The Future of Aging: Pandemic edition

July 29, 2020

A few weeks before COVID-19 reached pandemic scale in North America, my SE Health colleagues and I published our much anticipated book, The Future of Aging. We publicly launched to a full-house crowd in Toronto, alongside our partners at the design and innovation firm Idea Couture.

That was February 19th, 2020.

We had lined up a packed spring, summer and fall for our co-authors to activate the book and help people translate its insights into ideas, action and impact. The calendar was filled with bookings such as:

• Invited keynotes and panels at events across Canada, the US and Europe.
• Workshops to enable partners, organizations and entire jurisdictions to ‘future-proof’ for an aging society.
• A pipeline of thought pieces, public relations and media engagements with our co-authors and many like-minded partners to influence and shape the landscape.

Less than 4 weeks later, all this activity was ground to a halt (like nearly every other special project underway within organizations around the world).

As we begin to open societies back up and given the disproportionate impact the pandemic has had on the aging population globally, it is timely to reflect on if/how the signals and shifts we explored in the book have changed. And, what should those of us who design and deliver services, products or policies for the older population be considering as we adjust our priorities and strategies looking forward?

Recap of The Future of Aging book

Our book is a culmination of more than a year of research and discovery of several hundred ‘signals’ that suggest that almost everything we think, know and believe about aging in the future, will be nothing like it has been in the past. After reviewing the signals, 5 clear themes emerged, which are the basis for the book’s 5 chapters:

1. Community & Housing
2. Health(care)
3. Geron-technology
4. Economy, Working & Spending
5. Identity of Aging

This blog goes deeper into the shifts we explored in Chapter 5: The Identity of Aging

What has changed across the 4 shifts underpinning the future of aging & identity? Recall, this chapter explored 4 shifts that are reframing social and policy constructs of aging:

1. Identity of Aging: RED

The first shift about reinvention and recreation in late life gets a RED because such aspirations ground to a halt during the pandemic and might not recover for a year or more. The second shift describing a more impactful and necessary role for accumulated wisdom has also stagnated, but not as much. The third shift around less conformists enactments of gender and sexuality is neutral, while the fourth shift describing a reorientation around end of life journeys has regressed significantly given the disproportionate and inhumane death toll and experiences the pandemic has caused.

While things mostly went backwards, there are some silver linings.

A few notable, positive things happened over the past few months that might not have transpired had the pandemic not brought issues around the identity of aging to the forefront. Similar to how you sometimes need to fall to the bottom of the pool to push yourself back up, these modest but powerful changes may be momentum boosters that could end up overcoming the negative progress:

• Intergenerational solidarity strengthened, as we more “fully realize that an able-bodied condition is ever so temporary” [REF]. Examples abound of youth helping aging and isolated adults in their communities with upkeep of their homes, delivering food and groceries, and regularly checking in to maintain connection and ensure they are aware of resources available.
• Grassroots movements such as Future of Worth™and Nextraordinary™ continued to take hold without being held back by the pandemic, leveraging digital platforms to keep things moving forward. Major Canadian bank RBC also doubled down on the recently launched Boomerang platform to connect seniors around sharing latent skills. These movements are formally – and at scale – opening up possibilities for aging adults to expand and apply their wisdom in entirely new ways.
• Traditional approaches to planning and managing for the end of life exploded with innovation given constraints of in-person contact. This has opened up windows for people to try different ways to deal with the remains, announce someone’s passing, have a ‘funeral’ service, and memorialize, meeting people where their values and interests lie. Virtual obituaries, drive-in funerals and “funerals by Zoom” are now the standard. People can choose things like what their last Tweet will be, what music to play, and whether to have their remains pounded into diamonds. The cohort of startups offering modern and highly tailored end of life planning experiences -such as Cake and Lantern – are experiencing unprecedented demand for their services. There is a growing chorus suggesting that the pandemic “will be the event that turns end-of-life planning into a common part of adulthood” [REF].

2. Aging in One’s Community: YELLOW (with a sprinkle of GREEN)

Similar to the previous chapter on Identity, the underpinning desire to neither seek out nor accept pre-ordained models for where and how to live has not been altered by the pandemic. If anything, home has been re-positioned as the only place (and safest place) to be right now, and this focus will remain for at least another 18-24 months.

Despite this, due to the Draconian spatial distancing policies enacted globally, levels of social isolation of the aged have exploded, especially in congregate settings. Many experts anticipate the separation of older adults from their families, friends and support networks will lead to a secondary pandemic from the fallout of decompensated physical health, new and exacerbated mental health challenges, and accelerated dementia and cognitive decline.

Countering this reverse progress, are two positives; first, the shift towards more meaningful virtual connections has accelerated such that the pre-COVID baseline of digitally un-connected seniors will never return; second, the disproportionate percent of COVID deaths that occurred in nursing homes (from 40% to as high as 90% of all deaths), will have years of adverse impact on occupancy rates in nursing homes and other senior living facilities.

This will pave the way for new, creative intergenerational and other living arrangements in one’s own community to emerge, as predicted in this chapter of the book.

