Senior Care Academy
Senior Care Academy is a podcast dedicated to providing valuable information and expert advice on navigating the world of senior care for both senior care providers, and families with aging parents. Hosted by industry professionals, each episode covers a wide range of topics including healthcare options, legal considerations, financial planning, and emotional support for caregivers. If you are a healthcare provider, have aging parents, or are a senior adult, this podcast is for you! Tune in to gain valuable insights and resources to help you make informed decisions and provide the best care for your loved ones.
Senior Care Academy
Charting the Future of Senior Care: Dr. Stuart Smith's Innovative Fusion of Technology and Compassion
Embark on a journey of discovery with Dr. Stuart Smith, who lifts the veil on merging neuroscience, psychology, and cutting-edge senior care technology. From the weightlessness of space at NASA to the intimate setting of home-based elder care, Stuart's story is anything but ordinary. He illuminates the nuances of aging and shares how his work with Intel is pioneering advancements that are reshaping how we support our senior community. Grasp the essence of his multidisciplinary approach that champions data-driven decisions and collaborative problem-solving, and how these principles are revolutionizing the delivery of health services to our aging population.
Prepare to be inspired as we discuss the transformative concept of Shift Left Health with Dr. Smith, bringing high-quality health services into the comfort and familiarity of one's home. Discover how technology is not just a tool but a bridge connecting the worlds of health, aging, and disability services to create solutions that are both accessible and cost-effective. Stuart's insight into the creation of a game designed to reduce falls among the elderly exemplifies the innovative spirit needed to tackle the pressing issues in senior care. This episode is a testament to the potential that lies in harnessing technology to improve lives.
Wrapping up, Stuart Smith not only shares his vision but also challenges us to imagine a future where innovation in health services is the norm. Through stories of video games in rehabilitation and smart glasses in aged care, Stuart paints a picture of a world where creativity meets care, empowering workers and uplifting the spirits of those they help. His reflections on the necessity of evolving service models to meet the demands of an aging society will leave you contemplating the role of disruptive technologies in crafting a future where age is just a number, and the quality of life is paramount. Join us for an episode that's not just about foresight but about hope, as we explore the frontiers of senior care technology with a true pioneer in the field.
Welcome everybody to the Senior Care Academy podcast, where we dive into the heart of health and senior care. Each episode we aim to enlighten and inspire, bringing you the latest insights, innovations and voices leading the way in elder care. Our guest today is Dr Stuart Smith. Dr Smith is a highly experienced professional specializing in innovations related to health, aging and disability. He has a diverse background that includes roles in research, higher education and industry. Stuart is known for his work in translating research into practical applications, especially in the context of aging and technology. His career has spanned multiple disciplines, from neuroscience and psychology to public health and technology development. Stuart, welcome to the show. We're so excited to have you Walk us through the beginnings of your career, like your first job, maybe while you're still in your master's program or post-bachelors and then walk us through those and then transferring over to the senior space. How did that work for you? Yeah, absolutely.
Speaker 2:So after my PhD the trajectory particularly for Australian researchers the best thing you can do is leave the country. You've actually got to get out of. Australia's a really small place and you can't learn anything new if you just sort of keep working with the same people all the time. So I was on the job boards looking for jobs overseas postdoctoral fellowships and I found this job at NASA in California at the Ames Research Center, and the job ad said I'm looking for a recent PhD student who's got experience in the vestibular system. So I went great, I did that as my master's. I understood how the balance system in the human brain works. I also need someone that can do some work on visual psychophysics and guess what that was my phd and also be really handy. If they had some computational modeling background and, yep, I'd done a fair bit of computational modeling as well. So that sort of ticked all of the boxes for me.
Speaker 2:Plus it was at nasa and I thought how cool is that? Because you know, as a geek growing up I I was really interested in space and actually I got interested in robotics because I'm old enough that I saw the original Star Wars films when they first came out in the theater and I was fascinated by this idea of sort of a humanoid robot that could wander around the world and do human-like things. So I always wanted to build robots that were like humans, and particularly if I could build robots that were associated with space and space exploration, that would just be super cool. So here I am years later and suddenly I've got this postdoctoral fellowship at NASA Ames in California doing some really interesting research on addressing the question of why is it that astronauts, when they return from long-duration orbit, can be standing at the podium giving their speech and all of a sudden they black out and they fall over. So we're really interested in the mechanisms of adaptation to a microgravity environment and then how that affects things like cardiovascular regulation and posture control and skeletal integrity in astronauts. Because you think about it, when an astronaut's in microgravity there's no down, so there's no mass acting on their bones and the bones, the skeletal system, is basically there to keep you upright against the force of gravity, so the bones start to leach calcium and they become brittle and porous and all that kind of stuff. Plus there's some neuro adaptive changes in the way that we take information coming from our vestibular system and integrate that. So all sorts of really weird stuff goes on when you're in orbit, and I was interested in a component of that.
Speaker 2:So a couple of years into that role, I met an Irish girl and she wanted to go back home to Ireland and so I thought, okay, well, I'll see if I can get a job in Ireland. And there was a job advertised at Trinity College in Dublin in the psychology faculty, so I applied for that role and got the role. I was on a bit of a lucky streak, I guess. So I ended up in Dublin for a few years, and in Ireland particularly, there was no astronauts that I could work on. So I had to think about other ways of doing research, and one of the best bits of advice I ever got was from somebody from the EU so the European Union and their funding agency and he said the best thing you can do to advance your career in Europe is to read European parliamentary documents. I thought what the hell would I do that for?
