July 2008

Informal Caregivers as the Backbone of the US Economy  
The most capable and committed potential support for telemed and assistive tech: 50 million informal caregivers  

By Janine M Lodato
LodatoClan@aol.com

The future of the US economy, including solutions for major problems like healthcare, environment, innovation, depends on micro enterprises and small businesses especially if they are organized in the lower cost environment of the rural communities. The 50 million informal caregivers, family nonmembers and friends of the care recipient, are positioned to organize and run these small and micro enterprises. They will concentrate on clean, green and assistive technologies (including telemed) taking the many products of the various manufacturers to the 100 million people in need of care and other users in general.

These caregiver-guided micro and small enterprises will represent and service the products of companies with products that have keywords as outlined in the application segment below.

The first such micro-enterprise is myproviderspace.com.

There are more than 50 million family caregivers in the USA and they provide 80 percent of the long-term care services to the 100 million homebound people in need of care. These uncompensated services provided by the caregivers amount to more than $400 billion annually. The combination of the informal caregivers and their care recipients do amount to half of the population of the USA. And it is the same in the other 9 industrialized countries of the G-10 group of nations.

This very large group of caregivers and care recipients need local community support in the form of a Web Server, located in each community, providing Web-based collaborative services and applications

The major applications supported by a Web 2.0 style collaborative network we could call the Ablery project, are the following:

Tele-Medicine and Tele-Watch
The caregiver can become the one who takes and reports the vital signs of the care recipient, thus lower the cost of medicine

Keywords: Electronic Patient Records, Electronic Health Records, Integrated Care, E-Health, tele-consultation, users’ mediated use, information and communication technology (ICT) Telemedicine is the application of telecommunications to medicine, so allowing consultations and medical intervention to be carried out with the patient and doctor in different places. Experiments are being tried in many countries with remote consultations, sometimes called televisits or teleconsultations, and with remote control of surgical operations, telesurgery. It seems from the neologistic lexicon that most branches of medicine can now have a telecoms component, from teleradiology and telepathology to telenursing and telepsychiatry.

The caregiver can also monitor via the Web the general condition and vitals of the care recipient even when the caregiver is not on location this can be accomplished by the ConnectR product of irobot.com allowing tele-conferencing so the care recipient would not feel alone.

Keywords: tele-monitor, teleconference, tele-presence

Tele-Work
Allowing the caregiver can work and give care at the same time, some care recipient can do tele-work as well with the financial support of the government

Keywords: A particularly significant group of such words covers the various aspects of using computers and telecommunications to work at home instead of at the office. Originally a futuristic idea in which teleworkers would be able to telecommute (connect to their offices electronically instead of physically moving themselves there), it has become a reality for many people. Workers may “meet” and discuss issues through teleconferences. It was quickly recognized that there were economies of scale and other advantages in having communal facilities that could be shared by a number of teleworkers, especially in rural places where assistance and services were not easy to come by; these locations have usually been called telecottages (though a scheme in Scotland, perhaps inevitably, came to be known as a telecroft). Sometimes they are called telecenters, though this word is also used more generally for any location in which business is conducted by telephone. A residential and business area designed and built to enable people to telecommute is sometimes called a televillage.

Tele-Training
So the caregiver can train for additional services and bring green and assisted living technologies

As well as tele-medicine technologies to the communities from many small companies and from the members of AmericanTelemed.org, these smaller companies are not directly represented in that community thus the caregiver be the representative, some of the care recipients can also receive training in preparation for doing tele-work.

Keywords:The possibilities of telecommunications to help learning at a distance have long been recognized. As the technology has advanced, new terms have arisen: televersity (a university run by distance learning methods over high-capacity data lines — one is proposed for the Scottish Highlands); telecourse (one so taught); telelearning, teleteaching and teleschooling (all with the idea of telecommunications helping distance learning); and teleseminar. The concept has been called tele-education.

