Connected Nation

Telehealth experts on the future of senior healthcare in a tech-driven world

• Jessica Denson • Season 6 • Episode 3

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Telehealth has transformed how older adults access healthcare, but significant barriers still exist. In this special roundtable episode of Connected Naton, we're joined by a panel of telehealth experts to discuss how technology, innovation, and collaboration can improve healthcare access for aging populations.

PRODUCTION NOTE: One of the guests, Tom Kamber had a previous engagement that he had to step out for around the 30:00 minute mark.

Recommended Links:
Tom Kamber LinkedIn
OATS Website

Anoush Khachikyan LinkedIn
LVING Website

Kari Gray LinkedIn
CTN Website

Marisa Rossetti LinkedIn
Alta Senior Living Website

Jessica Denson (00:08):

This is Connected Nation, an award-winning podcast focused on all things broadband from closing the digital divide to improving your internet speeds with talk technology topics, and impact all of us, our families and our neighborhoods. When it comes to bridging the gap in healthcare access, telehealth has become a game changer, but how do we ensure these services reach everyone who needs them, especially those in underserved communities. And what role do technology and partnerships play in making that happen? That's what today's guests are here to explore. I'm Jessica Denson, and this is Connect Nation. I'm Jessica Denson, and today we're doing a special round table focused on telehealth and the needs of older adults. I have four special guests that are enjoying us today, and I'm going to introduce each one of them and ask them to tell me one little thing about what they do in their current role. First, Tom Camper, who is the founder and executive director of Older Adults Technology Services, also called Oats. It's part of a RRP. Sorry, Tom, do you say ARP or is it a RRP? A Tom Kamber (01:13):

A RP. Jessica Denson (01:14):

Okay. He returns to our podcast with insights on empowering older adults through technology. We did talk to you several years ago, directly after, or right at the end of the start of the pandemic. It all bleeds together. But thank you for joining us again. Tom, tell us a little bit about what's going on with your organization right now. Tom Kamber (01:33):

Sure. And I'm really happy to talk to you again about this. It's been a while, but there's a lot of new stuff happening, so it's a great time to discuss it. And I am the Executive Director of Older Adults Technology Services, boots from A A RP. And we are a national organization that helps people over 50 get online and use technology to improve their lives. And we spent a lot of time on our digital property, which is called Senior Planet Senior planet.org, where we offer about 4,500 free classes a year and serve about 500,000 visitors. But we also run partnerships at 600 locations around the country with libraries and senior centers and sites where we deliver our programs. And we have a headquarters in New York and other really amazing sites in Miami and Denver called Senior Planet Centers that people can visit. All of our programs are free, and we're an affiliate of a RP, as I mentioned, Jessica Denson (02:27):

If memory serves, last time I talked to you is when you did the study that I referenced, but that was done with the Humana Foundation, correct? Tom Kamber (02:35):

Correct. Jessica Denson (02:36):

And you guys have done some updating with that? Tom Kamber (02:39):

We did do some updating, so we're really excited we have it. It's not even hot off the presses because it hasn't gone to press yet, but I'm looking at the data tables this week, and we updated when we did the survey about, it was about five years ago now. It was using 2018 data. We found that about one out of every five older adults was not online at home. They didn't have the basic, what we call wireline internet access, which is a sort of standard for people. And so that was about 42% at that point. The numbers have improved over the last five years to the place where today it's about 32% that lack wireline at home, and the improvement has also gone into the cellular space. So we're seeing that about roughly three quarters of older adults have a cellular connection. So there's better numbers than there used to be, but that's still pretty surprising when you realize that one out of every three older adults in America doesn't have wireline internet at home. That's a really stark number for people when we realize how critical this is for things like telemedicine. And then it gets pretty ugly when we look at mapping onto things like rural residents. So when we look at rural versus metro, the number goes from 32% that are lacking all the way up to 41%. So rural older adults who are most in need of this, in many cases, have even less connection. Jessica Denson (03:59):

Well, I'm really interested in seeing the full study when you drop it. I'm glad we got a little preview there. I'm going to move on to my next guest. Her name is Anush. Now she gave me a great pronunciation, so I'm not, I'm trying not to kill it here for you. Anush. Kaon, right? Yes. Kaan. Anush Kian. She's the Chief executive officer, CEO of Living Inc. Specializes in creating on-demand solutions designed to meet the unique needs of older adults. Now, I gave Tom chance to talk a little further about Oats. So explain to us a little bit about what that really means with Living Inc. Anoush Khachikyan (04:37):

Yes. What we're doing at Living Inc is making on-demand services more accessible for individuals who want to maintain their independence and the comfort of their homes. If you think about services that incorporate home management, personal care, pet care, transportation, we're condensing the most requested services down to one product that caters to the user who just wants to stay within their home. Jessica Denson (05:04):

