My good friend Dick Duncan of the R.L. Mace Institute is interviewed about Universal Design in this issue of  Remodeling. The topic is rarely covered well, but Dick gets all the point across here.

Dick is here in Orlando with me at the International Builders Show. We had dinner last night where we discussed the same old stuff, our kids….and Universal Design. We are doing a panel on topics similar to this interview this morning with Amy Levner from AARP.

I‘m heading to Orlando this week for the National Association of Home Builders’ International Builder’s Show. I will be part of the second annual Universal Design Day education and show floor tours. Last year’s activities were very well received so we are repeating it.

There are two parts. One is education and networking in the 50+ Lifestyle Central, room 314 A-B near the show floor.

The second is UD tours of the show floor. The experts tour small groups of builders to booths on the show floor that have Universal Design products. The booths are prepared with handouts and talking points to educate the builders. We organizers have helped the manufacturers to prepare their materials and presentations. Everyone involved learns from each other.

This year’s heavy lifting was done by passionate environmental gerontologist Esther Greenhouse and energetic architect Amy Martino of Building Site Synergy. These folks did triple duty overtime pushing committee members and manufacturers and working with Patricia Lynn Basso, NAHB staff assigned to UD day. We owe them big time.

There have been frustrations as we tried to help manufacturers focus on Universal Design instead of defaulting to accessibility. For many the distinction is subtle. Esther put together points, expanded by Amy and others and provided to the manufacturers. Here are Esther’s points.

Please remember that Universal Design is not the same as accessible design or aging in place. The best way to see the differences is:

• Aging in Place is a GOAL for a lifestyle.  It needs services, policies, and design to make it a reality.  Design approaches include UD, accessible, and adaptable design.
• UD is a design approach, which is a component of achieving AIP.  While UD helps older persons & persons with disabilities, it may not meet all their needs (add adaptable and/or accessible), but it also meets the needs of many more people than accessible or adaptable alone.
• One of the most important aspects of UD is that it has broad market appeal.  By making sure we design to be inclusive, we meet the needs of people who may need some extra support temporarily or long-term, but we also benefit everyone by making it beautiful and easier for all abilities every day.

It will be fun to be among my colleagues and working to increase our ranks!

My friend Bob Barkin asked me “How was the big summit?”  At first I did not get what he was talking about. He had glanced at my blog and saw more than one Summit headline.  Then I realized he thought all the summits I have written about lately was ONE summit.  He thought it was one… significant… event… a summit.

But I had written about just some of the summits relating to my subjects lately

2011 mhealth summit,   Silvers Summit,  Digital Health Summit,  Care Innovations Summit to name a few.

It is good to know attention is coming to issues about which I care…BUT This won’t work.

We need to get down from the summit, down from the heady conversations, down into the valleys where you can see from one side to the other and figure out how to cross the divide. How to bridge the gaps, cross the barriers. We need to develop the base. Lay the foundation.

The clearest divide I see is between healthcare, like CMS,  insurance, people talking reimbursements and  social, home care, equipment and community services that rely on limited funds and private pay. These folks don’t attend the same summits. Think of the image at the top…not a lot of room on the summit!  Without crossings we won’t get far solving the housing and care crises coming down the pike.

We need more attention to the details and connections, the every day, what works and what doesn’t. I’m not sure what we call it, but the real stuff doesn’t happen at the summits.

The big buzz in creating better models of care is the $1,000,000,000 CMS Innovation Center plans to throw into the mix in the next few weeks. A billion dollars should create some buzz. I have spoken to folks from major corporations and venture funds about their applications for the CMS Care Innovations Challenge funding. It seems a great idea for the folks who are charged  to save our money to stimulate innovative models so we can benefit from many imaginations and see what works.  I heard there are over 7,000 letters of intent, finals do this Friday.

Will the money reach the most creative minds? The application process is formidable. Will the legacy of rules and reimbursement models water down the innovation? Are the folks best able to generate new ideas capable of winning through the application process?

Will this volume of money determine what will be the future? Whether they are great ideas or just because they were funded? I have little doubt some neat ideas and savings will be demonstrated. I am excited about the possibilities. Some may become models that are replicated into the future.

