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Apple’s new health features give new focus to elderly care technology

Apple’s new health features will be available to anyone with an iPhone. But two of the tools announced at WWDC 2021, gait stability and the ability to share health data with family members, can be especially helpful for older adults.

People who work with older adults are happy that a company like Apple is interested in technology that can be used for this group. Experts have spent many years frustrated that companies do not design products to meet the needs of the demographic. There have been a few attempts to introduce new tools, but no one got much of a grip, says Richard Schulz, a social psychologist who studies aging at the University of Pittsburgh.

“I think the reason is that the big boys ̵

1; companies like Apple – never got into it,” says Schulz. The new features are a signal that the tide is starting to turn. “Apple getting into this is a big deal.”

Fear of falling

The first function, the indicator of walking stability, addresses a major problem for older adults: falling. Falls are the leading cause of accidents, injuries and death for the elderly in the United States, and they are responsible for billions in health care costs each year. Researchers have been studying falls – and trying to figure out ways to prevent them – for decades, says Jacob Sosnoff, who studies mobility at the Department of Physiotherapy and Rehabilitation Sciences at the University of Kansas Medical Center.

“We can do a very good job in the laboratory to measure degraded time and give predictions and recommendations, but we are not very good in the real world,” says Sosnoff.

Apple’s new feature for walking stability aims to track people as they move through everyday life. It uses calculations such as walking speed, stride length and time both feet are in contact with the ground to monitor how stable a user is. It can only be measured on an iPhone, not an Apple Watch, because some of the calculations must be calculated as close to the hip as possible, says Apple – so in a pocket or a bag works best.

The Apple Watch already has a fall detection feature that can prompt users to call emergency services or automatically call if the user is untouched for about a minute. The new iPhone feature focuses on prediction, rather than response: it can tell people if they are moving smoothly and give a warning if they think they have an increased risk of falling. Apple says the system is based on data collected during a clinical study that included over 100,000 participants of all ages.

There are no major commercial products that track the quality of people’s movement, says Sosnoff. Until now, most movement trackers have focused on how much people moved. “That’s why there’s a lot of excitement around this,” he says. “It’s important to keep people aware of the risk of falling.”

But there is also a disadvantage to telling people that they can fall – fear of falling is linked to actually experiencing a fall. If alerts increase fear, people may limit physical activity or even stop leaving the house so much, says Clara Berridge, a professor at the University of Washington who studies health technology in aging populations. “This is likely to contribute to their actual fall risk, because they reduce strength and activity,” she says.

It is a nice balance, says Sosnoff. “We want people to be aware of the risk, but not too worried about doing nothing.”

Sosnoff says he is eager to see if the ongoing stability feature can actually reduce falls in real-world scenarios. A challenge for the tool can be to monitor people with reduced walking – such as people with lameness. Algorithms that track gait often do not work so well in those situations, he says. If the Apple feature has that problem, it can flag people with different migration patterns that may not be a fall risk.

The Apple feature may not be able to help everyone at risk of falling. Walking patterns are just one of the many reasons why people fall: poor eyesight with age can cause people to stumble, certain medications can reduce balance, and objects around the house (such as loose rugs) can be dangerous. The Apple Walking Steadiness feature is designed to suggest that people who are in danger of falling do various stability exercises, which can be helpful in some cases. But for some people, balance may not be the most important issue. “Being asked to do exercises is not the only solution,” says Berridge.

Getting information about a user’s walk also requires them to carry their phone around regularly. Sosnoff says he is not sure older adults actually do. Many people may use their phones in different ways than younger people. “I know many older adults who leave the phone on the counter just like it is a traditional phone,” he says.

However, there are advantages to having a player like Apple work with falls. “They’re going to have a significant amount of data to see what’s going on,” Sosnoff said. If the iPhone could actually prevent falls, that would be a great blessing. “We put people back together if they fall and get injured, but we do not really do much to stop the fall. It would be exciting if we could. ”

Data sharing

Apple will also now let users share their health data with other people. The feature can be a great convenience for family members and caregivers of older adults, who may or may not need to keep track of someone’s health measurements. At the moment, they may need to gather information from several different sources – a heart rate app, a blood pressure measurement system. The Apple sharing feature can give them direct access in one place.

“I could see that this was very attractive to older children,” says Berridge.

It also provides privacy considerations for older adults. The Apple feature is completely controlled by the user, who gets to decide in the app what information they want to share and with whom. In reality, older people who are not comfortable with technology may not be able to take responsibility for that decision themselves.

“It’s very common for an adult child to buy a phone for an older adult, set up the settings, and take the phone out of his hand and say, ‘Let me just fix it for you,'” Berridge says. the capacity to withhold this information from the family member. ”

Some people may be very comfortable opening their Health app to family members, but there is still a power dynamic involved. Older adults like to monitor technology less than their adult children, and say they want to maintain privacy without feeling monitored. But their adult children are confident that they can convince parents to use surveillance technology, even if they say they are uncomfortable with it, Berridge’s research has found. “They are not necessarily inclined to engage them in the conversation, they are just very confident that their preferences will prevail at the end of the day,” she says.

On the flip side, adult children who use this feature may be inundated with information about their elderly parents that they are not sure how to interpret, says social psychologist Schulz. “Decisions must be made about how the information is analyzed and translated for the person gaining access,” he says.

In practice, Berridge is not sure how useful it would be to get a family member to see all Health app data. “People can say, ok, what do I do with this information exactly? At what point is it meaningful when I call a doctor and so on. It can also be an alarm overload situation. ” she says.

Despite these concerns, there is a growing interest in ways to keep older adults healthy at home. The COVID-19 pandemic showed that elderly care institutions can be dangerous, and people generally do not want to live in them, Berridge says. The new features from Apple highlight movement in that direction. “Moving surveillance out of facilities and into the home is going to be a big trend,” she says.

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