and uncluttered home.