Speaker 2:But he said, look at the language of Europe and find out what Brussels is most interested in funding. And hey guess what? Ageing popped to the top of the stack. Like all of the countries in Europe, we're suffering the same kind of an control. And what happens in older people? They fall over a lot. So maybe I could try and understand how we can keep older people upright against the force of gravity.
Speaker 2:So I started my research path sort of more down, looking at what are the multiple determinants of posture control in older adults, and we managed to get some really good funding for a project called TRIL Technology Research for Independent Living. That was a collaboration between three of the Irish universities and Intel, the computer chip manufacturer, and the purpose of TRIL was to build a suite of technologies that could go into the homes of older adults that could monitor the various states of physical, cognitive, social and emotional health and well-being, such that you might be able to detect changes in those overall states of health before it got to a critical incident like a fall or a cardiovascular event or whatever cardiovascular event or whatever. So that enabled me to get back into thinking about technology like how do you build tech to monitor the states of health and well-being of older adults and keep them living in their own home. So that was the sort of transition point.
Speaker 1:Wow, that's amazing. It sounds like your path. The doors kind of open themselves up to you. That's pretty amazing. When you worked at nasa, I'm sure the ideas of technology were prevalent and I like new advancements were coming every day. How would you take the influence you felt at nasa and applied it to this group that you worked with at intel for seniors? What kind of projects did you guys work on? What type of innovations did you maybe mastermind? What kind of things went on there?
Speaker 2:yeah, so look, so look. This was in the early 2000s, sort of 2002, 2005. And that stage a lot of Internet of Things was really nascent, like low power sensors. Edge computing wasn't even really a thing so much in those days. Intel was interested in aging and monitoring health, because health is a big area where a lot of data gets pushed around right and so obviously Intel makes the chips that pushes data around. So they were really interested in this new field of health and aging.
Speaker 2:I think the lessons that I learned in NASA were that were that if you had enough of a budget and enough interest from senior people, then you could do amazing things. Like when I landed at NASA, I wanted to have this bit of kit that I could measure eye movements. And I said to my boss so where is the local electronics store? In Australia? We had this thing called JCAR or Dick Smith.
Speaker 2:You could go along, you could get your electronic components and build your nerdy kind of electronic geek kits. And I said where can I go and get resistors, capacitors, chips, because I wanted to build a piece of equipment that would help me run part of my experiment. And he said why do you want to do that? We're the government. Just tell us what you want and we'll buy it for you. So that for me was kind of a point where I went oh yeah, you don't have to necessarily sort of scrimp and save and do things on the cheap to do good research if you've got enough backing from a major government entity or a major corporation, and so that kind of.
Speaker 2:When we were working with Intel, suddenly we had at our disposal the vast resources of a massive company like Intel to help us think through well, how do we actually build these pieces of technology, so we could focus more on the research questions rather than on the gee. How do I build this sensor? Because they just do it for us.
Speaker 1:Wow, that's pretty awesome. I'm sure you must have been a delight to work with as far as your innovation team Back in the day. I guess what were some of your aspirations at work? What type of things did you tell yourself that you wanted to do? What type of attitude did you carry?
Speaker 2:Yeah, look, for me this was kind of an amazing turning point in my career because up until that stage I've been very academic. When you grow up in a university and you work in a research organisation, it's all about the research and publications and getting the next grant and all that kind of stuff. And the thing that really started to frustrate me was that there's a lot of good stuff gets done in research laboratories worldwide. Hats off to all of those people out there who are doing the hard grind in science. But what I found deeply frustrating is that a lot of that good work never translated into products, into services, into policies that could actually make a difference into people's lives.
Speaker 2:So the opportunity to work on the TRIL project with Intel in Ireland really alerted me to the fact that you could have good collaborative relationships with universities and industry. But you had to overcome a couple of the kind of the entrenched challenges. Universities are driven by very different things to industry partners. There's different sort of KPI sets, if you like. There's different timescales that things have to be done by, and so at that point I really started to become much more interested and focused on how do I take research and turn it into something that can make a difference to people's lives straight away. So that was one of the key learnings for me, I think, in that experience.
Speaker 1:Definitely. I find that a lot of people with experience similar to yours a lot of education, a lot of prominent roles. They tend to hold great positions in the companies that they work for and they work with. They're very data-driven. It's amazing what type of mind that invites. Could you talk about the role of data in your life, just day to day? What type of processes do you implement to learn more? How do you keep your mind open to learning? How do you observe better, what type of things you do to extract more data from where you're at?