Tele-Shopping
From Amazon.com, to lower the cost of basic needs for the care recipients and their caregivers, also to save time

Virtual Group Interaction
For bot the care recipient and the caregiver thus improving the quality of their lives in social Web 2.0 style using the Huddle.net collaborative system allowing all participants to collaborate: caregiver, care recipient, doctors, nurses, social workers etc, this Internet session can be made easier for the care recipient if we equip the care recipient with an Epoc Wireless Headset by emotiv.com which could also help with Mind Gym type Alzheimer oriented interactive games.

 Infotainment
A combination of WebTV and the Web

These applications can be offered via a Web 2.0 type server software we have developed which we call Ablery server. This server could be a slice of a large server farm like the one Amazon.com owns. 

The Web then of course the Ablery server then can be connected to the end-user via a Whispernet offered by the wireless carriers (evdoinfo.com),  a meshed network using Wi-Fi or Wi-Max wireless network technologies.

One of the best ways to connect would be to use the HughesNet satellite connections then have this link connect to a micro cell of Wi-Fi type. 

It is imperative that to enable the caregivers to do tele-work from the homes of the people in need of care. These are the so called informal caregivers, family and friends, who work without pay and provide unbelievably valuable service. Then the caregivers and care recipients would tele-campaign for legislation which would provide tax credits to the businesses who allow their employees to perform tele-work style.

In addition to allowing the caregivers to earn a living, tele-work style from the  homes of  the care recipients they could also participate in tele-training to improve their abilities. Then they can become field representatives for the assistive technology industry, for alternative energy industry, for independent living home improvement industry and tele-work part time to very efficiently serve these industries and allowing the companies of these industry segments to penetrate markets which would not be available to them otherwise.

The employers of these caregivers could install an open source strong tele-work oriented tele-presence system on their Web server or they could use the Ablery server. A team-work oriented collaborative system like the one offered by ubuntu.com called Croquet would be installed on the Ablery server.

Recently in a Fortune article, Dr. Andy Grove made some very important statements regarding the healthcare costs in the US. His comments relate especially to the cost of care for the people who are in need of home based care: the frail elderly, the chronically ill and the disabled, about 100 million in the USA alone. Medical spending in the US is at 16 percent of the GDP and it is the fastest growing segment. The average American spends $440,000 in his/her lifetime on healthcare. Of that, $280,000 will be spent after age 65 and approximately 50 percent of this will be spent on assisted-living facilities and nursing homes. So it stands to reason that if there were a way to keep the people in need of care in there own homes longer we would have a better and lower cost system: we could save $300 billion per year.

This community-wide broadband Web connection connected via the Ablery server portal, serving the caregivers, can also help the care recipients, the people in need of care. For this user group, a simple voice recognition capable community based Internet server  is needed. We have developed such a simple voice capability for the Ablery server. 

The Ablery server acts in Web 2.0 style, the social Web similar to MySpace, Facebook, Wikia, etc.  The care recipient end user is connected to the Ablery server through a simple laptop such as the reliable, low cost machine from Zonbu.com, or a Web enabled TV, or the OLPC by Negroponte, or the Intel 200 dollar laptop, or the ASUS laptop. This allows the care recipients to participate in virtual group sessions, visit people virtually and in general get involved. This virtual group participation's can also be achieved with the Huddle.net system.

The caregivers also need political representation as well as non-profit support. They would be a loyal supporter of the Presidential candidate who represents them.

About the author
I have gained deep insight into the requirements of the people in need of caregiving and their caregivers when I worked for John Garamendi, now lieutenant governor of California, then State Senator. I have many years of personal experience using AT and found it very helpful in SPMS (secondary progressive multiple sclerosis) conditions as described below in a brief review of my personal experiences. In addition to my extensive experience with AT, I also have related graduate credentials from both California State Univ at Northridge (the center for AT corporate interactions) as well as CSU in Sacramento and UOP in Stockton.