“Do You Know What We Call Technology that Older Adults Either Don’t Understand, Can’t Use, or Don’t Want to Use? Bad Technology!”
Joseph Coughlin: The Resonance Test 55
Dustin Boutet, our Travel and Hospitality Vertical Lead, thinks about seniors and their driving habits. A lot. Joseph Coughlin, Director of the MIT AgeLab and author of The Longevity Economy, happens to share his obsession… and he’s been pondering it since before Boutet had a driver’s license.
Which is we had the pair take The Resonance Test out for a spin together.
Coughlin clears up some common misconceptions with his to-the-point pronouncements. On the topic of age and driver safety, he says, “Birthdays do not predict anything. In fact, birthdays do not kill; health conditions do,” adding sensibly: “I think that we really need to think about driving performance and wellbeing across the lifespan.”
He talks about how today’s cars designed for a “pilot,” and a specific one at that: “about 5’10”, 27-year-old male, both in terms of the structure of the vehicle as well as the toys and the technologies behind the dash.”
Together the pair circle around Silverkey , the EPAM Continuum concept project that aims to keep older drivers on the road safer and longer, the AgeLab’s work on BMW’s iDrive, and those tricky conversations (Coughlin calls them “exceedingly conflictual, emotional conversations”) families must sometimes have around senior driving.
Things get philosophical, fast. “Driving is far more than getting from point A to B,” Coughlin tells Boutet. “That would be a nice, easy urban planning problem to solve. In fact, it’s about independence and security.“
Hop in, and get an earful about what it means to age in the driver's seat.
Host: Kyle Wing
Engineer: Kyp Pilalas
Producer: Ken Gordon
Edited Transcript
Dustin Boutet
Can you can you talk a little bit about the work you're doing over the AgeLab and give us a bit of background for anybody that's unfamiliar with your work with MIT?
Joe Coughlin
Sure, my team at the MIT AgeLab, we are based in the School of Engineering but we have a very multidisciplinary group because if you think about it, aging—and by the way, we go across the generations, so this is not just about anyone who you think is older than you, therefore they are older—[requires that] we go across the generations because you have to compare what's different between one group to another to not only have good science, but also to delve [for] good insights. And so the team is about one-third every flavor of psychology you could imagine; one-third engineering and data science, largely doing a lot of our transportation work; and then another third are the folks that kind of provide the glue: The social workers, the gerontologists political scientists, economics, if you will. Aging is a multidisciplinary sport and living well, living longer, and living better requires that kind of thinking. And so the lab uses that team. We are funded entirely by industry, to explore the future of transportation and community caregiving, home services, and even longevity planning, which, if we have it our way, we will change the notion of retirement planning to longevity planning. But as Jimmy Buffett would say: That's my story, and I'm sticking to it.
“Driving is far more than getting from point A to B. That would be a nice, easy urban planning problem to solve. In fact, it’s about independence and security.“
Dustin Boutet
It's awesome to hear you say that aging is more than just our senior population because, as we were thinking about this work in this space, we found that if you're designing solutions that work really well for seniors, they're going to work really well for the rest of the population. [Being] focused [on] safe driving, we're thinking about seniors, but we found that there's this really interesting inverse bell curve in the dangers of driving. So you've got your really young drivers—15, 16, 17—[who] are the riskiest drivers. And then that risk goes down until you're about, what, 55 or 60. And then it starts kind of ramping right back up. And we were really focused on drivers 65 and above, because… I think the stat was [that] by 2025 they're going to be representing one in four drivers, which is pretty amazing, if you ask me.
