One day a week, Heidi Sundström visits a 93-year-old woman living with Alzheimer's in Helsinki. Sundström helps with some tasks around the house, doing dishes or vacuuming. But mostly, she and Helka hang out, go for walks, and sing their favorite songs.
Apps like the Finnish tech company Gubbe offer older adults and families support with tasks around the house, exercise and companionship. Sundström is a helper with Gubbe, a Finnish tech company where older adults and families needing eldercare support can hire assistance.
Gubbe is one of several platforms emerging abroad and in the U.S. that aim to make various types of eldercare easier to access.
A small subset of people utilize paid care, and very few rely only on paid care. 
As populations are growing older, many individuals and families are confronted with challenges related to caregiving. Aging at home is common — three-quarters of adults over 50 want to live in their homes as they grow older. 
But the arrangements can come with drawbacks, including access to caregiving and social isolation.
While Gubbe has been expanding in European countries, platforms offer care services in the U.S. California-based Alice Care operates a bit like Doordash or Uber, allowing people to hire caregivers on short-term notice for a wide range of needs. 
Another service, Papa, offers "companion care," which aims to reduce loneliness and stress among family caregivers. The service, offered through over 100 Medicare Advantage and some employer and Medicaid plans, partners older people with "pals." The pals provide social engagement through regular visits and help with everyday non-medical tasks.
Demand For Home Care
In the United States, the vast majority of people in need of care rely on family members or other unpaid care for support, according to Jennifer Wolff of the Johns Hopkins Bloomberg School of Public Health. 
A small subset of people utilize paid care, and very few rely only on paid care. But, in general, paid caregiving help is expensive, so that can be financially prohibitive for many people, Wolff explains. 
Trust can also be an issue; many households are cautious about bringing other people into their homes. In addition, there can be anxiety around leaving a loved one in the care of someone else.
However, Wolff sees a lot of potential for gig economy services that provide care help. "I think that this is an untapped area where there is tremendous pent-up demand," she says.
The option of a platform that could provide care support, which is not a significant financial burden, could help people access paid care when needed.
There are also possible benefits for people working in caregiving, she says. For example, platforms could also be attractive for direct care workers, offering opportunities for career advancement with flexibility.
Making Connections
After Sandra Lounamaa's grandfather died, Lounamaa's family needed help caring for her grandmother. They looked into services, but the only options they could find in Finland didn't provide the companionship and care they were looking for, Lounamaa explains. 
The option of a platform that could provide care support, which is not a significant financial burden, could help people access paid care when needed.
Different nurses came each time, and there was no opportunity to build relationships. The caregivers also weren't in communication with the family, so family members couldn't ask them to do specific things during their visits, like go for a walk or cook.
"We never knew who would come, when they would come, and they had like 15 minutes' time to do only the necessary stuff," Lounamaa says.
Lounamaa partnered with her friend, Meri-Tuuli Laaksonen, and the pair launched Gubbe in Finland four years ago. 
The company currently has about a thousand clients in Finland and has expanded to Sweden and the United Kingdom. Lounamaa says the company plans to continue growing, hopefully to the U.S.
A study Gubbe carried out in seven Finnish municipalities found that the service increased older people's physical activity level and time spent outside. Building relationships is a core goal of Gubbe. 
The service matches older people needing help or companionship with helpers, taking into account location, physical condition, interests and other criteria.
Sundström, a musician and kindergarten teacher, has always enjoyed spending time with older adults. She was very close with her late grandmother — the two sang karaoke together. With Helka, Heidi gets to do some of the same activities she did with her grandmother.
Before Sundström's visits, she calls Helka to remind her of their appointment. Then, she knocks three times on the door, so Helka knows it's her. After their appointment, Sundström is in touch with Helka's family about what she needs. She says she enjoys the relationship they've developed.
"It's very nice because Helka's memory is quite bad and she always remembers me," she says. When a family seeks a helper through Gubbe, meet-ups can often begin within a few days. Each visit costs 40 euros per hour (about $43 U.S. dollars). After that, the helper is paid 10 euros.
Lounamaa says they hear particularly positive feedback from family members who live farther from their older relatives, who get regular updates after Gubbe visits.
"We all live busy lives so we all need help with taking care of our older loved ones," Lounamaa says. "When you know that the same, lovely Gubbe helpers will be visiting your loved one, you feel calm."
Flexibility For Care Needs
In the Sacramento, California area, residents needing a helping hand with home care can get it through an app — often within hours.
Launched in January 2022, Alice Care offers home care without the financial commitments and minimum hourly requirements of many traditional agencies, explain co-founder Stephanie Dupzyk.
"We all live busy lives so we all need help with taking care of our older loved ones."
Alice Care grew out of Dupzyk's family's experience caring for her mother-in-law, who was living with Alzheimer's. Many agencies require long-term commitments and have a minimum time requirement of four hours. 
But not all people seeking professional care help need or want that much time, Dupzyk says. "There's a lot of people out there that need just certain services from homecare," she explains, "but they don't need four hours, nor do they want somebody in their house for four hours."
Some Alice Care clients have helpers for several hours at a time, according to Dupzyk, and some people have an aide come at the same time every day to help with tasks like getting out of bed.
Alice Care's caregivers, who are employees, not contractors, are certified nursing assistants. When someone puts the Alice Care app in the area, they get a notification and can decide whether to accept.
Unlike Gubbe, the helpers change with each visit. But the platform emphasizes flexibility. Someone can schedule visits in advance or put in a request and have a helper arrive within a few hours. Visits cost $45 per hour.
There are also benefits for workers who enjoy flexibility. Alice Care plans to expand to San Diego in 2023 and would like to expand nationwide.
Dupzyk gets inquiries from people across the country. She thinks that reflects the needs of many families. "The traditional model is broken, and it doesn't work for many people," she says.


