You know, we always say we want to meet people where they are in life, and by enabling people to be on the move to live the lives they want to live. I mean, it's something you've always said, which is it's not about aging well, it's about living well. And if we can be a condo it to enable that for older adults and for their families, then we feel like we've really accomplished what we've set out to do.
Back in two thousand and seven, I get involved with the Mount sin Medical Center, home to a nationally recognized geriatrics department. We established at that time the Martha Stewart Center for Living, which was to focus on the care needs of older adults. We knew then about the challenges that are looming in the United States. Ten thousand baby boomers turn sixty five every day and we do not have enough geriatricians to care for them. Along with this
explosion of older adults, perceptions around aging are changing. We're seeing people living, working, and thriving for years pass the so called typical retirement age. Our president is eighty two. Of the biggest rock tours of the past few years have been led by eighty year old Mick Jagger. And seventy three year old Bruce Springsteen. And there is a strong longevity economy growing to serve this demographic. This will be the first in a series of conversations that will
specifically address the changing population of older Americans. I'm here today with Dan jose Bachvili, the founder of Silvertree, a wearable medical device, and doctor Helen Fernandez, vice Chair of Education for the Brookdale Department of Geriatrics and Palliative Medicine at Mount Sinai. We're going to talk about issues that face older adults and new products and innovations to help them live a good, long life. Welcome to my podcast, doctor Fernandez and Dan. Thank you for having us so
Helen and Dan. People are living longer, stronger, better life today. How many Americans are over sixty five?
Sixteen percent of the population. Over fifty million Americans are over in the age of sixty.
Five, and by two thousand and thirty four, what will that number be?
That number will be one in every five Americans twenty close to twenty one percent of the population.
And what are we doing to take care of this older population? That's the big question today and the question not facing not just people who are getting older, but the people who have to help take care of those people who are getting older. So many of my friends are saying, oh my gosh, they have to take care of their mom, They have to figure out what to do with dad, They have to figure out where are they going to should they sell their homes. It is
a very complicated subject. And that's one reason why I did go into the field of geriatric medicine because it really interested me because my mom, who thank Heavans, was a healthy, beautiful woman up until ninety three when she finally died of a simple complication. But it brought the subject close to home and now with me. I'm an older American now and I wonder, you know, I have to make plans for myself. Really, all people have to
take care of themselves. And Dan has been working for how many years now on silver Tree, going on four years now, four years. Silver Tree is a bracelet device. I call it a bracelet. It is a wrist band and tell us what silver Tree does for us.
Yeah, So the whole idea is to help keep people that we care about feeling safe, feeling connected, feeling protected, and most of all, feeling confident to continue living the lives they want. So it's the ability to get in touch in an emergency, the ability to automatically detect the fall when a fall occurs, the ability to locate someone if you havn'ts forbid, they've wandered off or they don't
know where they are. It's that sense of peace of mind for family members and confidence for the older adult.
So it's not really a watchdog. I mean, it really is a device to alert other people very much. So.
Yeah, it's an industry that's been around for forty years, and unfortunately it hasn't evolved a whole lot since it came on the scene in the late seventies early eighties. So we saw an opportunity to come and do it a little different and make it a part of someone's life and not just that dreaded insurance that hangs around your neck in case something happens.
So all of you listening, If you have an older adult in your family who needs attention in this way, or if you yourself are feeling that you need to feel bitter about your everyday existence, this is the program to listen to. Doctor Fernandez has been working at Mount Signing for how many years.
It will be twenty five years.
Wow. This, so you have seen a drastic change in geriatric medicine and the care of older adults, in teaching older adults how to better take care of themselves. It's been an amazing journey. And indeed, now because there are so many older people that medicine that practice that geriatric attention is terribly important and we have to figure out what to do with the aging population. So you have a big challenge. Yes, we do.
And I would say even in my time at Mount Sina when I started, twelve percent of the population was over the age of sixty five, and that has exponentially increased. Right now, over one hundred thousand Americans are over the age of one hundred and that's.
Going really one hundred thousand, isn't that wonderful? I'd see. I love that. Yeah, I love that.
And then by twenty thirty five, there'll be half a million Americans that are over the age of one hundred.