One of the criteria (very reasonable) is a sustainable business model. If it is a sustainable business model why don’t the corporations invest their own money? Why do taxpayers have to subsidize huge and wealthy corporations to try new things? To create sustainable and profitable business models? Isn’t that what corporations do? or only what they did?

Is this crony capitalism? Is this another transfer of money from Main Street to Wall Street? Large and already well funded businesses will seize this opportunity to look for and try out new product and service offerings without investing their own money. This challenge allows middle class taxpayers to fund huge corporations to devise new and better ways to care for people and save medicare funds while creating even better opportunities for the corporations to profit. Large business organizations are subsidized to try new things at government expense.

Will we see great ideas and true innovation?   Can we expect truly disruptive innovation – cross disciplinary, drawing outside the lines ..or is mere incrementalism the best we can expect if new, small players are not able to win the awards? Will truly new ideas have the resources to demonstrate the savings and role in improved patient outcomes?

This does not change my hope and expectation that real cross disciplinary, out of the box innovation will come.  I am sure the newest models will come from novel collaborations, thoughtful and comprehensive management techniques and real attention to client desires. I will encourage and support all efforts from large and smaller businesses.

How do startups and entrepreneurs working in their garages and basements find the funds they need? I trust they will find a way…because they always have. That is the miracle of American ingenuity.

I am remiss. I don’t have a PRESS button my site or blog. Some friends asked me recently about a couple articles in which I have been quoted. As many of my lovely and dear friends and supporters do – these folks chastised me for not making more of these opportunities to toot my own horn.

Here are links to what others ask me.

CNN/Money May 2011

CNN/Money November 2011

Medtrade Monday Journal January 2012

Washington Post Real Estate September 2011

Susan Catlette in front of the home I remodeled for her.

Reflecting on the conversations I had at the Silvers Summit I realize I had the same three conversations quite a few times. These are not new points, the topics are review for folks I converse with all the time. (I may even have written about them in this space) I am going to share the gist of them here. They stand out because they are the meeting of what is on my mind and what is of interest to other folks on Aging in Place issues.

The three conversations are (1) How I got into this topic (2) demographics v. market, (3) steering wheels v. cars

(1) How I Got here

I am a carpenter and former design/build contractor. In 1988 I was asked to remodel a bathroom for a family whose 12 year old was about to return from spinal cord injury rehabilitation. I asked what they needed a contractor for, the mother said, “I didn’t help him in the bathroom before he was injured…I want him to be independent when he comes home.” I had no idea what to do, and I found no sources of information. (Pre internet!) What I did was helpful, he was independent in the bathroom, although it is not what I would do today.

I was totally turned on by the real, significant value I was able to provide to this family with my tools and skills. A few years later I read an article on the age wave and in the early 1990′s decided to focus my business on remodeling for older folks. I had two goals. (a) do more feel good work with real purpose, (b) differentiate my small design build remodeling firm from other companies in the DC metro area.

I began attending senior service provider networking events. People were very interested. They thought my service was a great idea. By the second half of the decade I was teaching classes on the topic for home builders, health and social service providers, under grants from the Administration on Aging and local communities.  Pretty exciting, but there was a persistent question:  “If everyone thinks this is such a great idea, why did the phone rarely ring?”

This question lead me to study aging issues, government silos, social/marketing, resulting in the White Paper, Aging in Place 2.0: Rethinking Solutions to the Home Care Challenge, published by the MetLife Mature Marketing Institute last year. Though my services still include work with individual families, companies and communities I am also working to find solutions to the question raised in Aip2.0.

(2) Demographics v Market

People looking into boomer and senior business opportunities talk about the sheer numbers…78 million boomers, 30 million older people…as well as savings, spending power, etc.. They refer to this as the senior or boomer markets. They too often confuse demographics with market. Demographics are statistical population data. Markets are the commerce resulting from buyers and sellers meeting to exchange good and services for dollars. They are not the same. The demographics are real but so far converting those demographics to a market based on the fact that people are older is pretty illusive, unless health problems and crisis are the motivators. (see more about THE Master, the late David Wolfe)

(3) Steering Wheel v Car

Many (too many) entering this market place with (really) good ideas are selling steering wheels, or tires, or windshields or rear view mirrors or seat belts. NO ONE is selling a car.  No one buys just a piece, hoping it will fit together sooner or later, or when they need it.  And once they have a car they need roads to drive on, stops signs and traffic lights to maintain order and gas stations, repair shops, and parts stores to make the car valuable.