Finding Home Care Help Through An App

Elizabeth Hewitt

It is difficult these days to read the news without encountering articles about artificial intelligence (AI). While technology's previous superstar, self-driving cars, has fallen out of favor, it appears that AI is here to stay.
Hero's smart pill dispenser aims to make managing your medications easier and more convenientA recent study shows only 9% of adults aged 50 and over have not heard of or read about AI. While the technology holds great promise to make life easier for older adults, this risk-averse group is not exactly embracing the concept with open arms.
Among consumers aged 65 and older, 84% say they are concerned about online privacy.
We have seen this pattern before: skepticism of new advances in technology gradually giving way to acceptance and then near-ubiquity. Not that long ago, many of us were reluctant to provide a credit card number to make an online purchase. With e-commerce sales topping $6.3 billion in 2023, it is safe to say that ship has sailed.
Impediments to Adoption
Two main hurdles are hampering widespread adoption of AI by older Americans. The first involves the same concern that slowed the growth of online shopping — privacy worries surrounding the collection and release of personal information.
Among consumers aged 65 and older, 84% say they are concerned about online privacy. Nearly three-quarters of this age group report that they have been targeted by cyber criminals, and 43% know someone who has been an actual victim.
The other hurdle relates to the sheer speed with which AI is evolving. Almost 75% of adults over 65 say they need help using new technology. That worked out well with laptops, tablets and smartphones, when tech-savvy children (or grandchildren!) can provide guidance. Beyond assistance setting up Alexa or Siri, not much expertise is available with AI since we are all trying to figure it out together.
There is a lot to be excited about now and in the near future. Here is a look at several key areas where AI is already delivering significant benefits.
Medication Management
For better or worse, we have become a nation of pill-poppers. Forty percent of older Americans take five or more medications per day, and 20%, almost 11 million, take 10 or more.
Keeping up with that many different drugs can be overwhelming. Combined with aging factors like cognitive decline, failure to maintain medication schedules is a common problem.
Medisafe Digital Drug Companion is a highly regarded med reminder app that doesn't limit the number of medications you can enter and has a customizable dosing schedule. It tracks adherence and provides family notifications when schedules are not followed.
Hero is a smart pill dispenser that can hold a 90-day supply of as many as 10 medications in any shape or size. One button sorting and dispensing plus both sound and blinking light alerts take away any guesswork. An app keeps users and family or caregivers connected.
Developers are working on AI-equipped pill bottles that provide real-time monitoring and intervention by detecting when a dose is missed and sending reminders. In the near future, chatbots will be able to engage in conversations, answer questions and provide personalized tips. Down the road, AI-powered robots will dispense medications and eliminate human error entirely.
Nutritional Support and Meal Planning
Researchers estimate that a "substantial" percentage of older Americans are malnourished. Poor nutrition often results from inadequate food intake, poor food choices or a combination of the two. Psychological factors such as anxiety and depression cause lack of appetite, as does loss of taste and general disinterest in planning and preparing balanced meals.
AI platforms of the future may act as virtual dieticians.
Numerous AI-powered apps are already available that do the heavy lifting of meal planning for you. ChefGPT provides recipe recommendations based on your dietary and lifestyle requirements. Don't want to go shopping for ingredients? Tell the app what is in your fridge and pantry and it will create a custom recipe with what you have on hand.
TummyAI is a comprehensive app that designs meal plans based on factors that include your favorite foods, dietary restrictions, allergies, location and grocery budget.
Nutritional support is on track to become more personalized with AI tools. Already DayTwo is able to analyze an individual's microbiome — the bacteria, fungi and other microorganism in the digestive tract — to control blood sugar levels with custom-tailored meal plans. AI platforms of the future may act as virtual dieticians that improve patients' health by understanding their unique health conditions and goals.
Cognitive Enhancement
Occasional confusion and memory loss are not unusual occurrences as adults age. However, frequently forgetting how to perform routine tasks of daily life like preparing meals and managing personal finances are indications of severe cognitive decline.
The $6 billion brain-training industry is trying to address concerns about such decline — and other conditions that often accompany aging — with products and services that vendors suggest may improve one's memory or keep at bay medical conditions like Alzheimer's, stroke and depression.
Do they work? The jury is still out, as a mixed bag of research has provided no definitive answers. For those hoping that a few minutes of game playing and problem solving are worth a try, these are a couple of popular options:
Lumosity is the world's most popular brain-training app. They have been at it for 14 years and boast 100 million members. After a free trial period, monthly subscriptions are $14.95 and annual subscriptions are $79.95.
Mobility and lack of independence issues may decrease if self-driving cars eventually find their way into the marketplace.
If promises to "push you hard with intense workouts" are what you are looking for, Peak Brain Training is ready to unlock your full mental potential. An AI personal trainer will be by your side to challenge you, keep you motivated and track your progress.
Safety Monitoring
More than 12 million Americans over the age of 65 live alone. According to the Centers for Disease Control and Prevention, one out of four in this group falls every year.
When you add all the other potentially adverse health events that increase as people age, AI home monitoring systems and wearable devices are a wise investment for both older adults living independently and their families or caregivers.
While many Apple Watch owners take advantage of the fitness functions built into the device, they may not be aware of various health monitoring features available. 
Fall Detection automatically calls emergency services and contacts when you have been immobile for more than a minute after a hard fall, alerting them to your location. Installing an EKG app notifies the wearer of low and high heart rates as well as irregular rhythms.
The watch can be taken to the next level by pairing it with a platform like Safeguard. Using AI and cutting-edge algorithms, Safeguard continually analyzes all the data it receives for warning signs that may indicate potential health issues, sending alerts to both the wearer and designated contacts.
What's Next
EnvoyatHome offers a passive technology requiring no cameras or wearable devices. Algorithms fed data from strategically placed sensors throughout the home learn the person's behavior patterns and constantly compare them to an established baseline. Customized system triggers alert caregivers of unusual activity. A dashboard collects data through charts and graphs that can be shared with primary care providers.
AI has immense potential to enhance the lives of older adults. Mobility and lack of independence issues may decrease if self-driving cars eventually find their way into the marketplace. Chatbots, virtual avatars and assistive robots may help combat loneliness by engaging in conversations and providing empathetic emotional support.
Developers can accelerate more widespread acceptance of this technology by first addressing privacy concerns. Soliciting input to create true age-friendly solutions along with easy-to-understand training, whether personal or online, are keys to older adults embracing the use of AI. Bridging this digital divide will empower them to lead healthier, more connected lives.


AI for Older Adults — Friend or Foe?

Edd and Cynthia Staton

Nature journaling is a centuries-old method of recording thoughts and observations about the natural world. It typically involves observing something in nature, such as a plant, animal or landscape, and drawing or writing about it in a dedicated sketchbook or journal.
A photo taken by the author during a nature walk. Although nature journals are thought of as the tools of naturalists and scientists, they can help everyone experience the natural world in a creative and meaningful way. By observing, recording and reflecting on your surroundings, you can develop a deeper connection with nature and a better understanding of the natural world. 
Nature journaling can also serve as a springboard to other satisfying activities like nature walks, wildlife watching, citizen science, poetry, painting and travel sketching.
Nature Journaling Tips 
Nature journaling is an excellent way to strengthen your observation skills and learn about something new. As you observe objects in nature, ask questions about what you see. What is it? How does it work? Why is it unusual? Where is it? When will it change? Write down the questions or answers in your nature journal to enhance your memory and make a record of the observation.
Try to depict textures, tastes, sounds and scents you experienced in addition to drawing or describing what you saw.
You can also use nature journaling to reflect on your experiences and express your creativity. As you study something in nature, think about how it makes you feel and then express your feelings through drawing, painting, poetry, prose, scientific notes or even just a list of words (amazed, enchanted, delighted). 
It can be tempting to focus only on what you see when making entries in your nature journal. Instead, try to depict textures, tastes, sounds and scents you experienced in addition to drawing or describing what you saw. This will help you immerse yourself in your surroundings and portray the whole multi-sensory experience in your journal entry.