Wow. Well, I recently took a test. There are these written tests that you can take and answer these questions about your lifestyle. I guess, and I came out to be one hundred and ten. So isn't that great? I just felt fabulous, And then people say, well, what do you want to leave live to one hundred and ten for? In this world? I have a watch to see and a lot to learn, and I really think that if I can do it in good health and with strengths and without being a burden to other people, I absolutely
want to see what's going to happen. I'm a curious person. And isn't that really what drives many many people who are living longer, a curiosity to understand what's going on.
Yes, definitely people want to explore what Dan talked about. Live as functionally as long as possible, independent, have autonomy, take up new hobbies, new tasks, maybe new jobs. It's really an exciting time. You know. I think of my own father, who's ninety two, great and he reads every single day, every single newspaper.
I get a report that was like my mom. She read the New York Times cover to cover every single day. She was better informed than me or any of my friends. And she put it together. You know. She was geopolitical, and I liked that so much about her. And she was also the chauffeur for her friends. She never had a car accident. I bought her a real safe car and she was the chauffeur. And I like to see that. I think that that is admirable. And also and so
many friends. That's what we have to encourage. That absence of loneliness. That's another big topic. But back to safety and feeling secure. Dan's wrist band this is a this is a risk device that you wear on your wrist. It is very nice, comfortable. I've been wearing it. It has you can wear it in the shower. You do not have to take it off at night to charge. Like the Apple Watch, you have to charge every night.
That's right.
The battery life is much longer. What's the battery life now?
Dan's up to fourteen days.
Fourteen days, which which is great because you don't have to you know, it's another worry, which is you know, you're charging your iPhone, you're charging your iPad, you're charging whatever else other devices you have around your house, and this watch every fourteen days, this just goes on a simple little charger by your bedside.
That's right. We designed the product to you know, we always say we want to meet people where they are in life, and by enabling people to be on the move, to live the lives they want to live. I mean, it's something you've always said, which is it's not about aging well, it's about living well. And if we can be a condo it to enable that for older adults and for their families, then we feel like we've really accomplished what we've set out to do.
So describe the device and what it does exactly, because I think people will be very interested to understand that there is something that you can wear, or your mom or your dad, or your aunt or your uncle can wear that will really help them tremendously.
Yeah, of course, So you describe it very well, Martha. I'd say wrisk warn device very simple technology. There is no screen, there is one button. It is a soft rubber material so it doesn't irritate the skin. It's light weight, and it comes in two colors, a light in the dark. And the whole idea is you can wear it anywhere to the gym, to pilates, in the shower, to a fancy dinner.
I take it off in pilates, do you I do? Because I'm lying on my back, I'm jumping up and down, I'm doing steps. It's a little active and I'm afraid it's going to go off.
Well, that's totally fair. One of the features is fall detection. But you know, God forbid you take a tumble and pilates. Well, I suppose there's someone.
They're always there, right, Yeah, I'm with an instructor.
Well that's good, that's good. But the whole intent for us was design with simplicity and design.
I'm gonna wear it tomorrow and I'm gonna see if it goes off.
I get a lot of grief from my engineers in the office because I wear mine all the time, including in the gym, and I trigger a lot of false alarms by doing.
Some but you have to catch those alarms. Do this device. It does change. It gets a red, a little bit of a buzz, a little bit of a vibration, and so then you can just press a button and the green comes back on.
That's right. It was designed to be simple. So there's the one button where if you ever need help, you can press it and the first alert goes automatically to your team whomever you've invited it.
How many members of a team can be put into this device.
As many as you like, so it could be friends, family members, neighbors, It calls them, It sends them a push notification on their phone and a text message, and it gives them your exact location, and it tells them that you've either pushed the button asking for help, or if a fall has been detected, that you've fallen, and it gives your family sort of that first chance to
intervene and make sure you're okay. If within a minute there is no reaction or intervention from the family, it immediately goes to a nine one one call center and that kicks into gear, this process of sending an ambulance and making sure that you're taking care of it.
And it does work. Because I was out and about on my phone, which is a very large farm, and it went off without me detecting it because I was I was on a tractor or something bouncing around in the field and it went off, and three people came looking for me and they found me. Well, that's great that I felt safe. I felt that I had attention.
