1/ Thread: Older generations have known what it means to be stuck at home. The experience of being stuck at home by younger generations is generating newly found empathy for the elderly that may enhance the #tech and #policy efforts for everyone to stay connected in the community

2/ In addition to younger generations experiencing isolation at home, the shocking number of deaths in nursing homes have made the elderly that survive less forgotten and voiceless. Tragedies like Kirkland are raising the frail from lowest part of the public policy totem pole.

3/ Loneliness no longer an older people problem. It's a ubiquitous health determinant. And it's becoming a profound comorbidity. Now that elderly are suddenly more visible, we must not lose site of the importance of aging in the community as we design post-COVID tech & policy

4/ #COVID19 experience is unmasking technology innovations for aging in place: A family friend (85) has mild cog impairment living in assisted living in 1 BR apartment. They shut down group dining immediately. They put social distancing measures in place very stringently...

5/ ...& they've reaped benefit with not a single COVID case. But there've been trade offs. Family friend stuck in his 1-BR apartment for 2 months. He's coped w/ isolation by using his iPhone to do a beautiful tour of apartment that's engaged whole family & made him feel connected

6/ Another family friend (90yo) is living in a 2000 unit assisted living/nursing home. They too were very quick to socially isolate. They too haven't had a single case of COVID.

7/ While great in COVID control, I was concerned about isolation. Activities director got tablet out to everyone. They had daily "social" rounds to assist residents, ensure everyone stayed connected w/ their families. It meant a lot to us to have that daily communication.

8/ Challenges that transcend #COVID19 can be addressed through catalytic innovation during #COVID19. For example, hearing loss is very prevalent & a big challenge. It's a challenge that has been profoundly unmasked as we communicate with elderly family members via zoom/ facetime

9/ But what do we do when they can't hear us!? A low-tech hack has made a big difference: captioning. @zoom_us has captioning but font is very small...

10/ ...We jerry-rigged calling our elderly family friend through an #iphone which went to his blue tooth cochlear implant for audio and used zoom through the computer for the shared video with multiple family members.

11/ While we could have all tried to coordinate a shared #facetime to solve the problem, family members shouldn't have to hack around hearing loss. How have we gotten this far w/ tech and yet it's so far behind? Why doesn't facetime have captioning?

12/ Tech innovators should eliminate the friction for us. It's the common everyday simplicity that is the difference between our elderly family members feeling helpless vs feeling empowered and connected #aginggracefully #DesignThinking

12/ As technologists design for the thriving in place world, keep in mind the psychology around aging. Let's build on the hearing loss example. We know many ppl need hearing aides. But many people don't want to wear them b/c it makes them seem old

13/ We know from focus groups that if "i have to switch from no hearing aide to a hearing aide, it's not that I'm older, it's that I'm OLD, I'm no longer independent." That mental shift, that psychology is powerful.

14/ As tech & policy designers, how do we design experiences to not make people feel old, just older. If our 90 yo relative can learn to use an iPhone b/c it's so simple & then stay engaged, be part of the community; it's now not just and elderly thing, it's an everyone thing.

15/ In fact, now is the time for us to not just reinvigorate aging in place but to reframe it as thriving in motion and independence on the go not just at home.

16/ With the pre-COVID19 focus on creating smart homes, the @amazon Alexas and the @Google Home's of the world have an enormous opportunity to play a prominent role in the aging in place and "thriving in motion" movement. @KBDeSalvo @JeffBezos

17/ Tech redesign and policy redesign go hand in hand in the shift from from in-person and provider-led care to virtual and self care. There are many levels of policy change. #Medicare #Medicaid

18/ In a recent chat w/ an architect who designs dorms for college campuses, they noted that old guard of dorm design made it very easy to stay in your room and become isolated (or study). So the architects designed dorms so that it's natural to bump into other people...

19/ ...to reinforce a communal feel. This of course has downside when trying to social distance, but important thing to remind ourselves is to use design first principles when thinking about the "job to be done" or "how might we" aspects of aging in place or thriving in motion

20/ Those design principles should be applied to policy impediments to Access to broadband/wifi, revamping siloed palliative and hospice care, aligning supplemental benefit design, and interoperability between tech.

21/ The challenges of social isolation are palpable to almost every American. But those Americans that don't have access to wifi don't have access to one of the only lifelines to connectedness.

22/ Long term care (LTC) has siloed home care, palliative care, and hospice care. A family friend has metastatic lung CA. She doesn't want cure, just wants to be comfortable and pain free. She got really deconditioned from multiple hospitalizations...

23/ ...To get to home, she needed to relearn to walk up and down stairs. Here's the problem: in palliative care, we can get PT paid for. In hospice, we can get all other comforts but NOT PT per Medicare rules.

24/ Another policy design snafu: Fam friend can't ambulate. She's starting to get a discoloration on butt which could turn into bed sore. Can't get gel mattress unless she has FULL bedsore. To qualify, she needs to develop a completely preventable bed sore.

25/ Another policy problem: not having good interoperability standards. Recent rules hold promise, but they're delayed. Current/future rules need to enable the tech community to not compete on proprietary data but rather on bells & whistles of how they use data & customer service