Speaker 2:I think if you're curious about how the world works I was just lucky that I grew up being that kind of a kid I was just always interested in trying to figure out how things work and to be curious about the world. And I think if you're blessed with that sort of a mindset, then you are naturally open to really trying to understand the world in as many different ways, from as many different perspectives as possible. And the more that I learned, the more that I realized that I didn't know. You know, so you can become really highly educated and know even less than you started out when you started on your education journey, so that for me it's always been the case that I've tried to make decisions based on the evidence that's available. My poor, long suffering wife, whenever we have some problem that we need to solve, well, let's look at the data, let's try and gather as much data as possible so that we can have an informed decision-making process, and whether or not that's trying to look at the statistical distribution of scores on some psychological or health instrument, so that you can sort of compare and contrast different groups of people to try and understand what's going on in the world. And, importantly, I really like teaching that kind of approach as well. Like a lot of psychology students come into their degree programs and all of a sudden they're faced with this horrendous course called statistics and they just freak out because it's mathematics and it's formulas and all that kind of stuff, and I think we can teach people how to think about assessing the world from a quantitative perspective. It doesn't have to be hard, it's just, you know, it's just numbers and figuring out what's going on the numbers. So yeah, that's kind of the approach that I take. I also like to take a very multidisciplinary approach to the work that I do.
Speaker 2:Way back when I did my master's, I was a psychology student but I was doing my research within a neurology ward at the local hospital. There was patients coming in who had vestibular disorder, like dizzy patients. People would fall over and that kind of stuff. And I'd go along to the seminars and in the seminars would be the chief neurologist you know big, clever, clogs person that knew a lot about the brain. There'd be my professor, who was really good at psychology. There'd be biomechanical engineers, biomedical engineers. There'd be nursing staff, there'd be occupational therapists. There'd be a whole range of different people in that room and we were all focused on the problem. And the problem might be here's this patient they've just come in, these are the symptoms that they're exhibiting, what's wrong with them? And everybody in that room would have something to say about what they thought was the problem with that person.
Speaker 2:And that, for me, taught me the power of multidisciplinarity, of trying to understand the world from multiple divergent perspectives. And when you think about how the brain works, that just makes sense. The brain integrates multiple sources of information in order to figure out where it is in the world. So you know I'm here talking to you, I'm largely using vision, but I'm also hearing you, so there's two sensory systems that I'm integrating together. I know where I am because I've got pressure on my backside cheek, so I've got another body sense that's telling me where I'm located. So the brain is integrating all of this information all the time to make its decisions about the world, and I think that's a model for how I approach trying to understand the world. Gather data, gather all of the data that you can and then try and make sense of it.
Speaker 1:That's a pretty powerful approach, comparing the way that you work and comparing it to the brain's function. I love what you mentioned about being curious. I loved how you mentioned not knowing and being okay with not knowing and the more that you know, the more you end up not knowing things. I love that. Can you talk about your role now at Shift Left and talk about maybe consulting and the leadership position that you have now? I really like that perspective that you've shared.
Speaker 2:Sure, so I've given the title Shift Left Health. Now I've borrowed that from a guy called Eric Dishman. So back in Ireland when I was working on that Trill project with Intel, eric Dishman was the lead within Intel of their health sciences research group a really clever guy, and he used to talk about this idea of shifting health service delivery age service delivery leftwards. What does that mean? So if you plot it on the vertical axis quality of life and on the horizontal axis, the expense of health service delivery. So at the very right of that plot, at the bottom, is hospitals. Like hospitals are very expensive health service delivery entities but for the patient that's almost the lowest quality of life. Like if you're in hospital things aren't great, it's an unfamiliar environment, everything's out of your control. But if you think about the left of that plot, at the very top left, that's in the home. So doing things in the home is not expensive because you've got all of the things that you need around you but your quality of life is really good because you're in your home environment. So if you sort of think about this shifting health service delivery leftwards, so if you sort of think about this shifting health service delivery leftwards, away from hospitals into the home, into the community and into the home. That was a powerful message for me to think about. Well, how do we actually make use of technology to translate delivery of health, aging and disability services away from the big, expensive, centralized mechanisms into community and home? So that for me was kind of way back then. That was almost a guiding direction for me in how I would do the rest of my career.
Speaker 2:Came back to Australia after Ireland in 2007. I actually met my now wife, who's an Australian woman. I think Ireland didn't go too great, so I came home and I was still on a bit of a research track but I knew that I needed to do something. I said to my wife I'm getting out of university so I'm going to set up my own business, because I've really got to do something to make a difference in people's lives. And alongside the track of thinking about aging, I'd also been doing some work with young men in spinal cord rehabilitation units.
Speaker 1:When I was in Ireland.
Speaker 2:So I had this master's student, really clever young guy, and he was volunteering at the local spinal rehab unit and he came to one day.
Speaker 2:He said Stu, we can't get these young men who are in the spinal cord to engage in their rehabilitation, they just don't want to do it.
Speaker 2:So we went down to the rehab gym and had interviews with some of these patients and sort of said about their accident and all that kind of stuff. We asked them what interested you prior to your injury and, without fail, every single one of them said they loved playing video games and they were desperately sad that they couldn't play video games anymore because it was just too hard to hold a controller. So we thought about, okay, well, let's use video games as a motivation to engage in rehabilitation. And luckily at the time Sony had just released the iToy camera like a peripheral device that you can plug into your PlayStation, and they started releasing these games where, by moving your body, you could interact with game elements. And, what's more, the kinds of movements that you had to execute were large arm movements to sort of grab and pop the balloon or whatever, and those movements mapped onto the sorts of movements the physiotherapists and the occupational therapists wanted their patients to engage in in the rehab setting.
