Technology for Aging

2020 Market Overview

March 2020

Laurie M. Orlov
Principal Analyst
Aging in Place Technology Watch
FORWARD

In 2020, a modest category becomes mainstream. It took the aging of the baby boomers and
the sheer size of the aging population to turn a 2009 market niche into a 2020 major market
category. That category is less about products specifically designed for older adults as it is about
the marketing of many existing offerings as useful to them. This includes smartphones, tablets,
smart home technology, Voice First hardware and virtual assistants, and in-home sensors. Each
of those devices is enabled for older adults by either more targeted marketing and packaging,
enabling software, or bundling into solutions for in-home caregiving and/or healthcare.

The older adult market presents a challenge and an opportunity. Large players like
Samsung, Amazon, and BestBuy see a market opportunity worth seizing. In 2020, Medicare
Advantage plans began covering some in-home technology to help seniors remain independent –
and the use of digital health technologies, including remote patient monitoring and remote
consultation, continued to grow. During 2020, hearing technology advances and changes in
buying patterns will further disrupt that industry.

What’s new? The title, for one. Useful technology for ‘aging in place’ is also useful for those
aging in senior living communities – or any other place. Almost every line in this Market
Overview has been updated to reflect current demographic data about older adults, policy
changes, as well as inclusion of new data about what tech they own and/or prefer. To make space
for interesting new examples, some previous offerings were removed to enable inclusion of 25
recent entrants (some winners of innovation competitions).

A pandemic crisis pushes the technology accelerator. This report was initially posted on
March 5 – prior to the widespread news of the Covid-19 pandemic and its implications. From a
technology perspective, when the entire country is homebound and older adult are without access
to face-to-face doctor appointments, no visitors in senior living, and social isolation in the
extreme, technologies noted in this report become more useful than ever. And some
technologies, like telehealth, find a tipping point in a hurry.

What else has happened since the last update? In March of 2019, a new White House report
“Emerging Technologies to Support an Aging Population” was published, suggesting many
new technologies that are needed, some in process of being developed or released, to help older
adults remain independent. The Appendix at the end of the report lists many of these suggested
product/offerings. Looking over this list, perhaps some entrepreneurs will study it and see an
innovation opportunity for their current or new business. Please advise if that happens!

Here’s to the year of 2020 that ends with balance and safety for all.

Laurie M. Orlov
Aging and Health Technology Watch www.ageinplacetech.com
Page 2
WHO SHOULD READ THIS REPORT?

This report was revised in March 2020, adding 25 new companies and updating products,
services, websites, and apps. It serves as a market overview with a single purpose: it is intended
to describe the need for, and the current market of, offerings to help aging adults live full lives in
their homes of choice. As such, it is relevant to:

• Vendors and entrepreneurs marketing to baby boomers and seniors

• Social networking sites targeting baby boomers or seniors
• Advocacy and tech training groups
• Retirement Communities that serve independent adults
• Senior living communities, and long-term care providers
• Senior housing developers
• Home care and home health agencies
• Geriatricians
• Hospitals and integrated service delivery networks
• Government agencies and policy makers
• Geriatric care managers (Aging Life Care)
• Naturally Occurring Retirement Communities (NORCs)
• Startup incubators
• Venture capital and angel investors interested in the boomer/senior market
• Caregivers, seniors, and family members

“Every venture firm or corporate venture group should read this and create an investment thesis
around these trends – Mary Furlong, CEO, Mary Furlong and Associates

Aging and Health Technology Watch www.ageinplacetech.com

Page 3
THE CONTEXT OF AGING – EVERYBODY’S DOING IT, MOSTLY AT HOME

The majority of older adults today live in their own homes – with 76% of aged 65-69 and 68% of
those aged 80 and over. Not surprisingly, the majority (76%) would like to stay there or may be
forced by finances to do so. After age 65, the likelihood of living alone increases sharply (see
Figure 1). For those who live in cities, after age 80 they want to live in their own home or
nearby. However, as the calculators of net worth by age indicate, unless a home is sold, there
will not be enough to pay for seniors’ potential health costs when they are in their 80’s or 90’s.

Figure 1 Source: JCHS Housing America’s Older Adults 2018

Within that context, aging in place reflects the desire or ability to successfully age and remain in
their home of choice, whether it is a private home, condo, apartment, or group settings. These
group options includes variants of senior living – in 2019 which reached its lowest occupancy
level in eight years and is viewed as out of reach by most middle class homeowners. Aging at
home is further underpinned by the very recent growth of interest in the mature market. During
2019 and into 2020, new product introductions were presented at multiple events, including the
following, CES 2020, Voice of Healthcare Summit, and pitch events run by AARP in 2019 and
at CES in 2020. Even if startups fail, they represent a sharpening focus on caregiving and age-
related spaces. Three factors drive a wave of interest in caregiving, home care and aging in place:

Rising health costs and health policy drives care into the home. As Medicare penalties for
hospital readmissions grow, hospitals seek to better control their destiny in the face of closings.
They are providing outpatient clinics and buying rehab facilities (aka skilled nursing facilities, or
SNFs) and managing hospital-to-home care transitions. Insurers try to reduce readmissions with
improved care coordination and care transition programs. During 2019, Medicare

Aging and Health Technology Watch www.ageinplacetech.com

Page 4
reimbursement for use of telehealth technology remote visits. And out-of-pocket healthcare
spending rises as people age – for medications, hearing aids and end-of-life care.