The most important thing to remember when nature journaling is perfection doesn't matter. A nature journal is meant to be a record of your time in nature, not an award-winning work of art. Many of your sketches won't come out the way you planned, but that's okay. 
Daily weather entries from the author's nature journalIt is better to focus on what you draw and write rather than how you draw and write. Getting your observations, thoughts, and feelings down on paper is more important than pretty pictures, flawless penmanship or perfect spelling.
Nature Journaling Materials 
One of the best things about nature journaling is that there is no right or wrong way to do it. You can use whatever materials work best for you. Many people start small with just a pencil and a sketchbook. Other common nature journaling materials include pens, colored pencils, markers, watercolors, rubber stamps, glue sticks, magazine clippings and pressed flowers.
Additional supplies can also be helpful, depending on the topic of your nature journal. For example, binoculars and magnifying tools can help you get a closer look at wildlife; field guides can help you identify birds, plants and insects; and measuring tools can help you quantify observations and represent proportions and scale.

Technology and apps can also help you navigate the natural world and create journal entries. Cameras are great for capturing an image of a landscape or organism you'd like to study later. Mobile phones and other devices work well for recording sound or video that can be analyzed later. Free apps can help you learn more about what you see or experience outdoors.
The Merlin Bird ID app from Cornell Lab of Ornithology identifies birds based on descriptions, photos or sounds.The Seek app created by iNaturalist uses image recognition technology to locate and identify wildlife, plants and fungi.The Windy app provides detailed local weather forecasts and worldwide wind reports for outdoor enthusiasts.Nature Journal Prompts 
The following journal prompts for nature walks, birdwatching, daily weather observations, backyard gardening and other everyday activities can help you get started on your nature journal.
A nature journal is meant to be a record of your time in nature, not an award-winning work of art. 
Take a nature walk. Enjoy the sights, sounds and smells as you walk down your chosen trail. Identify interesting discoveries along the way. Then, draw a map of your route and note where each discovery was located. Use drawings, text-based labels or embellishments (like magazine clippings or stickers) to represent each item, animal, place or moment.Sit at a window overlooking a bird feeder or find a comfortable spot outside and watch birds. Identify them by name if you can. Listen to the sounds they are making. Then, focus on just one bird. Draw the bird, using as much detail as you can. Listen to the bird's song. Is it loud, barely audible or high-pitched? Does it sound like a buzz, whistle or trill? Use thick, thin, straight, sloping and wavy lines to create a sound diagram representing the song.A map from the author's nature journalSpend 5-10 minutes each day outside or at a window observing the weather. Then, record the weather conditions in your nature journal. Note the temperature and humidity, the amount of cloud cover, the wind speed, the presence or lack of precipitation and any other observations you make. Then, make notes about the impact of changing weather patterns on you or the environment.Grow a plant in your window, on your patio or in a garden bed. Use text and drawings to record its progress in your nature journal. Note its size, shape, scent, texture and color. Identify any insects or other organisms that interact with the plant. Compare the plant's journey to a journey you experienced in your life.  Select a natural object, such as a leaf, flower, rock or pinecone. Study it, and determine what color it is. Be specific. The object may seem green at first, but upon further examination, you may notice many different types of green — from light green to forest green. Then, use colored pencils, crayons, markers or watercolors to represent the colors of the object in your journal.Find something that interests you in nature. Write down what you know about it. Then, create a list of things you would like to know. Use your questions to guide future nature observations.

Using a Nature Journal To Connect With Your Surroundings

Anna Champagne

Crystal Bailey, who lives in the Chicago area, noticed that her 86-year-old mother Editha Walker had begun to have problems managing technology. "As my mother continued to age, it became obvious that the traditional applications and phones were too small for her arthritic fingers to manipulate," Bailey says. "In addition, her eyes were not able to read text messages or to select the appropriate buttons."
About a third of U.S. adults ages 65 and older report they have physical issues that keep them from participating fully in some form of daily activity, and that can trickle down to technology useMany older adults are keen to incorporate technology into their daily lives, but they may face physical challenges that make it difficult to use or manipulate devices. According to a Pew Research Center analysis in 2021, adults 65 and older still lag behind the younger demographic when it comes to internet use. 
The good news is that the gap is closing; 75% of those 65 and older report being internet users, and 64% of that group has home broadband.
Vision loss, hearing loss, and dexterity issues can make even the simplest computer-related task frustrating.
But about a third of U.S. adults ages 65 and older report they have physical issues that keep them from participating fully in some form of daily activity, and that can trickle down to technology use. Vision loss, hearing loss, and dexterity issues can make even the simplest computer-related task frustrating.
It is a problem that faces many caregivers and their loved ones. Although technology has offered speedy, secure ways to communicate, some members of the older population struggle with confusing apps, small icons, or unlabeled buttons. But companies have stepped up to offer solutions, including apps that help caregivers manage the daily needs of patients or loved ones.
Overcoming Obstacles 
A few companies are realizing the importance of modifications or innovations to available technology. For instance, The Virtual Caregiver is a program implemented by CareBuilders at Home. The company installs a small box that plugs into the television, turning the device into a video call that can be activated by voice and on demand.
"In the wake of COVID, this program has provided clients the opportunity to connect visually with loved ones. This technology delivers peace of mind to families who aren't geographically close to their loved ones by allowing them to see and engage with their aging parents to verify they are okay," says Lori Yount, vice president of operations, CareBuilders at Home. 
"For CareBuilders, this program allows us to take a more proactive approach to care. By engaging daily with our clients during our check-in and chat services, we are able to monitor for changes in condition, patterns, or behavior, so that we can alert the family and medical providers of any potential issue they may require medical intervention," she says. "By addressing these changes early, we provide our clients a better chance for swift resolutions and positive outcomes."
In her search to make technology easier for her mother, Bailey found GrandPad, a tablet and telehealth platform that targets adults over the age of 75. The program is used by 71 centers in PACE (Programs of All-Inclusive Care for the Elderly).  
The tablet works on a secure platform with built-in LTE (long-term evolution) and web applications on the cloud. Caregivers and relatives can communicate with the user without using Wifi, which is a boon for people who live in rural areas or places that utilize security blocks. A family member serves as administrator, managing the GrandPad through a web portal or smartphone app. Icons are simple, easy to see and use.
Because Bailey's mother is comfortable using the device, she will send an email or a text to one of her family members if she wants to share news or ask a question. And if there is a communication roadblock with caregivers or staff at her assisted living building, she can connect with Bailey to help her through it.
Apps That Can Help Older Loved Ones 
For individuals managing the care of a loved one, smartphone apps can help with appointment setting, daily health monitoring, pill schedules, and more. Smart doorbells and door locks can help secure the homes of older adults. GPS tracking devices are available as wearable jewelry or even shoe soles and have apps to find a wandering adult.
Some apps are part of a larger health care program and available to patients; others can be used on an individual basis.
Some apps are part of a larger health care program and available to patients; others can be used on an individual basis. Talk to your family member's doctor or health organization about apps that can streamline the doctor/patient relationship and manage chronic issues. Find the app that works for you, your loved one, and the medical team. 
Here are several other examples:
Carezone: Manage medications, medical instructions, and more with this convenient app. Take pictures of medications, keep a list of medications, dosages, and schedules, and receive a reminder when you need to dose or refill a prescription.My Medicine: Created by the American Medical Association (AMA) this records medications, vaccinations, and allergy restrictions.Vital Signs: Log results from your blood pressure monitor to record how diet and other factors affect blood pressure. The record can be emailed to a loved one or medical staff for review.Elderly Care: Keep older adults connected while allowing them to retain independence with schedules, alarms, etc. Caregivers can receive notifications of when their loved one wakes, takes medicine, exercises, etc.Chair Exercises for Seniors: Older adults can exercise in the safety of their own home, doing easy chair exercises using this app.Magnifying Glass and Flashlight: You don’t have to be older to appreciate having a way to read fine print. Read prescription bottle instructions, menus, and other small text using this app.Symple: Track food and manage symptoms by logging photos and journal notes on well-being.