Joe Coughlin
If you look at the infamous U-curve that’s used in transportation safety, [it] shows what you were just talking about: that [people] between [the ages of] 16 and 24, they are the most lethal drivers. Hence that's why they typically pay more insurance. And they're lethal because I think it's proof, generally speaking, that testosterone—because it's mostly the young guys—and gasoline do not mix with alcohol very well. And so you see a lot of a fatality at that end of the curve related to pure behavior. There's a lot of debate as to why we see death and injury, shall we say, at the other end. There are some who believe that birthdays predict, and I'm happy to tell you and anyone who's listening, that birthdays do not predict anything. In fact, birthdays do not kill; health conditions do. And so what I would suggest is that as you look at the fatality rate at the other end of the curve, [what] you're looking at is that the same injury that someone 40-, 50-years-old may have gotten that may have led to, shall we say, a broken rib or leads to [in an older person] a deadly pneumonia, or a punctured lung, or something like that. Or the very safety system designed to keep that smaller, older woman safe, actually may have killed her. And so there's still some debate in that, but I'm on the side of that it's less about the-driver-per-se than it is [about] the context that we have put [the driver] in.
Dustin Boutet
That leads us really nicely into the next area I'd love to talk about, [which] is how we're designing these systems and [technologies] for senior drivers. And how do you think we're doing as designers of these systems for our older counterparts?
Joe Coughlin
Well, I'd also like to kind of, shall we say, parse the vehicle when we talk about design as well. Because in the last 10, 20 years, we can’t ignore the electronics, the computerization of the vehicle, as most of us now know that essentially our four rubber wheels are essentially holding up a computer that is mobile. So we should talk about the design and interface with the technology. We should talk about the design of ingress and egress of the vehicle. And then ultimately, of course, [we should talk about] the safety elements. So I would divide the design question into three. But before we go there, Dustin, one of the things I would also suggest people think about is the changing nature of why people drive. Where they're going to go. The types of trips. And it's only then that you can start to think about: “What's the nature of the vehicle going to be?” It's not about making today's vehicle safer. It's about, frankly, an entirely new lifestyle that's being born out of a new group of older drivers. This group of drivers has been driving even longer than previous generations. They're more educated. They're more tech-savvy. And, by the way, 70% of the 50-plus population in the United States live in suburban and rural areas. That car is not just about transportation. It is fundamentally a lifeline, providing them with mobility to the things they need, as well as the things they want, because transit either serves poorly, or does not exist, where they live.
Dustin Boutet
That's such an interesting topic. I'd love to put a pin in that for later in the conversation, just around slowing the cognitive decline through connection to your community. And it's exactly what you're saying, with seniors being increasingly inhabiting suburban and rural communities, I think [the] car is such an important lifeline. But back to your really nice division of how we think about the vehicle. [I’m] thinking about how we've evolved from a really simple interface in the car to something that's so much more advanced. It's a computer on wheels.
How do we balance the complexity and learning curves of this new technology with the actual benefits it's providing seniors?
“Birthdays do not predict anything. In fact, birthdays do not kill; health conditions do.”
Joe Coughlin
Unfortunately, that is still very much a work-in-progress. Decades ago, the car was a product of designers [working] with largely mechanical engineers, and even a few civil engineers thrown in there for color. Today, if you will, the vehicle is more a reflection of what aerospace engineers have put into the pilot’s cockpit. The challenge is, is that the pilot is trained and checked out, both health-wise and usability-wise, on a regular basis. What we have done now, to your point, is that we've added an incredible complexity, all with very good intent in terms of convenience and safety and comfort and the like. But here's the challenge. We have not taken on the [issue] that pilots have to deal with, which is data fusion. How do I take in all those different inputs—from things that beep and bop and seats that vibrate to lights on the dashboard, not to mention the countless smaller buttons and smaller dials that require a greater target time for people of any age, let alone older age wearing bifocals, to identify the sound, respond to what the alarm is—and then to reach where [I] need to go? So I would say that it's a work-in-progress. We are still designing for a pilot. And for those who are doing better, generally speaking, they're still designing for about a five’10”, 27-year-old male, both in terms of the structure of the vehicle, as well as the toys and technologies behind the dash.
Dustin Boutet
And I love that you use the pilot analogy because I often refer to the newer vehicles as the cockpits to spaceships. And there are so many controls. It seems like they've elevated everything to have a control at the top level of the hierarchy. And I'm interested to hear your perspective, as we move toward larger touchscreens and more contextual interfaces: (1) Do you think we're currently doing a good job of that?; and (2) What do you think the future holds for removing some of that burden and distraction from the interface?