You mentioned pet care. That's kind of an unusual, explain that a little bit. Anoush Khachikyan (05:08):

Yes. A lot of individuals have pets that need attention and care, and due to mobility restrictions or healthcare restrictions, individuals don't have the access to go out and get these services or provide these services for their loved ones. So what we offer initially is we're doing pet walking and pet city services, and we'll extend out to mobile pet grooming and pet food delivery as well. Jessica Denson (05:33):

That's awesome because for a lot of older adults, especially, sometimes your pet is your family member or somebody you feel very close to be taken to be separated from them must be difficult. Anoush Khachikyan (05:47):

Yes. Jessica Denson (05:48):

Yeah. And it will surprise no one who's listened to our podcast. I'm a big pet person, so I had to ask that. And it is living, but it's L-V-I-N-G, right? Anoush Khachikyan (05:58):

Yes, living. Jessica Denson (05:59):

Okay. I'll include links to all of these organizations and the representatives that we talked to throughout. So now our next guest, Carrie Gray, she's a social impact program director at Community Tech Network, which is CTN and organization Breaking down Barriers to Digital Inclusion for seniors and their supporting agencies. Welcome, Carrie. Kari Gray (06:20):

Hi, how are you all doing? Jessica Denson (06:22):

Great. Why don't you tell us a little bit more about your organization? Kari Gray (06:26):

Absolutely. So Community Tech Network, we provide services directly to older adults by working with them in groups or one-on-one virtually or in congregate living facilities, senior centers, other places like that. And we also provide training for the volunteers and staffs at those facility after, so they can continue to provide advice and support on navigating the internet and technology. And I'll talk a little bit more about that later, but I also want to talk a little bit about where we fit in with the other people on the call. So for example, senior Planet provides this really robust online product for folks to get all kinds of classes. And so the people we work with are the people that Tom mentioned earlier who don't have internet at home. They use Dialup. Many of the people we work with don't even have cell phones. They have phones in their house and they've been using their senior center computer labs, or they go to a senior center and don't use the computer lab.
(07:33)
So we work with people to get them to the place where they can go to Senior Planet and find an experience that is right for them. And so we work with folks who may not have ever touched a computer, might not have ever navigated anywhere on the internet, and so we get them to Senior Planet and then we have this kind of warm referral to Senior Planet or to an app like Living where they can find folks to help them at home. We also refer people, we, and I'll talk a little bit more about this later too, but it's also we find out what people need and what they want. And if you're talking to somebody, they're like, oh, I'm so worried about my pet's healthcare. We can refer them to an organization like Living. And when Marissa introduces herself, you'll see we work with a lot of senior living facilities, and so we're kind of in all of these places at the same time. Jessica Denson (08:30):

That's wonderful. And I love how you led in for Marissa, for me, Marissa Rosetti, final, but not least guest, national Vice President of Sales at Alta Senior Living, who is leveraging innovative technology to enhance senior care. That's the approach of your organization, but do you want to expand a little bit on that? Marisa Rossetti (08:51):

Sure, absolutely. So at Ulta, we are a national company. We do have local corporate management near all of our communities so we can really implement on the ground in the communities, all this new research, all this new tech, and it's been a focus of ours since day one. All of these things are out there. It's just a matter of the senior living industry, accepting it, taking it in training and implementing. So we can provide these resources to not just support seniors, but help them thrive as well. Jessica Denson (09:27):

I really love how the four organizations that you all represent really do fit together for this conversation. So let's dig in. Telehealth has really opened doors to better healthcare access, but it's not without challenges, obviously. Let's start with a broad question for all of you. What steps can we take to make Telehealth services more accessible to all communities, especially those facing significant barriers? So we'll start with you, Tom, and then you could pass it to Carrie. Tom Kamber (10:00):

Okay, sure. The most important thing that we can do with making it more accessible, of course, is addressing the connectivity problem, still kind of afflicts the country. We've got to find better ways to get people online at home with high quality connections, especially people that are in underserved environments, communities who may not have resources. So one of the real policy opportunities here is to promote broadband subsidies for people. The affordable connectivity program was a really important effort, but that ended over a year ago now and has not been replaced with a new program. So finding a new way to subsidize low income folks, getting online is really critical. New York State has a rule that requires telecoms companies to provide a low cost 15 or $20 a month internet line as part of the state's regulations, which was just affirmed by a court case last week. So there is some effort around the country for people to support digital inclusion. I think that's really critical in that first stage of it. And I will say that older adults themselves, when they do have a connection, they do use telehealth in great numbers over, I think it's now 73% of older people surveyed by a RP last year, say they had used telehealth in the last year. So people really want to get online and they want to do these visits, but they've got to be able to do it safely and privately from their homes. Jessica Denson (11:32):

