Tag Archives: geriatrics

Gamification in Healthcare – Let’s Play!

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Bernadette Keefe MD

 “Playing a game is the voluntary effort to overcome unnecessary obstacles.” (Bernard Suits)

Introduction

Game-play focuses and controls our attention, taps into our innate strengths, thrills us utterly, and compels us to greater resilience in the attainment of more powerful and effective skills. For these reasons, some believe that game-play is an invaluable tool to employ in tackling the biggest problems in our world today.

The ability of gaming to focus human attention so completely has attracted all those who wish to harness just a piece of that attention for their own ends. Business, education, and healthcare have all used gamification with the hopes of affecting certain desired behaviors. The goals of gamification in healthcare would be no less than to effect personal and societal behavior change, to achieve improved individual health, and the health of populations.

A flurry of aspirational papers and some early results propelled gamification in healthcare to a Gartner’s Hype Cycle * peak ‘hype’ in 2011-2013. Years 2014-2015 found gamification in healthcare in a period of disillusionment. Now the sentiment for gaming seems to be on the upswing, as more attention is being paid to high quality game design and targeted use.

 In this paper, I will give some history and context to game play, video game design, and the gameful mindset to show how gamification in health and healthcare can and does happen successfully when done well. I will also include demonstrative examples and a large number of references for further perusal.

What is A Game

Games are a structured “form of play or sport, especially a competitive one played according to rules and decided by skill, strength, or luck.” –wikipedia

The history of gaming goes back to ancient times and game-play is one of the oldest forms of social interaction. In essence, the games we play are a celebration of our potential, our dreams, and our innermost passions. Game-play is self-revelatory, and, at the same time, takes us ‘out of ourselves’.

The vast variety of game forms, both ancient and modern, speaks to the centrality of games, and game-play in human life. We play games seated, across from each other, standing, poised ‘in combat’ at the 50 yard line in stadiums, and across the world, in online video games. We stand, jump, kick, run for both online and offline physical games. ‘Exergaming’, the combination of video gaming and exercise, has taken individual and group exercise to a new level. The brilliant ancient Chinese game of ‘Go’, a territorial board game of strategy, is played with as much passion today, as it was several centuries ago!

Game-Collage

Collage of Non-Sport Gaming

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Sugar High Halloween

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Candy Corn

Candy Corn

Bernadette Keefe MD

It’s Halloween… but:

‘We need to start talking about how our food supply is making many of us sick.”

 “Sugar high” is the term used to describe the cascade of responses after eating a sugar load. A high sugar load, especially a pure sugar load, triggers is a rapid release of insulin to counteract the high blood sugar. With that response, glucose is absorbed into cells and the blood sugar plummets. We feel hunger with the low blood sugar and if we consume a sugary snack or meal, the cycle restarts. The taste of sugar is also ‘addictive’ over time. At this time we have a cultural sugar high, a palate tuned to the taste of sugar, across our nation and indeed the world. It has led to unprecedented levels of Type 2 diabetes and obesity. Continue reading →

Aging: It’s A Good Thing!

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 Honoring Active Aging Week 2015, September 27th– October 3rd.

From Active Aging Week website,

“This year’s Theme: Live Your Adventure!  Led by the International Council on Active Aging, Active Aging Week celebrates aging and active living. Each year event organizers engage participants in wellness activities in a safe, friendly and fun atmosphere.”

             my-adventure-book

 

Each day of active aging week has a corresponding theme, thus the “adventure book” has 7 Chapters, each devoted to a specific aspect of wellness in aging. Chapter details follow:

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Boomers, Got Fit (bit)?

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Boomers – Got Fit (bit)?

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Bernadette Keefe MD

“You can’t manage what you don’t measure.”                              

 (credited to by not said by W. Edwards Deming)

 Introduction

If you are 50 years of age or older you are a baby boomer, that means by 2030, there will be 77 Million people over the age of 65 in the U.S. alone. The U.S. National Institute of Aging has designated September as a Go-4-Life month: a national exercise and physical activity campaign for people 50+. The goal is to empower older adults to become more physically active. The last week in September marks the beginning of Active Aging Week (September 27 – October 3) for the United States, Canada and Australia. Each day is devoted to a specific healthy life habit: from walking to nutrition to social connection.

The importance of our lifestyle/behaviors, to overall health is now undeniable. It is thought that 70% of chronic disease is caused directly or indirectly by the poor lifestyle choices we make. Now we can seamlessly measure our daily behaviors through fitness trackers. Continue reading →

Falls Prevention Day 2015: Will the real ______________, please stand up!