Joe Coughlin
Well, we saw a little bit of a live experiment in that back in 2005. In fact, my lab was working with BMW, who's an incredible innovation shop. They’re a lot of fun to work with. And if you remember, in 2005, they introduced the iDrive, that little central controller to essentially navigate a central screen that did everything from your tire pressure to your radio, to your nav system, and the like. And the idea was to clean up all that real estate, as we like to call it, on the dashboard. To eliminate some of the buttons, the dials, and the like. And that was a brilliant move, because it did effectively simplify the real estate. But it also really required the driver to learn an entirely new menu structure. So when they first deployed that or commercialized it in the United States, they saw great challenges because at that point, the average BMW driver was clicking over age 50. And they were having to really learn how to drive. The challenge to real innovation, real design, is to leave enough breadcrumbs as to where the designer wants you to go, without being so far out front to show your intelligence that you leave your consumer behind. So I'll just give you a little example of the designer’s dilemma, which is they could not—they, BMW, working with us—could not figure out why the system was not taking off as well as it should. In fact, a lot of the complaints they were getting [were] about switching radio stations and the like. And a lot of us don't have that problem now, because we don't necessarily use AM radio for traffic. What was going on was that they could not understand why there was such frustration with drivers who wanted to go between FM and AM radio. Because in an old-fashioned radio, you could hit one button to get immediately to the AM station to give you traffic reports and one button back to listen to music or some other programming. Whereas the design to simplify actually added complexity. It required me to learn a new menu. It took two, three, four, five clicks to get what I used to do with one thumb or one index finger push. You know, politics and design have a lot in common: People will never be upset with you for not giving them something they've never had. But boy, they will hold you hostage for taking away something that they've always enjoyed. And so what we've seen is that technology evolved over time. BMW and others have been using that central controller idea and simplified the dash. We found that, for instance, adding a little mental model such as an escape key at the 11 o'clock position that brings you to the top of the menu structure, made it far easier to understand. Because older people in particular, were saying: “Gee, what is this thing in my hand that I'm manipulating [and] appears to be a cursor on a screen?” Well, they went back to their mental model [and said]: “It's a mouse. But wait a minute, I can’t easily get to the top of the menu and I can't move this side to side. It's a very bad mouse.” What designers have to do is to break that mental model but leave just enough so that I can learn how to use it. Because very few of us want to have the second-largest purchase we make—our car—be, shall we say, a devil's deal with trying to learn it. We should enjoy it.
Dustin Boutet
And [in] some of these interactions, there [is required] a little bit of a learning curve to understand how to interact. What that human-machine interface is going to be. A lot of the manufacturers are moving towards direct-input-method touchscreens. And we're seeing this trend of larger and larger touchscreens in a car. At what point do we see diminishing returns, or have we already started to see them? And what's your opinion on the need for controls that allow us to have muscle memory especially with the driving experience?
“That car is not just about transportation, it is fundamentally a lifeline providing them with mobility to the things they need, as well the things they want, because transit either serves poorly or does not exist where they live.”
Joe Coughlin
Especially as the technology now is moving at a half life or speed of consumer electronics. It used to be if you bought a car, you kept it seven, eight years. And generally speaking, the next car, you had had a better color, perhaps a better smell. But you kind of knew where everything was. We are now seeing technology moving so fast that even every time you rent a car, get into a new vehicle, [you’re] relearning all the time. I would suggest that probably what we're going to have to start seeing is not just larger screens so that I can see them or haptic interfaces that are easier to manipulate, but a higher priority put on personalization. So as part of that purchasing experience—some dealers already do this, but they don't do it enough, as far as I'm concerned—is to understand how you drive. What you prioritize. What do you want to see in that field of view, your first-level field of view or the primary area real estate versus a secondary versus the center stack. Over time, I bet what we'll be able to do is to put some machine learning in the car that will understand “Joe seems to ignore two-thirds electronics in the vehicle. But he really prioritizes these, so let's put this at the top, if you will, that screen structure.” And so in many ways, they will start to replicate what a lot of us have on our cell phones, 50-odd apps, and then five that we actually use.