And Carrie, how would you answer that same question? What can we do to make things more accessible to all people? Kari Gray (11:39):

Well, I think with some people, you really need to demystify what telehealth is. I think we have a lot of older adults who are nervous about giving confidential information online. And so having a trusted messenger from their community, from their congregate living facility, from their senior center who can work with them to help them feel more comfortable online is critical. I think there's also, when you're talking about underserved communities and people who are facing significant barriers, we also have to talk about folks who the telehealth user experience may not be available in their language. And so they absolutely need somebody sitting with them to help them access some of the sites, to get them registered, to sign them up. We saw this all with the Covid vaccines, that the Covid vaccine sites were in three languages. I'm in California. There's no way that's going to hit everybody. And so it's especially important to have that trusted messenger from your culture, speaking your language to help you navigate something, especially for the first time. And a lot of marginalized communities think online stuff is not for them. And so this really helps people see that it is part of their everyday life. If they see somebody they know and trust helping them, Jessica Denson (13:10):

Really, there's a lot of answers. So part of it, the importance of that is to help people understand why it's not just having the access is what you're saying. Kari Gray (13:22):

Right. And to Tom's point, once people are comfortable online, especially home bound people or people who take buses to appointments, they're all in. They love it once they've started using it, but it's getting over that first kind of trust and familiarity barriers. That's really important. Jessica Denson (13:41):

Anush, how do you see this as falling into what living does? What are some services? What's something we could do to make Telehealth services more accessible and help those people that are facing significant barriers within this? Anoush Khachikyan (13:58):

In my personal opinion, I've worked with individuals in their homes for the past eight years, visited over 1700 homes in Los Angeles. I've got to experience and hear the stories firsthand. And in order to address Tom and Carrie gave some great insights. And in order to address Telehealth access, there's really four different categories that we need to address. Number one is the financial, the affordability, and getting broadband access, smart device access. There's the usability restrictions, the design and the user interface. Are they smartphone optimized? Since a lot of individuals do tend to use internet with their smartphone devices rather than the home. And then there's a cultural, as Carrie mentioned, how do we address the cultural barriers and the language barriers when trying to make telehealth more accessible? And in my personal opinion, I think there's the fourth category, which is the stage of life, the individual, are they in the silent generation and the baby boomer generation and the level of care and attention that they need and how we're going to reach these individuals.
(15:11)
Those are my personal experiences. And what I've witnessed and going forward, what I believe would work best is to add it as an extension service with home care companies, home healthcare companies, and get reimbursed. For example, there is Geek Squad that works with tech companies. We should start incorporating some sort of a service that we can get reimbursed through insurance companies where individuals can come into the homes and help individuals get set up depending on the level of care needed and if it's a chronic condition or if they need a diagnostic oversight. And I think, Jessica Denson (15:50):

So that's a point that's important too. Telehealth isn't just calling your doctor or being online with your doctor. It also can be the health monitoring devices, right? Anoush Khachikyan (16:01):

Correct. Jessica Denson (16:02):

Where a doctor might be monitoring your heart rate or your diabetes or that type of thing, right? Anoush Khachikyan (16:11):

Yes. There's a lot of heart related care, chronic conditions like diabetes, and there's a lot of individuals that have these devices that get sent home to the house. But in order to continue that continuum of care, it would be best to set up the telehealth services as an extension service as well. So the individual has direct access and not just the wearable device that gets sent out to the doctor and they don't know what's happening or they have to follow up by going out to see the doctor. Jessica Denson (16:45):

Makes sense. Makes sense. And Marissa, for you, what do you see that, what steps need to be taken to make telehealth services more accessible to all communities, especially those facing significant barriers? Marisa Rossetti (16:59):

Sure. So excuse me. I would say we need to look at tech from the senior's perspective. We often live in our own reality with our own abilities. Our seniors are often living in a different reality with different abilities and strengths and weaknesses. So meeting them where they are, whether that's changing interfaces, making them user-friendly, providing adaptive equipment to block out background noises, whatever that may be, we need to meet them where they are and create these opportunities that they can use on their own if able. Jessica Denson (17:41):

And this is going to lead me to my next question, which we've kind of touched on in this first one. But Marissa, do you feel that this demographic has some unique challenges that we really have to be aware of? Marisa Rossetti (17:52):

Absolutely. So for instance, we love to do telehealth at our memory care communities because it allows the residents to stay in an environment that they're safe and sound in, but they have a really big difficulties focusing on, say a FaceTime with a doctor. They can't cancel out the background noises or what they may hear in the background of the doctor's office. So we implement something called Ever sound headphones to be able to use with the telehealth and provide it and make it an easier experience for the resident. This has helped significantly with our residents with dementia, those in our memory care units. It's been phenomenal. Jessica Denson (18:33):

