The Decline of Multi-generational Living; the Rise of Assisted Living

With a growing middle class and the pull of urbanisation we're starting to see a shift in South East Asia where the traditional practice of multi-generational households is on the decline. A burgeoning middle class has created more opportunities for young families to break out on their own. At the same time savings for retirement can mean that an aging population are now looking for, and can achieve, independence in their golden years.

The middle class boom is great to watch but with it come some very Western issues like Type 2 Diabetes, Obesity and Hypertension. So what does this mean for Mum and Dad who are now living on their own?

It has been common in the UK and countries like New Zealand to provide assisted living to this community. Helping them manage their conditions at home where they feel comfortable. Moving the point of care outside the institution brings many benefits to patient, health provider and the extended care team which often includes the family.

The New Zealand response includes businesses like Ryman Healthcare that builds and operates retirement villages that includes onsite medical facilities.

For the Patient - they maintain their sense of independence and are not constrained by frequent visits to the hospital other than for checkups on an annualised cycle. They are in familiar surroundings and can quickly bring their self-driven treatment into the daily routine. They have lived through a period of rapid technological disruption and many are tech savvy as a result. They see the smartphone in their pocket as a useful device for staying connected to their sons, daughters, grandchildren and friends. That can now be used as a tool to help them manage their health. When we combine this with the rise of the quantified self and the wearables movement we have a major opportunity to empower patients to manage their own health with the right level of support and supervision. As an example have a look at the changes that Dartmouth Hitchcock has been achieving with ImagineCare.

For the Providers - moving the point of care allows healthcare providers to break free of the volume constraints of their institutions. The predicted shortfall in clinical staff in countries like Thailand is not insignificant; we need to find a way to extend healthcare coverage at a fair cost without compromising on the quality of the outcome. The advances, scale, security and reliability of platforms like Office 365, Azure (Microsoft's Public Cloud) and a growing ecosystem of partners like RingMD now offers viable alternatives that make telehealth and remote monitoring accessible and cost-effective.

For the extended care team - being able to offer a level of care in the patients own home creates an environment for better patient-centric management. Home visits are readily augmented by telehealth, remote monitoring and self reporting provide the inputs care givers need to deliver effective preventative and reactive treatment. For the family members involved in care delivery they have peace of mind that their parents have the necessary support as and when it is needed. The ability to be constantly informed and involved empowers them to make the right interventions but at the same team have visibility and transparency on the quality of care being given. The Microsoft Digital Advisory team in the UK has done some great work in this are, the eDayBook is one example.

So with the advances in technology that can now assist the scenario what could Assisted Living look like? My colleague Paul Thomas in the UK worked with the NHS to do some thinking. This video from 2013 shows the outcome of that applied innovation. Just 3 years later we have better technology support at our fingertips that reinforces this scenario even more. Capabilities offered from increasing smart wearbles and the rise of Digital Assistants like Cortana make assisted living a reality that enables our aging populations in South East Asia to be independent and safe at the same time.