And are you still writing the tractor? Of course, and we've done our job.
Yes, I am still writing the tractor. So now it is powered by.
So it works pretty much anywhere. It has Bluetooth to connect to your phone. It has cellular when you're out and about, it has Wi Fi when you're at home, and it has GPS so that if you're sort of out in a remote place, we can pinpoint to within a few meters where you are.
Okay, So that all works very well. And doctor Fernandez, what do you think about that?
I think it's an outstanding device because I recommend to my patients who are one have fallen or at risk of falls, have difficulty with walking, or patients who have cognitive issues like dementia, to have something that will provide some really safety right and for caregivers to know that they don't have to be right there, and that patients
can live independently and older adults can live independently. You know, falls are really really actually one of the most common problems that older adults encounter.
Is it instability or is tripping or what is it? It's a combination of things.
Our gate changes that we get as we get older. We have more of a stewed posture, we have shorter steps. Plus you add, if somebody has a chronic illness like arthritis or other things that kind of contribute or issues around balance also are a problem, and we see somebody falls every older adult every eleven seconds. There is an older adult who goes to emergency room every twenty minutes
due to a fall. And what we're trying to capture are those falls, right, and so people at risk and then the recovery because sometimes people fall and then nobody knows they've fallen and they're maybe not found for a couple of days and they're dehydrated, they have to be hospitalized. And if we can detect this much earlier with devices like this, how much reassurance that is one for the patient but also for the caregiver.
Well, Dan, you have a big job ahead of you. You have to inform each and every hospital staff about the Silver Tree. We have to get the word out that this device is very efficacious and very useful and very available.
That's right. And I'm thrilled to be here with doctor Fernandez because we were talking before we came on air that there's a lot we can be doing together.
And I think that families have to know this too, and as I said, the caregivers. So there's more and more attention being paid to the aging population. As we mentioned, what else can we do for this aging pup in terms of education, in terms of just helping them.
Yeah, I think one, what are the risk for falls? What do you have around the home that's putting you more at risk?
A loose rug?
Yeah, they're beautiful.
A friend of mine slipped on her rug and she ended up, you know, falling badly and having to have a hip replacement as a result. So you have to really look around and learn at your house, right, Yes, you do.
You have to think about kind of their extension cord stairs lighting when you're getting up and going to the bathroom in the middle of the light, is there a good light, even if it's a little dim that can just light the pathway, So really being alert that.
There are those lights that you plug in that are motion detectors and as you walk by the light, Yes, and we've put those on all our stairs. My daughter, who is not over sixty five years old, she fell down a stair in my house in Maine and broke her ankle. And and the next time I went to that house, guess what, there were lights on all the stairways, these little motion detector lights, which was very useful.
Other things, thinking about if in the bathroom where it's a very slippery environment obviously, so if there are issues around around your balance, making sure you have grab bars, making sure you have non skid rugs, you know in the bathtub, things that you can grab onto if you're feeling a little dizzy, or just to setting you, and then exercise walking. Walking is the best type of prevention in terms of falls. We found that if people just move it, they're less likely to lose it.
I love that. I like that.
Yeah, so getting out there and I think you know, one of the things that we've learned a lot during the pandemic is people became very physically isolated and socially isolated, and this is an opportunity to really take advantage and go out be protected. But you can go out, you can walk, and having an assisted device like this that is going to detect a fall, we'll give you that safety to be able to take that walk down the street in the park. Because we want people to be
more active, to be more socially engaged. It's really really important not just for falls, but also for your memory, your cognition.
Well, the Americans lifespan has increased a lot over the years. Oh what is it now? What is the life expectancy.
Seventy eight point eight years, and it was dramatically you know, in the nineteen hundreds. If somebody was born in nineteen hundreds, your lifespan would be forty seven point seven years. So just think about kind of that dramatic change. And a lot of it.
Had to do.
You know, we learned sanitation was a big issue treating our waters, as well as some great medical advances like having antibiotics, vaccinations, a big development in the nineteen seventies around treating heart disease that used to be the number one killer and now that's a really treatable disease and people live a long time.