Paid home care picks up where families and senior housing leave off. On average, home care
fills a care gap of 20-27 hours per week at a presumed lower cost ($22.50/hour paid to agency),
than a move to assisted living. However, non-medical home care work (or personal care aide)
has been one of the fastest growing job categories in the US, and costs rose 7.1% in 2019,
according to Genworth. Pay to the worker averages around $12/hour for the worker. And for
much of the industry, median caregiver turnover rate reached 82% in 2018 and staffing
challenges are top of mind for home care agencies (see Figure 2). As the projected shortage of
home care workers worsens – especially in urban areas in which workers cannot afford to live –
shortage predictions are dire, predicted to amount to 7.8 million unfilled jobs by 2026.

Caregiving – a dilemma of high costs and demand for workers. The most recent data
indicates that 22% of adults age 85+ need help with personal care. As families and seniors
compare the costs of aging at home to aging in a senior living community, the cost projections
begin to look similar – with the median monthly cost of full-time home care now at $4290,
versus $4051 per month for senior living, according to Genworth Financial.

Figure 2 Source: Bureau of Labor Statistics

Aging and Health Technology Watch www.ageinplacetech.com

Page 5
Data breaches and scams worsen, and so does the risk to seniors. The closing of physical
locations like Social Security offices or bank branches has yet to accelerate the urgency of
helping offline seniors to move online. Seniors and their families should be cautious, however, as
2019 also turned out to be another memorable year for data breaches, most notable were Marriott
(hackers got into 500 million SPG accounts). In October, 2019, the FTC presented its report,
Protecting Older Consumers, to Congress showing the sharp difference in fraud loss for the
oldest population (see Figure 3). In addition, financial exploitation of the elderly is on the rise,
creating more opportunity for caregiver involvement and use of scam avoidance technology.

Figure 3 Protecting Older Consumers 2018-2019 Source: Federal Trade Commission

DID YOU KNOW Facebook exposed the telephone

numbers linked to 419 million user accounts in 2019?

Stark consumer economic realities challenge senior living occupancy... Average net worth of
the 75+ inclusive of home equity is $200,000 (see Figure 4). Low level of savings slows moves
to assisted living, where move-in age is closer to mid-80’s (see Figure 5). With more than half
of assisted living residents aged 85+, this has become a frailer demographic, needing help with
multiple ADLs. But boomers are right behind them – and will be even less able to move in. They
have simply not saved enough – holding an average retirement savings portfolio in their 70’s of
$186,800. That’s not enough to live on after retirement and later afford more than a few years at
a private assisted living community with an average nationwide monthly now at $4091.

Aging and Health Technology Watch www.ageinplacetech.com

Page 6
…And life expectancy at age 65 is still substantial, especially for women. For example, in
2018 updated life expectancy, used in pension fund calculations, projects that women aged 65,
on average, can expect to live until they are 86.7; men can expect to live on average to be 84.
Worried about outliving their savings, for 25% of workers, 80 is the new 65. The combination of
limited savings and longer life expectancy has raised fear of outliving assets. Being unable to
afford more than a few years of assisted living averaging $48,000/year may keep seniors at
home. Average age assisted living is 22 months, with 59% moving to a skilled nursing facility.

Median Net Worth $

75+

65+

70 to 74

65 to 69

55 to 64

45 to 54

35 to 44

Under 35 years of age

0 50,000 100,000 150,000 200,000 250,000

Figure 4 Median Net Worth Americans by Age Source: WalletHack January 2020

Figure 5 Senior living rents versus occupancy (Source: Bloomberg)

Aging and Health Technology Watch www.ageinplacetech.com
Page 7
Investors and Policy Makers Care More about Caregiving and Technology

Caregiving demands of an aging population drive policy change in 2019. In January, 2019,
the coordinating body for Health IT (ONC) released interoperability advice, connecting people to
their care, that requires representing the relationship between a patient and another person
(provider, caregiver, or family member). In February, ONC proposed a further rule change that
would allow individuals to securely and easily access structured Electronic Health Information
using applications for smartphones and other mobile devices. Furthermore, Medicare Advantage
and Medicaid plans are more likely to cover PERS devices and other in-home technology.

White House Report in 2019 offered useful suggestions that deserve follow-up. The release
of the 2019 White House report in March added new emerging categories of technology to
enable living independently, including dental hygiene, critical for older adults (See Appendix at
the end of this document). The report also made recommendations about boosting adoption,
noting that design of’ ‘zero-effort’ technologies should include an ‘adequate assessment of user
needs, usability analysis, and studies…and needs-finding through interaction with older adults.’

Despite enablers, tech adoption by older adults has not kept pace. The surveyed ubiquity of
technology has led to a belief that it is everywhere it needs to be, with media assumptions about
the benefit of smartphones and online tools, ownership of devices, or access to broadband
speeds. But barriers remain. For example, with smartphone adoption of the 70+ at just 62%,
device complexity, price, poor usability, forced obsolescence combined with lack of standardized
professional training have created big barriers to broadening smartphone usage of an aging
population, particularly for individuals aged 70+. (See Figure 6 and Figure 7).

Older Adult Device Adoption through 2019

Device Age 65+ Age 70+ Source
Cellphone (not 39% Pew 2019
smartphone)
Smartphone 53% 62% AARP 2019
40% (age 74-91) Pew 2019
Wearable 11% AARP 2019
17% (age 50+) Pew 2019
Tablet 49% 40% AARP 2019

Computer (Desktop, 73% AARP 2019

Laptop) 71% Census 2017
Use the Internet 73% 44-60% Pew 2019
Home broadband 59% N/A Pew 2019
Smart Speaker 12% AARP 2019
19% Pew 2019
Need help with 73% N/A Pew 2017
setup/tech training
Very confident re: 12% 13% AARP 2019
privacy

Aging and Health Technology Watch www.ageinplacetech.com

Page 8
 Figure 6 – Tech Adoption, Source, age 65+, age 70+
Enablers/Barriers to Tech Adoption and Older Adults

