The Longevity

Guest Voices: Marguerite Manteau-Rao, Co-founder of Neurocern, on 7 Things Healthcare Startups Need to Understand About Caregiving and Aging

For all the noise about market opportunities in caregiving and aging, healthcare startups in the space have had a hell of a time succeeding. The problem lies in a lack of real understanding of the complexity of the needs for both caregivers and older adults. Answers are right under our noses and require that we pull from a variety of disciplines: public health, design thinking, new tech, and neuroscience. Here are 7 things for you to consider if you are in the caregiving technology business:

1. Less is more

When designing a solution for caregivers, one needs to understand their emotional landscape. Consider those numbers from the 2017 Alzheimer’s Disease Facts & Figures: 40% suffer from clinical depression, 44% have anxiety, 46% experience high to very high care burden, and 59% have high to very high stress. What those numbers mean is a very low threshold for frustration and taking on more tasks. Products and services need to lighten caregiver burden, instead of making it worse. This raises the bar in terms of designing new solutions that are super easy to set up, and use. Otherwise the caregiver will not give you a chance, or if they do, it will not be for long.

2. More is more

Paradoxically, more is also more when it comes to caregiving technologies. Partial solutions do not work because they require users to use multiple apps, hence more hassle. As a user, all I want is something that will magically remove all my pain points. This suggests a vertically and horizontally integrated platform that goes across diseases, and also management tasks. If my mom has dementia and diabetes and macular degeneration, I don’t want to have to use three separate apps for each disease. Likewise, I need to manage a variety of tasks, from arranging transportation, to making sure she takes her medications, to helping her stay safe at home, and I want one place from which to do it all. This does not mean you need to build a whole solution, but at a minimum, you should integrate other niche services into your platform, so that from the user’s perspective, there is only one interface, one end-to-end solution.

3. “Speak to ME”

There is no such thing as a caregiver or a caregiver journey. Instead, you are dealing with an individual with very unique pain points and needs. Think about differences in: personal situation, gender, geography, living situation, relationship to care recipient, care burden level, resilience, care challenges. Extreme personalization is key. That of course needs to be balanced with scaling considerations. AI and deep machine learning, bots, predictive analytics, IoT, peer to peer matching and social intelligence are not just the latest buzzwords, but also becoming necessary parts of any startup that wants to be successful in the field.

4. Don’t mention the D word

Yes, dementia represents a significant share of elder caregiving. And at the same time, only 80% of dementia patients living at home are either not diagnosed or not told about the diagnosis by their doctor. This number has been largely ignored and yet is critical to figuring out how to reach this important segment of senior care. Hence, when communicating with caregivers, do not talk about dementia. It is likely the word may not feel relevant to them, although they may be dealing unknowingly with a full-blown case of dementia. Instead meet the caregivers where they are, and talk about memory loss, mental confusion, or age-related mental decline.

5. Start upstream

Startups should catch a much broader net than just marketing to ‘caregivers’. It can be years before a caring family member identifies as a caregiver. Meanwhile, they are still hungry for solutions to help alleviate their concern. In particular, many families are faced with the worries of watching a loved one struggle with Mild Cognitive Impairment, a condition where the person can still function independently but with greater difficulty. 15% of older adults live with Mild Cognitive Impairment. While not actively engaged in caregiving, family members usually become very concerned and start looking for solutions. Hence, when communicating with users, consider a blend of ‘concerned families’ and ‘caregivers’, using both words interchangeably. Furthermore, we know all the big stakeholders in the space, including pharma companies are dying to reach those MCI folks and their families. If you are able to reach the MCI population, lots of business opportunities can open to you.

6. Don’t forget the care recipient

New caregiving technologies have to also meet the needs of older care recipients. To that end, tech companies should take into account the multiple layers of care needs that are associated with aging: physical changes, co-morbidities, social isolation, possible depression, cognitive changes, as well as living situation. User interfaces need to also be streamlined so that minimal or even better, no work is required from the person. The old way of relating to devices through touch and typing is on its way out, and that is a good thing. Older adults, and particularly the very old have not really taken to apps because it has been too much of a leap and a change in lifelong habits. The next challenge will be to design voice control solutions that accommodate hearing impairment as well as speech and other cognitive challenges.

7. Bring the family in

Social isolation for both the caregiver and the older adult is a common curse that gets even worse in the presence of a cognitive impairment. A big plus for a caregiving technology can be to enable connections between family members, thereby helping to distribute the burden of care, and facilitating social integration for both members of the caregiving dyad. A side business benefit for startups is the built-in virality from expanding to the larger family network, including reaching out to long-distance caring family members in new geographic areas.

Designing technologies for caregiving and aging is both a big opportunity and a big challenge. Is your startup up to it?

Sources:

2017 Alzheimer’s Disease Facts & Figures, Alzheimer’s Association

2015 Alzheimer’s Disease Facts & Figures, Alzheimer’s Association

Changing the Trajectory of Alzheimer’s Disease, Alzheimer’s Association, 2015

The Detection of Dementia in the Primary Care Setting, Valcour et al, 2000

AARP Caregiver Identification Study, AARP, 2001

Caregivers & Technology, AARP, 2016

About the Author

Marguerite Manteau-Rao is a thought leader in aging and caregiving technologies. Marguerite advises startups on strategy and new product development. She co-founded Neurocern, a dementia tech startup that enables personalized care decision support for families and caregivers at scale. Prior to Neurocern, Marguerite founded and led, Presence Care Project, a nonprofit organization that teaches and researches the Mindfulness-Based Dementia Care (MBDC) training program she developed while at UCSF Osher Center for Integrative Medicine. She was co-principal investigator on a California State Department of Public Health, 2-year research study with UCSF Institute for Health and Aging & School of Nursing. Marguerite also served as Clinical Director for several dementia care communities, where she led clinical teams and developed new person-centered care processes. Marguerite has written a book on ‘Caring for a Loved One With Dementia’, and has spoken at national and international conferences. Marguerite is a Licensed Clinical Social Worker. She has a Master in Clinical Social Work from Loyola University of Chicago, an MBA from University of Chicago Booth School of Business, and an MS in Engineering from Ecole Centrale de Paris.