Using Technology to Chart a Course for Care

Rosie Wolf Williams

Like bungee jumping, leaping out of a plane and riding on a mechanical bull, looking for love on dating apps is not for the faint of heart.
You may be thinking, at least when you throw yourself out of a plane, you get a parachute to ease your fall, right?
"With an online-dating app, you can gaze happily at a recent snapshot of your upcoming date and read the person's profile. You possibly won't be unpleasantly surprised. You have no obligations to meet the person in the photo."You may fret: But I'm too old to use a dating app! I don't know whether to swipe right or left! An "LTR" — say WHAT? I don't even recognize the difference between Match and Hinge — or un-Hinged, for that matter. I mean, I don't understand how much of a lie to write down to impress a stranger. And I went to Harvard — and Stanford!
Let me put your mind at ease. NOBODY is too old to use a dating app — or to master one, for that matter. Keep it simple, stupid: Just think of a dating app as a glorified blind date — only better.
Let me put your mind at ease. NOBODY is too old to use a dating app — or to master one, for that matter.
When you agree to go on a blind date, you have put yourself at the mercy of a well-meaning friend or a loved one who is so anxious for you to settle down that they would celebrate your attraction to a doorknob.
This do-gooder has ASSURED you that your future companion is great looking, charming, tall enough, cultured, financially secure, culturally and politically simpatico with you, refined, well-educated and a witty conversationalist. You imagine having either a latte or a martini or a meal with someone glib, funny, quick-witted — and did I mention great looking?
Then, within five seconds of ringing the doorbell and saying hello, you wish you were back home, in front of the TV set, checking out Netflix or Amazon Prime or the ballgame or Anderson Cooper or even the Weather Channel. Anything else!
On the other hand, online dating gives you a built-in home court advantage. With an online-dating app, you can gaze happily at a recent snapshot of your upcoming date and read the person's profile. You possibly won't be unpleasantly surprised. You have no obligations to meet the person in the photo. (Of course, if the person is a serial liar, all bets are off.)
Creating a Successful Dating Profile 
Here, then, are 9 easy tips for thriving in the wild, wild world of online dating:
Do NOT tell a lie. Why lie at all? Are you already ashamed of how you look? Or where you went to school? Or how many university degrees you possess? Or that, once upon a time, you actually majored in anthropology? Or that you have seen 124 Bruce Springsteen concerts? Or that Barry Manilow is a staple on your iPhone playlists? So what, if any, or all, of these factoids is true? And if they are true, well, own up to it. Don't merely admit it. Brag about it. Because this is you, after all. And the person fidgeting across the table from you on your first date may just find these details to be endearing. Present an accurate photo of yourself. Hey, the other person is going to find out sooner or later, anyway, that you have a bit of a gut. Or that you're five inches shorter than you said. Or that you may be prematurely gray or follicly challenged. So what!Don’t wear sunglasses in your profile photo. You will look less attractive and besides, that person wants to see your eyes.Don’t be photographed while you’re chowing down some food. Terrible optics, and it detracts from your essential smile, too.Be witty! Try not to be too eccentric and iconoclastic.
Make it clear what you want. Do you desire a quick fling? Or are you hoping for that "LTR" — long-term relationship? Oh yes, there are blessed dating apps for both and everything in between.    Don’t express bitterness or hostility in your profile. Nobody wants to be around a Debbie Downer. Instead, radiate hope and optimism. Remember, you are not so unique. Everybody who uses a dating app is in the same leaky boat.Watch out for un-funny humor. If you attempt to kid around, keep your quips at a minimum and don’t write something that can be misinterpreted for antisocial behavior. Be witty! Try not to be too eccentric and iconoclastic. And pssst, maybe you shouldn’t brag that you have all of the charm of Hannibal Lecter or joke that your favorite scene in “The Godfather” involved the horse’s head in the bed. Save those bon mots for your weekend together in the country.Now, go for it! Have an upbeat attitude, swipe away and let us know when you're toasting your first wedding anniversary!