Anush, I'm going to come back to you because you kind of touched on the idea of there was a fourth knee based on stage of life. Are there some other unique things that we need to be aware of for that demographic? Anoush Khachikyan (18:48):

It ties back into, as Marissa mentioned, the visual impairments, the hearing impairments, fine or gross motor skills. What we need to do is make sure we're addressing these when we're building out the technology product and how we're educating or marketing or reaching the individual to better make them understand how to use the product itself. Jessica Denson (19:18):

And Carrie, I'm going to come back to you and then Tom, I'd like to round out this question with you. What are some of the things that we really need to be aware of when you deal with an older population and this demographic and things that maybe just might not be intuitive necessarily unless you're dealing with that demographic daily or are part of that really, what are some things that we really should know, Carrie? Kari Gray (19:45):

Well, I think, like Marissa said, some of the challenges are working with people that have memory issues, multiple disabilities, physical limitations that need to be accommodated. And there's also the self-identity aspect. A lot of older adults thinks the internet is not for them. It's video games and social media, and they don't need that for cultural or personal reasons. They just don't think it's for them. And so one of the things we've noticed is that when people start to become confident and safe online, they really redefine who they are and what their aging experience is, especially if their friends are asking them for device or they master something, which I think it was, for us, it was kind of an unexpected benefit. An unexpected impact is people gained confidence in one area of their lives. They kind of redefined who they were as human beings in the world.
(20:44)
And I thought that was pretty interesting in of our post-program impact data. I think one of the interesting things is that older adults also as MRSA suggested, you don't know why somebody wants to be online until you start talking to them. And so it might be something as simple as looking at their hometown newspaper, which is pretty standard. And we work with a lot of refugee and immigrant communities who are delighted to see their hometown newspaper 40 years later. They want to know what happened at the place that they left. And that's something that people who haven't had that experience, it may not have the same impact to see their hometown gossip and news. The other thing is that the one application of AI that's been especially helpful for older adults is using AI to interpret test results or medical jargon. I think anyone can appreciate that, but we know that notice that that's one of the most common uses of AI in our classes is to demystify medical jargon. Jessica Denson (21:57):

I think all of us could use that for sure. For sure, for sure. That also makes me think sometimes I think all of us are guilty of this, where we think we're the only ones dealing with this issue, right? That it could be eyeopening to see, oh, no, this is something that we all deal with at all ages in different ways. Also, I miss opening up a newspaper. I miss that very much so I can understand wanting to go back to look at your hometown newspaper, Kari Gray (22:27):

Tom, or just Google satellite to see your old house. Oh my gosh, that's a powerful thing. Jessica Denson (22:33):

That's really interesting. So they're opening them up to some of the past, but also in a new technological way, I guess. Right, Kari Gray (22:42):

Exactly. Exactly. Jessica Denson (22:45):

And Tom, it strikes me that the last time we did talk, and we mentioned this at the top of the podcast, the older adults technology services study really focused on that social isolation piece. What is Oats? I know you talked about it some, but Oats has been instrumental in helping older adults use technology to manage their health. So do you want to expand upon some of what's going on with that and what do you see the future where this is going? Tom Kamber (23:16):

Sure. We are doing a lot of telehealth work, but interestingly, it's evolved in the last few years where people seem to be combining their traditional telemedicine activities and to broader patterns of using tech for their sort of general health and wellness. So one of the things we learned when we started putting up classes online and teaching in some of our centers was when you put up a course on telehealth skills, we might get a fairly small or modest number of people taking the class, but when we integrate those skills into a broader course on tech and health or tech and wellness, we might get 200 people in the class. And in fact, people are using their sort of experience of telemedicine to kind of compliment their other activities. So telemedicine, the classic case of somebody just doing a doctor visit online is now over 90% prefer to supplement that with in-person visits to their doctors.
(24:17)
They don't just want one modality where they're just doing telehealth, and that sort of is the only element of it. So at Oats now, we've started to really see huge numbers of people on our wellness classes. We have just, I was looking at our list this week. We've got a class in the next couple of days on, we have a Wellness Wednesday kind of support group for people, and then we have Tai Chi. We have a course on balance and a morning stretch class that gets like 800 people per class. And so people are really using technology as a way to build a more multifaceted set of health and wellness activities. They want it for diet, they want it for helping with fitness programming or stretching or mindfulness or mental health. And then they're incorporating a lot of that into the telemedicine tools that are simply kind of a supplement to it.
(25:08)
So we are working to sort of support people both on the curriculum side. We're supporting local programs around the country through a licensing initiative where we've got about 480 sites that are using our curriculum in different states. And somebody mentioned ai, and I'll close with that. Open AI has a program called Social Resilience where they're looking to help mitigate the effects of AI and promote positive community activities with it. And we're their partner for aging this year. And so we've been working with their staff to develop curriculum. We did a research study where we interviewed people about using AI including related to health. And what we're finding is that people are excited to do it. They think it's going to enhance their lives, but it's critical. People learn how to use it safely because, for example, if you put your personal information into an AI engine, there's no regulation about how that gets protected and what the AI engine or app is going to do with your personal medical information. So we are encouraging people to use it as was mentioned, for sort of demystifying or maybe writing a letter or support, researching different conditions, but without uploading your own personal data into it. So getting people at the community level to know that and support older adults using this stuff safely is kind of a big focus of ours lately. And I think a lot of the future now is to get people to integrate all these different tools and different patterns with your community in ways that are most relevant to older users. Jessica Denson (26:43):