Speaker 2:Wow so we thought, okay, here is potentially a way of leveraging video games to get these young guys to participate in at least some sort of exercise. And it worked. These young guys would be lined up outside the gym door waiting to come in and play on the PlayStation video game console. So I came back to Australia with this sort of experience of having a consumer technology that we could use to engage people in their health and rehabilitation. And the question was well, how do I do that? How do I get that technology out into the field? What are the distribution channels? What are the service and support channels for this? How do I get clinicians used to the idea of using this kind of technology? And, of course, clinicians like me are very data-driven. Unless they've seen a publication on the effectiveness of this intervention, then they just won't go anywhere near it. So I thought, okay, well, I've got to actually get back into research and I've got to start doing research that can demonstrate how video games are useful.
Speaker 2:And we kind of looked at this issue of falls in older people. A lot of research had been done over a long period of time trying to understand what are the determinants of postural instability and falls in older people and a lot of research also on what the interventions might be to reduce the risk of falls in older people. And guess what? If you can do lots of strength and balance challenging exercise, it reduces your risk of having a fall. So dancing is a good thing to do. Any exercise where you actually have to activate your leg muscles is really good and, what's more, if you can do that in response to some sort of a cognitive challenge, even better. So I thought, all right, we've got this evidence base, but still fall rates are the same. They're one in three in the community. How do we build a system to encourage people to engage in lots of strength and balance challenging exercise?
Speaker 2:And I was kind of thinking it must be a video game out there that can do that kind of stuff, surely? Yeah, for sure. And guess what there is? It's called Dance Dance Revolution.
Speaker 1:I love that game.
Speaker 2:You think about that. It's a game that involves stepping, transferring your weight, and it also means that you've got to transfer your weight in response to some kind of a cognitive stimulus. So the arrows are drifting up the screen. You've got to time your steps so that you step onto the right arrow button, the map button, when the drifting arrow hits the target. So I thought, okay, let's check that out.
Speaker 2:So obviously, most of the dance dance revolution games were on the market were way too hard, like there's no way that I could have got a 75 or 85 year old to play the game. Some could, but most couldn't. So I had to build a modified version of dance dance revolution, and that's where the inner geek in me came back out. I coded up my own version of Dance Dance Revolution using some software and worked out in an experiment what the parameters of Dance Dance Revolution gameplay were to be suitable for an older adult, like what speed do you have to drift the arrows up the screen? How many arrows have to come up on the screen at any one time, such that older people can play? So I ran what they call a parametric study. I just varied speeds and I varied the number of arrows on the screen at any time. I varied the size of the arrows, all that kind of stuff. I took away a lot of the flat graphics and found out yep, older people can play Dance Dance Revolution. You just have to make it easy enough for them.
Speaker 2:I got a grant to explore this proper scientific randomized control trial, hired a couple of computing students to build for me a modified version of Dance Dance Revolution that could run on. Well, I wanted it to run on something like a digital photo frame, like. I wanted to be able to have a device that I could put into an old person's home that would run Dance Dance Revolution. And that was kind of hard. That was pre-iPad days, right. So we ended up having to find a really low-cost Intel PC that we could sort of install all this on.
Speaker 2:Found an open-source version of Dance Sense Revolution called Stepmania. We hacked it a little bit to make it really easy and then eventually built this device that could be put into people's homes so that they could play Dance Dance Revolution, and we've then published a whole bunch of papers on the effectiveness of that to reduce fall risk in older people. I was really happy to see just recently that my old colleagues from that time have kept doing that work and they've just published a paper in Nature Medicine showing that if older adults use this Dance Dance Revolution game, then you can actually reduce the number of falls not just the risk of falls but the number of falls that people have. So that for me was sort of really cool. But again my frustration was how do I commercialize that?
Speaker 2:yeah and the group that I was working with at the time their research institute. They weren't terribly interested in commercialization, so so I thought, okay, I've got to go out and I've got to set up my own business to try and do this. And that's really where Shift Left Health came from.
Speaker 1:When you started, it was it primarily in Australia. Did you do any other work anywhere?
Speaker 2:else. The research work was done in Australia for the Dead Sands Revolution work. But not long after I left the employer where I developed that, I moved to another university and I started to explore another video gaming technology that had come out. The Microsoft had released the Kinect camera. When it came out, it was this new peripheral device for the gaming console.
Speaker 2:The problem was that it wasn't a product differentiator enough for Microsoft. They couldn't get enough people who wanted to play games to be interested in playing games where you have to move your body right. People who play games like hardcore gamers. They want to use their controllers to blast away at aliens or zombies or whatever. So Microsoft set up this accelerator program where they invited a whole bunch of companies to the Redmond office and said here's the kit. Think of ways in which you could make use of this really cool technology and we'll back you.
Speaker 2:And a couple of the young guys that went to that program were from Canada and their company was called Gintronics J-I-N-T-R-O-N-I-X, and they figured out that they could actually use movement-based video gaming as a rehabilitation tool for patients following stroke. Now I thought it was a really cool idea and I'd been introduced to them through my local contact at Microsoft Australia. See, I'm kind of a networker, I like to meet people, I like to talk to people, and so I got to know the guys in Microsoft Australia pretty well, in particular Simon Koss, who eventually became Microsoft's sort of global chief health officer, and Simon introduced me to these guys at Gintronics, and so we started a dialogue where we would trial Gintronics in Australia and modifications to Gintronics that came about from the sort of work that we were doing would be trialed in Canada and US and elsewhere. So some of the work that we've done is also sort of worked its way overseas.