3. Healthcare Interventions: NEUTRAL

Chapter 3 explored how (formal) healthcare delivery models, life sciences innovation, and therapeutic interventions will evolve in the future of aging. Overall, the 4 ‘shifts’ above are neutral in the context of the pandemic.

The trajectories we were on have not really changed, other thn, a temporary drop in focus as the life sciences sector pivoted to working on vaccines, tests, PPE and other immediate healthcare system needs.

The one area that I suggest has been buoyed somewhat by the pandemic relates to the first ‘shift’ around agency over one’s healthcare interventions as they age. The opening up of virtual- and home-based channels to receive healthcare services in all settings (hospital care, family medicine, home care, pharmacy) has enabled more choice, control and convenience for people and their families.

We saw most health systems go from as low as 0.25% of all healthcare being “virtual” to >75%. This is more progress for virtual healthcare options in days than has been achieved in decades of investments, globally. We don’t expect seniors or their families go back to institution-focused, mono-channel options for healthcare going forward.

4. The Promise of Gerontechnology: NEUTRAL

This chapter was about how emerging technologies of all types will enable aging, living and healing in a manner, magnitude (and pace) that is unprecedented for our species.  Other than the acceleration of shift IV (aging in place, instead of in institutions), which was already described above, the promise of gerontochology is relatively status quo.

That said, because the lion’s share of the (health) impact of COVID-19 has been on aging adults, their needs, aspirations and voice are more than ever in the spotlight, globally. This will bode well for product and service innovators in aging tech who now have an even more engaged and activated user to design for.

Another catalyst for the shifts in gerontochology is the stronger acumen with digital tools that have expanded to a wider user base of aging adults, as tablets, internet, social media, Zoom and other apps became the only lifeline to the outside world for many. We have been inspired with how tech giants, telecoms and banks stepped up to help close the digital divide for seniors during the pandemic:

• Barclays (UK bank)introduced online resources for seniors to improve their digital skills within the Digital Eagles platform where thousands of current and former Barclays employees teach local communities to be more confident with technology.
• Google Nest & Best Buy (North America) – offered a free Google Hub (large interactive TV screen) to any congregate seniors’ facility for free so that loved one can connect to family in a much more immersive way than a phone or tablet. Best Buy’s “Geek Squad” supports the set-up, maintenance and support. All at no cost.
• Telus (Canadian Telco)– donated 10,000 devices, with Wi-Fi, to seniors to allow them to access services and healthcare online. LINK
• Lloyds (UK bank)– teamed up with organizations to offer practical and emotional support to customers over 70 by donating up to 2,000 tablets to keep them connected with everyday digital activities.  One partner, The Silver Line, allows the bank to offer help and friendship 24/7 to anyone feeling lonely or isolated.

5. Economic Context of Aging:

Social constructs and enabling policies and products that shape how older adults make money, save money, spend money and leave their legacy were undergoing a revolution when we explored the economic contexts of aging in Chapter 5 of the book.
YELLOW [with specks of GREEN]

The prolonged shut down of society has now led to nearly every economy entering a recession, and possibly a depression. Similar to the financial crisis of 2008-2010, this means massive and prolonged job loss, and lower cash flows from pensions or other retirement vehicles due to market devaluation.

These economic patterns will strain the ability for older adults to reframe how they retire, buy things, save/invest, and define their future legacies on their terms (instead of fixed terms set by others).

While the shifts explored in this chapter are somewhat slowed down due to the economic collapse underway, there are some exciting signals that momentum will continue based on how governments and companies pivoted policies and products for seniors.  We witnessed policies and products emerge in days, that would have taken months (if not years) to develop pre-pandemic.  Some examples:

• Canadian government added ~$400-500 in top up ‘grants’ for pensioners to smooth the burden of extra costs from social isolation (buying food online, etc.)
• Caixabank in Spain advanced €2 billion worth of pension payments by almost 2 weeks to avoid unnecessary visits to branches or ATMs. The bank also ensured that bill payments for utilities do not bounce even if the account is overdrawn.

• Many banks launched specialized services for customers aged >65 such as preferred queues on call center phones or in retail branches; KBC (Ireland) staff proactively call customers who may require additional help in managing their finances during self-isolation, as these customers may not have social media or email to reach the bank digitally.
• Starling Bank (UK) introduced the Connected card, a second credit card customers can give to a trusted person to help them buy essential items on their behalf as they shelter-in-place.
• Commonwealth Bank (Australia) promoted a service to help seniors access more than 200 benefits, rebates and concessions they are eligible to claim, but might not have known about.  Usage and monthly claims for free benefits worth millions of dollars spiked.

Looking ahead: Adjusting Your Pathway Towards the Future of Aging

The Future of Aging book provides an evidence-based, comprehensive roadmap to guide anyone who has a stake in policies, products or services for an aging society.  I’ve highlighted above how the terrain has been altered by the global COVID-19 pandemic. There have been some roadblocks, a few detours, and some entirely new laneways have opened up. But the journey remains the same. The call to action now for citizens and innovators in this space is to be aware of how the shifts have changed, so you can adjust – and in some cases pivot – your work now so you can ‘future-proof’ for tomorrow. Our aging population depends on you.