High Tech or High Touch to Age in Place?

Seniors with caregiver

High Tech or High Touch to Age in Place?

Will Video chat and online telecommunications really make it possible?

When I read the NYT article Choices Give New Meaning to “home Sweet Home”


My first reaction was they are missing the main points of what is needed in Senior Care and Aging in Place

.  Seniors need interpersonal, human, contact and the emotional and social connection that brings.

 Seniors generally miss the lack of social contact, lack of being needed, even if it is needed just as a companion and co TV watcher.  Somehow I don’t see an  I-pad screen sitting next to you and watching your TV in your home with you will replace the feeling and idle chit chat having a real person in the chair next to you offers.

While video conferencing will undoubtedly be a tool it more reasonably

will be a tool a new breed of old fashioned, primary care doctors who accept the role of being a full time Doctor and the responsibility of making all the medical decisions.

They will visit the house, know your family and social system and then can use these tools to support that direct, personal, attention all people need.

If you build on the care team idea and continuity of care with ONE DOCTOR who does home visits, sees you in your own home regularly, and then add in some outside Home Care, a Back up video monitoring option that can succeed.

While the programs and ideas we have known and used for decades, simple home modifications, and meals on wheels do give hope to those who are at home they will not begin to replace what they really need which is a doctor supervised home care team where the doctor visits, knows the senior and the seniors entire family.

In the picture of the NYT article it looks like the two granddaughters and their mother all are very involved in the care of their grandmother.  If you have the human staff, then of course staying home is possible now!  The point I do not want you to miss is no technology will replace what senior’s need which is care and care from the same, consistent, care team.  If that is your own family and family are at home and not working then of course that works.  Even then you will do best with a Doctor and back up care system of known doctors and caregivers who you have an interest in and who in turn have an interest in you.

Seeing a new doctor, new caregiver, is always the same no matter what their training.

That is a new interpersonal contact and as a new interpersonal contact their can only be the care and caring two people share on the first hand shake and no more. 

No one just feels safe when meeting any stranger and the stranger also takes time to earn trust from you.  That is how relationships and caring that comes from a relationship develop.  I do not see technology replacing that any time soon.

Technology is good, if the Senior is able to interface with it and does not have ANY cognitive decline but that is exactly why all seniors need home care, they can’t do it for themselves due to physical and or cognitive decline in function.  If they can use the technology then they don’t need it. 

Moreover, if they can do it now when they age more this technology only plan will fail.

If the senior has used video chat in the past of course then they might be better able to use it now.  Most have not and are two or three decades removed from that technology.

Finally, communication skills will vary, language, and social customs and maybe most importantly understanding the fine print of your insurance.  What is covered and what is not will always require a care giver and generally younger person to sort out for most seniors

What is needed is Coordination of Care from the top down.  You need a doctor you really can call your own.


Instead of looking for video conferencing to assist with those whom want to age in place, one might look for care settings like

Tender Loving Care Senior Residence

Where they offer continuity of care, complete with a relationship you can count on as you age.  They too use email and internet but we use it to help the family remain connected to the parent.  We know families all want to have the physical plant, staffing, skills and time to be able to care for their parents but often time s they do not have all of those resources.   We have staff sit with residents to email the families to help the FAMILIES feel connected and less guilty that they can’t do more.

When it comes to providing human services Technology is only as good at the Individuals and the relationship they have to expand that relationship.  If you text a stranger you will be less inspired than if a known friend texts you and shares the same idle chit chat.  If you don’t know your doctor or are meeting a new doctor 3-4 times a year it is likely those will be “first dates” with the trust and caring that goes with a first date as opposed to trust that is earned through a relationship.

Value the direct care team and you will get the best care and best value for your Senior Care Dollars.

Disclaimer. I am a doctor who offers old fashioned primary care in a residential care home and know all of the patients and families by their first names.

Dr Shawn McGivney

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