Talk about that, a little bit, about the idea of how difficult it must be to try to be the expert and stay ahead of that curve while also helping older adults understand it. Are you always looking to that horizon? What is the next thing I have to get in front of? Tom Kamber (27:01):

Yeah. What I learned a bunch of years ago was it's better for us to understand what we don't know first and not try to be experts in everything as the healthcare programs and advances are moving such a rapid pace. So we've tried to partner with institutions that have a lot of capacity and then tap my curriculum team into their knowledge. And then our expertise, of course, is how older people use the knowledge. So we're good at, we're working with United Health Group this year, for example. There's a whole initiative around health equity for Medicare Advantage plans, but many of their customers don't have the tech skills to use to access all those resources that United has available. So we have a contract with them where they worked with our team to develop a series of classes and programs and curate from our list of initiatives that we have.
(27:55)
And then when they have people that are struggling with technology, they literally refer them to us. We have a call center that will assess what their needs are, figure out what's most relevant for them, and plug them into a free class that then enhances their skill level. So we don't have to know which of those classes is most relevant to what people are asking from United. They have a huge database of all of this, but they can help guide our practice so that the training we create is actually relevant and useful, and then they don't have to learn how to figure out how to teach technology to 90 year olds. What we're really good at, it's Jessica Denson (28:29):

Partnerships are extremely important in this space. Then Tom Kamber (28:32):

Yeah, I think the partnerships are kind of essential and also going into the community level with what Anusha is doing, and Carrie and Marissa there, where those community organizations and community settings have the data and the capacity that they have is absolutely at the same level of critical criticalness as what a big institution like United or Humana or OpenAI has. It's just from a different part of the process. So we all have to go to those partnerships as equals and make sure that people are valuing the work that's being done in the home or in the housing group or in the community center. Jessica Denson (29:07):

Which leads me perfectly into my next question, which is for you, Anush, your work at Living focuses on designing telehealth solutions for older adults. So talk a little bit about what those solutions look like. What are some things you are focused on? Is there anything that really stands out that really older adults need to know now and that we should be looking at? Anoush Khachikyan (29:32):

Yes. When we're providing our services, what we want to do is to make it more accessible by reducing a lot of the barriers. So we're looking at what are, instead of adding more features, how do we reduce more features so that the individual is able to go on there and request that service really quickly? What we want to do is educate individuals about financial scams targeting older adults, and the only way we could do that is through education and awareness, making sure that we're letting individuals know to only have conversations or interact with individuals within the organization, through the application, and not through text. And yeah. Jessica Denson (30:22):

From your perspective, if you could wave a magic wand to increase investment in one specific initiative that supports the wellbeing of older adults, what would you choose and why? Anoush Khachikyan (30:34):

Just to add an extension service on tech support and tech education through home care companies. As I mentioned earlier in the podcast, through home healthcare agencies, adult healthcare centers, because what happens is we already have the infrastructure set in place where individuals are going out to provide these services, but what we're lacking is the educational component of introducing services, for example, telehealth, other applications that can help enhance the individual's life at home. If we can add this additional extension of services where we could either get reimbursed through the state or through insurance companies, I think that will really go far. Jessica Denson (31:21):

Yeah, we saw a big investment, or at least an opening of telehealth services during the pandemic, and that's slowly over the years, gone back the other direction. Would you like to see more telehealth services open again, where they're across state and where that's being approved across the board? Anoush Khachikyan (31:41):

Yes. Personally, here in Los Angeles, what I'm hearing is when individuals go out to the hospital, if it's an emergency case, there's long wait lines. So if we can look at and use data to figure out, okay, individuals who have chronic needs, healthcare wise, individuals that are getting re-hospitalized often and making sure that we can educate and get them on a support system like telehealth services or at-home diagnostic services and try to monitor in order to reduce them having to go physically to the doctor or to the hospital or to get rehospitalized, that would improve greatly in the outcomes going forward. Jessica Denson (32:30):