How to Flourish on Online Dating Sites

Jon Friedman

This article is part of Navigating Change, a Next Avenue initiative made possible by the Richard M. Schulze Family Foundation and EIX, the Entrepreneur Innovation Exchange.Will Wiseman, at the young-ish age of 27, has stories to tell about cataclysmic climate-related events. They're compelling enough that he has parlayed them into a mobile app-based startup called Climatize that enables people to make small investments in solar projects.
Will Wiseman at a protest in StockholmFor Wiseman, climate change is personal. Last year, his hometown, Santa Cruz, California, was evacuated several times because of extraordinarily heavy rains dumped on the coastal city by atmospheric rivers. He also recalls that in 2018 the California Department of Forestry and Fire Protection cut a fire line about 25 yards from his family's backyard.
"Between fires and flooding, we're seeing these climate impacts here and now," Wiseman says.
Since 2019, when Wiseman and his Climatize co-founder, Alba Forns, joined global climate strikes in Barcelona, Spain, and Stockholm, Sweden, he has been telling the company's story and building a following. In April, Forbes included the entrepreneurs in its 30 Under 30 list as leading figures in "social impact" in Europe.
Elevated Elevator Pitch
By using the origin story of Climatize, Wiseman engages in the time-honored tradition of using a good tale well told to get people excited about investing in or working for his company. Consider it an elevated elevator pitch.
The storytelling exemplar just might be Steve Jobs, the late, legendary co-founder of Apple.
"The most powerful person in the world is the storyteller."
"The most powerful person in the world is the storyteller," he said in a Rolling Stone interview in 1994, when he was the chief executive of Pixar between his Apple tours of duty. He spent years developing a storytelling framework that proved enormously successful at hooking an audience.
When it comes to corporate storytelling, it would be hard to top his 2007 iPhone product launch. Clad in his trademark black mock turtleneck and blue jeans, he held the Macworld audience in San Francisco in thrall as he spooled out the tale of a "revolutionary and magical product that is literally five years ahead of any other mobile phone."
He reminded the rapt attendees that the 1984 introduction of the Macintosh had "changed the whole computer industry" and that, in 2001, the iPod had changed the music industry. Then he really revved up the crowd.
"Well, today, we're introducing three revolutionary products. . . . The first is a widescreen iPod with touch controls [robust applause]. The second is a revolutionary mobile phone [rapturous applause]. And the third is a breakthrough internet communications device. An iPod, a phone and an internet communicator. Are you getting it?"
Yes, they were getting it.
"These are not three separate devices," he added, hitting his punch line. "This is one device. And we are calling it iPhone."
Technology for the Tongue-Tied
Sophie Thompson, a London-based entrepreneur, was so afraid of speaking in public that she couldn't even order food at a restaurant. In 2016, she co-founded VirtualSpeech, an online training program that uses virtual reality and artificial intelligence to help people improve their communications skills.
"The best stories evoke emotional reactions."
As Thompson sees it, entrepreneurs typically create a product or service to solve a problem they have experienced themselves. By telling the back story in a highly personal way, they can connect with potential customers, employees and investors.
"The best stories evoke emotional reactions," Thompson says on the company's website. "People genuinely relate and connect with these stories and they believe in the company and what it stands for. . . . Today, it's difficult to find a successful brand that does not have a compelling story behind it. Stories provide meaning, create context and evoke a sense of purpose."
Story Lab for Startups
TED Talks — online lectures, some of which receive millions of views — have helped to demonstrate the power of storytelling. With studies showing the value of storytelling in business, universities are intervening to train students who fear public speaking or need coaching to develop an irresistible narrative.
At the University of Iowa's Tippie College of Business, students wishing to improve their skills can sign on for the extracurricular Story Lab. One of the program's aims is to help entrepreneur wannabes prepare for the day when they'll need to bring in investors. Story Lab had its inaugural semester a year ago; the current semester has 42 participants.
The program uses, among other resources, "How to Tell a Story," a book by The Moth, a nonprofit organization dedicated to the art and craft of storytelling.
"Telling your own story is a foundational skill when it comes to leadership," says Nick Westergaard, a lecturer in business communication at the University of Iowa and faculty director at Story Lab, which teaches people to write and deliver compelling stories. "It's an important building block in work and life."
Will Wiseman in BarcelonaWestergaard heaps praise on the storytelling skills of three female executives: Sara Blakely, the self-made billionaire who founded the Spanx shapewear company; Melanie Perkins, the Australian founder of Canva, an online graphic design tool; and Thasunda Brown Duckett, president and CEO of TIAA, the financial services giant. She connects with people by sharing the vulnerability she felt about being the only Black girl on her soccer team and not being invited to a teammate's birthday party.
In a recent article for Harvard Business Review, Westergaard described five types of narratives: "Vision stories, which inspired a shared one; values stories that model the way; action stories that spark progress and change; teaching stories that transmit knowledge and skills to others; and trust stories that help people understand, connect with and believe in you."
With the Climatize app for iPhones, which launched in May, Wiseman seized on a variety of storytelling strategies. (An Android version of the app is in development.)
Every Startup Has a Story
He uses Instagram posts and podcast interviews about his own climate anxiety to help developers of renewable energy projects raise funds, especially in underrepresented communities.
The startup has some backing from angel investors and venture capital firms, but it mostly attracts funds from small investors who buy the company's fixed-interest "crowdfunding" debt notes. Interest on the debt is paid by cash flow generated by the sale of electricity from, say, a solar project to the surrounding community.
The average investor account at the moment is $1,450. Project developers pay Climatize's fees (5% of funds raised and 0.5% per year of funds raised over the lifetime of the offering).
"Climatize helps the public to become active stakeholders in the energy transition," Wiseman says. "It gives power to the people." With climate change inducing anxiety around the globe, he said he plans to keep telling the Climatize story for years to come.


