Comment by SkyPuncher | Hacker News Reader

Comment by SkyPuncher | Hacker News Reader

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I worked in these spaces for the past few years.

Money is the biggest challenge. Elderly who can afford to pay for their care have plenty of options available for all of this. Many elderly (on Medicare or fixed income) simply don't have any money.

> 1. Technology that helps doctors/practices service more elderly patients

Telemedicine and home care services, like Honor, are addressing this. Telemedicine will improve as more technically adept people age.

> 2. Wellbeing technology for seniors (Headspace/Calm should totally push towards this area)

This is purely a monetary issue. The moment Medicare covers these services, they will be used extensively.

> 3. Personnel management for homecare nursing

This one is part money and part skill. There simply isn't enough money to pay people with homecare skills. The price most people are willing to pay typically falls in the range of a Home Health Aid. There are some great ones, but there are also tons that lack skills, ethics, and compassion for the role.

I don't blame them either. Why would you do home health when you can get similar pay working at a factory, warehouse, or, even, fast food.

> I don't blame them either. Why would you do home health when you can get similar pay working at a factory, warehouse, or, even, fast food.

My mother was a nurse for years in the aged care sector. The pay for a qualified nurse is actually pretty good (I would still argue it should be higher for the work, but it was well above average).

Homecare aids (or AIN/care assistants as they were called here) are paid horribly and treated as expendable (even when the roles are difficult to fill since no one wants to wipe asses and give 89 year old dementia patients bed baths for $18.6 AUD per hour).

Most of the care assistants I met were checked out and only there because they had no other option. The combination of minimum wage and high turnover also means you end up with some really horrible people in these roles. I remember hearing multiple stories about care assistants stealing from homes and mistreating patients. If you paid a little better and treated the staff with respect, you wouldn't need to hire the dregs of society to look after the most vulnerable in society.

We are at a turning point in society right now because of all the things you address. In the last few decades have seen a rapid shift in the willingness of family members to look after their elderly.

There's a few reasons for this, the biggest I think is the ageing population. When your parents need care at 85 years old, and you are 60 looking at retiring soon (or perhaps can't retire and need to work for another 7 years), most people decide they'd rather enjoy the last few years of their "active" life before perhaps even needing care themselves, rather than be "burdened" with caring for parents, relatives, etc. And so it falls either on the state, or on the generational wealth of the elderly to foot the bill and pay for care. Relatives often shoot themselves in the foot though. Their inheritance is being spent on paying somebody to wipe their mum's backside, because they didn't want to look after them themselves. (Unless their parents are on medicare or whatever, in which case there's even less reason for them to care).

The only part is just societies disdain and repulsion of sickness, bodily fluids, etc. Centuries ago, if you could live comfortably (not amazingly, but not be in the street), just by showering a few old people and cleaning up poo, you'd have people lining up round the block to do it. Now, the willingness to work (and therefore the salary curve) has inverted, and you need to pay people increasing amounts of money to do what was once considered menial or easy work.

"Centuries ago, if you could live comfortably (not amazingly, but not be in the street), just by showering a few old people and cleaning up poo, you'd have people lining up round the block to do it."

I'm not sure you'd need to go back centuries. There were times in the 1900's that was the case. And in some countries, other that the USA, it still is.

"Now, the willingness to work (and therefore the salary curve) has inverted..."

And surely this is a sign of people's laziness, rather than increasing costs of living relative to wages... Rent, student debt, randomly allocated medical debt, ageing parents with caretakers to pay... These things add up. Minimum wage work just moves you backwards; probably better to take a risk on further schooling to get something that pays realistically.

This is a good thing and is a mark of progress, it seems you're arguing we should lower wages and living/working standards so that people are willing to do these jobs. This is close to a backward and selfish line of thinking that 'people should be willing to do things for me for less money'.

Why should essential jobs like caring for people be paid so little compated to jobs that provide little value to society like banking and PR? It's essentially the 'Bullshit jobs' argument made by David Graeber

> Relatives often shoot themselves in the foot though ... because they didn't want to look after them themselves.

Or because it is too difficult to do so. People are having children later in life and moving to different cities. Housing affordability in many places makes it difficult to provide for a family on one income. If your parents need care as young as 80 and you are 50 with young teenaged children, your capacity to also provide daily living assistance to up to four people who live 100 miles away in opposite directions is rather limited.

> Centuries ago, if you could live comfortably ... you need to pay people increasing amounts of money to do what was once considered menial or easy work

Jobs like this in domestic service or healthcare often came with accommodation and sometimes board.

Even if that's in a dormitory, it would still often be better accommodation than you would be able to afford on the market. The level of comfort relative to others of your class would be enormous.

Nowadays, those affordability problems that everyone is experiencing are compounded for people in roles that would previously have been live-in positions.

Another issue is that the job of a healthcare assistant is not only poorly paid, but is also not part of a career path. Previously, much of this work would have been done by (often trainee or junior) nurses, with all the prestige and potential that that career brings with it.

There are refuges from poor countries that would love to live in my parent's basement and take care of them. They would think it is great - a kitchen of their own (not all houses have this, it happens my parent's house does), bathroom with a tub, a private bedroom, plus a living room that is larger than the mud hut they lived in back home. Of course they will discover in winter that they won't be going outside so that much space is small, but there is also the rest of the house that is semi-available. Of course everybody has a different house and so situations are different. However if you are reading this odds are you have (or could afford if you wanted) a house large enough to have spare space for servants.

Legally though you can't do it. You can't import such people easily. Even if you could, you have to pay them a wage that is affordable despite also providing room and board. I'm not sure this is a bad thing overall, but even though for the world's poorest just room and board, and $1/day would be a lifestyle improvement.

> Telemedicine will improve as more technically adept people age.

There's a little bit of user blaming in that statement (not being critical, just thinking out loud). Dealing with the elderly and folks who are less familiar with tech is an interesting design space.

Does anyone know design patterns that specifically seek to improve the experience for non-tech savy elderly?

I think user blame is a bit of an under simplification.

In this case, the issue stems beyond just the product. In many cases, these elderly households don't even have internet access as it's simply not something that's needed for their daily life.

No matter how good a telemedicine product is, it's nearly impossible to deliver without the underlying infrastructure (and desire for that infrastructure) in place.

For the elderly with internet connection, telemedicine is already a pretty simple user experience.

This is a good article on design patterns and considerations when designing for older users: https://www.smashingmagazine.com/2015/02/designing-digital-t...

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