Fantastic. Thank you, Anush. And that brings me to Carrie Gray, who is with CTN. She provides services directly to older adults, or the organization, excuse me, provides services directly to older adults and the agencies that support them. So Carrie, what are some significant barriers you've encountered in helping older adults access and effectively use the internet within your organization? Kari Gray (32:55):

Well, thanks for asking, and it's similar to everybody else. Some of the most significant barriers. As Tom mentioned, some folks just don't have internet access where they live. People in rural areas may not have a broadband option, or people might not have an affordable option where they live. So that's a huge barrier because most older adults are in a fixed income and they don't have the financial capacity to shop around or to change or get plans for something that they don't know if it's useful. But we work with many older adults who have very limited English and in many cases limited literacy in any language. And so our instructors, volunteers, digital navigators, are trained how to work with adult learners specifically with those challenges and how to adjust curriculum and their instruction pace to match the abilities of the learners. One example is the California Public Utilities Commission has a grant for digital equity work where you're to provide eight hours of instruction.
(34:05)
However, many of our learners, as I mentioned before, have memory challenges or physical challenges. And so sometimes that eight hours is more like 10 or 15 because we're really committed to working with folks who might need to slow down. They can't have a two hour class, they need to have a 45 minute class with a break. So these challenges are embedded in the way that we work directly with learners and also in the advice that we provide for other people who are planning to work with older adults. Digital literacy really is such a big topic, and we don't want people to feel overwhelmed or just take the tablet, put it on a shelf and never use it again. For sure. Yeah. Jessica Denson (34:56):

So do you partner with lots of different organizations to tackle those challenges? Kari Gray (35:01):

Oh, absolutely. Absolutely. Because one of the things we do when we first start working with folks is we get to know them through what we call our diagnostic needs assessments. So we find out a little bit more about what the partner's own capacity is, what their resources are. Do they have any instructors who are bilingual? Do they have a community that they're not serving? Does their volunteer manager for example, have a particular passion for technology and recruiting technology volunteers? So we always do a technology assessment as we start to work with a partner. I have an example, just going back to the language challenges. When we first started working in Contra Costa County, we were referred to an organization which serves older lotion refugees. And so a lot of older lotion refugees are don't read any language and they speak dialects. And so what we decided, what we do is we trained and paid their own community members to distribute the devices and provide training.
(36:08)
So a lot of the people in the program, especially socially isolated, home-bound people, we're thrilled to have somebody teach them in their own language and dialect. This had never even occurred to them. They had not realized that it was possible to change the language on the devices. They didn't know that there were news sites or websites in their own language. They didn't know they could use a screen reader. They didn't know that you could watch videos in your own language. So it was really like a light bulb went off for a lot of these folks. People could now kind of connect with their friends and family, and there are a lot of older people who are physically and socially isolated, so it really does open a window for them and they can apply for benefits.
(36:54)
There was one woman in Sonoma County who was a retired teacher but didn't have her own device, and so she was able, got the device, she did the training, but she immediately was very proficient as soon as she got the device and the data plan, and she renewed her qualifications so she could tutor people online and create a little revenue for herself. It's interesting because I find that when people are thinking about older adults, I think as you mentioned, the people over 80 are different than the people over 50, but I think that, well, other than those of us on this call, I think people don't recognize how many times older adults are going to use the internet to apply for benefits. There's a huge benefits gap in California. How many people are going to apply for work and use the internet for their work, or they need something to make themselves self-sufficient in the way that people who are also not older adults? I think a lots You could think of it. Yeah, sorry. Jessica Denson (38:05):

That's all right. I can also imagine that if you feel that there's this whole technology that the world has access to and you don't quite understand how isolating that could be, especially if you have another language and you're surrounded by English language speakers and you've yet to make that transition. So it would open up a whole world, I think. Kari Gray (38:26):

Yeah, it really does, but it's also, they're not looking at technology and saying, oh, that's not for me. Some of them don't even know what's possible until you find out what their interests are. Jessica Denson (38:37):

So then introducing them to all of that. Kari Gray (38:40):

Yeah. I have another great example. So we were working with Russian speaking refugees. So these are people who had moved to the Bay Area in the eighties and they spoke Russian, and they are not learning English. They are also 80 years old themselves. But what they could do is they could video themselves making food and send that to their grandchildren, and it was just, I am just overwhelmed at how people are very, they know what they want to do, and technology helps them do that. Jessica Denson (39:15):

So rather than just saying, Hey, here you go, this is what you should do do with this. This is everything. Going to them and having a dialogue and a conversation about what would you like to use it for? That's awesome. Marissa Alta, senior Living is known for its tech forward approach to senior care. How does your company incorporate technology to improve the lives of seniors, particularly those who may be dealing with Alzheimer's or dementia? Marisa Rossetti (39:42):