Dustin Boutet
That's great. And the personalization aspect… we're getting into some sticky territory, in my opinion. We're trading a little bit of that access to our driving and behavior, allowing that monitoring. So what's the fine line that we're walking in the balance of privacy and convenience here?
Joe Coughlin
Privacy… goes across my entire lab and my team [is] looking at [privacy of all sorts], whether it's privacy in your homes, the medication you're taking, how much a refrigerator knows [about your eating baits and if] you've been sneaking more than your fair share of Ben and Jerry's, [or] whatever it might be. What we find, however, is privacy is the new currency. So while most of us will say that our privacy as a priority—“I don't want to share”—it's amazing how much of your privacy you'll give up for a tangible good. I like to say my American Express knows more about me than my wife of 30-plus years. And so one of the things we may see in the vehicle, as we are seeing in the home, as we see with our financial transactions, is I am allowing a vendor, a platform, whomever it might be, [access to] information about me as long as I am getting a tangible benefit. Which could be ease of use, could be customized information, the idea of more comfort, if you will, in the vehicle, because it knows my positioning, my health condition, what I like to do, and how I behave. So I would say yes, privacy is going to continue to be an issue. But it's amazing how many of us are willing to negotiate if we see something at the other end.
Dustin Boutet
Speaking of negotiating that privacy… something that we were thinking about, as we really investigated senior driving and the connection to the community and family, was this idea of looping in [one’s] family members into the conversation of potentially declining ability to drive. And sharing some of the driving behaviors and participating a little bit in some level of monitoring. Any thoughts or insights there?
Joe Coughlin
Well, you know, we're approaching Thanksgiving season. And unfortunately, Thanksgiving is when we seem to identify more drivers [who] might be candidates for giving up the keys because unfortunately, what we have is typically adult children who've not seen their parents for a while sitting down at the Thanksgiving table, and they see a couple scratches on the car, or they saw dad or mom pull into the driveway in a way they didn't particularly like, and the conversation kind of goes like this: “Pass the peas, and hand over the keys.” And the fact of the matter is that driving is far more than getting from point A to B; that would be a nice, easy urban planning problem to solve. In fact, it's about independence and security and freedom. And so as a result, that privacy to have someone watching me is something that turns into often an exceedingly conflictual, emotional conversation. However, we at the AgeLab, particularly my colleague, Dr. Lisa D'Ambrosio, and others, have done a lot of work on how to have that conversation. So even if you did have the data—which I'm not entirely sure people would prefer—but even if you had the data, the question then becomes: Have you done the homework to start planning the alternatives? Have you thought about the power of the conversation? It's not one fender bender that should predict; it should be a change in health conditions. It should be confusion behind the wheel. Getting lost. These are indications that it's no longer safe to drive. Hitting the mailbox or hitting a shopping cart? How many of us would like to admit to that? Last thing is, and perhaps this is where you might be thinking of going in terms of data collection: The person we will most trust, to give us advice on how well or how poorly we are driving, is the person that rides with us. So just because Dad hit a birthday, or Mom doesn't look that great, the fact of the matter is, they are more likely to listen to you, and believe it or not actually relinquish the keys without much of a fight, if you have driven with them considerably. And you can identify clear areas where there's a challenge to their driving ability.
People will never be upset with you for not giving them something they’ve never had. But, boy, they will hold you hostage for taking away something that they’ve always enjoyed.”
Dustin Boutet
Do you think that technology offers us the ability to collect objective data and have a conversation based in fact, and not emotion, and use some of those things that you were talking about—confusion behind the wheel, potentially reaction time, looking at trends more longitudinally—to have more effective conversations with our family? Because [often] they are wrought with emotion and stress when [they do] happen, and usually [the conversation is] happening later than it should.
