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Health Care

South Korea senior care industry gets smart boost

Aging population sparks need for services but cost pressures limit profitability

South Korea is coping with a host of challenges surrounding its rapidly aging society.   © EPA/Jiji

BUSAN -- In the 22 years since her husband died, 85-year-old Hwang Young-suk has lived alone in Busan's Haeundae seaside district. Her children also live in the southern port city but are too busy to visit every week.

Hwang frequently visits the neighborhood senior center to chat or try to win some rice money playing hwatu, a kind of Korean poker. In her apartment, the TV is always turned on at medium volume. "I miss the sound of people," she said.

Thus, Hwang was excited to hear that as part of a trial she would be getting daily calls from CLOVA CareCall, an AI-integrated phone system created by Naver, South Korea's biggest internet and technology conglomerate.

"Even if it's not from a human," she said, "it's welcoming to hear a voice in my house."

Socially isolated elderly like Hwang are increasing in number as South Korea follows countries such as Japan and Germany -- so-called super-aged societies where people 65 and older account for more than 20% of the population.

Hwang Young-suk, like many seniors in South Korea, craves communication. (Photo by David D. Lee)

Large companies such as Naver and SK Telecom, as well as startups, are responding with products and services in a sector the Korea Health Industry Development Institute (KHIDI) estimates was worth 72.8 trillion won ($59.7 billion) in 2020. But a sense of corporate social responsibility and the need to keep offerings affordable for pensioners limits profitability.

SK Telecom, the country's largest wireless carrier, in 2020 introduced NUGU opal, an AI speaker with voice recognition that serves as a 24-hour home digital caregiver.

Services available for 2,200 won a month include a brain exercise program, stretching and exercise, medication reminders and other alerts. For 4,500 won a month, a 24-hour security service can be added for emergency help.

"Family members are usually satisfied with the practicality and ease of the service," said Lee Yoon-hui, a team leader for AI service products at SK Telecom, "while seniors themselves are satisfied with its emotional side, such as talking with the devices or listening to music they like.

"We have continued to develop it as a means to provide assistance to the socially disadvantaged, so we plan to make most of it free of charge starting in late March."

Payment will still be required for the more expensive service that includes the 24-hour security function.

SK says NUGU opal was never intended to make money. The fees were created to pay for the content from its social business venture partner Happy Connect and to generate seed money for business-to-government ventures. "But we realized that even though the fees may not seem like a lot of money, they can still be burdensome to many seniors," Lee said.

Yang Yeong-ae, a professor of occupational therapy at Inje University and president of the Korea Aging Friendly Industry Association, says the senior care industry consists mostly of small to medium-size companies, big tech players like Naver and SK Telecom being an exception.

"For the industry to grow, we need major corporations to jump into the market," Yang said. And while profit constraints are keeping them away, there is a more fundamental issue.

"The health system in our country is too rigid," she said. "For example, the future of managing health is in telemedicine. But our country's doctors oppose doing medical checkups through digital screens."

South Korea, with about 51 million people, is on track to hit the super-aged milestone by 2025. According to Statistics Korea, the population is set to begin a long decline with the total seen dropping to about 37 million in 2070.

The agency also says that of the country's current 9 million elderly, 1.76 million live alone. Health ministry data shows that 1 in 10 of the latter had no contact with family members in 2018, while 1.5% did not participate in social activities.

The government is aware and in 2007 enacted the Senior-Friendly Industry Promotion Act to foster development and standardization. President-elect Yoon Suk-yeol, who takes office in May, made pledges during his campaign to decrease medical costs for the growing cohort of seniors. He has also mentioned increasing the monthly basic pension of 300,000 won to 400,000 won and has advocated making it easier for families who live with seniors to take time off from work, decreasing costs for home care and nursing services while increasing their overall quality.

While nursing homes were the dominant choice for families with loved ones suffering from dementia and other chronic conditions, reputational problems arising from highly publicized cases of neglect and violence have made many hesitant to rely on them. That has resulted in home-visiting caregiver services for seniors who need direct assistance.

Ariacare Korea, launched as a startup in 2016, is one. Its monthly fees of 2.5 million won are similar to what nursing homes charge. Clients can arrange when caregivers visit. Many clients are families with seniors at home but whose other members are busy working during the day.

"We are the first to make home visitation senior care mainstream in our country," said In Tae-keun, the 28-year-old CEO of Ariacare Korea, which has 130 branches and 3 billion won in annual revenue.

It employs more than 10,000 workers who visit seniors; the amount of time the caregivers spend depends on family needs.

"The government provides 1.3 million won in aid for seniors using our service," In said, "but the number who receive this benefit is too low." There are 800,000 seniors who receive Long-term Care Insurance for the Aged out of the total 8.5 million in the country, In said.

The central government has been promoting the program with public service announcements on television, and In sees it as keen to spread the word. But he says when seniors visit local community centers, many cannot find staff who are aware of the program due to weak cooperation between the central government and localities.

Pulmuone Foods is focused on optimizing nutrition for South Korea's elderly. (Photo courtesy of Pulmuone Foods)

Another company involved in senior welfare is Pulmuone Foods, focused on improving diets. The company has been developing ready-to-eat or prepared senior food items, including chopped vegetables and meat.

"But we realized that the most pressing issue for them was swallowing food and also receiving the necessary nutrients from food which becomes harder with age," said Shin Hee-kyung, team manager of the food innovation business division at Pulmuone Foods.

The company is also developing products for particular needs such as a pre-meal drink that hydrates the mouth and does not hinder digestion, while launching protein drinks for seniors who naturally absorb less calcium from food as they age.

But it has had to battle ingrained societal attitudes.

"Our country is in the 'incubation stage' for senior-friendly food products, so we are trying to change the way they are perceived by the public," Shin said. "These products are not necessarily for the old and weak, but foods that help you live a long and healthy life."

Accounting for 24.2% of the total senior-friendly industry, food was worth 1.76 trillion won in 2020, according to KHIDI. And alongside medicine and rehabilitation, food was listed as a top need. Nevertheless, 66.4% of people between 40 and 69 said they had never heard of senior-friendly foods.

Ultimately, Inje University's Yang said it all comes down to seniors who can't afford such services and thus are passive or nonactive consumers of them. The average senior takes in just 15.58 million won a year, according to a 2020 report by the Korea Institute for Health and Social Affairs.

"Our country," Yang said, "doesn't have a big percentage of seniors who are financially independent."

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