Sure. So on the basic level, like every community, I hope every community senior living is using that basic telehealth to call with doctors. That has been crucial, especially in memory care because of the speed in which we can react. If we can get a doctor on the phone and get an infection or an intervention taken care of, the resident is calmer, more peaceful, and there's length of stay is often longer too. So seeing that basic tech work, we thought, what else is out there and what else can we implement on another kind of physical care level? We've implemented the vigil system in our memory communities, so everyone that comes into this community doesn't matter their level of cognitive impairment, but they do have a diagnosis of dementia or Alzheimer's or another type. We've implemented the vigil system in these communities because what wasn't working were the pull cord systems.
(40:41)
When a resident with dementia needed help yelling out at the top of their lungs at three o'clock in the morning, that's every adult child's nightmare to know that their mother or their father was going through that. So out of frustration, we implemented Vigil, which is a monitor and sensor set that's calibrated specifically for the resident in their room. So if someone gets up at three o'clock in the morning and is confused, disoriented thinks it's 6:00 AM and it's time to start getting ready for that day, vigil will alert us. No alarms go off in their room, and it saves so much dignity for the residents. It's giving family peace of mind, and it's allowing us to provide better faster care. The another piece I just want to make sure we talk about is the isolation that seniors go through and what telehealth can do as far socially socialization. We also implemented an app at all Alta communities so that family members can log onto this app and see exactly what their loved one is participating in. They can see videos of their loved ones smiling and talking to friends, and they can connect with their loved ones too in the community. So we've bridged this gap where there's that socialization piece, that mental health piece that we need to touch on too, just as much as the physical health, and that's what we've been able to do with Sagely, which has been pretty phenomenal. Jessica Denson (42:11):

Lastly, and I'd also like Anish for you to address this last question as well. I know you mentioned you were in LA during the recent wildfires near your Santa Monica location. Your technology played a key role in supporting residents and keeping 'em safe. Talk a little bit about that. Marisa Rossetti (42:30):

Sure. So we were dangerously close to an evacuation zone, and this is again an all memory impairment community. You cannot have anyone leave go out in times like these. So the vigil system kept the community safe, kept us alert to where everyone was, every door that was open and closed to make sure everyone was completely physically safe. We also used the Sagely app to connect with families. So many of the family members of our residents lost their homes in the Pacific Palisades and in Malibu. So we were able to, while they're going through all of that, provide them with the peace of mind that your loved one is safe, they're okay, here's a picture of them, and that just, it made a world of difference for some people. Jessica Denson (43:17):

I can imagine you're already losing everything. You don't want to have to also worry about your loved one. I know you mentioned you were in la. Was there some sort of approach that Living Inc took to helping seniors during this time or during emergencies? Anoush Khachikyan (43:36):

Since we work with individuals independently who reside at home, we didn't necessarily connect with them on one-on-one, but I was able to go into some of the homes during this time. A lot of individuals within Santa Monica did relocate. Unfortunately, they got evacuation orders and the smoke in the air was horrible. But other than that, we didn't really work with individuals. And then the LA fires as far as my organization. Jessica Denson (44:13):

Gotcha. Makes sense. I would be remiss if I hadn't asked, is your family all okay as well since you're in la? Anoush Khachikyan (44:21):

Yes, we're okay. It was a horrible time. There were so many fires, different fires happening. We only got one evacuation order. Unfortunately, one of my good friends, his home burned down in Altadena, so he's terrible. A lot of individuals lost their homes during the Jessica Denson (44:42):

Period. Yeah, I just can't imagine just losing everything all at once and just a blink of an eye. I know. I do have a final closing question I want to touch on before I let you guys go. I have one other thing listening to you talk about these issues. I'm really struck by how each of you seem really moved and passionate, and I feel like I could talk to you for a couple of hours about these issues. If you could each tell me why it's important that we address the technological needs and the telehealth needs of seniors or older adults, why it's important to each of you. I would love to hear that initiative you were just speaking. How about you start us off? Anoush Khachikyan (45:31):

Of course. There was actually a recent data that I saw where 600,000 individuals lose their ability to drive on a yearly basis, and these are individuals that have mobility restrictions, chronic health conditions, and they need to go out and complete tasks or see their doctor. Why technology is so important in bridging the Gap is those that need it the most don't necessarily have the access or the means versus those that have grown up with the technology we use today. And the three core pillars that I like to focus on within living is voice. Voice. Automated technology will outperform any other technology. So how do we incorporate more voice automation within technology? Use visual suggest pictures. We like to communicate through pictures. What items do we use in case it's a health condition, wound care. We like to convey what's happening in real time. And also there's a human emotional component, which we don't address a lot of times because we're so fixated on the technology component is we want somebody on the other end to understand our frustrations. And while we want to use technology to automate a lot of these things, we want to keep the customer, overall customer experience and overall customer journey in mind and bringing back the human component. If an individual has some sort of a restriction, their frustration levels are going to be very high. So we want to make sure that there's always that human component that they can talk to in addressing any issue that they come across. Jessica Denson (47:11):

