The ageing population: Designing public services that are targeted to older persons

The number of people aged 60 years or older will rise from 900 million to 2 billion between 2015 and 2050 according to the World Health Organization. This is significant and presents major challenges for governments everywhere. The UN’s ‘World Population Ageing’ report in 2015 stated “it is more important than ever that governments design innovative policies and public services specifically targeted to older persons”.

Since 2015, much work has been done globally to highlight the true impact and complex web of issues surrounding ageing. This includes rising healthcare costs, pressured pension schemes, housing issues, caregiving, and the impact of cognitive decline.   

The reality is that, as we age, we are more likely to develop physical or mental impairments linked to or resulting from multiple long-term conditions such as cardiovascular disease or dementia. The prevalence of disabilities, physical illnesses and mental health issues, such as depression and social isolation, increases as we age. These changes can have major impact on our quality of life and the ability to complete everyday tasks. In the UK, health and social care services are already strained from increased demand and will need to focus more on early detection and better prevention, as well as approaches which help older people to better self-manage their conditions and live healthier lives. 

Individualised solutions for a demanding population 

While the world has woken up to the huge societal challenge – as shown by the wealth of research papers, policy documents and continual debate – actually developing solutions to solve the plethora of problems has been patchy. However, user-focused technology is now changing that. Digital technologies, digital infrastructure and data production are already revolutionising our day-to-day lives and hold the power to be transformative in supporting healthy and active ageing. Digital solutions can automate aspects of the home and improve efficiency to make our lives easier, provide us with a greater degree of interaction and communication, provide personalised support and care, and allow health and human services to be delivered remotely.  

As the baby boomer generation ages, they – and their wallets – are demanding better designed and more sophisticated technology and will increasingly refuse to settle for stigmatising or unattractive products and services. They increasingly want more technological developments and, perhaps most importantly of all, they want suppliers to focus on them as customers – not as patients, end users, or care clients. Many of these technologies will create large cost savings for health and social care, by removing some of the need and/or desire for traditional public healthcare facilities. Yet, this change won’t happen on its own and significant barriers remain to be overcome such as interoperability between devices, institutional inertia, developing sustainable business models, and designing usable, functional and stylish products that people want to use – to name just a few. 

Innovation as a strategy

The US is one example of a nation keen to harness technology to support its ageing population. In March 2019, the government released its new report ‘Emerging Technologies to Support an Ageing Population’ that highlighted six key ways in which technology has the potential to help people live longer, healthier and more independent lives. The report recommends Research & Development (R&D) and advances in technology to address the six challenges:

  • Key activities of daily living (eating well, managing medication etc);
  • Cognitive skills (training and systems to help individuals live safely and independently); 
  • Communication and social connectivity (in relation to hearing loss, social isolation and loneliness);
  • Personal mobility;
  • Access to transportation, and;
  • Access to healthcare.

The report acknowledges that getting these cutting-edge innovations into homes and communities requires R&D across a wide range of disciplines spanning the public, private, and philanthropic sectors. 

In the UK, the government’s mission for people to enjoy at least five extra healthy, independent years of life by 2035 will be met by harnessing the power of innovation to help meet the needs of the ageing society. Under the Industrial Strategy Fund, the government is investing up to £98 million in research and innovation that supports people as they age, while also helping those that care for them – the Healthy Ageing Challenge is part of this solution. Through the challenge, government will bring together UK businesses and researchers to support people to stay in their homes for longer, tackle loneliness, and increase independence and wellbeing – although the initiative is very much in its infancy.  

It’s clear that globally, a spark has been ignited and there is now a strong appetite to develop technology-led solutions that address care, healthcare, independent living and cognitive issues. In the UK, the NHS is taking technology seriously when it comes to an ageing demographic. One example is a tablet loaded with an app that gives practitioners access to all the data they need to deliver care, wherever they are. A community nurse could use a smartphone to take regular photos of a bed sore to monitor its progress using the app, which colleagues can also securely access, supporting better clinical decision making and improving care outcomes.

Further afield, China, India and Japan are making great strides in developing responses to their ageing demographics. China is experimenting with entire urban developments designed specifically for the elderly, while scientists in India have developed the ‘MindEye’ that diagnoses dementia non-invasively by just tracking a person’s eye movements, before the symptoms even appear. In Japan, their rapidly greying society is demanding fast, technology-driven solutions such as the Shichifukujin app that collates data to manage diabetes. 

Getting ahead of the game

While this is all encouraging, unlocking creative, fresh ways of thinking and new ideas in a timely manner is the priority; and waiting for researchers and business to deliver new innovations may not be the only answer. With ageing presenting such a huge societal challenge on the very near horizon, leveraging innovators and inventors in today’s fast-paced digital age requires an additional mechanism – one that fast-tracks ideas through to effective products and solutions and seeks out ideas from non-traditional as well as traditional sources.   

One model that is proving to be a game-changer is the challenge or incentive prize initiative – underpinned by incentivising innovation from both in and outside of a specific sector, developing technology for issues that pose a current problem or are anticipated to be a problem in the future. The success of the challenge prize model is largely due to the fact that it’s an open market initiative, encouraging submissions from everyone and anyone; from a teenager designing solutions with software in her bedroom, to a new start-up that desperately needs seed funding to develop its break-through idea. Challenge prizes go one-step further than a grant or financial prize by offering additional support from experts and consultants, access to data sandboxes to test solutions, and introductions to new partnerships. Added value comes at the end of the challenge prize when all intellectual property is retained by the winners, enabling them to take their solution on to commercial development. 

The US has recently increased its number of challenge prizes recognising the value that they can bring to a variety of sectors by seeking new thinking from unlikely sources. ‘Challenge’ is open to members of the public to help the US government solve problems big and small. For example, the “Improving Care for People with Alzheimer’s Disease and Related Dementias Using Technology (iCare-AD/ADRD)” Challenge aims to improve the quality of care for persons living with Alzheimer’s Disease and related dementias. It stimulates innovation in the use of technology to improve care coordination and/or navigation and/or aid with the care experience, so that overall dementia care quality is improved.

Overcoming the challenge in the UK 

In the UK, Nesta Challenges has been working with partners from the health, care, voluntary and social enterprise sectors to test and scale new ideas in ageing for a number of years. Nesta’s experience in designing effective challenge prizes means that, from concept to winner announcements, the process can be fast-tracked without compromising quality of response or deliverables. For example, in September 2012, we launched the Ageing Well Challenge Prize to unearth fresh ideas to reduce social isolation and/or help people stay mobile and active for longer. 

A few months ago, finalists of Challenge Dementia were announced – a challenge prize pioneered by Essex County Council and supported by Nesta Challenges alongside partners PA Consulting, Alzheimer’s Society and Tech UK. An impressive range of trailblazing technology and design-driven innovations were developed to improve the lives of people living with dementia in just under one year. The beauty of the challenge prize was that the finalists also included a 11-year old boy who had developed a personal solution featuring a touchscreen with a range of functions – all based on his experience with his great-grandfather who had dementia.

We know that currently there are many, many initiatives being mulled over by burgeoning social innovators, or that are starting out today as a drawing on the back of an envelope. Some of these ideas will only see the light of day thanks to forward-thinking initiatives like challenge prizes. We will need to utilise the best ideas to address the many issues and challenges of our ageing population. To find them, we have to open up the field so that society is allowed to play a part in designing support for our relatives, friends and neighbours; and challenge prizes provide this opportunity through their open market model. With very little time at our disposal, any way that we can leverage innovation is important not only to ageing individuals, but to our economy and society as a whole. 

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