The loss of mobility post-fracture can come as a shock to anyone, especially for an older person living alone. The solution I imagine is twofold: 1) a prescribed wellness plan using a one-stop-shop app, WalkShine and 2) provision of the hardware needed (recycled and refurbished smartphones to access the app. WalkShine is primarily focused on helping seniors who are ALONE to keep depression and feelings of futility at bay post-fracture so that they feel encouraged to continue on their healing journey and prevent future fractures.
Obviously care from a loving and capable family member is best. But for those who don't have anyone at all, accessing the app for contact with health care providers, physical therapists, long-distance family members and a community peers experiencing the same issues can make a difference.
The WalkShine app and a refurbished phone is provided to anyone who reports living alone and is coded with any fracture during a hospital or doctor's visit. The WalkShine app can help fill in the gaps when the patient is unable to afford DAILY home health aide visits or get to DAILY physical therapy.
The average American home has 2.8 TVs and 2.4 smartphones. However, where a patient does not have either, the app hospitals and other agencies will work with e-recyclers to provide the electronic equipment needed for patient's use during recovery. Once eligibility has been determined, the program will help the patient connect their own smartphone to their television for optimal viewing or provide both to the patient as needed.
Old devices are often collected, refurbished and given to people who need them for various reasons. Yet enormous amounts of electronic waste from phones shows that we are still not doing enough. Perhaps more concerted efforts to collect phones for healthcare would be well-received. This program has the added benefit of putting e-waste to good use.
Finally, the user would need Internet Service which can be cost-prohibitive. WalkShine would partner with hospitals, Senior Citizen consumer advocate groups and Internet Service Providers to provide WalkShine App-ONLY internet service 100% free to post-fracture patients. While the patient would be responsible for their already existing phone plans (if they have one), time spent utilizing the Walkshine app Wellness Plan would come at no cost to them.
The WalkShine app Wellness Plan would include:
- Live long distance Home Health Aide Video chat feature (direct and immediate human contact if the patient is experiencing increasing lonliness or physical pain.)
- Guided meditation/prayer/gratitude practice/visualizations (guided virtual walking tours through the woods, along a beach, on a busy street of a selected tourist destination, etc.)
- Education ("science of falling" (i.e. "Did you know that the biggest predictor of falls for seniors is the actual fear of falling?!"), the psychology of falling and what to expect during a loss of mobility, osteoporosis prevention, DEXA scan information, nutrition, cooking, bathing and doing daily tasks with an injury, health literacy and self-advocacy, anatomy and bio-mechanics, communicating effectively with your caregivers and health care providers, etc.
- Movement and daily prescribed Physical Therapy with therapist monitoring by video, chair aerobics, body resistance training, chair yoga, chair tai chi, specially tailored physical therapy videos, practice videos for navigating the home/stairs, etc.
- Socializing - Chat rooms, live interactive webinars and classes with other seniors about bone health, virtual dance parties, opportunities to cultivate an active social life offline, advocating for self and other seniors, participate in social justice issues for seniors.
- Progress Tracking - Tools to measure patient's adherence to prescribed Wellness plan AND progress toward pre-set goals personal goals.
The changing landscape of the senior demographic will soon no longer be dominated by the internet illiterate older person. With each passing year, more and more people of all ages will see the Internet and smart devices as just a regular part of everyday life. The challenge perhaps lies more in access to people in communities which are still lagging behind in this respect, particularly in poor communities and communities of color. In communities of color, osteoporosis is rarely discussed. While it is a lesser risk, it is still a significant one: when fractures do happen, whether due to osteoporosis, the mortality rate is twice as high in these communities. This is not surprising and it speaks to the urgent need to educate about osteoporosis and fractures in general and also redouble preventative measures to decrease this glaring health disparity.
The WalkShine app can tailor its messaging for patients with any risk factors for osteoporosis or higher mortality rates due to a fall or fracture.
It is my hope that the WalkShine App will include seniors as staff members who are highly visible and present in managing, maintaining and facilitating activities. Studies have shown these types of online senior communities have the most longevity. Messaging will also be very clear that aging does not have to mean a drastic loss in quality of life. The WalkShine app will speak to being confident and strong rather than being hyper-vigilant about the "dangers" of living at every turn. As with any healthcare issue nothings beats having a well-thought out plan of action.
1. Sustaining Online Communities Involving Seniors: https://pdfs.semanticscholar.org/a122/c1953b86d09a95b932bd5da6abb38e99f358.pdf
2. View of What Seniors Value About Online Community: http://www.ci-journal.net/index.php/ciej/article/view/545/880
3. Virtuality Improves the Well Being of Seniors through Increasing Social Interaction: https://link.springer.com/content/pdf/10.1007/978-3-642-15479-9_12.pdf