DéJà Vu: A Century of Airbnb?

The values of the sharing economy are nothing new to older demographics.

This week, my MIT AgeLab colleague Luke Yoquinto and I published an article in The Washington Post about how the sharing and on-demand economy stands to change the lived experience of old age — and how it will shake things up for business along the way. Whether you're considering the transportation, housing, or care industries, a new class of tech-enabled companies is coming to change the way things are done. In many cases, the new economy is taking services that were once the domain of traditional, "senior"-oriented entities — often not-for-profits and government agencies — and replacing them with services aimed at the full age span. Now, getting meals and groceries delivered, hiring a helping hand around the house, and requesting a ride to your front door have all become things that are not just for Millennials any more but for everyone of every age.

That trend has three major effects for the older consumer: One, there's now a way to get the benefits of these services without any of the stigma that once came with them. Two, this trend will introduce competition in many areas where there was none, ideally improving the quality of available services. And three, this will cost real money.

There are no easy answers to the question of how tomorrow's older adults will afford to take part in the sharing economy. Renting and hiring products and services instead of owning them will equate to a heightened need for liquid cash on hand at all times. One way of taking illiquid assets like real estate or a car and turning them into cash is to put those assets to work in the sharing economy. More and more drivers for Uber and Lyft are over 50, and use their own cars to make money. But perhaps more interesting is how many older adults are using services like Airbnb to rent out rooms, pulling cash out of the ultimate illiquid asset: one's own home.

What's fascinating to me is that as they do so, older adults are actually hearkening back to a longstanding tradition.

During the Industrial Revolution, working-class older adults relied on a sort of family economic strategy to make ends meet, wherein parents collected the earnings of both young and adult children on a regular basis. "Raising dutiful children constituted a wife's most important economic function, since the family eventually relied on children's wages," write historians Carole Haber and Brian Gratton. "In one respect, the costs of raising children, in direct expenditure and in wives' labor, became a form of savings."

It was children who, after older adults found it difficult or impossible to secure factory work for themselves, would support the household. "While [the male household head's] wages appear to fall across the life cycle, children's wages rents, and other sources increase; as a result, household income tended to rise well into the late middle age of the household head," Haber and Gratton write.

In an important respect, that's still the case today. Although the financial role played by children in that model has been handed over to government programs, the fact remains that dutiful (adult) children — usually the eldest daughter — are the ones providing the vast bulk of care for older adults. And there's yet another way that aging today resembles that of the Industrial Revolution. Once again, we're taking on boarders.

During the Industrial Revolution, as households aged, they became more likely to collect rent as a form of income. Around the turn of the 20th century, among working-class households that were neither poor nor wealthy, nearly 30 percent of the 60-plus took on boarders. (Read more in Haber and Gratton's Old Age and the Search for Security.)

Today, many empty-nesters with room to spare are discovering that it makes sense to do the same, this time through newfangled intermediaries like Airbnb. The products and services of the new economy will cost money, but sharing companies can also provide new income sources… that are actually far from new. In many respects, when it comes to how we live throughout the full lifespan, the more things change, the more they stay the same.

MIT AgeLab’s Luke Yoquinto contributed to this article

Photo: Shutterstock/sdecoret

'Upstreamism': Your zip code affects your health as much as genetics

Upstreamism advocate Rishi Manchanda calls us to understand health not as a "personal responsibility" but a "common good."

Sponsored by Northwell Health
  • Upstreamism tasks health care professionals to combat unhealthy social and cultural influences that exist outside — or upstream — of medical facilities.
  • Patients from low-income neighborhoods are most at risk of negative health impacts.
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After death, you’re aware that you’ve died, say scientists

Some evidence attributes a certain neurological phenomenon to a near death experience.

Credit: Petr Kratochvil. PublicDomainPictures.net.
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Yale scientists restore brain function to 32 clinically dead pigs

Researchers hope the technology will further our understanding of the brain, but lawmakers may not be ready for the ethical challenges.

Still from John Stephenson's 1999 rendition of Animal Farm.
Surprising Science
  • Researchers at the Yale School of Medicine successfully restored some functions to pig brains that had been dead for hours.
  • They hope the technology will advance our understanding of the brain, potentially developing new treatments for debilitating diseases and disorders.
  • The research raises many ethical questions and puts to the test our current understanding of death.

The image of an undead brain coming back to live again is the stuff of science fiction. Not just any science fiction, specifically B-grade sci fi. What instantly springs to mind is the black-and-white horrors of films like Fiend Without a Face. Bad acting. Plastic monstrosities. Visible strings. And a spinal cord that, for some reason, is also a tentacle?