Good Startups Need Good Stories

Martha Groves

"The first time I played it, I found myself breathless and sweaty inside of ten minutes. I took a break, but an hour later, was back in the ring, swinging wildly and gasping for air."Apart from watching instructional YouTube videos, playing New York Times word games on our phones and streaming a show over spotty WiFi in the evening, my wife and I are not big techies. That's why I was surprised when she hinted that she'd like a virtual reality (VR) headset for Christmas.
 This thing was made for everyone.
"I've heard it's really good exercise," she said. "Mmmm hmmm," I replied skeptically, but the message had been received, and I surprised her with one under the tree.
Prior to that, I thought that video games — especially the VR sort — were something an adult leaves behind in their twenties, or, surely, their thirties. The moment I strapped on that headset, though, it was clear to me that this thing was made for everyone.
A Whole Other World
The makers of VR headsets have smartly included free games and apps that help new users familiarize themselves with handset controls, body movements, and the immersive experience as a whole. One of these games was my first introduction to VR, and I was blown away.
You may find yourself walking among dinosaurs.
If you're new to VR technology, then getting to know your device inside an incredibly detailed make-believe world you could never have imagined is a first step I highly recommend.
Depending on which brand and model of headset you buy, you may find yourself walking among dinosaurs, meditating in a psychedelic 3D field of color and sound, or shooting space puffins that have landed in your living room through a hole in your ceiling. Rather than making you feel as though any of this actually taking place in the real world, today's VR headsets do a very convincing job of bringing you into their world.
A Sweaty, Heart-Pumping, Bebopping World
As my wife correctly guessed, the prospect of exercising in VR was what really piqued my interest. Once I'd gotten familiar with the headset and hand controls, I created the 6.5' x 6.5' virtual "safe space" required by most games in one of our rooms and then I was ready to work out.
Depending on the brand and model of device, there are dozens to hundreds of active VR games, apps and experiences that can be downloaded or streamed via WiFi. On the recommendation of family members, we started with a low-cost boxing game.
The first time I played it, I found myself breathless and sweaty inside of ten minutes. I took a break, but an hour later, was back in the ring, swinging wildly and gasping for air.
I soon found myself logging marathon workout sessions 60, 70, even 90 minutes long.
I had previously been exercising regularly, but this was the hardest I had worked out since training for a series of obstacle course races in my mid-forties. Not only was it an incredible workout, I found it addictive. That first week, I played the boxing game two or three times a day, until one day I overextended on a punch (something the game's cautionary statement warned me not to do) and injured my elbow.
I sulked for the next couple of days as I rested my elbow but eventually found a free streaming dancing game that didn't aggravate it. Again, I was smitten, and although my heart rate didn't get into the red zone with this one, that just meant I could play longer. I soon found myself logging marathon workout sessions 60, 70, even 90 minutes long.
My wife was the same way. "You know I hate cardio," she panted one day that first week, "but this is awesome!" A month in, we're both still jockeying for time with the headset every day.
Looking at my fitness tracker stats over the first 30 days of using the VR headset, my average workout time per week increased nearly 50%, and the average intensity of those workouts was much higher. I feel fitter than before, and am noticing some muscle definition I haven't seen in years.
Research Backs the Benefits
My wife and I aren't the only ones reaping the benefits of VR exercise. A 2020 systematic review found that VR exercise was as effective, if not more so, than traditional exercise across a number of physiological, rehabilitative and even psychological outcomes.
VR games and apps are also well-suited to more specialized training. A 2023 meta-analysis published in the Archives of Gerontology and Geriatrics found it to be more effective than conventional exercise at improving balance and preventing falls in older adults.
For me, the "fun factor" is the biggest advantage of VR exercise.
For me, the "fun factor" is the biggest advantage of VR exercise. It's well-established in exercise science that if an activity is enjoyable, you're more likely to stick with it, and the same is true for perceived exertion: if something doesn't seem as hard, you'll probably do it for longer and/or more often.
In a 2022 study, researchers at San Francisco State University, San Francisco, found that subjects' actual exertion during exercise with a VR headset was much higher than their perceived exertion. The researchers also asked participants to rank the enjoyability of each exercise session, and were surprised to find that the most intense games were rated as the most enjoyable.
Player Beware: The Risks and Cons of VR Gaming
Working out harder and longer can have great physical and mental benefits, but it also comes with risks. As a former fitness professional and lifelong exerciser, I know my body's limits. I feel okay pushing my heart rate to near-maximum during some of my workouts, but this would be really dangerous for a large segment of the population. As with any exercise program, you should talk with your health care provider before you begin a VR workout regimen, and then start slowly and progress incrementally.
All of my exercise experience didn't protect me from tweaking my elbow (and later pulling a rib muscle playing the same boxing game). So, if like me, you tend to get caught up in the competitive heat of the moment, the risk for injury is real.
No matter your age, and whatever your thoughts on VR gaming have been up to now, I encourage you to give it a try.
If you're not a workout nut, then a VR headset could actually increase your sedentary time. I discovered this pitfall one evening when I "just wanted to check out" an online escape room type of game, and emerged goggle-eyed and woozy two hours later.
Finally, none of this stuff is cheap. Compared to a monthly gym membership or home-gym set-up, VR exercise might still be a little more cost-effective, but only if you're choosey about which games you purchase. Some have fairly hefty one-time price tags, and others require a monthly subscription.
I splurged on the latest iteration of headset available at the time, and my wife's Christmas morning reaction convinced me that was a good thing. So far, we've only spent around $30 total on games, and between that and the free streaming ones, we feel enormously entertained.
As spring brings warmer temperatures and dry ground, I know I'll get most of my exercise working and walking outside, but with months of winter still ahead, I can't imagine going back to my boring old basement workouts.
No matter your age, and whatever your thoughts on VR gaming have been up to now, I encourage you to give it a try. Test out a friend's device before you buy one if you're not sure. I bet you'll be glad you did.