Key Enablers for Tech Adoption Key Barriers to Tech Adoption

ONC Interoperability – including family, Device ownership and trust of technology,
caregivers of patient especially fraud-related
White House recommendations for ‘zero- Availability of standardized training
effort technologies’, specialized training programs across US
Smartphone-wearables to track wellness, Perceived value and training among older
motivate activity users
Medicare Advantage reimbursement Device management forced
changes to support device use obsolescence, upgrades, software
versions
Discounts available for broadband (low- Standard price of home broadband
income)
Voice First (Amazon speakers, Google Concerns about privacy with always
Assistant) broad visibility, deployment listening devices
Figure 7 Tech Adoption – Enablers and Barriers in 2020

Medicare Advantage changes will feature tech-enabled home care services. Besides further
cementing consumer commitment to support aging at home, A far-reaching change began in
2018 to expand benefits for the chronically ill and further resulted in changes to Medicare
Advantage plans (currently covering a third of Medicare beneficiaries). These plans are
beginning to cover in-home services and technology devices in 2020. This change will no doubt
drive interest in labor-saving caregiving technology in both home care and senior living settings.

Digital health usage grows in some categories. The Digital Health Summit at CES 2020 was
bigger than ever – with 4000 exhibitors across 2.7 million square feet and attended by many of
the 175,000 CES 2020 attendees. And technology for older adults could be found, innovators
exhibited, with a number of offerings that could be of benefit if broadly marketed and resold. In
addition, adoption of online digital health tools continues to rise, notably in the growth of
consumer access to online information (see Figure 8). While wearables were now more popular
in 2019 for adults aged 55+, seniors aged 65+ are still unlikely to own them.

Fall detection innovations moved off body, into the room. More offerings emerged recently
seeking to detect falls without a wearable on the body. These include an AI-enhanced video tool,
SafelyYou; Vayyar’s Walabot Home, Essence SmartCare, and Starkey’s Livio hearing aid.
Fall prevention could include detection of changes in movement, as with BioSensics (on the
body), and StaySmartCare (in the room with infrared and radar).

DID YOU KNOW that one in four adults age 65+ falls each
year? According to the CDC, the estimated medical cost of
falls across the U.S. healthcare system is $50 billion annually.

Aging and Health Technology Watch www.ageinplacetech.com

Page 9
Figure 8 Source: American Medical Association February 2020

TECHNOLOGY UNDERPINS, DOES NOT REPLACE SERVICE OR FAMILY ROLES

The categories of technology offerings required to age successfully include independent market
segments – each useful – but together, they complete a puzzle for a fulfilling and interactive life
for older adults, enabled as needed with the support of families and caregivers (see Figure 9):

Communication and engagement. For baby boomers and younger, life is unthinkable without
web surfing, Facebook, smartphones, and texting. As 2020 began, tech vendors like Samsung
and BestBuy both honed the opportunity for a line of technology for older adults. Larger,
brighter and more expensive smartphones like the Samsung Galaxy Fold or the iPhone 11 Pro
Max compete with today’s general purpose tablets. The newest versions of voice-first interfaces
(like Alexa, Google Assistant, Siri or Bixby) raise the bar on in-home tech experiences for the
growing numbers owning the devices. For the one-third of 65+ individuals with hearing loss,
attractive and functional hearables add to a disrupted hearing technology market, along hearing
aids that are more attractive, lower cost, or more available through direct-to-consumer channels.

Safety and security. The ability to remain at home depends on whether the home is free from
obstacles and dangers, especially for the 46% of women aged 75+ who live alone. Basic home
alarm systems for fire and flood are mandatory, but today seniors can also be served by smart
home sensors (IoT), many announced during 2019 and early 2020. PERS vendors that get
monthly fees from their PERS and call center businesses will increasingly link to other services
that can be voice-enabled, for example MobileHelp-LifePod. Innovative approaches to fall
detection are also entering the market (like Essence’s radar or SafelyYou’s AI/Video offering) .

Aging and Health Technology Watch www.ageinplacetech.com

Page 10
Health and wellness. The risks associated with obesity and lack of exercise only worsen with
age. Health-related technology received significant attention at the CES 2020, with an increasing
focus on personalization. Even HIMSS, largely focused on the non-consumer Health IT market,
included a number of technologies that involve patients directly. Sensor-based home monitoring
technology has increasingly been marketed as remote patient monitoring (RPM). In November,
2019, CMS finalized rules for reimbursing telehealth and remote patient monitoring (RPM),
which could invigorate physician adoption.

Learning and contribution. Experts have noted that once the basic needs of communication,
safety, and health are addressed people have both the need and capacity for more. This includes
learning, staying aware and active in society, contribute through volunteering and growing
numbers of older workers. They also are leaving a legacy of stories (not just money) for those
who love them. In addition, a 2019 study showed the benefits of telling their stories for seniors
with dementia. Due to labor shortages and the percent (one in five) of workers aged 65+, AARP
and OATS help an older person obtain skills to prepare them to find a job.

Caregivers care about technology – wish it supported them more effectively. According to a
recent study by Cambia Health, 64% of surveyed caregivers use at least one digital tool to help
them with caregiving. Forty-one percent expressed interest in using a tool that would connect
them to experts, as well as a health guide via chat to answer questions. But 25% of responders
expressed concerns about data privacy, a growing worry in the face of numerous hacks and
identity thieves today. Other concerns raised included ‘too many tools’ and lack of awareness.

