Coping with an ageing population

The ageing populations of developed societies, explained by an increasing life expectancy, are now presenting huge challenges in terms of funding and structure of our social welfare and socio-medical systems.

By 2050, one in every three French people will be over the age of 60! But old age is becoming less and less synonymous with illness or disability. People are losing their independence much later in life. All senior citizens are different and their expectations are not all the same, depending on how independent they are.

However, whether they are active, vulnerable or dependent, senior citizens can create value for society and addressing their needs can be a driver for economic growth.

The Silver Economy is, therefore, the economy geared towards the elderly. The issue is crucial: to enable and encourage innovations to support people as they grow older and to reduce the numbers of people losing their independence.

Key figures:

  • Nearly one person in three in France will be over the age of 60 by 2050, compared to one in five in 2005. According to INSEE’s latest forecast, the number of French people over the age of 60 is expected to rise to nearly 21 million in 2035 and to 22.3 million in 2050, an increase of 80% compared to 2005.
  • In overall market terms, the Silver Economy represented €92 billion in France in 2013 and will exceed 130 billion in 2020.
  • 90% of French people would prefer to grow old at home rather than in a retirement home.
  • 85% of people over the age of 90 live at home.

  

In practical terms, how can digital technology help people to age well?

When people talk about the Silver Economy, all too quickly their minds conjure up images of the service and welfare professions, and they don’t often think of innovation. However, these days more than half of all senior citizens have a smartphone and a quarter are on Facebook; use of digital technology is, therefore, already a reality, even for the over 65s.

The innovations in products and usage generated by this technology mean that now their wishes can be granted: they can age well at home in total safety.

Digital links offer senior citizens access, either directly or through their carers, to a wide range of information and services, and to maintain social connections with their friends and family.

Connected objects also mean that their living environment can be made secure, particularly when these objects relate to the home itself (burglar alarm, fire alarm etc), to the person’s environment (air quality, temperature control of rooms etc) or to the individual themselves (smartphone to monitor heart rate, connected materials to measure physical exertion etc).

The application of Big Data techniques to the analysis of data sets collected from these objects or from the behaviour of senior citizens may also revolutionise the prediction and prevention of lost independence (forecasting vulnerability, early diagnosis, determination of local preventative action etc).

The computerisation of healthcare pathways will also constitute a major change in coming years. As well as making it easier to coordinate treatment around the individual, it will provide new sources of information and analysis of this new data will make it possible for elderly people who are losing their independence to access appropriate solutions more quickly and help society to adjust to its ageing population.

Orange Healthcare has done a great deal in the field of support for vulnerable and dependent people.

So as to:

  • provide reassurance to people who are suffering loss of independence with its tele-assistance service or companionship and reassurance services over their land-line phone;
  • help co-ordinate the medical and social services teams and the carers who support these individuals in their own homes (the Conseil Général of Cantal’s “tablet and social ties” pilot, which was awarded the French Senate’s Territoria award in 2009);
  • digitalise the funding of dependent care and improve the management of homecare providers (Conseil Général of Loiret’s Tiers Payant Social pilot, which delivered 12% efficiency savings, improved allocation of APA (Allocation Personnalisée d’Autonomie or Personal Autonomy Allowance) benefits by the local authorities and more efficient financial processes with service providers);
  • enable the efficiency of homecare services to be managed and monitored using a timestamp service;
  • use digital technology for the benefit of old peoples’ homes (EHPAD) with the Solution Résidence Seniors;
  • or to assist with setting up service platforms to help keep dependent elderly people and/or patients with chronic conditions in their own homes, particularly through the Autonom@dom project in Isère.

Orange Healthcare is pushing for an increase in the number of these types of platforms, which we think are crucial to structuring the services available for prevention, supporting an ageing population and medical monitoring.

We are also very much involved in rolling out telemedicine solutions all over France, mainly in gerontology departments. This is another example of how indispensible information and communication technology is to the healthcare pathway approach.

  

Tomorrow’s challenge: achieving the life-style digital switchover

Healthcare, social and socio-medical services are sectors that have still not taken full advantage of the digital revolution. Although initiatives are being developed and some solutions are already working, there are still major steps to be taken to digitalise life-styles and so to place the citizen-user-patient at the heart of the system and in so doing to join up well-being with living well and ageing well.

Nowadays, there is a vast range of services available. To name just a few: electronic medical records (EMR), the PAERPA (Personnes Agées en Risque de Perte d’Autonomie, or elderly people at risk of diminishing independence) projects, Territoires de Soins Numériques (Digital Healthcare Territories), or the telemedicine or tele-monitoring programmes initiated by the healthcare establishments themselves or the Agences Régionales de Santé. They are all ambitious, but they lack coordination.

In fact, in the current climate of a boom in digital-based services, the real value of these services for the user will lie in how they are integrated into a care and healthcare pathway. Over and above how the services are structured, coordinating care and monitoring patients are even more crucial for elderly people than at any other stage in life.  In the end, then, it is by taking an approach based on a shared intermediation platform that synergies can be established between the worlds of social and socio-medical services.

The Autonom@dom project in Isère is a prime example of this: this shared information and orientation platform aims to address the demands of diminishing independence at home (in terms of well-being, prevention, vulnerability, dependency and chronic illness). It makes it possible to set out processes whereby human help interacts with technical aids to prevent interruptions in treatment, avoidable admissions to hospital and to facilitate admission and discharge when hospital is necessary.

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Silver economy terms

Homes for dependent elderly people

In terms of segmentation of elderly people as a whole, active senior citizens are considered to be retired people in good shape. The active senior citizens’ market will grow, based on the design of products and services and probably also through effective labelling and marketing which will bypass any stigma attached.

In terms of segmentation of elderly people as a whole, vulnerable senior citizens are considered an interim category, between active senior citizens and dependent senior citizens. The vulnerable senior citizens’ market is focused on support at home and improvements in how this support is organised. Better organisation is a key factor before plans can be made to digitalise these services.

or senior citizen with diminishing independence

In terms of segmentation of elderly people as a whole, dependent senior citizens are considered to be people assessed as between 6 and 1 on the AGGIR dependency scale (The French national AGGIR scale makes it possible to assess the level to which an elderly person has lost their independence or how physically or psychologically dependent they are in the performance of their everyday tasks.). For care-dependent elderly people in hospitals or care homes, pressure on the efficiency of retirement homes, nursing homes or old-people’s homes will drive an increased demand for computerisation (better monitoring of residents and of the actions of professionals, alert systems and security for staff and residents).