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              National Falls Prevention Awareness Day ~ September 23, 2015

                                        “Take a Stand to Prevent Falls” 
fallPrevention

 Bernadette Keefe MD

 “One of every three older adults falls each year, but less than half talk to their healthcare providers about it.” – Lawrence Z. Rubenstein MD, MPH Chair Geriatrics – U. of Oklahoma Health Sciences Center

 Introduction

Tomorrow, September 23, 2015, the U.S. will celebrate the 8th Annual Falls Prevention Awareness Day. The announcement on the National Council for Aging (NCOA) Falls Prevention Day website reads:

“The 8th annual Falls Prevention Awareness Day (FPAD) will be observed on September 23, 2015 – the first day of fall. The event seeks to raise awareness about how to prevent fall – related injuries among older adults. The 2015 theme is Take A Stand to Prevent Falls and the official twitter hashtag for this year’s event is #FPAD15 Continue reading →

losing our marbles – the dementia epidemic

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The marble saga continues! This shot was taken in our back yard. I must say the marble is a remarkably patient model...

I think my favorite part of this one is how the lines from the tall grass in the background seem to echo the swirls inside the marble.

By Bernadette Keefe MD

All of us have personally known or heard the familiar drill. Dad couldnʼt find his way home. Mom didnʼt recognize her best friend. More and more memory lapses are occurring. Thereʼs a kitchen mishap. Finally the trip to family doc with the dreaded questions: Is It Alzheimerʼs? Is It Dementia?

The answer is yes, and they have a lot of company.

4.5 Million in the US are currently living with Dementia. The estimated prevalence of dementia among persons older than 70 years in US was nearly 15% in 2010. It is estimated that by 2050 there will be 13 Million people in the US living with dementia. There was hope that the incidence might be tapering off and even declining (from data comparing 1993 to 2002), however with the recent sharp increases in prevalence of diabetes and obesity over the past decade, it is feared that the numbers may rise precipitously.

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The 100 Year Lifespan.

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The quality, not the longevity, of one’s life is what is important.

– Martin Luther King Jr.

100 Year Lifespan: The coming reality

The 100 Year lifespan is coming. As of 2014 there were 72,000 centenarians (U.S.) and projections of as many as 1 million by 2050. In the industrialized world, people over 90 years of age are the fastest growing segment of the population. By the end of this century the average life expectancy is expected to be 100 years. Notably, Japan’s centenarians, who number about 30,000, have quadrupled in the last 10 years.

Now there are 43 Million Americans over age 65 years age. By 2050 that number is expected to rise to 108 million. The number of those over 85 years could increase five-fold by that time.

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Falls in the older adult – Just not sexy enough?

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Two weeks ago, a $1 Million prize was announced in San Francisco Bay area: The Palo Alto Longevity Prize. Palo Alto Investors and guru Yoon Jun will award the money in batches to those researchers able to restore to youthful parameters certain physical functions in elderly animals. The group ultimately hopes to unlock the key to immortality.

Wow! After that first wow, all I could think about was why there are no prizes for:

  • Figuring Out How to Age Comfortably, Gracefully and with As Much Quality of Life as Possible;
  • Emphasizing the Improvement Over Quality, Not Quantity, of Life; or
  • Tackling the Awful Problem of Falls in Our Elderly.

The Elderly Falling….hmmmm….that just doesn’t quite have quite the “sizzle” of immortality, does it? Nonetheless,It Is A Big Deal! Continue reading →

slow medicine – not can we afford it, but how can we not?

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The_Doctor_Luke_FildesBernadette Keefe MD

The Unease

Over the past few decades there has been an increasing disquiet among doctors and patients. Prior to the late 1970s (pre CT/MRI era) other than basic blood work and plain xrays, there was little in the way of testing for disease. However physicians were well equipped with a robust heritage of  patient bedside history-taking and examination skills. Adept physicians in elucidating a pertinent historical record and performing patient examinations were brilliant diagnosticians. Lavishly written patient narratives and exquisite physical examinations filled voluminous charts.

The late 1970s ushered in organized medicine, HMOs, regulations and abundant technological and medical advances. This potent combination resulted in a tremendous escalation in the volume and pace of healthcare. Physicians, once loved for their bedside manner and comfort (1950’s-1960’s) found, from 1980s-present that they were so rushed and burnt out they had little empathy to spare. Patients picked up on this and, coupled with little time to ask questions and (now) electronic medical records consuming their doctor’s attention, stopped feeling cared for. They stifled their questions and stopped buying into the therapies being proposed for them. (Note: Perceived lack of empathy has been shown to adversely affect clinical outcomes.)

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