Aging and Health Technology Watch www.ageinplacetech.com

Page 11
 Figure 9 The interdependency of technologies for older adults

Complex Markets Require a Channel Strategy and Good Design

One go-to-market channel is not enough. Depending on the product or service, it may need a
mix of resellers/distributors, face-to-face, and online sales. As the 2019 Pew Internet/Broadband
Survey showed, 27% of the 65+ market is still not online. If that population needs a technology
or service, caregivers will peruse online sites, depending on need, like Best Buy’s Aging in
Place, FirstStreetOnline or AbleData. New entrants must form partnership early – at the pilot
stage with channels like these or PERS dealers who resell medical alert devices, for example.

What do caregivers and older adults need? The caregivers of older adults are sometimes
surveyed, but rarely about tech needs. The Catalyst survey showed the importance of tools for
care coordination and finding care workers; plus a smarter, lower cost PERS device that would
serve as more of a caregiver communication platform. As caregivers, professionals, and families
seek alternatives to better serve older adults at home, what are the requirements for making
technologies both useful and likely to reach the intended market?

• Technologies must be well-supported and intuitive. Most people have a laundry list of
frustrations with technology, regardless of age. The failure of previous direct-to-
consumer approaches underscored the fallacy of inventor-centric thinking that ‘if we
create it, they will buy it from us’ or at least find it Amazon. But what if it is a device
fitting into a Wi-Fi home network with other devices, a printer, a few voice devices and a
Aging and Health Technology Watch www.ageinplacetech.com
Page 12
 webcam? Instead, remote configuration and support partners must be a major part of the
offering – or doom the user and family to frustration and tech abandonment.

• Device and app vendors must be capable of integration and extension. Despite
standards initiatives, task force recommendations or ONC Interoperability (2019), many
of today’s gadgets still don’t communicate – especially with each other’s proprietary
systems or data sets (like Electronic Health Records). So mobile health devices, apps or
medication reminders may be useful, but touch a tiny aspect of the whole person. Patients
struggle to get their own records in a transferrable form upon discharge.

• Privacy and security features will be built into design of software and websites.
Cybercrimes targeting the elderly have ballooned to a cost of $650 million in annual
losses, and that includes only those that are self-reported. For safety-oriented apps and
sites that include the role of the senior, it’s critical to verify identify among provider and
user roles. Two-factor authentication will likely as part of online (and future voice)
health-related services.

• Costs to consumers must be affordable. As tech becomes more usable and useful,
consumers and families will look for ways to acquire technology like Wi-Fi or medical
alert devices. A fragmented set of discounts/subsidies are available for Wi-Fi. Some
insurers now reimburse for PERS and telehealth. But family will still play a supportive
role in acquiring technology. High speed internet enables engagement with grandchildren
and powers voice-first tech like Amazon Echo or Google Assistant. These tools enable
home automation and reduce social isolation, both in senior living and individual homes.

• Upgrades will be invisible or painless. Consumers already gravitate towards software

applications that mostly work with ones they already use, including Gmail, Facebook,
FaceTime, YouTube or Skype and now Google Assistant – regardless of device. With
content increasingly in the cloud, upgrade processes will be more seamless than the old
‘No Going Back, You Must Upgrade or Else!’ style. Personalized user interfaces (like
Amazon and Netflix), recognizable across devices, will increasingly be a design norm.

Technology Trends that May Help Older Adults

Across all consumer devices, wireless charging pads and stands have made coping with mobile
technology easier. Connections are less likely to wear out before the device is retired. Across
many devices today, consumers will find assistive features (for vision and hearing limitations)
that are built in. Older adults would benefit greatly if vendors and stores selling devices (or
providing training) spent time introducing them to those features (See Figure 10).

Pattern recognition and analytics augments simple monitoring. Pattern analysis, dashboards,
and predictive analytics have permeated tech innovation for years, including healthcare, but have
been slow to enter the world of caregiving for older adults. That is changing – and new entrants,
for example, StaySmartCare, SafelyYou and EnvoyatHome are pioneering use of pattern
analysis to indicate issues that caregivers need to address. During 2020, more will be announced.

Aging and Health Technology Watch www.ageinplacetech.com

Page 13
Wearables became more visible – on the wrist and in the market. The Apple Watch Series 4
disrupted the senior wearables market with its built-in ECG and fall detection, as well as Apple’s
partnership with insurers. That created revenue growth for Apple, but also more opportunity for
Apple watch-based alternatives like Fall Call Solutions. And as a result of Apple’s more senior-
capable offering, emergency watches (PERS) with call center integration, like MobileHelp, and
UnaliWear, got a boost. As the overall market continues to grow, expect more smart wearables
like Freedom Guardian’s smart watch, MobileHelp Smart, and TrelaWear smart jewelry.

Voice first technology – it’s everywhere and in everything. In 2019, Voice First represented a
category of technologies like smart speakers and voice assistants. Now health organizations and
providers are moving forward with voice-enabled interfaces to everything from hospital rooms,
appointment scheduling, doctors note-taking, prescription requests, and even discharge
instructions. The ability to ask Mayo Clinic a question or get an update on a prescription will be
a notable benefit to older adults who own smart speakers or have phone-based assistants. Expect
moving forward that older users to be willing to trade concerns about privacy with an always-
listening device against the benefit of this easiest interaction mode of speaking.

Amid market disruption, hearables market begins to resonate – and grow. The hearing
technology market is seeing disruption from multiple angles. Smart hearables were news at CES
2020, including AI-enabled hearing aids with fall detection, better and adjustable noise
cancellation – especially interesting for older adults in noisy restaurants. Add integration with
voice capabilities like Siri, Google Assistant, and Alexa and the ability to stream audio content
directly to in-ear devices. With the introduction of Over-the-Counter Hearing aid sales (and
recommended guidelines), coupled with the beginnings of insurance reimbursement, those with
mild-to-moderate hearing loss are likely to benefit from many of these changes.
Smartphone market saturates – and some prices drop. Only 2 major vendors, Samsung
and Apple, compete in the US smartphone market and the overall space is clearly saturated. The
top smartphone apps in 2020 cross platforms – those used by more than 50% of smartphone
users include YouTube, Facebook, Google Search, Google Maps, Gmail, Facebook Messenger
and Google Play. But for the general consumer marketplace, there is some optimism about smart
flip phones and their potential comeback. In addition, consumers are owning smartphones far
longer, than 2 years – and may not see a reason to upgrade to a pricier device.