Thank you, Anush and Marissa, what about for you? Why is this such an important issue? Why is it important to reach older adults through technology and telehealth? Marisa Rossetti (47:22):

Sure. My answer really comes from being in the communities and seeing breakthrough moments When you see someone with memory impairment that possibly couldn't communicate before that was not getting the physical care and help they need because they had no access to doctors at home or they couldn't go seeing those moments, it changes everything. And you understand how important this is. We need to look as seniors and tech going together versus total opposites. We just need to make it so the tech works for them and in their world and in their space. Jessica Denson (48:02):

That's a great answer. And for you, Carrie, why is this so meaningful for you? Kari Gray (48:09):

Oh, gosh. Exactly what Anusha me said, because at the end of the day, we all want everybody to thrive. We want everybody to be comfortable and confident and economically secure. And we see every day people who have been left out of the financial, social, mainstream. And so watching people regain their place in the world, people who are socially isolated, being able to connect with friends and family they haven't seen for years or connect with those part-time job opportunities like online tutoring, you're helping real lives and real people. So technology is part of it, but it's just a vehicle for other things like telehealth. And also just to follow up, there's so many people who are socially isolated, and they rely on those little transportation vans to get them to the senior centers or to get them to their doctor's appointments. And when the van is late emotionally, they just, they're so frustrated and so discouraged and giving them the opportunity to do telehealth, gives them autonomy. It provides autonomy and agency over the situation where you're getting on the little bus, which is so disempowering. So personally, I just want to live in a world where everybody feels useful and connected and they can thrive. And so telehealth is a piece of that, a technology is a mechanism for that, but there's so many other ways that we connect people Jessica Denson (49:56):

To the world. That's an interesting point, that losing a little bit of control. I saw that with my father too, that he wanted to have some control of his life. And so I can completely understand that and relate to that in almost a emotional way that I didn't expect to feel there. So like I said, I could talk to you all day. You all just have such great insights and I really appreciate it. And I would love down the road if you have anything new going on to let us know, we could visit each of your organizations individually as well. But let's end our conversation today with what is something that each of you would like our audience to take away from today's conversation. And I'll begin with you, Anush. What is something you would like our audience to take away from today's conversation about Living Inc. Or about why this issue with Telehealth and older adults matters? Anoush Khachikyan (50:51):

One great thing that we're doing is starting these conversations. I think one of the best ways to bridge the barrier gap or access is to start having conversations and working and partnering with organizations in order to make it more accessible for individuals to get the access that they need. So one thing that I would like individuals to take from this is it's not going to happen overnight. It's going to take time. And what we want to focus on is reducing red tape barriers when working with organizations and really fostering great connections in order to do something better for the greater good versus on a corporation level or on an organization level, on a partnership level or non licensing level, for example. Jessica Denson (51:43):

And for you, Marissa, what would you like our audience to take away from today's conversation? Marisa Rossetti (51:50):

I think we all really touched upon how important telehealth is to seniors, how much they can benefit from it, and that we really need to support them in that. One thing I think everyone should take away though, is the seniors are absolutely going to teach us something about it too. And working with them in tech, I guarantee you, they will help to improve it if we just give them that chance. Jessica Denson (52:17):

That's a fantastic point. I love that. And Carrie, you get the final word. What is something each of us, that you would like our audience to take away from today's conversation? Kari Gray (52:28):

Well, I think it's important to have conversations like these. One of the important things that we do, community Tech Network is we are a network and we work exclusively with partners. And in partnership, we always take referrals from other people. And I think it's important for people who are listening to understand the wide range of agencies that are helping these populations. So it's businesses, it's nonprofits, it's government agencies. Nobody has an exclusive responsibility, and we're all trying really hard to work together and to create solutions that are genuinely collaborative. And as Merc a said, listening to the communities we serve to see what they need, they may not need me, they might need something else, and that's okay. Jessica Denson (53:20):

Great. Well, we'll leave it there. Thank you everyone for joining us for our Telehealth Roundtable. I appreciate each of you and all the insight you have provided as well as all you do for others. Thank you, Kari Gray (53:31):

Thank you, thank you. Thanks for including us. Jessica Denson (53:41):

We've been talking today with a roundtable of telehealth experts that included representatives from older adults, technology services, or Oats Living Inc. Community tech network, also called CTN and Alta Senior Living. I'll include links to all of their websites in the description of this podcast. I'm Jessica Denson. Thanks for listening to Connected Nation. If you like our show and want to know more about us, head to connected nation.org or look for the latest episodes on iTunes, iHeartRadio, Google Podcast, Pandora, or Spotify.

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