What is the number one now.
Well, it's a combination. It's probably more cancer. We did see an uptick obviously around COVID where that was a shift. Dementia as well is within the top five and heart disease is still up there, but it has definitely come down. And the other thing that helped besides treatments was a decrease in smoking. Tobacco cessation really helped also in decreasing heart disease.
That's good, Yes, that's good. And are you recommending people wear devices like this? Oh? Yeah, nice? Silvertree.
Yes, definitely, And it has changed close to the twenty five years that I've been in practice. Originally it was this big, clunky necklace that everybody like, I don't want people to know that I have this. They would be hiding it, or they put it on the bedstand and never wear it.
Right.
I fell in the other room and I'm like, oh, where's your device? Oh it was by the bedstand, but you fell in the bathroom, right, So it's great that there's an evolution that these are more wearable, fashionable, less obvious. Patients are more likely to use them than this big device that has a big button in the.
Middle of it. My dream was before I met Dan, my dream was to have just like a little diamond on a chain around my neck. I like this, just a little diamond that you could press or or it would detect a fall. Now that has not happened yet, We're we're working on good. Dan just looks like a real piece of beautiful jewelry. Wonderful and wouldn't that be nice? Yes, And the same thing with the wrist the wristband. This
is a perfectly benign and lightweight and comfortable device. The silver Tree reach it's called and so easy to wear and so so very valuable in terms of detection. So so good. I'm glad that the hospital is behind these these this idea and and that we will encourage all the outpatients who come to Mount Sinai to the Martha Stewart Center for Living. Especially you see the age of
the life expectancy increasing. Aren't you amazed at how many people like over seventy are working and being productive and not being pushed out of their jobs?
Definitely, And one of my big initiatives is reframing agent, how we think about agents, how we really think about it, more about us, not them, because we all are what are your options?
Either die or live longer? And you're getting all the moment you're born exactly, it's always aging exactly, But what kind of aging is really what we have to focus on exactly?
Seeing that to live a healthier life, to be as much as one can independent, and so these are methods to do that in order to and be socially integrated, I think is really important. Yeah, a lot of older adults are still working, sometimes picking up other jobs out there. A lot of my patients are volunteers, even within giving back to the hospital or practices, which is wonderful to see.
And I think there's wonderful teaching of generations. One of the programs we run is linking my patients to medical students and having them get to know them over time as a person in their context, and they get really jazzed up to interact with each other. They talk every day, they.
Have lunch together.
So that's what we want to see.
Yeah, absolutely, so, Jan your history is buried. Tell us a little bit about your background.
So it's been a little bit. What I always like to cau is non linear. I actually started as a first responder, a firefighter, and that was where I sort of had a first first row seat to this ecosystem of emergency response and escalation and how ancient it is in many ways, and that always stuck with me. And as I've gotten older and I've had a number of different roles and sort of building early stage consumer things,
that concept always stuck with me. And now that I'm in this, you know, what we like to call the sandwich generation, where my parents are getting older and I'm worried about them, and I have my career and I have my family and my kids. I have to find a way to balance that, and technology has always been the place my generation has turned to to help solve
these kind of really intractable problems. Bringing that together with my time as a first responder, it was really clear that there was an opportunity to do something different right a category that's existed since those commercials from the eighties of help I've fallen and I Can't get up hasn't changed.
There was an opportunity to be a product and a brand that people were not ashamed of that tries to kick this old stigma of aging as the arch right where we peak in midlife, and it's all about confidence, and it's all about safety, and it's all about promoting connection between families, between caregivers and their parents, and doing it in a way where we're not asking a person to sacrifice, whether it's dignity or a sense of self in order to feel a little bit more safe.
I remember going to Washington on behalf of the Center for Living to the Council on Aging. It was so primitive, the discussions were primitive. I don't and I have not been for ten years. So what's happening in Washington with the government, What are they doing to help with this problem of the aging population.