ADVICE TO VENDORS: IT’S TECH-ENABLED SERVICES, NOT PRODUCTS

Probably the biggest issue that keeps more of today’s technology out of the homes of seniors is
the difficulty of marketing to them (“We are not old!”) and their afraid-to-interfere adult
children. Therefore, it’s important to sell through knowledgeable channels, appropriate websites
AND pricing right for resale and possible white labeling. Vendors must find:

The right customer or referral – families and service providers partners. Direct-to-consumer
marketing of products and services takes deep pockets just for the advertising – note the growing
number of ads for low-cost hearing aids. For early stage companies, start locally – get to know a
local home care agency, senior living company, or home security company. What they have in
common? Entry into the home.
Aging and Health Technology Watch www.ageinplacetech.com
Page 14
Standards enable users and integrators to cross tech boundaries. Times are changing – as in
this smart home interoperability initiative – a recognition that, despite intense competition,
consumers likely own a wide variety of devices and software that should be able to work better
together. Amazon launched a similar initiative for voice offerings like smart speakers and voice
assistants. Therefore, ensure that the new offering works across multiple platforms and comes in
multiple form factors – voice, smartphone, web, for example.

Access to ongoing training and refreshers – much work needed. To be sure, the oldest are
likely to approach smartphones as another variation of flip phones – until they can learn of their
utility in a store, online, from their family, or in community training centers. Automatic updates
and application software changes push users back for refreshers to avoid considerable frustration.
Despite the efforts of senior centers and other non-profits like NCOA and its Online Banking
training, training services lag the pace of tech change and rapid growth of threats, including
hackers’ ability to pinpoint location and/or steal identifying information.

The real user need – a service problem solved. Seniors and their adult children may not
imagine on their own what to do with sensor networks, web cams, or smart speakers. A home
security company could someday help explain the benefits, for example, of care coordination,
when selling tech to a home health agency. Instead of offering point products out of context,
vendors should fit solution descriptions, service provider stories, and senior support processes
along the continuum of needed care and socialization. This necessitates a grasp of the decision
points that spike need and interest, using these as part of websites and marketing (see Figure 10).

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. Reseller partnerships can extend
reach, service configurations and specific geographies. For example, PERS vendors may market
through multiple regional service providers, but prices can vary for local markets. Retailers like
Best Buy’s Aging in Place may provide white label options for home care agencies, pharmacies,
senior housing organizations or insurance partnerships, many of these adding voice activation.

Partnerships matter – first as announcement-ware. Fresh posted announcements of

partnerships are indicators of forward business motion. For example, announcements of
transportation partnerships to help older adults sprouted like weeds – but we may never see an
announcement if they are weeded out. A few examples: Lyft Concierge and Medicare
Advantage plans, Humana and Philips or LifePod and MobileHelp.

Aging and Health Technology Watch www.ageinplacetech.com

Page 15
 Figure 10 Technology needs of older adults evolve over time

Senior-focused non-profits matter. From AARP’s Innovation Labs and media channels, to the
local tech fair, each play a role in helping startups gain awareness and get their offerings into the
market. The American Society on Aging (ASA) runs a national event each year called Aging in
America – with a large presence of attendees in the social services and vendors who are potential
partners. Regional lifelong learning organizations run tech fairs like San Diego Oasis are a great
way to help development teams learn about the end customer and what they care about. And
national organizations like the National Council on Aging (NCOA) plan to increase use of
technology to improve awareness of their service offerings like Benefits Checkup.

“Every technology is of value to older adults – for example, new technologies like
conversational AI and personalization algorithms can help create a customer segments of one
with personalized solutions to each individual older adult.” – Saeed Elnaj, CIO, National
Council on Aging

Aging and Health Technology Watch www.ageinplacetech.com

Page 16
HOW DOES THE TECHNOLOGY MARKET FOR OLDER ADULTS EVOLVE?

The marketplace of products and services today is still fragmented, with ever-shifting cottage
industries comprised largely of startups, challenged by channel complexity and end user
resistance. According to AARP’s Longevity Economy projections, the 50+ population will
control 51% of technology spending by 2030, just a decade away. That market will be dominated
by new tech likely introduced by the largest players who will acquire startups that matter.
Benefits of new tech will accrue to all, but challenge users at every intro. Service providers,
caregivers for older adults, and senior living organizations will need to keep up (see Figure 12).

What are the key trends to watch in 2020?

As 2020 began, trends that became apparent in 2019 come into sharper focus. The market for
technology for older adults will continue to grow, but it increasingly looks like the market of
technology for all consumers, not just the elderly, is the one to watch. Consider that:

It’s still Digital Health, now more useful to older adults. The dream of reimbursement is
becoming a reality. Especially interesting? Remote patient monitoring (RPM) during an
epidemic, which persists as the way to replace or supplement institutional care for in-home care
by hospital/health systems and medical practices. And regulation changes in the past year are
have begun to turn the adoption tide. Also at HIMSS and the Digital Health Summit, vendors
are beginning to learn that older people, consumers of a significant portion of healthcare
spending, will need many of the Digital Health technology categories.