The system we need is not too hard to understand, but difficult to create. Entrepreneurs who think it will happen on its own, or is nearly there, or the government will do it, are mistaken. It is our job to create the Aging in Place industry to realize opportunities and serve older citizens. My idea on this subject. The Aging in Place Institute . Please let me know how you want to be involved.

My how time flies!  I started to report on last week’s Silvers Summit at CES  (Consumer Electronics Show) by referring to my write up last year. Turns out the last one I wrote was two years ago! This was the first time I attended the Silvers Summit or CES. So, Can I write the same things or does time and real experience change my point of view?

I am sorry to report things have not changed as much as we hope. Folks, the future IS bright but it is a LOOOONG way off!

The Silvers Summit folks are dedicated but the program has two problems. 1. There is still confusion about whether we are talking about an inspirational, vital market of boomers or a frail, caregiving assist market of older home dwellers. Many of the products seeing some success are deployed in housing and care facilities. These are good or even great use of the products, BUT they are not about using technology to enhance independence or the progressive alternative of Aging in Place. This is about more efficient use of resources in assisted living, independent living, nursing homes or continuing care residential communities (CCRC). Nothing wrong with that. It is just not new or exciting.

2. Though these excited, dedicated, passionate entrepreneurs are gung-ho, none are clear how to reach people in their homes. I hear what are now tired platitudes about reaching older folks through their adult children but I have not seen it work so well. (I never had any luck convincing my dad to do anything.) Reaching older consumers in their homes is complex and difficult.

In contrast, the Digital Health Summit is more progressive and more exciting. The biggest category is physical activity monitoring. The iBike garnered the most buzz. You put your i-phone into a handlebar carrier that protects it while connecting it to oodles more circuits within the carrier and the sensors on your wheels. It provides lots of data and great, readable displays of your activity.

iBike is representative of the type of data collection – arm bands, chest bands, patches, ear buds, and more and availability- small screens, uplinking, etc. Some others at the show included BodyMedia FIT, Polar, Wahoo, Fit Bit.

The Digital Health Summit focuses on the push to use the data is probably most important.  Engagement. Can insurance plans and employers encourage those with health conditions that may grow to be expensive to change their behavior? Simply stated, can these devices be used to help overweight people shed some pounds and keep it off?  That is the big $ question.

The answer is not clear but there is starting to be evidence that when used the devices are helpful. How do you get people to use them? A combination of carrot and stick, but still complex. a. Encourage people to buy the device. b. Monitor so you can encourage and reward use. c. Over time. Lots of steps and a real need for continuity. How many smokers have quit? More than once or twice?

United Healthcare Group had a large booth with multiple impressive and innovative stations showing their efforts to educate and involve clients in their own care. This is the future of technology and engagement for improved health outcomes and money savings.

I enjoyed my time at CES/Silvers Summit. Not the least because of the great hike I took  to Red Rocks Canyon with Jason Popko of Bosch and Good Design/Age Well, Joel Shapira of Beyond Age and Innovation Invigoration, Susan Estrada of Happy at Home (who loves Fit Bit), P. K. Fields about to launch Rtime.com and Marcie Rogo, soon to launch Silver Seekers.com.

I predicted my panel would be the best at the Silvers Summit. I was right! Not that the competition wasn’t fierce. There were plenty of great folks talking about great things.

I lead off with the twin themes that Aging in Place is not about isolated homes and individuals but homes that are part of communities thoughtfully serving all residents and that following what provides dignity and respect for older citizens in community policy, products and services will lead to benefits- even unexpected ones – for all. I referred to the Clarity study which basically says putting our older citizens in nursing homes is a fate worse then death. Then I moved through the elements of livable community-

1. Places to go- retail, spiritual and recreational

2. Transportation- on your schedule not operator convenience

3. Affordable and Appropriate housing

I showed just a few slides depicting  a. an attractive no step entry and curbless shower, b. Universal Design, c. corollary benefits like close captioning and curb cuts, d. that ‘walk and roll’ communities permit those who don’t drive- younger and older – to get where they want to go, as well as out on the street, lowering carbon footprint as well as increasing interaction. e. I finished with my point- that DOING the RIGHT THING will always pay off.