Speaker 1:I guess.
Speaker 1:Moving into how the commonalities in delivery and aging services between the United States and Australia I know I've did a little bit of research on the two and I know that for the most part things seem to be pretty similar I would argue that the government provides a little bit less of the United States than I've seen elsewhere, I've heard elsewhere, and a lot of, I guess, insurance or a lot of Medicaid and a lot of payment options is a good way to phrase it are privatized in the United States, whereas it might be different elsewhere.
Speaker 1:In my experience, the company that sponsors the podcast company workforce called Helperly and we're an in-person care agency and I know that in order to get a caregiver and then implement them and then have their hours structured, it's very expensive and tedious process and that's about as extensive as my US healthcare knowledge goes to. Is the personal care side, the senior space side. Can you talk about delivery in Australia, what that looks like, challenges that you've encountered and overcome? Maybe share a story or two? I'd love to learn more if you could teach me personally. I'd love to hear what it's like in Australia to deliver services to seniors.
Speaker 2:Look, it's a really great topic to talk about. We could probably talk about it for hours and hours. So through the research that I was doing on Dance, dance Revolution and video games and stuff with older people, my primary focus was always how do I do things that can keep people living in their own home for as long as they want to? Right, because I don't want to go into an aged care facility.
Speaker 2:I remember my grandfather was in an aged care facility when I was like a teenager and it was horrible. Like you'd go to visit him and he was one of four guys in a room. It was a very sterile, hospital-like environment. They had no personal stuff around them. It was just terrible. I thought there's no way on earth that I ever want to go into aged care. And then when I came back to Australia, I started to do this research. I found that I actually had to do some of my research in retirement communities, because it was just easier to take your kit along to a retirement community and set it up and have the people come to you to do the experiments, rather than us traveling around Sydney to try and put our kit in people's homes. So that was sort of that opened up my eyes to this whole idea of retirement communities, which is, in my opinion, is it benefits the developers, and the developers only.
Speaker 2:But these massive corporations that build these communities of units where people can retire to and they can all be in this community where everyone else is the same age as them. And what I noticed is that there was no kids playing ball on the street right. There weren't families wandering around these environments. Often they were gated communities, like you couldn't even get into them unless you were invited or unless you were a resident. And I thought, gee, this is terrible.
Speaker 2:And the people I was working with were older adults. They were 65 and older, still fit, healthy, active, able to live independently, like they lived in their own. Sometimes there were little villas, so it's almost like their own house, but within this gated community. And I thought, gee, that's a real shame. Like, why aren't they living in home? And about the time my parents had sold up from Sydney and they'd moved to the Sunshine Coast. So it's like the US. I guess older people move south to Florida, but in Australia they moved north to Queensland, so my parents had moved up into a new development on the Sunshine Coast. It was just a standard community. There was young families, there was you name it older people, whatever.
Speaker 2:It was very car-based, like a lot of the US. The shops, the hospitals, the doctor's surgeries, all of that kind of stuff was a car drive away and there was no good transport services. And I started thinking about this issue of well, as my parents get older and they might become more physically frail or cognitively frail, how am I going to keep them living in that community that they really like living in? How am I going to get them transport? How am I going to get somebody to mow the lawns for them or clean the house or whatever? So I started then thinking about service delivery services that could be delivered for older adults into their homes. And this is where kind of the challenge is.
Speaker 2:In Australia you have to be assessed by the government to be at a stage in your life at a functional state where you require funded aged care services.
Speaker 2:So there are different levels of aged care services in Australia, but you have to be assessed.
Speaker 2:And one of the big challenges is if you live in regional, rural or remote areas. And Australia is a big country, like it's geographically the same size as North America, but we've only got 26 million people or something. Sometimes there just isn't a workforce in your area that can come and do that assessment for you. That's one of the big challenges that I think that we have in trying to move us towards a position where we can enable older people to stay in their own homes, because there just isn't a workforce that can assess them in the first place to know, oh, do they need a step placed in their home or do they need a grab rail or whatever it might be to make their home safer for them to live in. So that's one of the big challenges that we've got to overcome, and I guess it's the same in the US Health and allied health workforces on the decline. We don't have enough people working in those areas and I welcome your insight into what it's like in the US.
Speaker 1:Yeah, it's a very unique situation that we have here in the United States For my research. Again, take it with a grain of salt, but we suffer from a lack of education. I think that tends to be the number one issue that we have. It's not necessarily the infrastructure or the employees, it's a lack of education. Common examples would be people my age just learning about certain tax things that they could do or certain benefits that they qualify for with the government, or even local things that they qualify for, and the same goes for seniors and their families.
Speaker 1:Oftentimes seniors are apprehensive to moving into these communities, these age-restricted communities, per your perspective, due to what they don't know and a lot of the times they won't move or they won't do anything because they don't know what's available to them. A big solution that I've seen is taking the time to educate them, obviously on a one-to-one basis. I've seen case managers teach the people that they help manage. I've seen people like me or people like my boss talk to seniors directly and offer them services or enlighten their mind as to what's available. Education is a major problem. As you get older it gets worse. I guess not to be pessimistic or a Debbie Downer, but it does get increasingly more difficult. As you get older, your options vastly grow and a good way to think about it would be based on your insurance, or based on private pay or Medicaid or whatever funds your medical. You're networked with other medical services, and those networks of medical services seldom communicate with one another.