Joe Coughlin
I do think that that that data would certainly help either start the conversation or provide, shall we say, in many ways, evidence. I do not believe that we will ever take out the emotion or the intensity, unless you've got a seamless, safe, easy, socially acceptable alternative. I mean, the number-one alternative to driving yourself is riding with somebody else who does drive, then walking, and if transit’s available, maybe transit after that. So the emotion will always be there, because this is not about going to the grocery store. It is not about going to the doctor's. As I like to say, the number-one metric of whether you've got true transportation alternatives is: It's a hot summer night, and you want a soft-serve ice cream cone. No one books that ahead of time. No one buys a cab fare. Few people get on the T. And most of us don't want to bother our oldest adult daughter, who's the caregiver, to do that. And so taking away that seamless ability to go where you want, when you want, is something that’s always going to be an emotional, charged discussion.
“The number-one metric of whether you’ve got true transportation alternatives is: It’s a hot summer night, and you want a soft-serve ice cream cone."
Dustin Boutet
And thinking about that transition, I wonder how we can engage senior drivers in some of that driving and coach them to improve their ability or slow the decline, instead of replacing it. Because I think what we're hearing is: There's this silver bullet coming, and autonomous driving is going to solve all our issues. But I personally don't think that that's the solution. I think [about] engaging drivers as opposed to replacing them. There's a middle ground there, to use technology to augment their ability as opposed to replace it.
Joe Coughlin
It was always the philosophy [in] the AgeLab. I started the AgeLab based upon the notion that technology is an assistive technology to everyone at every age. So it's: "How do we better engage, train, keep awareness?" And [also] to compensate for whatever that driver’s failings, or even their strengths, might be behind the wheel. So I definitely agree with you on that. But it's gotta be a systems approach. It's gotta be about managing our health, our nutrition, the medications we take. This is not just a relationship between the driver and the vehicle and the infrastructure, the classic transportation matrix. Rather, this is really about how well [individuals] can maintain themselves in optimal performance. Polypharmacy at any age jeopardizes your ability [to operate] any technology or any vehicle system… well. Being well nourished at any age is also a problem. So it's about that cognitive performance. It's about caring for ourselves. But also to your point about having technology in the car that might be able to monitor those changes: I would submit that the technology is available today, and that many of us in our 20s and 30s and beyond would be kind of shocked at how stress affects our driving capability. Not any phone call or cell phone call, but the one from your boss that says, “We need to talk,”—and in the words of Jerry Seinfeld, “No one needs to talk”—and what that does to your stress driving down the road. So no, I think that we really need to think about driving performance and wellbeing across the lifespan.
“When we think about transportation innovation, yes, the vehicle is a major part of it, the infrastructure, the individual, but we have to think about the context, the nature of trips, and the changing nature of the user.”
Dustin Boutet
I think the stress point is such a good one. Anyone has ever driven in the rain or hard snow… that instinctual reflex to turn down the radio so you can concentrate and kind of reduce that additional input is one that everyone has done.
Joe Coughlin
I've got colleagues in the lab, Bryan Reimer and Bruce Mehler, who have worked on the issues of stress and distraction their entire careers, and they will tell you that that cortisol rush that you get when somebody cuts you off, or a poor phone call, or something else that's on your mind, can be as lethal as [being] somebody that quote unquote, is “too old to drive” and [that it’s wrong to] think it's all about their age, rather than their actual health.
Dustin Boutet
Coming back to that point that you made about “What is the transition plan away from driving?” and having that plan in place long ahead of time. It makes me think about community connection and building an ecosystem that's a senior can drive in, also connect to and maybe assist others before their cognitive decline has started. Have you guys done any thinking about the ecosystem of driving and how [the people within it can] connect to their communities?
Joe Coughlin
Absolutely. And this has been an area of research for decades, not just with us but in the field in general. So there are volunteer-driver networks, probably the best-known and most successful is the Independent Transportation Network started by a good friend, Kathy Freund, in Portland, Maine. And that's gone global, let alone national. So a network of volunteers of other people like me or like you, so to speak, giving rides. Our communities provide van service. Our transit systems provide assistive transportation. The problem is that most of those alternatives, however, do create what I call “mobility triage.” They will get you to the doctor, the grocery store, and things you need. Transportation is about being the glue that holds together all those big and little things you call life together. So it's the trips you want, that are the most important, not necessarily the trips you need. And by the way, just one quick thing you mentioned, Dustin. And what we're having here is a failure to think in terms of systems integration. The driverless car. My colleagues in the lab are doing considerable work on adoption of these technologies as we move down the road, mixed-metaphor intended, to the autonomous vehicle. But the challenge is the following—If you're not well enough to drive due the physical wellbeing or cognitive performance, who puts you in the car? How do you get from the couch into the driverless vehicle? Who do you trust to have in that vehicle by themselves? And by the way, who gets Mom out of the car at the other end, to get to the final destination? So when we think about transportation innovation, yes, the vehicle’s a major part of it, the infrastructure, the individual, but we have to think about the context, the nature of trips, and the changing nature of the user.
