Our first example of Wellthcare leveraged the local postal service to create new, health-related value. It was able to do so because the people involved knew their postal worker – they were part of the local community.
Our second example – GeriJoy – uses the emerging digital infrastructure to sidestep the geographic constraints inherent to using something as ‘local’ as a postal system. In doing so, it enables us to reimagine ‘community’.
I was lucky enough to meet its CEO, Victor Wang, when he spoke at TEDMED 2013. His talk made me see the world differently, and made me realise that by doing so we can find new forms of health-related value.
Pritpal S Tamber: Hi Victor, so tell us about what you’re doing.
Victor Wang: We provide virtual companions for the elderly in the form of adorable, talking pets that live inside tablets. They’re actually avatars for our staff that work behind the scenes 24/7. Our staff share family photos, positive memories, and things like that; in essence, we provide seniors with personalised, intelligent and compassionate companionship.
Pritpal: How does your staff know what to share?
Victor: Family members or other caregivers who subscribe for GeriJoy’s service volunteer certain information, such as the senior’s interests and background. We use that to tell them about the latest news that matches their interests and ask them about their life stories. Family members can also log in to the GeriJoy Family Portal to add photos and associated comments that our staff use to engage the senior with. If the family share older photos they can be a form of reminiscence therapy; newer photos are a great way to reinforce ongoing family connections.
Pritpal: So family members are directly involved?
Victor: Yes. That’s important. We leverage existing family connections and cultural trends towards digital, asynchronous communication among the tech-capable.
Pritpal: Wow, wait, that’s complicated; say that in English…
Victor: Ha, ok! The family members provide conversation starters like photos and comments through the Family Portal. They do it whenever they have a bit of time. Our caregivers then use them to engage the senior when they want to use their tablets. This means you can leverage the limited time that the family member has and provide a responsive channel of communication and connection. The asynchronous engagement of the family member is essentially converted into a synchronous, or real-time, experience for the senior.
Pritpal: Ok, cool, but why is it needed?
Victor: Right now, most of the work in senior care involves making sure that seniors stay alive; that's what most of health care seems to be about in the US. So people are getting really old but now there are a lot of old people that are really lonely and rates of depression in nursing homes, for example, are really high. There is also something like a million Alzheimer's patients in the US living by themselves; not such a good thing. So there's a huge need to provide more companionship and emotional support in senior care. Obviously the best thing is for the family members to be there, but that's not always possible given people's lives and given that people don't just live in nuclear families anymore. You can pay for alternative companionship but it’s really expensive - $21 an hour, on average; more than many Americans can afford. GeriJoy is an affordable solution and can be a great complement to traditional care services.
Pritpal: What kind of feedback are you getting by your early users?
Victor: It’s been great. We have customers who will contact us to say that their GeriJoy Companion – the avatar – is essentially their home-bound parent’s best friend, or that it’s apparently reversed their Alzheimer’s as far as being happier, more open, and more conversational. We have ‘Companion Logs’ (notes between seniors, caregivers and family members) that have been going for almost a year now, and it’s really inspiring to see the depth of the day-to-day, ongoing relationships that we help build. Home care agencies and retirement communities are starting to catch on too, and we have successful examples of use ranging from home care to high functioning assisted living, to people with significant dementia living in a skilled nursing facility.
Pritpal: Sounds great but a lot of this is anecdotal; are you looking to ‘prove’ the value somehow?
Victor: Yes, we have an ongoing study with Pace University. We think we will be able to measure improvements in loneliness, depression, and perhaps even cognitive function in older adults due to GeriJoy’s companionship service.
Pritpal: In your TEDMED talk you described GeriJoy as leveraging the global supply of compassion, but now I see it’s partly global and partly familial, right?
Victor: Yes, it certainly is. We can have a relationship with a senior just through the support of our staff, without any family involvement. However, it really is helpful to have a family member introduce and catalyse the relationship with the GeriJoy Companion. And in turn, the GeriJoy Companion is also helpful in strengthening the family connection. The great enabler is that in addition to whatever interaction they traditionally have, the Gerijoy system allows the younger family member to contribute small amounts of time, averaging say a couple of minutes per day, and we leverage that all day, every day, into continuous companionship and family-oriented conversation. That’s the synchronisation thing again.
Pritpal: Excellent. Describe how it helps the family members too?
Victor: Beyond the intrinsic value of supporting one’s loved ones, it can have very tangible benefits for the family members. Peace of mind in knowing that an ageing loved one is doing well and is in good company can have health benefits, whether it’s for a concerned family member living at a distance or a more involved caregiver. Family caregiving is often tremendously stressful, and there is plenty of research showing effects on the caregiver – such as decreased personal health and increased healthcare costs. Caregiver burnout is also a huge cause of poor quality of care and health outcomes for seniors.
Pritpal: So how can GeriJoy help?
Victor: GeriJoy can help to provide what I call “micro-respite care". One of the best ways to reduce caregiver stress and to prevent caregiver burnout is to offer respite care, which is basically another care service coming in to allow an otherwise full-time or live-in caregiver to take a short break. Finding or paying for a substitute caregiver, enrolling the senior in a day program, or a temporary stay in a care home are common forms of respite. Micro-respite enables an otherwise heavily burdened caregiver to have some peace of mind when going out to buy groceries, for instance. They feel safe knowing that the GeriJoy Companion is keeping their loved one company, and that our staff can give them a call if anything urgent comes up. In fact, when caring for somebody with significant dementia, GeriJoy can even provide reassurance and keep the dementia patient occupied while the caregiver goes to prepare something in the kitchen, or goes to the bathroom.
Pritpal: Micro-respite; nice idea. How do you see it being paid for?
Victor: I’d like to see the GeriJoy service reimbursed to the consumer, whether by private or public payers, since it is likely to decrease overall cost of care in many situations, especially as we move toward certain clinically oriented applications of our companionship and oversight system. In the meantime, it’s paid for on a subscription basis, directly by family members who are seeking a way to complement the care services that are currently available to them. We are also working on distribution partnerships with senior care providers, and some decide to purchase our services themselves to augment their own quality of care and to realize the value within their own portfolio of care services.
Pritpal: Thanks, Victor; keep us posted on how the service develops.
Victor: Sure, will do, and thanks.
We know that traditional health care, while important, contributes only a small part of what it takes to stay healthy. Our ageing populations need a lot of support, which is getting all the harder as working-age people migrate to where the jobs are. The emerging digital infrastructure enables us to create new, health-related value. It also enables us to overcome ‘time’; by enabling family members to express their love in ways that fit their working lives, Victor and GeriJoy are setting an important precedent for how we see caring. It’s by seeing things differently will we be able to see even more forms of health-related value.
You can find out more about the study with Pace University in this issue of Pace Magazine.