Speaker 1:So, you might have ABC insurance and ABC insurance is connected to the best skilled nurses. And then the best skilled nurses are connected to Shady Grove retirement community and Shady Grove is connected to a grocery store. They might be connected to a caregiving network. Like as the individual, I don't know those things until I experience it.
Speaker 1:Or if I break my leg, and then every home health and hospice agency is gunning for my business, every skilled nursing agency is gunning for my business wound care and so there really is no medium to communicate this education, to communicate what's available, what isn't. In the United States, that tends to be a major issue that we have.
Speaker 2:Absolutely Same here in Australia. It is one of the fundamental issues that service delivery is so siloed. You absolutely hit it on the head. And this is health service Like you go to a hospital, right?
Speaker 2:And you think I've gone to this central location. There's all of these different specialties. They should be able to help me out. But if I'm an older adult and I go to a hospital, cardiologists will look at me from the perspective of how's my heart doing. Someone else is going to look at me from the perspective of how my kidneys are doing. The neurologist might look at me from the perspective of what they think is going wrong with my brain.
Speaker 2:But actually we're an integrated system. Like all of those systems operate together and so those specialists need to be able to talk to each other, but they often don't. Communication of data between different specialties at that level is often so very poor and that's a massive issue that we could discuss at length. But for the individual you're absolutely right kinds of providers of service that are all gunning for your business and they're all knocking on your door saying hey, you know, we can sell you this package.
Speaker 2:It becomes really difficult for the individual to make sense of it all. Now we throw layers of technology on top of that, where the way in which you engage with all of these service providers is increasingly technological and you may not have necessarily had the luxury of growing up technology environment where you've just second nature to make use of apps etc. Then that can also be a bit of a barrier for the people themselves, like I've got a very good friend. His mother is older, she's got parkinson's disease, she lives on her own, and just simple things like engaging with her bank, because you can't go into a bank anymore and talk to a person- right.
Speaker 2:You've got to interact with the bank via an app.
Speaker 2:Well, she's got Parkinson's disease, so her hand is sort of shaking all over the place and she can't actually use the app because it hasn't been designed for somebody with Parkinson's disease. And so, again, I think we can do a lot better in finding ways that we can make the technologies with which we engage to be usable by everybody and to be appropriate used by older adults or people that might have challenged cognitive function or whatever. And the service providers have to be digitally literate as well, have to be digitally literate as well. They've got to know enough about the technology that they can use it in a way that helps their clients.
Speaker 2:And I think you're right from an education perspective, we're not training our health workers to be digitally literate, like one of the biggest arguments I used to have with people in universities when I'd work in, I'd say, a health faculty and I'd say what are we doing about training our nurses, our occupational therapists, our physiotherapists on how to make use of technology? How do we improve their digital literacy, how do we improve their data literacy? And very often the response that I'd get was oh well, our curriculum is jam-packed with all of these other things that we have to teach them.
Speaker 2:We can't shoehorn in digital as well? And so we're letting loose on the world, you know, a generation of health workers who haven't been taught how to think about making use of technology to improve service delivery, and that, for me, is one of the things that we need to address, and I suspect it's the same in the US from what you've said.
Speaker 1:It definitely is. I would 100% agree. I would even go so far as to say the fewer discussions we have result in greater and greater turnover rate, whether it be employee or client. When I often talk to professionals about caregiver burnout, I talk to them about employee burnout in any regard, and then clients that experience one or two rough visits from a provider and then they're done. They're done with providers as if all of them are like that. These conversations are essential. I've actually found that one thing to be interesting is that talking to people experienced such as yourself like brings a lot of wisdom, a lot of guidance. I know you said the best advice that you got was well, what did you say? The best advice that you got was read European Parliamentary Documents.
Speaker 1:Parliamentary Documents was well, what did you say? The best advice that you got was to read European parliamentary documents. As someone who notices these problems in the healthcare space, what advice would you provide to other leaders, like what would you say to them to do, maybe something to implement?
Speaker 2:Really good question. I don't have anything off the top of my head, but let me work through it. So it's at a number of levels we have to think about how we can get back to this idea of shifting left. Like, how do we enable a large workforce, who may not be super technically trained, to be able to deliver increasingly sophisticated services, but leveraging the power of technology? So give you an example, and I think this is a way that we can address some of these workforce challenges. So, to give you an example, and I think this is a way that we can address some of these workforce challenges, let's say you've got an older person living in a really remote community and they need to get an assessment of some sort.
Speaker 2:But there's no occupational therapist in that community that can go to that person's home's in that community Like maybe the postman or the postwoman who's delivering the mail on a fairly regular basis to that older person's home is somebody that we could sort of leverage up and let's say that we equip that postal worker with a set of smart glasses that they could wear, that's got a forward-facing camera and it's got a display and let's say and hopefully there is enough internet connectivity that you could connect up that postal worker with a centrally located occupational therapist and that therapist can guide the postal worker through doing a home modification or a home assessment of that older person. That's a way that we could actually leverage an existing workforce that's out there in the community to deliver a relatively sophisticated job by leveraging the power of communication technologies and an existing workforce who may not be necessarily physically proximal. And I think we need to think through what are the potential new business models that can make use of innovative technologies like smart glass technology. So if you read Clayton Christensen, so Clayton Christensen was a professor and he's sort of famous for this idea of disruptive innovation, right? So he wrote a book on disrupting healthcare and there's a beautiful diagram in that book and it really talks about the fact that innovation is never just about technology in and of itself. You've got to have smart technology, but you also need to have a well-articulated value network.