Chuck Parker from Continua Health Alliance continued explaining that interconnectivity is critical. Seeing the plethora of devices in the Digital Health, Silvers Summit and entire CES it is clear this is the case. Without connectivity and standards we will create technical silos worse than the funding and eligibility silos we already have.

Alex Go from Virtual Health* talked about the community of providers his startup is orchestrating to make sure people are not stranded with technology monitoring their health but no coordinated services following up on the data.  This makes Virtual health different than GrandCare, IdealLife, Telekin, Life Station,  Independa, and others using similar technology.

Adam Vollmer from IDEO talked about out of the box solutions relating community and health focusing on electric bicycles. Adam’s team recently won the Oregon Manifest bike competition for their electric entry, the Faraday. The implications are far wider than you might think.  This is great technology use, augmenting your physical abilities and stamina, making it easier to be outside, get some exercise, enjoy and be a less polluting part of the community. It turns out I know lots of folks who have/ride them. My friend Marc Gunther has written about it and our mutual friend Charlie Richman has a site ElectricCyclist.

The line of folks ready to continue the discussion proved to me that the point was driven home. Aging in Place uses technology as well as design, Universal Design, and works because thinking about dignity and respect for older citizens results in new and exciting services, products and policies with benefits for all.

*disclosure- I am in discussion to do some strategy consulting for Virtual Health

I am heading to Las Vegas to lead a panel at the Silvers Summit day of the annual Consumer Electronics Show. I am very excited because this is the first time the Silvers Summit is covering the issues of home and community. I put together what I know will be the very best panel of the day’s events!

Our theme for the day? A holistic Do The Right Thing. The thesis is that creating products and services for older consumers will have benefits – unplanned, even unguessable – for everyone. This simple but clear idea points entrepreneurs and existing business in the right direction and gives investors guidance and metrics for success.

Panel Description:

Field of Dreams 2020: Home & Community — Plan for Aging, Benefit for All

Today 35 million Americans are over age 65; in 10 short years this number will double. An older population’s lifestyle presents endless opportunities for your business. Panelists discuss trends in “smart” homes and towns: how builders and community designers are using technology to meet the needs of aging citizens.

Our incredible panel includes:

Chuck Parker, Executive Director of Continua Health Alliance, an international organization of healthcare and technology companies dedicated to establishing a system of interoperable personal connected health solutions. Chuck has over 20 years of experience in health care technology and the strategic design of evaluation and measurement strategies.

Alex Go is strategic leader of Virtual Health, the premier solutions integrator bridging consumers with health and wellness service providers. Prior to joining Virtual Health, Alex was global director of new markets for Intel’s healthcare business. He brings 20 years of experience working for Tyco Electronics and Intel Corp., in strategic planning, sales and market development positions.

Adam Vollmer is a senior mechanical engineer at IDEO, the international design firm.  Adam brings years of medical device design and biotechnology expertise to IDEO’s Health, Wellness, and Social Impact group, as well as a passion for designing products and services that  address pressing human needs. Adam is also co-host of the PBS Kids engineering show ‘Design Squad Nation”. Most recently, Adam led the IDEO design team responsible for the creation of the Faraday, an aesthetically unparalleled electric bicycle that captured the people’s choice award at the 2011 Oregon Manifest bicycle design contest.

More about the panel, the silvers summit program and reactions to come!

I am an innovation immigrant.

I don’t often feel inspired. But I am inspired by the incredible third annual Aging Means Business Conference held Friday in Boston associated with the Gerontological Society of America annual meeting.  This was my second time at this conference organized by Greg O’Neill and his team of Sarah Wilson and Dani Kaiserman from the National Academy on an Aging Society working with Mary Furlong and this time with the always provocative and fun (and of course, natty!) Joe Coughlin from MIT AgeLab.

