For decades, we’ve known that aging would one day be a major issue for Americans. We are each getting older. The nation as a whole is getting older. Our labor pool has fewer entry-level workers. Social Security and healthcare are expensive, and the cost of healthcare for senior citizens is rising dramatically. In the 1980s and 1990s, AIDS became not only a massive health issue but also a financial issue. Today it only costs $30 billion a year. The current cost of dementia care is $350 billion a year. By just 2050, this cost will grow by 3 to 10 times. Dementia care alone may soon cost more than the entire U.S. military budget. And this is just one of the many physical disorders associated with aging.
The Federal Government is well aware of the growing costs of aging in America. The latest major government attempt at controlling that cost is Outcome-Based Care. That’s the concept of measuring and comparing the tangible results of competing care options. For example, a provider that treats depression scores higher if their patients always show up. They get even more points if the patient starts to feel better. Of course, it also means that other treatments where patients don’t show up as often or don’t improve as much will lose funding.
Of course, the definition of “effective treatment” differs. Aside from how effective a treatment can be, we also need to take cost into account. A treatment that is 1% more effective but costs 100 times as much is unlikely to be adopted. Then what do we do for conditions like aging and dementia, that cannot be cured? Instead, treatments can only slow the progress of the disease and perhaps reduce suffering. For many aging Americans, a significant part of their treatment will be to learn how to cope with reduced abilities.
But when our abilities are significantly reduced, how will we be able to care for ourselves? Increasingly, aging Americans depend on care workers, increasingly in their own homes, to help maintain their independence. Almost everyone (individuals, their families, health care providers, insurance companies, and even the government) agrees that living at home is the best solution. The longer someone can live relatively independently at home, the better. The next transition is a retirement home, managed care, and eventually a hospital. Each step in this downward “slide” means a less happy life and higher costs for everyone involved.
There is, however, a problem. The life of a care worker (and most healthcare workers) is difficult. The pay is low, the work is very demanding (physically and emotionally), and the burnout rate is exceptionally high, often exceeding 60-80% annually. Not surprisingly, while the demand for care workers continues to rise, more workers are leaving the field than joining it. A recent study said that by as early as 2028, there will be a deficit of over 100,000 healthcare workers. Home health aides and personal care assistants will be especially impacted as these individuals are rapidly aging out of the system. The impact of recent cost-cutting in Washington will target senior workers with higher pay.
Lower-paid workers may still be available, but they tend to have higher turnover, which results in much higher training costs. In past years, this gap was solved by immigrant workers specifically hired for healthcare positions. That may no longer be an option.
In addition to a rising population in need of care services and fewer experienced care personnel, we can expect fewer entry-level young workers due to declining birth rates in the US. Unless there is a breakthrough in medicine that will cure the many diseases and dysfunctions of old age, which seems incredibly unlikely, we need to look for something that hasn’t been tried before. Something involving technology.
Artificial Intelligence or AI is a catch-all for many different technologies. AI has been around for decades. Antilock Brake Systems (ABS) were a very early and very primitive form of AI that took control of your car if it went into a skid. Exact numbers are hard to come by, but it is estimated that over half a million lives have been saved by ABS and similar safety devices.
While it may not save as many lives as ABS, another three-letter abbreviation for AI is GPS. It’s hard to say how many lives have been saved by GPS. But we can be confident that millions of hours of traveling time have been saved by GPS since handheld versions arrived in the 1980s. even SIRI has been around for over 13 years.
The latest versions of ChatGPT, Perplexity, and other popular AIs are far more capable and… conversational. It often feels like you are speaking with a very capable and skilled human being. We can expect tremendous improvements in AI speed and capability. An AI by itself can help monitor someone with limited physical or mental capabilities, sending out reports on health and activities, and alarms in case of a fall or accident.
When coupled with other technology it can control the lighting, monitor temperatures, reorder food and household supplies, and even manage your robot vacuum cleaner. Later, your self-driving car will talk with your home AI, and a humanoid robot can aid care workers, doing the heavy lifting if the resident needs help to use the shower or the toilet. Today’s care workers often quit because of repeated injuries from lifting older or disabled individuals.
As America’s population ages, memory therapy is becoming increasingly common. As is physical therapy. Both of these popular therapies, and more, could be delivered in an individual’s home. Perhaps even more importantly, throughout the day an AI can talk to you, discuss the day’s news, have a conversation about a favorite show, or even play games. AI can be an excellent companion, entertaining, and a 24×7 therapist.
Some believe that embracing AI and other new technologies is too much too soon. But what are the alternatives? Perhaps humanoid robots will be dominant, or specialized robots (automated kitchens, bathrooms that automatically bathe you) may take over. But some form of intelligent automation is in your future. Not just if you are old or disabled. The automation that works best for people with limited mobility works just as well for the fully abled.
What do you think? Are intelligent systems and robots the solution, or are they just a new problem?