When senior citizens are the early adopters of contact tracing tech - The Verge

Digital contact tracing wasn’t up for debate in senior living facilities.

But when the COVID-19 pandemic started devastating nursing homes, the team quickly spun up a new feature: automatic contact tracing.

Contact tracing helps control the spread of an infectious disease by tracking down anyone who has been in contact with a sick person and monitoring them to check if they caught the disease.

For months, tech companies like Google and Apple and countries like Germany and the United Kingdom have tried to use high-tech systems to automate the contact tracing process.

While public health experts argue tech-driven contact tracing has a role in the fight against the coronavirus, there’s open debate over how and if that might happen.

Some senior living facilities in the United States, though, are already quietly using automated systems to guide contact tracing, facilitated by companies like CarePredict.

Because the tools are used for older adults, it’s assumed that the benefits are worth any trade-offs.

Concerns around autonomy and choice aren’t given the same weight, says Clara Berridge, a professor at the University of Washington who studies health care technology in aging populations.

Some Lifewell living facilities have already used the feature to track down the contacts of people who tested positive.

But it has had people tested for the virus, and it used the contact tracing tool while they were waiting for the test results to come back.

“We were super pumped when they came out with the contact tracing, because it’s just such a time saver,” Walter says.

Other companies that make location tracking systems for senior living facilities, like the North Dakota-based ZulaFly, have similar features.

ZulaFly’s systems can run location history reports on residents wearing tags, says managing partner Stephanie Andersen.

Health care company CenTrak has listed location history as one of the benefits of its location tracking systems for years, says Ari Naim, president and CEO.

Experts working in health services refer to older adults, who often have other chronic health conditions, as a “high-need, high-cost” group, Berridge says.

Arguments that call for using apps and digital systems to automate the contact tracing process lean on similar principles.

The contact tracing apps used for the general population aren’t fully analogous to the location monitoring systems used in nursing homes.

Nursing facility systems, on the other hand, are usually opt out, not opt in, Berridge says.

It takes more and more detailed information on older adults living in nursing homes to get the benefits facilities are looking for.

“It’s pretty darn useful if you’re in independent living, and you decide to go for a walk,” says Laurie Orlov, elder care advocate and founder of Aging in Place Technology Watch, which documents and analyzes trends in technology for older adults.

Contact tracing apps created for the general population could add value as well: advocates say they could help flag interactions people don’t remember they had and take some of the burden off of the manual contact tracing workforce.

Apple and Google talked just as much, if not more, about privacy when they announced their Bluetooth-centered contact tracing tool.

When it comes to technology like this, she says, there isn’t as much consideration to how the older adults they’re attached to might feel about it.

It’s not uncommon for there to be gaps between how adult children and caregivers think about monitoring technology, and how the seniors they care for think about it, Berridge says.

Monitoring systems are often sold as ways to help give older adults more freedom.

The power dynamics are amplified when monitoring systems are used for older adults with dementia or other cognitive impairments who often have caretakers making decisions for them.

The oldest wearable tracking devices used to keep dementia patients from wandering off were based on lockdown technology invented for prisons, she says.

Even though the stated goal may be for safety, they have their roots in systems that were used on people who had no say in the matter — and should have extra scrutiny before they’re introduced.

For an added layer of protection for this and future disease outbreaks, many senior care facilities and nursing homes are newly interested in location tracking systems, the companies that make those products say.

CenTrak’s Naim says that they’ve seen an increase in orders for tracking tags since the start of the COVID-19 pandemic.

CarePredict is also seeing a surge in interest focused on its location tracking capabilities, Zobel says.

Certain nursing homes are going to have more access to that contact tracing, and the help that provides during a crisis,” she says.

Like contact tracing apps, these location monitoring systems haven’t been used for infectious disease outbreaks before.

Berridge worries that a rush to adopt these systems could distract from efforts to fill the gaps in infection control practices in nursing facilities?

“If we say, we think we have a solution to our contact tracing problem, yet we’re not providing PPE and we’re not adequately training staff and we’ve got major turnover issues, that’s a problem,” she says.

If Zobel’s prediction that these systems will become standard is correct, integration of location monitoring for older adults won’t be temporary.

In the context of a crisis, scaling up some of these systems may make sense, Berridge says.

If and as location monitoring systems from older adults become more common, people involved in their adoption should have similar conversations around privacy and autonomy that swirled around contact tracing apps