The essential, the preferred and the nice-to-have
I recently celebrated my 70th birthday so what better time to take stock of how digital health can help me in the next few years? I reckon there are three ways in which digital health will hopefully ensure I have a longer and healthier life than I might otherwise:
Firstly there are those things that only digital health can really do, like managing the potential interactions between many different drugs, and ensuring efficient checking on a loved one without appearing nosey.
Secondly, there are the things that can be done much better with digital technology, such as delivering continuous care (I’ll explain more in a moment), or rehabilitating someone after a stroke or operation – both are possible without technology, though hugely consumptive of human resource
Thirdly, there are the things that it’s just nice to have, like being able to work more from home, getting advice and encouragement to exercise more, dietary advice, cognition exercises and such like. All can be done, though technology makes them much easier.
One of the great things that digital health can do is to check on drug interactions. Sadly as we get older, the number of drugs we need to take can increase so it’s not uncommon to have someone on twelve different medicines when in their 80s. Checking manually on the potential interactions between three drugs is easy and only involves three separate enquiries. For twelve drugs that goes up to 65 and if you’re worried that there might be interactions between three drugs that goes up to at least 175 – far beyond the average GP or clinician.
It gets better too – most drugs are not trialled on people over the age of 65 even though it’s known that medicines may be less effective, or more toxic, for older people. Therefore, a digital health connection to a patient, say to monitor their health or even just to check they are taking the pills, offers the opportunity to check on drug efficacy.
Organising the care of a loved one is challenging even if part-time; ensuring someone is always available and that messages are reliably passed on to the next person to pick up the baton is really challenging. That’s where apps such as Carers UK’s Jointly can be good – doing everything with the minimum of fuss and at a tiny cost.
When I was young and I went to see the doctor, I typically came away with a prescription, or some advice – sometimes even a stitch or two, and whatever the problem was duly sorted itself. That’s episodic care: after the episode I was ok. However now, following diagnosis of a clot in one leg, I have been diagnosed with an auto-immune disease that will probably require me to keep taking anti-coagulants for the rest of my life. That’s continuous care as I will need regularly to be checked to ensure the right amount of anti-coagulation (in my case measured by INR) is happening. Continuous care takes up lots of time – both seeing a doctor, and being checked by a nurse. Digital health much reduces the health professionals’ time I take up, enabling me to check my own INR at home and alerting my doctor if I go too far away from my target figure. It even adjusts my medication for me, if needed. Older people need much more continuous care, so digital health is a huge bonus to ageing well in this case.
All manner of electronic monitoring is possible at home now, meaning also that people can leave hospital much earlier, saving beds and avoiding infection and indeed many can be treated at home whilst, if visiting a hospital at all, doing so only as an outpatient.
Another example where even more time is saved is rehabilitation, after a stroke or after a major operation. Rehabilitation after a stroke takes up a particularly large amount of time requiring the stroke victim to repeat and repeat a physical exercise, a phrase, a cognition etc. With few therapists around, unless you have lots of money or are married to a therapist, you have two choices: use the technology or remain only partially recovered. And that technology is good now – it can for example listen to you repeating a syllable and tell you how to improve your diction. Likewise it can measure the pressure you exert when squeezing your hand or pushing on a pedal and urge you on.
A seemingly unavoidable side-effect of ageing is a change in the way things are remembered. For most people this means forgetting more. Digital technology helps here by providing appropriate reminders for taking medication, exercising, etc.
There is much evidence that continuing to work longer is good for people’s health, giving them a continuing purpose and life and, if remunerative, helping eke out their pension. Many dislike the commute though which gets increasingly onerous as people age. This is where digital technology scores highly, enabling people to work from home, to communicate with colleagues using audio or video technology
For those less able to get out, the technology also offers the opportunity to chat to friends from the comfort of their own armchairs. However I well-remember when working in a social care department a good few years back, suggesting to the professionals OTs there that the disabled people should try using home deliveries from their supermarkets, only to be immediately told that getting out of your home once in a while is a good thing as helps keep people’s minds stimulated so people should always be encouraged to do that, regularly.
Finally the technology can give access to advice and encouragement on exercise and diet, to help people stay fit in mind and in body – research has now conclusively proven that exercise helps regenerate brain cells even in older people…following up with cognition exercises gives those new grey cells extra exercise!
In conclusion therefore, I reckon that digital health is an essential supporting act for ageing well – without the technology people would need far more assistance from others, such that in many cases there simply wouldn’t be the resource to help them, so they’d be at risk of living a much less enjoyable and fulfilling life, and dying earlier.