Speaker 2:So basically, who's going to make money out of this innovation? Who stands to benefit all across the value network? Then you've got to have a clever business model. So is it a subscription service? Does it make sense? Are people going to afford to pay for this? And then you've got to have a regulatory environment that can make all this stuff happen.
Speaker 2:And COVID actually helped telehealth enormously, certainly in this country, because prior to COVID we were trying to get remote rehabilitation services out into the community but there was no payment pathway for that to happen. Then COVID happened and all of a sudden you've got a Medicare item number that a clinician could use to say, yes, I'm delivering a remote tele-rehabilitation service. So that was the importance of sort of regulatory control. So I think we need to get people thinking about innovation in the way that we deliver health, aging and disability services in much the same way that we think about innovation in any other domain. But those services tend to be a little bit rooted in a traditional way of doing things. They don't tend to be very flexible, and what I would love to do is to really inject into the mindset of our clinicians and our health, aging and disability service workforces that spark of innovation and creativity.
Speaker 1:I'm writing that down spark of innovation and creativity. When we spoke with John Warner, he mentioned that oftentimes the best solutions, if you're not thinking about them, they're somewhere else. And he said, like looking to India for something that India specializes in, or maybe looking to Australia for something an Australian company specializes in. And for those who are listening and don't know what Stuart brought up in terms of disruption, I'd just love to go over that. Clayton Christensen's theory of disruptive innovation is exemplified a really simple example in the steel industry with the rise of these things called mini mills.
Speaker 1:And mini mills targeted low margin rebar segment and mini mills utilized electric furnaces to melt scrap steel as in a cheaper method than traditional blast furnaces used by the bigger mills, than traditional blast furnaces used by the bigger mills. And eventually, as mini mills utilized and improved their technology and their production quality, they expanded into producing higher quality steel products and they were allowed to encroach on the market of shared traditional mills. And the shift allowed mini mills to drastically reduce the cost and enhance production flexibility, effectively out competing the larger, less agile mills. So the people that couldn't compete with the mini mills arc furnaces were ran out of business and it was due to their innovation and their creativity that they really were allowed to grow and to prosper.
Speaker 1:And this theory of disruption is found everywhere. You think of Apple's iPhone knocking out BlackBerry. You see that iPhone had innovations in cellular connection. They had innovations in text, they had a better interface, they had an integrated app store secure system that they could text, they could email remotely without charging you minutes, and that's where they really grew. So this idea of new technology and new innovation, disrupting what's currently going on, is a good thing for everyone, everyone in the space of the senior care industry. If you're listening, you think of ideas or innovations that you can make in your own space and implement them, and your implementations of those will spark innovation and creativity. And other remarks. Whereas in an ideal world, your mailman is also your therapist, he's also your doctor, and it kills two birds with one stone. It's an amazing idea In your career, stuart. Can you talk about maybe stories of disruption that you've had or small innovations that you've had recently that you're proud of or would love to talk about?
Speaker 2:A completely different field. I got to a point where I was burnt out by really trying to shift the needle on innovation in age service delivery. I just kept hitting these walls of recalcitrance and I thought I've got to get out of this, I've got to do something else. So I worked with a buddy of mine that had a software company We'd actually met years before on a health-related project.
Speaker 2:He built a digital twin of an ophthalmoscope these sorts of things that optometrists need. You know, when you get on an optometrist you get your eyes checked, they put you in this device and they change all the lenses and stuff. He built, effectively, a computer game to train people in the developing world how to deliver these sorts of eye examinations using this, because they couldn't have an actual ophthalmoscope there in front of them, so they built this video game. I really liked his video game-based approach to training and education, like a simulator approach.
Speaker 1:Yeah.
Speaker 2:We actually also built a simulation game to train aged care workers on how to recognise risk when they're delivering services into a person's home. So we just built this realistic it's like video games, but a realistic home environment into which you could put different risks, like spilt water on the floor that's just a slip hazard. Or cables snaking across the floor like extension cables. Sn water on the floor that's just a slip hazard. Or cables snaking across the floor like extension cables snaking across the floor that's a trip hazard. And you could get these aged care workers to train on how they can identify that risk by playing a video game. And the nice thing about video game is that you get immediate feedback.
Speaker 2:Like, if you didn't see that risk, then you can be alerted to it straight away and you can put different risks into the scenario at different times.
Speaker 2:That kind of concept is now being used by another guy that I'm working with who started a company called Enabler Interactive and he's a guy that lives in a wheelchair, contracted polio when he was a kid in Vietnam and so now he's in a chair, but he's an engineer.