A VR Gaming Headset Revolutionized Our Workouts

Rashelle Brown

With U.S. household debt at a record level and credit card debt topping $1 trillion, it's not surprising that paying off loans and credit cards is the most common New Year's resolution for boomers and Gen X in 2024, according to The Ascent personal finance site. The trick is actually doing it.
"If you're in the early stages of falling behind, there's still a way to work things out with your creditors to get back on track without going to the nuclear option,"Only 47% of credit card holders with balances have a plan to pay them off, a recent Bankrate survey found.
"If ever there was a year to avoid getting further into debt, this is that year."
"An increasing number of people, especially older Americans, are carrying debt from month to month. And the balances they're carrying are growing," Bruce McClary, senior vice president of the National Foundation for Credit Counseling said on the debt-reduction episode of the Friends Talk Money podcast I co-host.
Especially concerning: Interest rates on credit cards are about five percentage points higher than in spring 2022, on average, and rates on some department-store cards now exceed an eye-popping 34%. That has led to a rise in late payments.
Add Car Payments, Doctor Bills, Student Loans
Monthly car loan payments have been soaring, too, due to rising auto prices. So has medical debt, which is owed by one in three Americans.
Another problem: Student loan borrowers are facing long hold times trying to reach their loan servicers and getting inaccurate billing statements, according to a January 2024 report from the Consumer Financial Protection Bureau.
Debt has become so overwhelming that the number of people aged 55 and older filing for bankruptcy has doubled in the past 16 years, accounting for 20% of all bankruptcy filings these days, my podcast co-host Terry Savage noted.
Depend Less on Debt
"If ever there was a year to avoid getting further into debt, this is that year," said McClary. "If you become less dependent on debt and your credit-card balances are under control, 2024 is going to be a winning year for you."
Here are a few suggestions to reduce your debt load in 2024:
"It's an easy conversation to have, but you don't know what you can get unless you ask."
Call your credit card company and try to negotiate down your rate. A recent LendingTree survey found that 76% of people who asked their card issuers for a lower rate got one — often six percentage points below what they'd been paying.
"It bothers me that so few people actually think to call up their creditor and have that discussion," said McClary. "It's an easy conversation to have, but you don't know what you can get unless you ask."
Look into a 0% offer for a balance-transfer credit card. Many card issuers, eager to attract customers, dangle 0% interest rates for 18 months or so for people who transfer over their current credit card offers.
Swapping your high-rate credit card for one charging 0% might save you hundreds or thousands of dollars. You can find such offers on sites like NerdWallet and Bankrate.
Just be sure you know what the new card's regular interest rate is since you'll pay that when the 0% deal expires if you have a balance at that time. "This is not a long-term strategy; it's great in the short term," said McClary.
Find out, too, if there are fees to transfer your credit-card balance. Typically, the fee is 2% or 3% of the balance you're rolling over.
Ask About a 0% Balance-Transfer Card
Not everyone can qualify for a 0% balance-transfer card, though.
"To get one, you can't have had any late payments," said Friends Talk Money co-host Pam Krueger.
You generally also need a top credit score in the high 600s or above to get approved for a balance-transfer card. So, before applying, ask your bank for your credit score or go online and request a free credit report. You are entitled by law to one free report per year; if you need more than one, you will have to pay for the score from one of the three big credit bureaus: Experian, Equifax or TransUnion.
You Do Have Other Options
If you have a lot of medical debt, try negotiating with your doctor or hospital. You might get a reduction in the amount you'll owe by agreeing to pay the provider faster.Meet with a nonprofit credit counselor. The free session to create a debt action plan will likely take 30 minutes to an hour, either in person or by phone.The National Foundation for Credit Counseling, the nation's oldest nonprofit for improving financial well-being, never turns anyone away; its 1,215 certified credit counselors work in 250 locations around the country.A debt action plan can stop the debt collection calls and emails that heighten financial stress.If you have student loan debts, apply to enroll in the U.S. government's SAVE (Saving on a Valuable Education) plan. This income-driven repayment program, which replaced the REPAYE (Revised Pay as You Earn) plan, calculates your monthly payment based on your income and family size.SAVE lowers payments for many borrowers and it will become more generous in February. Then it will start forgiving debt in as few as 10 years if borrowers originally took out $12,000 or less in student loans, down from 20 to 25 years previously.Loans eligible for SAVE are direct subsidized and unsubsidized student loans, direct PLUS loans for grad students and Direct Consolidation Loans that didn't repay any PLUS loans made to parents. Loans that aren't eligible include Direct PLUS loans made to parents, Federal Perkins Loans and any loans currently in default.Debt Forgiveness Extended
Take advantage of the government's newly extended deadline for debt forgiveness. Originally, the program to consolidate loans for the forgiveness was scheduled to end Dec. 31, 2023. "It just got extended to April 30," said Savage.This debt forgiveness program is for Federal Family Education Loans (FFEL), school-held Perkins loans, Health Education Assistance Loans (HEAL) and Parent PLUS loans in repayment for at least 25 years.If you're not sure whether your loan qualifies, go to the Loan Breakdown part of the StudentAid.gov site."If you're in the early stages of falling behind, there's still a way to work things out with your creditors to get back on track."
If your debt load is crushing, investigate filing for bankruptcy. A nonprofit credit counselor can discuss the pros and cons and help you go this route if appropriate.In fact, nonprofit credit counseling is a required part of the process for filing a Chapter 7 liquidation bankruptcy or a Chapter 13 bankruptcy with a debt repayment plan."If you're in the early stages of falling behind, there's still a way to work things out with your creditors to get back on track without going to the nuclear option," said McClary. "But if you're facing potential legal action, that may be a more appropriate time to think about settling your debts and trying to get out of this with a pennies-on-the-dollar kind of approach."Sign up for a budgeting app to take control of your spending. The most popular one — Mint — was shut down by its owner Intuit late last year. But there are quite a few others that could be helpful.They include YNAB (formerly called You Need a Budget), Quicken Simplifi, Rocket Money, Tiller and PocketGuard. You'll typically pay $35 to $100 a year, but many of the apps have one- to three-month free trials."If you'll be using an app," said McClary, "just make sure your data is secure."


How to Get a Handle on Debt in 2024

Richard Eisenberg

I was driving solo from Baton Rouge to Pensacola — almost on autopilot, along a familiar route — when I spied the Alabama Visitor Center, which I knew would offer a clean bright ladies' room. Then, in gratitude for their hospitality, I decided to wander into the cavernous welcome area and see what was on offer.
"Paper maps had helped me develop an excellent sense of direction for, as I studied them, I oriented myself to the geography of a new place,"A cheerful female voice drawled hello, asked where I'd come from and was going, then waved enthusiastically toward the sprawling area with its extensive array of stands, each rack stuffed with colorful brochures. The four-color advertisements created a broad, pointillist impression; hundreds of individual brochures, invitations to attractions of all kinds located in Alabama. 
Perusing a map presented the same delight as wandering through library stacks — the opportunity for serendipitous discoveries.
I was poised to wade in when I suddenly spied a small, wooden box on her counter. It held three or four old-fashioned paper maps crammed into its small maw, the neatly folded, thick and printed kind, with a face-page reading: "Alabama official highway map."
Suddenly, like Proust responding to the Madeleine, I was warmed with happy nostalgia. I hadn't seen or used a paper map in years, not since the digital age swamped our lives. "May I have one?" I asked. She regarded me quizzically; clearly, these old-fashioned way-finders were not her hottest item but nodded yes. I left, clutching the folded paper like a treasure.
Although the National Geographic Society defines maps as "symbolic representations of selected characteristics of a place," a straightforward, visual presentation of somewhere, maps, for me, held a deeper meaning. Perusing a map presented the same delight as wandering through library stacks — the opportunity for serendipitous discoveries.
A Sense of Direction 
Before Google and Waze changed my life, I was a collector of maps that reflected places I lived, had visited or simply wanted for the delight of armchair travel — local, regional, national, international.  Paper maps had helped me develop an excellent sense of direction for, as I studied them, I oriented myself to the geography of a new place; I got rather efficient at figuring how to walk, drive or take the metro in a place I hadn't been before.
I owned a few historical maps which I loved like charming visual documents that were akin to reading historical fiction because their geographies had become obsolete. But most of my maps were the practical, travel-useful kind, reflecting exploration near and far — cities I'd meandered, like Paris, Santiago, Tblisi, Istanbul — or driving trips in which we wended our way through the countryside of Tuscany or the back roads of Normandy. My maps were keepers of memories.
In planning any trip, I spread the map across the dining room table or the floor, to get the grand scope of a place.
Admittedly, paper maps had challenges. Because they were usually large and unwieldy, I'd need to create a messy fold of exactly where we were and wanted to go, whether walking or driving. But that scale was helpful. In planning any trip, I spread the map across the dining room table or the floor, to get the grand scope of a place. (I also discovered that two maps spread open across my dining room table created an entertaining tablecloth though I rarely did this, not wanting to risk spilling soup on a beloved, or anticipated, destination.)
Legends on paper maps were captivating with their specific symbols representing important information. Population of a metro area, for example, was characterized by the size of its printed name and its physical blob on the map. 
Tangles of roadways crisscrossing the map created a Jackson Pollock-like effect, and various colors differentiated the road's importance, from large highways like Interstates to rural meanderers such as the narrow, winding roads of Louisiana parishes. Splotches and splashes of green represented parks and recreation areas; pale blue indicated water bodies — rivers, lakes and reservoirs. Here was an airport, signified by a tiny airplane; a circle with a star was the state capital. 
I calculated distances between one place and another by spacing my fingers along the map's scale of inches to miles, then quickly transferred my poised fingers to the map. It was never as accurate as digital plotting, of course, but the approximation always served well enough.
Perhaps my smartphone's digital mapping app can offer many of the same details but it doesn't; moreover it gives no sense of a place, nor scope.
The legend of my new Alabama map was especially captivating, containing even more details than the standard menu I remembered. It designated scenic byways; offered blocks of print listing numbered attractions that corresponded with numbers imprinted on the map in their exact locations; the sites of community colleges; explanations of the meanings of Alabama road signs; and graphics of each species of fish that visiting anglers might catch in the Gulf of Mexico which laps Alabama's southern coast. 
Perhaps my smartphone's digital mapping app can offer many of the same details but it doesn't; moreover it gives no sense of a place, nor scope. And when I minimize a digital map size to see a broader landscape, most of the details disappear. I do credit the app, however, for its ability to offer specific printed directions or, if I choose, a robo-voice directing me where to turn, in its tunnel-visioned precision, guiding me from here to there.
Actually, however, this idea of tunnel-visioned mapping isn't new. We used to order a trim rectangular booklet called a TripTik from AAA in which they had kindly plotted a direct course between where we started and our destination. It was mission specific and focused, a welcome aid when the family drove from Louisiana to Maine, delineating the fastest, most direct route. But I also remember that, as we headed north, we stuffed the glove compartment with a collection of paper maps to check nightly, to find detours beyond the TripTik for adding local attractions. 
Lost to Recycling — For Now 
My collection of maps consumed several drawers of a file cabinet and more maps were tucked inside my driver's side car door pocket. The maps in my car were the ones I consulted most frequently, either for wayfinding or while researching for articles I wrote about area history and culture. My car's map library held tattered paper for the city, state and nearby areas such as Mississippi and, yes, Alabama. I had used them all a lot.
My extensive map collection, I regret, went into the recycle bin when I downsized and I became as addicted as any other twenty-first century being to the omniscience and professionalism of digital mapping. 
But my discovery of the Alabama map instantly provoked such happy memories of wandering, exploring and getting wonderfully lost with my paper map friends that I'm now seeking an empty drawer somewhere in the condo: it's where I will stash the Alabama map, and other new paper maps that I hope will join it.