Dustin Boutet
And it seems like we have some fragmented players in that that area. Whose job is it really to think about that outside of the vehicle? I think we have manufacturers clearly thinking about the experience inside the vehicle. But you know, that last 50 feet or that last mile? Who should we be leaning on, or leaning into, for that type of work?
Joe Coughlin
You know, it's interesting, to my knowledge, I do not know of any major institution thinking about that. We certainly have city governments and others that are promoting initiatives such as age-friendly communities, livable communities, talking about generally the infrastructure, the sidewalks, the connectivity, if you will. As you mentioned, the auto industry is certainly interested in everything that's within the greenhouse of the vehicle itself, but right now, the people that are doing the integrating of how Mom gets in and out of the car, tends to be their caregivers. And so that's leaving a very big job for people [who] are already, shall we say, underwater with [the] emotional, physical, and financial stress of providing care.
Dustin Boutet
And being on the cutting edge, Joe, I'm wondering, with only a couple of minutes left, what are the most exciting things that you see right now, or that you're working on, that you think offer the most benefit or promise for some of our senior drivers?
“COVID has demonstrated that, with enough need, with a value proposition, and a simplistic design, [seniors] will jump that digital divide as fast, if not faster, than many younger people."
Joe Coughlin
One of the things that we're seeing is that, for instance, my friends and colleagues at AARP have fully integrated technology into their driver safety program. So to the point you raised earlier: It's about, “How do we keep drivers not just driving safely? But how do we improve their performance or keep them, shall we say, fit in terms of driving?” I do think the industry has done a far better job [recently] than they have in the past, [in] making a car that is not an old man's car, because we know from the industry and from almost every other product category, that if I make an old man's car, or an older woman's car, that a young man won't buy it and neither will a younger woman, but more importantly, an old man and old lady will run from it with their hair on fire, if you will. So I think they're finding ways of designing an ageless vehicle that is safe for all, that is easy for all, that's personalized with performance. That's about the driver not just about their age or frankly, for that matter, of the gender. And then finally, I think many communities, not nearly enough, are moving past age friendly, which to me seems just a little too polite. They're moving towards being age-ready? What are the transportation alternatives we can provide people [who] have paid their taxes, lived their life, and deserve to remain seamless, safe, and mobile for a lifetime?
Dustin Boutet
Well, that is fantastic, Joe. Really appreciate you taking the time. One last question, and then then we'll let you hop off. We've talked a lot about designing technologies for seniors. What I'd like to ask you before we leave is: How do you think seniors are adapting to technologies?
Joe Coughlin
Well, I think older adults are adapting far greater than we ever thought possible. We had this mythology that older people don't like technology. In fact, with all deference to my friends [who] are engineers and designers: Do you know what we call technology that older adults either don't understand, can't use, or don't want to use? Bad technology! It is the only domain where we blame the consumer, the user, for the failings of the design community and the engineering community to make [the tech] ready to use. COVID has demonstrated that, by the way, with enough need, with a value proposition, and a simplistic design, [older people] will jump that digital divide as fast, if not faster, than many younger people. We just need to raise the bar in design, engineering, and making a value proposition that says, “Yes, I need this. I need to learn it, and I will use it.”
Dustin Boutet
Well, Joe, thank you for spending the time, this half-an-hour with us. It's been a really enlightening conversation for me and I appreciate your insight. And it's exciting to hear about all the great work that you and the rest of the team are doing over at the AgeLab.