Speaker 2:He's a really clever engineer and an artist and all sorts of things he told me recently. He's learning to how to fly a plane just one of those people that's good at everything he does. So his company, enable Interactive, uses video games to train disability workers on how you work with a disability client and you can build these scenarios where, if your job as a disability support worker is to get a person living with a disability up out of bed, showered, breakfast changed and off to a job interview, then you can play this out through a video game, and I think that's a really cool way of expanding the scale of our ability to train this workforce that we so desperately need, and you made the point earlier that education is really the key. Empowering the workforce to do increasingly sophisticated things within their remit, I think is a way that we can actually encourage people to not get burnt out, to stay within the workforce that they've joined.
Speaker 2:And let's face it, service providers aren't paid very well, certainly not in this country you know it's one of the biggest disincentives for getting people into aged care or disability care is that the frontline workers, the people who are engaging directly with clients, get paid horrendously poorly. So we have to think of ways that we can actually encourage people to stay in that workforce and to assume greater responsibility, and so I really like the way of using new technologies to empower that workforce to both learn the skills that they need to learn in a closed loop, iterative fashion, but then potentially also make use of technology to help them do increasingly sophisticated things that can be facilitated through either AI or direct connection back to some person who's got a little bit more training than them.
Speaker 1:Wow, that's a wonderful point. It's something I seldom consider is the utilization of technology and innovation. Even in the state that I work in now, the place that I work in now, we utilize technology every day, and it's for the betterment of seniors and it's for the betterment of the general population. That's part of our mission statement is to help other people and help them be stronger and help them be better. As technology advances, those opportunities continually become open, but you don't want to be stuck waiting around for the new advancement. It's fun and it's innovative and disruptive to be able to implement something new, which I think is a beautiful point that you've made Wrapping up here. I just want to ask you one last question. If you had I always ask this everyone on the show but if you had a magic, magic wand, you could wave away a problem in the aging space or even a problem elsewhere. Like what would it be?
Speaker 2:two-factor in here. I'm thinking about the population that is aging now, like me and you, and the five-year-old, like everyone, is aging okay. Yeah, the way in which we set ourselves up to age well age independently. Age productively is determined by the things that we do throughout our life.
Speaker 2:Okay, so we know right now that general practices in some areas of Sydney, melbourne, chicago, whatever are seeing patients who are in their 30s who have the kinds of non-communicable diseases that we typically have seen in people who are in their 70s and 80s, like coronary disease, diabetes, alzheimer's disease, dementias, and these are disorders that are very well correlated with the sorts of lifestyles that we lead Access to cheap, affordable, highly processed but questionably nutritious food like your burgers and fries, and all that kind of stuff like your burgers and fries and all that kind of stuff is really driving an obesity epidemic right now in younger and younger people. That is having really serious long-term impacts on health and well-being of those people when they get to age 70, 80 and 90. So I think for me the magic one might be let's try and address the major financial impact of aging on our health and our aged care systems now.
Speaker 2:But let's get ahead of that curve. Let's try and do something downstream, like let's try and improve the overall health and well-being of our population, because that big bubble of people that are coming through who are massively overweight, who've got all sorts of metabolic disorder, they're going to struggle when they're in their 60s and 70s and they're going to require increased service provision of health services and aged care services. So that for me, would be the kind of the magic one that I think that we can actually do something about now to affect change into the future.
Speaker 1:That's one of the most detailed answers I think I've ever gotten to that question. Every answer varies, but that's wonderful to be able to effectively change, improve your lifestyle now so that you're aging age well, you age comfortably.
Speaker 2:That's a wonderful prevention is the cure. Like yeah, aging is a part of life. Maybe, if you will indulge me, the second magic wand that I would like to wave is around ageism like it is rampant in our society.
Speaker 2:Older people are invisible. You look advertising, you look at movies, you look at anything. The representation of older people is so highly biased against in our everyday life. It's biased in our employment practices. Like I'm of an age where you know I'm in my 50s, I have a lot of friends who've all had really good careers but for whatever reason, they're now out of work and they're looking for work and they're not being hired. Not because they don't have considerable skills and capabilities and experience that they can bring into roles. They're being hired because they're old, and when I say old I mean 45-olds aren't getting jobs because of their age.
Speaker 1:Yeah.
Speaker 2:Now, I know that this is actually illegal in the US and certainly here, but I've heard from recruiters that they, when they're recruiting for people for their clients, their clients are saying to them don't send us the CVs of anyone over a certain age because we don't think they're going to be a cultural fit.
Speaker 2:Wow of anyone over a certain age because we don't think they're going to be a cultural fit, and that, for me, is just a distillation of the ageism that is entrenched in our society we have to stop thinking about. Older people are a burden, older people are deficit. In some way Older people can't catch up. They're not innovative enough, they're not clever enough, they can't use technology. All of that's complete crap. I think older adults bring with them a wealth and a depth of expertise and experiences that really can benefit society, not be a detractor from it.
Speaker 2:So that would be my second soapbox-based launch of the magic wand.
Speaker 1:Yeah, I guess two wands would be pretty proficient. I'd be okay with two wishes. I love those words. I think that's a good spot to end. Everyone, this has been the Senior Care Academy podcast. I'm your host, Alex Altridge. I've been here with Stuart Smith. Stuart, it's been a pleasure and lovely conversation today. Thank you so much.
Speaker 2:Likewise Look. Thanks for the opportunity. I really look forward to listening in on your future podcasts.