Yeah, I think they're looking at innovative clinical models to better meet patient needs. So Dan and I talked about even beforehand kind of link with emergency response services like EMTs and what we're now calling it paramedicine and actually having them go and do visits, not even bring patients right to the emergency room, just go do a visit, connect with the primary care doctor, give information, report back, do a video, and prevent a hospitalization. So this is
really key innovative. We really ramped up during the COVID pandemic to be able to offer this throughout the city and we're seeing more and more models like this, and Medicare is investing in models now.
The fewer people that have to go to the hospital to crowd the wards and the emergency rooms, the better. Yes, and Dan with his Silver Tree company, you have a very very long road ahead of you to make sure that all these places to help are aligned.
Absolutely, we see this as a long journey starting with a place of critical importance, which is physical safety. But as we expand and as we grow, it's not just about connecting family members with their loved ones with emergency services. But it's about creating a community around living well in this stage in life. And if we can do that, and we can be a connector of service providers and clinicians and products, we can be part of this solution
to help push this forward. Because as much as we love to think that the government is going to step in and do the job for us, they will follow innovation. And if we prove that there is a way for us to not just improve life outcomes but reduce cost of care, there's a really strong argument for government involvement to push this forward.
So some people might find it counterintuitive to develop a tech product for older people. Why do you disagree?
Because technology is all around us and when older adults were younger, they were working with technology of their time. So it's not a matter of can older adults work with technology? The answer is obviously yes. It's a matter of can technology companies and creators create and design technology for the right user, And it's about designing with intent. And as much as we love Apple and all the other big tech companies, it's clear where their focus is
and where their focus isn't. And so you know, as doctor Hernandez pointed out, earlier. This is an unbelievable opportunity to design with intent for a demographic that's going to make up twenty percent of the country that still has the highest disposable income and highest purchasing power. So we see it as a great business opportunity as well as the right thing to do.
So why are people reluctant to subscribe to such a service.
Historically it's been about stigma and the thought of I'm at a stage in my life where I need this because I am fill in the blank, let's stable on my feet, I have some chronic health condition. It's a really sort of personal taxing feeling, and a lot of that has to do with the way these other companies before us have marketed and positioned their products as medical products, where they're not quite right. They sort of blend that line between it's a medical product and it's a consumer device.
And so for us to be able to say, hold on a second, it is not about positioning aging as pathology. It's about being a product that solves a real problem really no matter the age. You know, we don't really talk about this as being a product for older adults. We know that that is a very applicable use case. But the feelings of confidence and peace of mind really extend to across generations.
True, And I think that your marketing has to make that so clear. Because if you're a runner and you run by yourself early morning, what if you do fall in a hole, yeah, you know, and you need help, you might as well have this bracelet on, right.
That's right, that's right. And again the whole intent is about simplicity and meeting people where they are.
That poor guy who they just found on a bear cam in Alaska, there is a hiker hiking in the mountains, remote area of Alaska. He found a bear cam, which is a camera you know, that studies the actions of and movements of bears. He looked in there and even begged for help. Somebody saw it, because I mean a lot of people have these on their and their iPads or on their computers. They're looking at the bears and they see this poor man begging for help. They found it with a few hours.
That's great.
They saved him. He was starving and dehydrated and and he'd been wandering around out there for a few days.
Not good.
No, But but if he had had the device.
Yeah, if he if he had had silver tree, we would have found him right.
Away, hopefully not the bear's right, that's right.
He's lucky that there wasn't a bear waiting.
For him with the camera exactly. So are you finding Doctor Fernanda's patients still being reluctant to get this kind of help?
They are because a bit about what Dan's saying in terms of stigma. Stigma, what does it mean? Does it mean that I can't live independently? Does it mean I can't be where I am right now and it's been my home for thirty forty years?
It means that they can exactly, And so it was reframing the reverse of what they're thinking.
Exactly. Yeah, So I think they're two things. One it's reframing how it can help them live independently, and two that they're better designs out there that it isn't like this plunky button that you that you have to wear and hide.
Now, what if you fall and your wrist is underneath you or something, what do you do?
Well, that's where the automatic fall detection kicks in. Okay, So it is capable of detecting a fall with no movement after and then the cavalry will come. The cavalry will come.
How are you getting more users for the silver Tree?