I have been involved with Mary’s events for a few years…having been a semifinalist in the first year of her Boomer Venture $10,000 Business Plan Competition and on the winning team a few years ago. This time the results Mary has been working toward really came together. There was a healthy mix of long dedicated and newly interested business thinkers. The energy was palpable. Just being in this crowd was fun.

The air of excitement started at a Friday night reception hosted by First Republic….a bank that is doing things differently. As we learned in one of the next day’s presentations, they are paying attention to their customers! What a novel idea! The innovation I heard that sounds great?…NO music! (Turns out I am not alone unable to hear and concentrate with music playing in the air around me. I avoid retail and restaurant experiences for this problem. This bank listened.)

Curiously (or NOT- maybe expectably) that issue rose again later in the day. Gretchen Addie and Jose´ Colucci  from IDEO, the quintessential design and innovation consulting firm, engaged us in a process throughout the day rather than just giving a presentation. Innovation worksheets were on the tables when we came in. We were encouraged to state ideas, note the participants, explain the idea, make a sketch and then hang them on a board. Gretchen and Jose´ reviewed them, then shared their take on a few, putting our new ideas in a context of some of their previous projects. We saw how they help ideas grow.

One of these ideas related to the bank practice- Cones of Silence for restaurant tables – allowing diners to dial the background ambiance/noise up or down to balance their desire and threshold for atmosphere and conversation. BOY would I love that!

Matthias Hollwich, the keynoter was a real hit. Matthias is a co-founder of HWKN and the design leader of the BOOM senior communities. Those of us in the senior  community design field for many years might say there is really nothing new here, other than wild looking/futuristic house forms. That misses the point. The point is a young, excited and out of the box designer came to this field cold, with no prior knowledge or assumptions and came to the same conceptual conclusions about lifestyle and community we have been promoting for years. That is totally validating! Second, his work is evidence of fresh and growing interest in these opportunities. Third, he brings fresh ideas for reaching the solutions. This young and really pleasant architect and…. just  plain….leader,  pulled together an extraordinary team, bringing real excitement to housing older folks in community.

True to form, Matthias would not be satisfied with the same old survey data. He engaged Hunter Tura of Bruce Mau Design, also new to this field, to develop a tool (looks like an app, folks) to gain customer insight. They hit the nail on the head.

I was excited, but not inspired, when I went to bed. I woke up ready to work, and, reviewing some materials, the inspiration hit.  What turned up the volume? Two more stories.  Do you have the patience?

1. I was so happy to see Jan Hively when I walked into the room Friday morning. Jan Hively, human extraordinaire, is lively, engaged, committed and she gets things done! Jan showed me a brochure from the European Union AAL program (Ambient Assisted Living- the EU term for aging in place or community). The EU has declared 2012 as the European Year on Active Ageing and Solidarity between Generations.  Saturday morning I downloaded the ‘brochure’, a catalogue really, of projects- and started looking for individual project pdf’s to download for reading on the plane home. I was bowled over by the sheer number of ideas they are pursuing in the EU effort.
2. That reminded me of a conversation I had at the conference with Marcus Wilhelm, Research Director from Redstar. Marcus, like Matthias, is an innovation native.  He explained the way his company building company works. They generate eight ideas a month, winnow them down through research with the goal of supporting a few startups per quarter. I had heard this sort of thing before but never got much of a handle on it.

I have been trying to get a handle on innovation for a few weeks. I thought I had it recently- thinking it was about leaving assumptions behind. That is part of it. Now I  think it is about the process of rapid idea generation. That fits the pace of the digital/internet world, where I am also an immigrant.

This is exactly what Gretchen and Jose´ did with us.  It clicked for me as I paged through the plethora of ideas being pursued in the EU.  The process of innovation is to generate lots of ideas and consider them. For we immigrants it is a new way to think.

I feel inspired to generate lots of new ideas for the problems I am trying to solve, many of which are identified in Aging in Place 2.0: Rethinking Solutions to the Home Care Challenge

Trust me there was much more to think about and many other exciting, even inspiring, people at this conference. I may get another post or two out of it.

Congratulations and THANKS to those who worked so hard to pull this together. Inspiration is a gift. I appreciate it. I hope I see all of you at next year’s conference November 14-18, 2012 in San Diego.    Why miss a chance for inspiration?