Voice first interfaces will be ubiquitous. For older adults, voice-enabled interactions will be
preferred when they are possible and when cloud-based services are accessible. Why? Because it
is easier for them – enabling the transformation from typing, pinching, zooming and glass screen
frustration into a services world in which what you say should get you what you need. As
happened with IoT apps, voice interfaces will be added to every feasible device (and new car),
whether it makes sense or not as with hackable dishwashers or ’peak stupid’ toasters. Older adult
users may not want easily hacked or always listening devices, though. And they are also not
enamored with self-driving or electric cars.

Hearing technology markets will be further disrupted – users win. Consumer Report’s 2018
survey found that nearly one-third of people who reported difficulty with hearing did not visit or
delayed seeing a professional. Reasons vary, but often include denial of hearing loss, perception
of stigma associated with hearing aids, and concerns about cost. As lower-cost options grow –
hearables, retail and at-home self-service/self-fitting and purchasing of hearing aids, individuals
with hearing loss may opt in to alleviating hearing loss earlier than the typical 7-year wait.

Caregiver shortages will boost interest in home monitoring technology. The intersection of
three simultaneous trends of aging alone at home, worsening caregiver shortages and turnover,
and the percentage of adult children working, interest in monitoring technology in the home will
grow, including web cameras, sensors, smart doorbells or voice-first tools.

Virtual reality and robotics usage will continue and grow. The press loves to write about
robots and seniors. Still largely at the anecdote stage, widespread use of care-related robots in the
Aging and Health Technology Watch www.ageinplacetech.com
Page 17
home or in senior living communities hasn’t happened and is not expected for years. On the
other hand, virtual reality tool possibilities expanded during 2019, particularly in the area of
caregiver training (Embodied Labs) and more senior living communities are deploying virtual
reality (MyndVR).

The absence of widely available tech training and support should prompt innovators. It’s
not just seniors who need help. The proliferation of devices, persistence of AARP Tek Training
workshops, the growth of the Best Buy’s Geek Squad into Total Tech Support (any device) – all
point to one conclusion. New technology requires training and support – and profit for
companies that can deliver cost effectively. With the aging of baby boomers, newer offerings
like Support.com (any connected device) will tailor messages to reach an older adult audience.

Category Changes 2020 Current Moving Forward

and beyond
Digital health, Remote MD resistance, limited CMS reimbursement,
Patient Monitoring reimbursement expansion of mHealth
Voice First technology Smart Speakers Ubiquitous voice
assistants
Hearing technology High price hearing aids, DTC, hearables, low cost
sold by audiologists hearing aids, self-service
Caregiver technology Assisting care workers, In-home supplement to
time recording, PERS care, sensors, voice tech
PERS, fall detection On body pendant, private In-room sensing,
pay insurance reimbursed
Virtual reality for seniors Experimental Programmatic, caregiver
training
Tech training for Seniors Fragmented, senior Standard in retail, online
center
Figure 12 Where is the market heading for technology and older adults?

Aging and Health Technology Watch www.ageinplacetech.com

Page 18
About the Author:

Laurie M. Orlov, a tech industry veteran, writer, speaker and elder care advocate, is the founder
of Aging in Place Technology Watch, a market research consultancy 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 technology background
and years as a technology industry analyst, Laurie was a certified long-term care ombudsman
and received a graduate certificate in geriatric care management from the University of Florida.

In her previous career in the technology industry, Laurie held senior positions in IT
organizations, followed by 9 years as a leading industry analyst at Forrester Research. While
there, she was often the first in the industry to identify technology trends and management
strategies. She has spoken regularly and delivered keynote speeches at forums, industry
consortia, conferences, and symposia, most recently on the business of technology for boomers
and seniors. She advises large organizations as well as non-profits and entrepreneurs about trends
and opportunities in the age-related technology market and was a participating expert on the
Think Tank for The Philips Center for Health and Well-Being; the Personal Connected Health
Alliance Aging Task Force; AARP Inclusive Technology Roundtable 2019. She also testified
before the US Senate on the role of technology for older adults. Her perspectives have been
quoted in California Healthline, Forbes, AARP Magazine, the New York Times, and the Wall
Street Journal. She has a graduate certificate in Geriatric Care Management from the University
of Florida and a BA in Music from the University of Rochester. Her other most recent research
reports include Voice, Health and Wellbeing 2020; The Future of Voice First Technology
and Older Adults (2018); and Tech-Enabled Home Care (2017).

Aging and Health Technology Watch www.ageinplacetech.com

Page 19
2020 Technology Categories and Vendors (Examples)

For inclusion as an example-only technology to facilitate aging in place, the vendor meets two of
these criteria (those firms listed are only examples, not an exhaustive list). Because of growth of
relevant technology announcements during 2019-20, more startups, including pre-launch and
innovation award winners are included than previous versions. In addition, please note that the
“**” entries can be new for this publication of the 2020 Market Overview, though they may have
been in business previously but were not included in the 2019 report. The criteria:

a) Incorporate messaging to and about boomers and/or seniors – or their family or

professional caregivers.
b) Is expected to be available across the continent, not just in a single region.
c) Addresses one or more categories described in this document.

