AAL: Active Assisted Living

The demographic change, with the shortage of skilled and unskilled labor in nursing, is changing the way we celebrate the last third of our lives. The current multiple crises are acting as an accelerant and ruthlessly exposing the weak points.

This affects us in a very personal way: Care is increasingly becoming a family responsibility, but this means that people have to dig deep into their private pockets. This is a social time bomb that many of those affected and politicians are not yet aware of.

One of the solutions is AAL: Active Assisted Living.

AAL encompasses assistance technologies and concepts that enable people who need support to organize their living space in such a way that they can manage their daily lives largely without outside help. The goal: To be able to live as long as possible with a high quality of life and as healthy, independent and self-sufficient as possible.

In care facilities and sheltered housing, these technologies support staff in carrying out their tasks.

THE STRENGTHS OF
ASSISTED LIVING APPLICATIONS

Assistive technologies support and relieve the burden on nursing staff at times of high work pressure and make care organizations more responsive overall. Patients receive help and the necessary support more quickly. This allows the patient’s state of health to be monitored more closely and for rapid intervention in the event of changes. Illnesses are thus detected and treated at an early stage. Artificial intelligence will enable a wide range of applications in the future.

The solutions take on bureaucracy, routines and improve planning, and the freed-up resources can be used more meaningfully for care. Important: They do not take over care, but only individual work steps.

Private applications offer solutions to support older people or people with disabilities in their daily lives or in emergency situations. They involve nursing staff, relatives and doctors, thereby improving existing (communication) structures.

Important: Technologies are only one part of the big picture. It is important to use several levers. The goal must be to enable people to live as long and as healthy as possible in their own four walls. Countries like Sweden or Denmark are already relying on an overall concept that focuses on a high degree of personal responsibility, help for self-help and technology. Showrooms show people which AAL products and concepts are already available on the market. Educational institutions train health and care sector employees in digital and technological developments, explaining how they can be used in practice. Older people also receive individual advice and training on how to live healthier and more sustainable lives.

OPPORTUNITIES

Innovation comes from the region: Projects serve research, or improved advice and information on how to prepare the home for old age, making it safe and comfortable. More collaboration is needed here to make developments and findings visible – and to prevent each region from starting from scratch. Ideally, this should also be done across countries and states. “We would already be much further ahead if the exchange of ideas were improved,” explains one participant.

The opportunity for political embedding: Those who have understood the topic in politics are creating structures to embed the topic in the federal state or region. Political core teams are drivers of regional innovation. Political embedding ensures that new, innovative approaches are heard in political committees, and that they are given improved visibility and feasibility.

Future topics of prevention, early detection & personal responsibility: The development from pure repair medicine and the fight against symptoms to early detection, prevention and personal responsibility is a major concern of the interview partners. The aim is not only to achieve savings: It would enable us to live healthier lives and avoid a great deal of suffering.

Improve opportunities through visibility and explanation: In order to support the go-to-market of solutions, innovations and ideas need visibility in order to reach stakeholders in the care and health sector, in insurance companies, to end consumers and their relatives. These technologies require explanation, especially for target groups that have had little contact with digital technology.

THE CHALLENGES

New approaches are needed: The system is inflexible and the concepts from the past are no longer suitable for solving the current challenges. According to the interview partners, new approaches are needed, a fundamental transformation of the care system. Technology is only one component here: What is needed “is an integrative structure in which care funds and insurance companies work together with institutions, cities and service providers.”

Care will increasingly be decentralized and provided at home. The future therefore belongs to the collaborative interaction of patients, doctors, nursing staff and relatives.

Interdisciplinary networking and collaboration: Smart health applications are also changing the way we build and renovate. This also affects professional groups such as architects and construction companies, and trades such as electricians: They plan and design, are responsible for installation, renovation and refurbishment, and for operation and maintenance. We are still in the early stages in this area.

Technology in the “valley of death” & gaps in financing: Despite billions of euros in funding across Europe, companies have not addressed market development. Essential questions remain unanswered: Who will sell the products, what could cost models look like? What should be paid for privately and what should the state provide? And who is responsible for regular maintenance and modernization?

Further financing gaps are currently emerging as a result of the multiple crises: The high costs in the areas of interest, rent, energy and food are exploding the budgets of care facilities.

There is a social time bomb ticking in our care and health system: Federalism, bureaucracy and fragmented competencies create major challenges. Services vary from state to state, and funding for the implementation of assistance solutions, for example, also varies. Local development depends on engaged personalities – if these personalities are no longer available, for example due to retirement, the projects often come to an end.

Conclusion: The pressure on our health and care system is acute and will continue to increase due to the shortage of skilled workers and demographic change. Money is still stuck in the old system and in traditional silos of thinking. The transformation to a modern system is proving challenging and is not yet paying off. One participant said: “Resources need to be reallocated; they are currently misallocated.”

THE WEAKNESSES

High market risk due to insufficient visibility: The existing solutions are not visible enough, and this applies at several levels. The regions and federal states do not work together, they research independently and each implement their own solutions. In this fragmented market, it is difficult for companies to scale up. Similarly, solutions are not sufficiently visible to private end consumers, and the target groups (the affected individuals themselves, their caregivers and their relatives) are often difficult to reach. As a result, solutions are in little demand, which also contributes to the high market risk.

AAL technology is still not mature enough for large organizations: The solutions and products available on the market are suitable for private individuals and small to medium-sized organizations. For large municipalities and cities with several thousand employees and people in need of care, an overall solution is needed – and this does not yet exist, or scalability has not yet been proven due to a lack of larger projects.

Those in charge help themselves by screening the market and looking at how other municipalities are dealing with the challenges.

Calls for proposals require reflection: The more detailed the application for research funding is, the better the chances of receiving funding, as several interview partners explain. As a result, the calls for proposals become very rigid, and interim results cannot be sufficiently integrated. Conclusion: The specifications do not lead to the desired output. Another challenge: In the three to five years of development, the market has already changed, so the products are outdated by the time they come onto the market. Some developments were “flops” because, for example, the Apple Watch was launched with a better fall detection system.

Insufficient co-creation: This refers to the integration of end users in the development of products and solutions. It is not about making sure that they can do everything (too expensive) or that they are “cool”. They must be able to do the right thing and be usable for the users. According to the interview partners, users are often not integrated into developments at all or only at a much later stage. However, the success of products and concepts in care organizations depends to a large extent on the involvement of the target groups.

Infrastructure basis is missing: The basis of many AAL applications is a functioning internet connection. In urban areas, this requirement is less of a problem, but in rural areas it is indeed. In particular, in Germany there is a lack of this basic requirement in rural areas. Investors are currently withdrawing because the planning figures and the capacity utilization of the networks have proven to be too optimistic. In Austria, market providers have already called for a digitization offensive to strengthen broadband demand.

WOULD YOU IKE TO KNOW MORE?

I would be very happy to provide you with a more detailed presentation of the findings and to organize workshops:

  • Strengths of AAL solutions
  • Seizing market opportunities
  • The weaknesses of the market
  • Challenges in the market
  • What a project’s success depends on
  • Developing next steps