Well, it starts with awareness, right, People need to know that we exist. People need to know that this product is out there and available. And then it's about really conditioning people, as doctor Fernandez are saying, it's really about understanding the value and not what you're at being asked to give up. So it's talking about the features, talking
about what it enables you to do. And so today we're focused on a direct to consumer model because one of the ways we found that the best way to fight stigma is to position this in a channel in an market that people are already associating with. Oh, it's a consumer product. It is how I buy eighty five percent of my electronics. And so by starting there and building a community and building a following, we can expand. And then it's about finding the right partners like Mount
Sinai AARP. It's about finding the places where our audience is captive and listening and telling them the story of why this product is so good for.
Them and what does AARP say about this?
They love it. I mean look, ARP is the type of organization that, because of where they sit and the trust that they hold amongst the community. They can't single out specific products in a category that is competitive for
natural reasons. But we're working with them on a campaign right now that's going to launch later this year where it is about telling the story of living well and really trying to kick that old paradigm and really help people see and feel themselves in this stage of life that is all about potential, not about pathology.
And helen what other new products are helping people live longer and better, more productive lives well.
Other innovative clinical models. We are embedding ourselves in other practices in neurology and surgery so that people have the best outcomes because many times, I mean, surgeons are great at what they do, but they're not thinking so much about the holistic approach what an older adult would need. And so we're there to really do a comprehensive geriatric assessment so that our patients, our older adults, really get the best outcome with any kind of procedures, with any
kind of treatment. So more and more of these models, we're placing ourselves in other places besides being at Martha Stewart. We're lucky at Martha Stewart really lucky. We have a tea, we have a social worker, nurses, nurse pectition, and we know that this is a team sport that isn't just the provider. That caregivers need resources. So that's the other piece, is helping to support the caregivers and giving them resources to be able to care for their loved ones at home.
And what innovations do you still want to see being used?
Well, I want to see obviously an expansion of training. We train at Mount sign A twenty percent of the workforce of new geriatricians for the whole country, and under my leadership, that's grown. It was ten percent, it's grown over twenty four years to twenty percent. What I'm now looking at are developing healthcare leaders in geriatrics that will change the health system, not just the individual patient, but how can we make the hospital, clinics, everywhere you go
more age friendly. And so I think that's what's really the antidote, and the other is reframing what people think about older adults and really see them as people that are part of our society that give us a lot of wisdom.
When did that stop? I mean when when did it stop? When they the older adults and many many cultures are revered. Yes, and then all of a sudden in America as a you know, it was it was they're just they're just older throwaways. Yeah, it is really horrible.
And you know, I've been working with ARP. It's part of eight organizations to think about how are people featured in films? How are people featured in commercials?
Right?
The living? Well?
Right, well, you see some silly movies, but but there they are making a point like eighty for Brady. Yeah, you've.
Grace and Frankie, great series. So we there is impact the movie industry is.
And it makes a difference. And I post in my bathing suit on the Illustrated and that made that made a huge impression worldwide. I mean, we got one hundred and eight billion impressions from that cover. Now a friend of mine who's in her seventies got on the front page of Wall Street Journal as the most successful private
banker in America. Amazing because and she's in her seventies, and they have more of this has to happen because she's a valuable human being and it has helped many, many, many people in her job, as so many other doctors and lawyers and professionals help people well into their seventies, eighties, and even nineties. So I'm not going to be a crusader exactly, but I am certainly a huge supporter of making sure that aging successfully is the best revenge.
Yeah, I love that.
That's a way to phrase it.
What else can you say? It's just really important and you can make a very lasting impression on younger people that it really does make a difference. That age is just a number. And so I'm so happy that both of you are working towards making aging successful, making aging just a good part of living a good, long life. I hope you can continue for a long time with your work, and I really want Silver Tree to be
seen on pretty much everybody's wrists. It will is a very big goal, and it will be really helpful to our country. Look what's happening with social security. I mean, we don't have any guarantees that all these governmental in yeah and will will help us. So we have to do it ourselves, and we have to work at that.
Let's make a big effort. But thank you so much for your time, both of you, and we're going to continue hopefully talking about successful aging and interview people who are above the U sixty five, who have who are still contributing tremendously to our country, and good luck to both of you. Thank thank you, thank you for having us