But like any good science fiction, it's only a matter of time before some manner of it seeps into our reality. This week's Nature published the findings of researchers who managed to restore function to pigs' brains that were clinically dead. At least, what we once thought of as dead.

What's dead may never die, it seems

The researchers did not hail from House Greyjoy — "What is dead may never die" — but came largely from the Yale School of Medicine. They connected 32 pig brains to a system called BrainEx. BrainEx is an artificial perfusion system — that is, a system that takes over the functions normally regulated by the organ. The pigs had been killed four hours earlier at a U.S. Department of Agriculture slaughterhouse; their brains completely removed from the skulls.

BrainEx pumped an experiment solution into the brain that essentially mimic blood flow. It brought oxygen and nutrients to the tissues, giving brain cells the resources to begin many normal functions. The cells began consuming and metabolizing sugars. The brains' immune systems kicked in. Neuron samples could carry an electrical signal. Some brain cells even responded to drugs.

The researchers have managed to keep some brains alive for up to 36 hours, and currently do not know if BrainEx can have sustained the brains longer. "It is conceivable we are just preventing the inevitable, and the brain won't be able to recover," said Nenad Sestan, Yale neuroscientist and the lead researcher.

As a control, other brains received either a fake solution or no solution at all. None revived brain activity and deteriorated as normal.

The researchers hope the technology can enhance our ability to study the brain and its cellular functions. One of the main avenues of such studies would be brain disorders and diseases. This could point the way to developing new of treatments for the likes of brain injuries, Alzheimer's, Huntington's, and neurodegenerative conditions.

"This is an extraordinary and very promising breakthrough for neuroscience. It immediately offers a much better model for studying the human brain, which is extraordinarily important, given the vast amount of human suffering from diseases of the mind [and] brain," Nita Farahany, the bioethicists at the Duke University School of Law who wrote the study's commentary, told National Geographic.

An ethical gray matter

Before anyone gets an Island of Dr. Moreau vibe, it's worth noting that the brains did not approach neural activity anywhere near consciousness.

The BrainEx solution contained chemicals that prevented neurons from firing. To be extra cautious, the researchers also monitored the brains for any such activity and were prepared to administer an anesthetic should they have seen signs of consciousness.

Even so, the research signals a massive debate to come regarding medical ethics and our definition of death.

Most countries define death, clinically speaking, as the irreversible loss of brain or circulatory function. This definition was already at odds with some folk- and value-centric understandings, but where do we go if it becomes possible to reverse clinical death with artificial perfusion?

"This is wild," Jonathan Moreno, a bioethicist at the University of Pennsylvania, told the New York Times. "If ever there was an issue that merited big public deliberation on the ethics of science and medicine, this is one."

One possible consequence involves organ donations. Some European countries require emergency responders to use a process that preserves organs when they cannot resuscitate a person. They continue to pump blood throughout the body, but use a "thoracic aortic occlusion balloon" to prevent that blood from reaching the brain.

The system is already controversial because it raises concerns about what caused the patient's death. But what happens when brain death becomes readily reversible? Stuart Younger, a bioethicist at Case Western Reserve University, told Nature that if BrainEx were to become widely available, it could shrink the pool of eligible donors.

"There's a potential conflict here between the interests of potential donors — who might not even be donors — and people who are waiting for organs," he said.

It will be a while before such experiments go anywhere near human subjects. A more immediate ethical question relates to how such experiments harm animal subjects.

Ethical review boards evaluate research protocols and can reject any that causes undue pain, suffering, or distress. Since dead animals feel no pain, suffer no trauma, they are typically approved as subjects. But how do such boards make a judgement regarding the suffering of a "cellularly active" brain? The distress of a partially alive brain?

The dilemma is unprecedented.

Setting new boundaries

Another science fiction story that comes to mind when discussing this story is, of course, Frankenstein. As Farahany told National Geographic: "It is definitely has [sic] a good science-fiction element to it, and it is restoring cellular function where we previously thought impossible. But to have Frankenstein, you need some degree of consciousness, some 'there' there. [The researchers] did not recover any form of consciousness in this study, and it is still unclear if we ever could. But we are one step closer to that possibility."

She's right. The researchers undertook their research for the betterment of humanity, and we may one day reap some unimaginable medical benefits from it. The ethical questions, however, remain as unsettling as the stories they remind us of.