Interview: The future of connected care, with Axel Nordberg, Phd

Essity’s iQ Solutions department is tasked with innovating digital solutions for incontinence. Heading that department is Axel Nordberg – an engineer with a doctorate in medical materials from KTH and a background as a management consultant and entrepreneur within healthcare. We caught up with Axel in Stockholm, where he lives with his wife and three children, to find out what the future holds for elderly care and how TENA is preparing to meet the challenges of societal ageing.

Q: What are your predictions for how the care sector will change in response to the rapidly expanding elderly population?

We know that by 2050 there will be nearly a billion more people over 65 years old than there are today! Already today we have over 400 million incontinent people in the world, and we know that the prevalence of incontinence increases with age. So this really puts pressure on the system. 

What we see will happen with these trends is a shift to home care. And that means a shift to untrained caregivers – basically the caregiving relatives. They need support. And when we ask them, that’s what they tell us. 

The other thing happening is, if we have a shift to home care, we also have more resource-intensive cases in institutions. Because there you have trained caregivers, but they will have a different type of workload.

Q: How has COVID-19 affected this picture?

If we look at how the pandemic has impacted the trends, we don’t really see any new trends coming up. What we see is the ongoing trends often vastly accelerated by COVID-19. 

Take the caregiving relative example. You’re supposed to take care of a loved one. That’s tough, to begin with. Then, on top of it, you’re not supposed to physically meet that person, or keep social distance. So the requirements have increased, and the trends have been accelerated. How do you preserve the dignity, and how do you preserve that human touch of care when this is happening? So here at TENA we‘ve re-thought and re-imagined our way of delivering our services.

Digital solutions are already a part of healthcare today. Take blood sugar measurements. What has happened now is that you can continuously monitor your blood sugar and then act on an upward or downward trend. This enables preventive measures and also increases the outcome of care. 

I really think we need to be looking at prevention much more than we’ve done before. And stretching that even further: wellness. Which obviously comes before. If we can, in an early stage, be cleverer and more successful in protecting people’s wellness, then we save a lot of work when it comes to treatment.

Q: Can you give an example of digital solutions contributing to care delivery?

There are so many interesting examples. We see it with malign melanoma, where the patient can get support by taking a photo of a birthmark and asking whether this is no issue at all, or if it’s, “come in and we’ll check it out.” Instead of booking all these appointments, you can make the interaction much quicker.

I cannot resist mentioning: we should embrace getting older. I think it’s so much in the society, that we should prevent ageing. But I’d like to turn that around and say, “it’s a great thing being able to get older. It’s great. Let’s embrace it.” How can we support that ageing, would be the right question. 

An example: When you’re a resident in a nursing home, the way it’s done in many places today in the world is that they regularly check the resident’s absorbent product and change it if needed. This takes time and is an intrusion of your dignity. And if you extend that thinking to caregiving relatives, now suddenly you’re doing it with your loved one. So if we can support them in becoming more dignified in doing that, that’s a great help to them.

Q: So how is TENA addressing these challenges?

The “how” in addressing these challenges is to think of the complete continuum of care. In our world that means wellness, to begin with. Then prevention, assessment, treatment, care delivery, and then data monitoring or follow-up. 

As a senior consumer, being independent, living at your home, wellness can be very important. If you’re a resident in a nursing home, wellness might not be the most important thing, but prevention and assessment become crucial.

Our solution TENA Identifi™ is a good example of a position in this “continuum of care.” It’s an absorbent product, with built-in sensors, that the resident in a nursing home uses for 72 hours. After that period, the caregiver gets a report which is individual for the specific resident. And that’s the point. Because that allows the nursing home to individually set up a care plan for this resident. 

The direct outcome is that there will be more individualised care, the right products will be used, you’re able to also set up a schedule with the right toileting at the right time. 

And then we have the TENA SmartCare™ Change Indicator, which is a sensor that you put outside an absorbent product. It sends a signal about the wetness level to a dashboard and a smartphone. So the app will tell you when to consider a change and when you don’t need to. 

It’s a range of solutions, really. We have TENA SmartCare™ for caregiving relatives in a home care setting, and we also have TENA SmartCare™ for institutions – for professional caregivers. They use the same platform, but they have different “front ends.” Often you have more caregiving relatives taking care of one loved one. But in an institutional setting, it’s almost the opposite: you have many residents and typically fewer caregivers, so we need to display the information in a different way. Their needs are also different.

Q: So what do you do with the data monitoring?

Well, to begin with, it helps you to plan your care in a better way. It may contribute to spending a shorter time in a product that reaches saturation. But also advising the care staff on, “you don’t need to run here and do this now; this resident is all fine.” 

That’s in the first step. But, again, looking ahead in time: what if we could support with recommendations on when it’s likely to have a successful toileting? And what would happen if you extend the line even further and you apply artificial intelligence on it? ¬– again, not replacing the caregiver, but empowering them with recommendations? You can actually impact the 80% of residents in a nursing home who suffer from incontinence, plus the staff, with recommendations that save time and improve outcome.

At TENA we are in development mode for a wearable bladder sensor. And that’s truly preventive. The idea of a wearable bladder sensor is that we measure, not the wetness in a product, but the amount of urine in the bladder. And for some indications – spinal cord injuries and some other indications of incontinence – we’re actually able to tell when they need to go to the toilet before they use a product.

Q: What impact will all this have on the carbon footprint of TENA’s product line?

I believe that these solutions have great potential to reduce the carbon footprint by using the optimal products at the optimal time and in some cases even reducing the need for an absorbent product. For example, with the wearable bladder sensor that we’re developing.

Q: What are the priorities for TENA in continuing to innovate for the future?

It will be more and more important with prevention. It will be more important to preserve wellness. I also believe there will be a larger degree of co-creation. If we roll back several years, a company provided a solution from A to B. But now we see it’s more of an ecosystem, or a network, where the customer is a part of it. It increases relevance. 

We know that incontinence is a big challenge for caregiving relatives and professional caregivers. But they’re also dealing with dementia, they’re also dealing with nutrition, etcetera. So the question for us is where do we have those partnerships and how can we be the relevant partner to our customers and consumers.