Aging and Health Technology Watch www.ageinplacetech.com

Page 20
 Sub- Purpose Platform Contact
Category
Category: Communication

Amazon Echo Cloud-based Screen with voice- Appliance Amazon.com/

Show voice hub enabled AI access Echo
Embodied Virtual Caregiver training Experience Headset embodiedlabs.
Labs Reality Com
Connected Senior Engagement of Suite of software ConnectedLiving.
Living Living residents Com
Google Home Cloud-based voice hub Appliance store.google.com
grandPad Senior tablet Simplified interface Android grandpad.net
iN2L Engagement Games, health, PC Workstation in2l.com
System movies, spiritual
content
GreatCall Feature, Simplified keypads Android smartphone greatcall.com
Jitterbug smart connect to Call
Phones phones Center
JoyforAll Pets Robotics React and respond Toy joyforall.com
to touch
Starkey Livio Hearing aid Activity tracking, Hearing aid starkey.com
AI personalized
MyndVR Virtual Assisted Living Experience Headset myndVR.com
reality
LG Exalt Best Flip Good speaker Android flip phone LG.com/US
LTE** phone with
camera
Oticon Hands-free Internet connected Streaming to wireless oticon.com
calls for IoT controls hearing aids
Nuheara Hearables IQ Buds Boost, Hearing aid, Google, nuheara.com
Max Siri Integration
Phonak Hearing aid Integrated with Acts like a wireless phonak.com
AudeoM** Samsung phones headset
Rendever Virtual Senior engagement Experience Headset rendever.com
Reality
SingFit Music Dementia care Activities, sing-along Singfit.com
Therapy

Category: Home Safety,

Security

Care Wearable Senior health Predictive analytics carepredict.com

Predict Home monitoring
Envoy at Sensors plus Scans environment Continuous checking Envoyathome.com
Home** iPhone app of sensors for issues
Essence IoT/PERS In-home IoT Alerting platform essence-grp.com
Care@Home devices
GrandCare IoT Remote caregiving Touchscreen, portal grandcare.com
Monitoring

Aging and Health Technology Watch www.ageinplacetech.com

Page 21
 Sub- Purpose Platform Contact
Category
Best Buy Mobile Lively Wearable 2 Call Center greatcall.com
Lively App** PERS
GreatCall MobilePERS PERS with fall Mobile PERS greatcall.com
Lively Mobile detection available
Plus
LifeStation MobilePERS Uses LifeStation Bluetooth-enabled lifestation.com
MobileLTE** call center device, voice prompts
Locate Wander Pattern tracking for Wearable with locatemotion.com
Motion** management Dementia, Autism SenSights Dashboard
MobileHelp PERS Watch Samsung health Wearable mobilehelp.com
Smart Watch integration
Philips Cares Smartphone Manage care circle Mobile App and PERS lifeline.philips.com
and Lifeline app, PERS for Philips products
SafelyYou Fall Memory Care Video camera-based safely-you.com
detection
Speak2** Engagement Voice First for Daily schedule, care Speak2software.com
platform Senior Living plan alerts,assistance
by voice
TrelaWear** MobilePERS PERS Jewelry Paired with Mobile Mobilehelp.com
Help response center
TruSense IoT Voice-enabled Amazon Echo mytrusense.com
Monitoring passive monitoring; interface
GPS tracker
UnaliWear Mobile Voice-enabled Bluetooth low energy unaliwear.com
PERS watch mobile PERS
Vayyar Fall Wall-mounted Low-powered radio Walabot.com/
Home** Detection wave walabot-home
Vidapoint** Mobile Global service 120 countries globalwirelesshealth
PERS offering .com

Category: Health Wellness

AppliedVR** Virtual Pain education & Distraction and coping Appliedvr.io

Reality management tools for pain
Aiva Health
HandsFree Voice Voice-enabled, HIPAA compliant Handsfreehealth
Health** assistant health assistant reminders
Kardia Band Wearable Creates report of EKG monitor alivecore.com
wristband cardiac pattern wristband for Apple
Watch
Livongo Diabetes Portal plus app Integrates trackers livongo.com
App
Medminder Cellular 7-day, 4-dose per Prefilled trays from medminder.com
day reminder trays pharmacy
MediSafe Medication Notifies Deployed in medisafe.com
compliance 'Medifriend' if partnership with
app doses are missed pharma, research

Aging and Health Technology Watch www.ageinplacetech.com

Page 22
 Sub- Purpose Platform Contact
Category
Ōmcare** Medication Home health Verification of dose Ōmcare.com
compliance taken
hub
Orbita Voice- HIPAA-compliant Enterprise software orbita.ai
enabled Conversational for healthcare systems,
healthcare platform groups
Pillo Health** Robot Pill-Dispensing Companion Pillohealth.com
Reemo Health Remote mobile Senior living, senior reemohealth.com
Health Smartwatch, health platform care, healthcare
analytics
StaySmart** Health Sensors, medical Dashboard of status, Staysmartcare.com
Care monitoring devices nurse available
VitalTech** Connected Remote patient Patient health, vitaltech.com
Care monitoring wellness
Welt Belt** Men’s Smart Belt Android, iOS On Amazon.com
Health belt measures sitting, integration
waist circumference
Zibrio Smart Smart Scale Measures and AARP Innovation Zbrio.com
Scale** tracks balance Award 2020

Finance/Transportation

Golden Financial Account Includes financial care Joingolden.com

Financial** services for organization, bill specialists
older adults paying
Papa Family on Transportation, College students joinpapa.com
demand chores, socializing
LifeSite Family Caregiving Store, manage family lifesite.co
records financial records care documents
EverSafe Fraud Seniors and Detection and alert eversafe.com
protection families system
Uber Healthcare With uberAssist, Ride-hailing service uberhealth.com
Health appt rides door-to-help for paid by organizations
disabled
Intuit Mint Finance Manage banking Budget for aging mint.com
accts, finances parents
Lyft Includes Flexible ride Ride-hailing service lyftbusiness.com/
Concierge healthcare scheduling by paid by organizations healthcare
appointment sponsor
rides organization
TrueLink Financial Protect assets and Payment cards, truelinkfinancial.
Financial services for track payment investment Com
older adults activity management

Category: Caregiving
(Platform, Apps)

