CHESS Elder Tree David H. Gustafson PhD Center for Health Enhancement Systems Studies University of Wisconsin-Madison

Staying Alive: The Elder Tree Story Waukesha County Richland County Milwaukee County Center for Health Enhancement Systems Studies Loneliness Staying Alive: The Elder Tree Story Funded by the Agency for Healthcare Policy & Research

How to address lack of Trust? Fear the scam – keep promises; no sales Invest in deeply understanding the customer Walkthroughs What’s it like interviews Involve in design Gustafson, D.H., & Hundt, A.S. (1995). Findings of innovation research applied to quality management principles for health care. Health Care Management Rev., 20(2), 16-33.

Study Deployment Asset-Based Community Development (ABCD) Geographic area selected Strategy Team formed 300 Conversations & asset-mapping Top assets & challenges identified Harvest Festival Mobilization – connect the assets to the challenges AARC County Advisory Committees ADRC Advisory Board Learn about, provide feedback on study activities, findings and technology development Quarterly updates; “show & tell” of technology prototypes City of New Berlin Total Pop. = 39,669 % age 65 or older = 16.9% Strategy Team and NB chosen by ADRC Strategy Team = older adults & caregivers in NB, service providers for older adults & caregivers in NB & across all of Waukesha Co, City Council Member, Fire Chief, ADRC staff and Advisory Brd Members, Community Outreach RN, Sr. Center members, elder law atty., Food Pantry volunteer Mission Statement for NBC = an invitation to people of all ages in New Berlin to come together for the purpose of identifying assets in the community to help older adults and their caregivers remain living independently; with the help of technology, find ways to connect older adults and caregivers to these assets and to their community. 2 Asset Domains – Informal Associations & Physical World Questions: 1.) What is great about living in NB? 2.) What is your favorite place in NB? 3.) How do you connect with other people in NB? 4.) Do you belong to any groups in NB? 5.) If an older adult wants to connect with other people in NB, what would you recommend to them? 6.) What challenges do you see older adults facing in NB? What would be a solution? 7.) Is there anyone else you think I should talk to? Top Assets – churches, library, senior meal site, senior apt. bldgs., senior center Top Challenges – social isolation, “not knowing”, transportation

Adopt a broad definition of health Not just medical care. Elders Loneliness Meaning in life Local events & transport Clinicians Falls Adherence Dementia Depression Outcomes Stay in home Less admissions Quality of life Asset Based Community Development

Elder Tree (ET)… Goal: Independence: improving transport, meds, & reducing loneliness, falls, transport, CG burnout. Designed with elders For: elders and framilies, health systems, libraries, congregations, etc. Easy to use Works on tablet, laptop, and desktop.

Elder Tree: Honors strengths & limitations of elders & families. Make technology accessible to all Make it secure - within a “walled garden” Improve outcomes including costs Reduce re-admissions

What mTech adaptations for elderly? Meet us where we are Our hands tremble We forget Our eyes are dimmer Our filters go away – manage communication So: Maybe not mobile Keep it simple Training and incentivize to use. Automate data collection

ACHESS: too complex Monitoring and alerts Reminders Autonomous motivation Assertive outreach Care coordination Medication reminders Peer & family support Relaxation Locations tracking Contact with professionals Information

Keep it simple

David H. Gustafson U of Wisconsin 2011 Developmental Issues Meet people where they are: Make it easy to use Minimize typing, reading Audio & powerpoint Monitoring & feedback GPS tracking Caregivers David H. Gustafson U of Wisconsin 2011

Design and Look of Phone: Other Design Considerations Integrate into every day life Walled garden Video clips of others with same problem Push information to users Connect to care manager New stuff every day (e.g. gait monitor)