Paper Maps: My Lost Love

Mary Ann Sternberg

Tara Nurin has lived in seven states and seen at least a dozen doctors. So, in an effort to organize her health information, Nurin, a freelance journalist and author, started compiling decades worth of her medical records. Sometimes, the process has been surprisingly simple. Other times, it's been exasperating.
Nurin, 47, lives in Camden, N.J. — a city and state that both have health information exchanges, which enable record sharing across medical institutions. For Nurin, this means her current health care system links its virtual patient portal to her old system, making those records easy to combine.
"Your medical record ... varies from place to place. We're in an era where people need to be sure that they've got all the information and that information is right."
But tracking down her old medical records from a dermatologist was an exercise in frustration. Nurin couldn't remember the provider's name. After two emails to her primary care doctor, that office sent a name — the wrong one.
Finally, Nurin found a prescription from her former dermatologist. She filled out a form to allow her new doctor to request the records, but as far as she knows, they're still in limbo.
"The fact that I've had to chase this down through so many different doctors' offices multiple times is aggravating," Nurin says. 
"It concerns me a tiny bit," she adds. "I'm relatively young and healthy, so it's never been particularly critical to have my records. But I have no idea when I was immunized for certain things and no idea [about other aspects of my health history] and, theoretically, that could present a problem."
Why Isn’t This Process Easier?
Despite strides over the last decade to improve access to medical information, the U.S. health care system remains frustratingly fragmented. Many providers have online patient portals with at least some medical data, but you can't always depend on those systems to communicate with each other.
There's no master patient identifier to ensure all your records are linked back to you, says Dr. Harlan Krumholz, a cardiologist and director of the Center for Outcomes Research and Evaluation at the Yale School of Medicine. The only way to ensure you have all your health records, he says, is to compile them yourself.
"Your medical record, believe it or not, even in 2021, varies from place to place," Krumholz says. "We're in an era where people need to be sure that they've got all the information and that information is right."
Is It Worth the Time It Takes to Gather Your Records?
Patients who read their health notes are more likely to take their medications as prescribed.
There are several reasons why you should compile your medical records, even if you don't have a major health issue, says Catherine DesRoches, an associate professor at Harvard Medical School and executive director of OpenNotes, a nonprofit that studies and advocates for communication between patients and health care providers.
When patients have access to their medical notes, a 2019 study found, about a quarter identify an error — and half of those errors are considered clinically important. (That's a better success rate, DesRoches says, than many of the artificial intelligence systems that health care organizations use to catch potentially dangerous mistakes.) 
Also, according to research, patients who read their health notes are more likely to take their medications as prescribed.
Why the bump in compliance? Sometimes we just need a reminder. Unless prompted, patients only remember half of what's discussed during a clinical visit, one study showed. We might recall even less from a particularly stressful visit, DesRoches says.
"Looking at what's in your record is a really great way to be sure that you understand what the doctor is thinking, and you know what you're supposed to do next," she says. "Those two things are quite powerful for patients."
How Do I Get Started?
Here's how to compile, manage and use your medical records:
Go digital. Start by signing up for the patient portals of all your health care providers, DesRoches says, and finding out what they have there. Through the portals, you might be able to link your digital records, as Nurin did, or request your records as a printable PDF.(As of April 5, these online data hubs are even more rich with information. That's when a federal rule took effect that requires health care providers to give patients free access to all the information in their electronic records, including procedure notes and laboratory report narratives.)Consider an app. To streamline the process, you could connect your patient portals to a third-party medical record-management application. But a cautionary note: apps aren’t covered by federal HIPAA privacy rules, so the onus is on the consumer to review an app’s privacy standards.Krumholz, who founded Hugo Health, a company that uses a cloud-based platform to enable patients to compile their health data, says: Read the fine print to ensure your security is protected and you maintain ownership of your information.Know your rights. Though federal and state laws aim to make it easier for patients to access their medical records, discrepancies remain. Krumholz was a co-author of a 2018 study that found some of the top U.S. hospitals were not complying with medical-record release requirements.The Office of the National Coordinator for Health Information Technology has online resources to help patients understand their rights around medical records.Maintain your medical records. Make sure to hang on to any related to a major health event, such as a heart attack, cancer or surgery, says DesRoches. Related scans, imaging and other tests are also important, Krumholz adds, to help prevent costly and sometimes harmful repeat tests.Use your data. You can use your medical records to keep up with your doctor’s orders, prepare for upcoming appointments, share your health history with new doctors and keep family members in the loop. Having ownership of your medical records makes it easier to get a second opinion, Krumholz says, and to participate in medical research."I'm hoping within five years that this is going to be really common," he says. "[A patient's medical records] will tell a story of their health that can potentially provide insights that may help them and may help others."

Why You Should Manage Your Medical Records

Christina Hernandez Sherwood

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