Aging and Health Technology Watch www.ageinplacetech.com

Page 23
 Electronic Smart health 3D virtual caregiver Addison Care Addison.care
Caregiver** home
Aloe Care** Digital care Voice-activated Care coordination get.aloecare.com
assistant
CareLinx Non-agency Families, Marketplace of carelinx.com
home care organizations find registered workers
marketplace workers, rides
Care Care GPS tracking, Care professionals carepredict.com
Predict management reporting
Caring.com Elder care Articles and search Reviews from users caring.com
website tool – all care types
Caremerge EHR and Resident Senior living caremerge.com
Engagement engagement,
Platform Calendar
ClearCare Manage Home care agency Manage home care clearcareonline.com
home care platform agency tasks, EVV-
agency compliant
K4Connect** For resident, Engagement, Senior living, smart k4connect.com
operators Wellness home, voice interface
Kytera Fall Smart remote CES Innovation Award kytera.care
Companion** detection caregiver 2020
LifePod Voice First Proactive voice- Voice first care for lifepod.com
Virtual enabled care home and home health,
Caregiver solutions senior living
Outpatient** Smartphone Caregiver Share calendar, status Getoutpatient.com
app collaboration
PointClick Care Cloud platform Senior living, SNF, pointclickcare.com
Care management home care

Category:
Learning/Contribution

learn@50+ Training Tech, caregiving, Online, workshop learn.aarp.org

work, skills Education
LifeBio Storytelling Digital life stories Memoir-writing lifebio.com
services
Memory Storytelling Digital life stories Professionally written memorywell.com
Well
My Family Stories and family online tool myheritage.com
Heritage history tree
OATS Training Tech, job skills Regional workshops seniorplanet.org
Osher Lifelong Senior-focused Nationwide network osherfoundation.org
Lifelong learning courses
Learning
Support. Tech support Telephone support Any device support.com
com**
TimeSlips** Creative Senior-focused Network of trainers timeslips.org
engagement training

Aging and Health Technology Watch www.ageinplacetech.com

Page 24
 Appendix of Recommendations
2019 White House Report
Emerging Technologies to Support an Aging Population – Technology

Theme Sub-Category Tech should help with Examples such as:

Key Activities Hygiene: bathing, Enable safe bathing, Smart showers,

of Independent oral, skin care, showering self-care monitoring, sensors
Living including wound bacterial monitoring
prevention, care Devices for low vision,
poor coordination, hearing
Nutrition: meal Maintaining oral
Personalized dental regimens
preparation, health Feedback on at-home oral care
shopping, and Smart textiles, diabetic socks
eating Systems for skin pressure
Medication: variations, smart bandages
management and Prevent, monitor and Disposable, electrochemical
adherence care for wounds sensors for bacteria
GPS location for price compare
Virtual assistant food prep
Robotic feeding systems
Adherence sensors, wireless pill
Meet daily nutritional
Organizers, phone intervention,
requirements Smarter medication
Feed oneself Reconciliation
Maintain therapeutic link adherence to EHR
medication levels
Cognition Cognitive Assessing abilities Real-time, frequent, unobtrusive
monitoring Enhance baseline Research what works
Cognitive Training Provide Cognitive Explore tele-rehabilitation
Financial Security Rehab Adapt online banking interfaces
Review fraud detection, monitor
Prevent Exploitation
for indicators of exploitation
Evaluate identification tech, like
wearables, biometrics,
geolocation
Make ‘Financial Capacity
Identify older adults Instrument’ more available
with reduced financial
capacity
Communication Hearing Hear in noisy Share audio channels between
and Social environments Hearing aids
Connectivity Expand acceptance Develop open protocols for
Translation And implementations communication with other tech
Develop tech to improve
of hearing aids
performance in noisy rooms
Social Add computational power to
Communication Interface with other systems
Develop open protocols for
adjustment – today proprietary
Enable real-time translation
for non-English speakers
Identify interventions to reduce
social isolation, loneliness

Aging and Health Technology Watch www.ageinplacetech.com

Page 25
 Appendix of Recommendations
2019 White House Report
Emerging Technologies to Support an Aging Population – Technology

Translate Promote collaboration between

conversations Device manufacturers,
between physicians academia to design products
and patients to address social connection
starting in design phase
Maintain social
Add focus on tech for disabled
connections
Personal Assisted Navigate home, Design robust robots with
Mobility movement neighborhood affordable control systems,
Rehabilitation learning capabilities
Monitoring and Develop improved wearable
mobility systems
Safety Mechanically
Explore virtual reality for
compensate for improving independence
reduced strength, Improve sensor systems,
mobility Algorithms for fall recognition,
Enable in-home indoor location detection
rehabilitation Improve sit-stand transfers
Use tech for fall prevention
Monitor movement, Training
activity Tech for measurement of
reaction time
Correlate fall risk, management
of cognitive decline
Prevent falls
Transportation Driving Assess and maintain Develop tools to assess fitness
driving fitness Enable ‘practicing’ unexpected
scenarios
Public Assist navigation, Plan accessible routes
Notify user if about to make
transportation scheduling
wrong decision
Develop shared neighborhood
vehicle access
Facilitate access Enable personal profiles for
real-time travel support

Access to Telehealth Improve healthcare Evaluate telehealth effectiveness

Healthcare access and quality and outcomes for older adults
Provide smoother Monitor home-to-hospital,
care transitions intervening before readmittance
Integrate telehealth, RPM, and
Provide self-
medication adherence tech
management support Optimize care across
eCare Planning Improve coordination settings for primary, specialty,
of care acute care, post-acute care,
home care
Facilitate shared care Adoption of shared enabled care
planning Planning

Plan care for complex,

high risk patients

Aging and Health Technology Watch www.ageinplacetech.com

Page 26