After my family lost my mom to a cardiac event masked by other health issues, we wanted to make sure we could all have more info on my dad. He doesn't have any extraordinary conditions, so doesn't need specialized equipment. But with the consumer devices on the market, it seemed a no-brainer to upgrade his iPhone 6S and give him an Apple Watch to track his health -- especially his heart.
There was just one problem: My dad's not a big gadget guy. He turned 65 this year, and while no neophyte, he's never rushed out for the latest devices. Instead, he'd typically wait until we'd learned how our new cellphones worked before buying the same model so we could teach him all the tricks. This time around, he'd have to learn to use an iPhone without a home button. And he'd have to get used to charging his Apple Watch each day or so.
Ultimately, we had to consider whether this mainstream tech would be convenient enough to track his health on a daily basis.
"Since I've got the MacBook and the iPad and the iPhone, it was like, yeah, let's just get an iWatch," my dad said, punctuating his non-techyness by misnaming his newest device. But he also understood our concerns.
"I think I'm at that age where I gotta start thinking about my heart," he said.
My father's not the only one. Health tech is getting more important for his fellow baby boomers, many of whom have already begun aging out of the workforce. And seemingly on cue, the tech industry has shown up with a bevy of devices to help manage their care in their later years. While this technology has been a blessing for some, alerting them to heart issues like irregular rhythms or other unusual activity, companies themselves are still warning that we shouldn't rely on their devices just yet. Apple regularly warns, for example, that its wearable isn't "intended for medical use" and is "only designed for general fitness and wellness purposes."
Studies have been cautiously promising, like this 2019 Apple Watch study that found the wearable measured heart rate with "clinically acceptable accuracy" during workouts, though the authors felt it was too soon to recommend the smartwatch outright for cardiac rehabilitation, in part because researchers couldn't gather consistent-enough data yet to rely on it. Health care professionals, too, are still figuring out how to work health-tracking wearables into their practice, and those devices are far from being on everyone's wrist as some consumers can't afford them while others don't want technology monitoring their activity.
"In general, health care professionals recognize the immense potential of consumer technology to be able to advance clinical care and improve health outcomes," said Steven A. Lubitz, physician and associate professor at Massachusetts General Hospital who was lead author on a paper published in July on consumer wearables tracking cardiac health. But, he warned, they still can't replace professional equipment, which often uses many more sensors stuck around a patient's body to gather the most accurate information possible. Medical-grade devices have much smaller degrees of error than consumer gadgets, and for potentially life-threatening indicators like atrial fibrillation, it's risky to get the diagnosis wrong.
Still, my sister and I have been impressed with our respective Apple Watches over the years, so we figured that, if nothing else, it could serve as a form of techy reassurance beyond our father's doctor visits. Also, it might detect if he ever fell, which the World Health Organization says is the second-leading cause of unintentional death worldwide behind car accidents – which the newest Apple Watches track now too. The optional cellular radios for the Apple Watch make it that much more appealing too, knowing it doesn't need to be near an iPhone to call for help.
To be sure, setting my dad up with an Apple Watch wouldn't be a substitute for regular health checkups, which are especially important as people age. But there's good reason to do more. Heart disease is the No. 1 killer of men and women in the US. Someone has a heart attack every 40 seconds, data from the Centers for Disease Control shows, representing one out of every five deaths across the country. In the time you've been reading this story, about nine people have died from some heart issue.
It's a disease that hits nearly every family in the world, regardless of race, sex or wealth. It was a factor in my mother's death at 67 years old – much younger than we ever were prepared to lose her, with very little warning, before we thought to look out for her heart. Both of my father's parents and several of his uncles passed due to heart issues too. And while no wearable can directly anticipate heart attacks, keeping a close eye on overall health just seems smart.
"I wouldn't have thought that heart issues would affect you so early in life before mom," my father told me, speaking of his wife's passing. "She had health issues, but we never worried about cardiology."
What to buy when upgrading a tech-unimpressed parent
While health-tracking wearables have made major strides since they debuted as activity-monitoring trinkets, there are still some places where they need to improve before they become a commonplace accessory as we all get older. People still struggle to find the data they want and understand what it says, noted Ramon Llamas, research director at industry watcher IDC. People still need support from professionals and family to explain how they can track their most important metrics too, especially ones related to their health conditions. Said another way, these devices need to get past the gadget phase.
"Falling short of any of these makes the device a non-starter," Llamas said.
We settled on upgrading my dad to an iPhone 13 Mini, because he's one of the few phone owners these days who doesn't like large screens. I worried that he'd struggle with losing his old iPhone's home button to rely completely on Face ID, but he adjusted easily. One thing I learned from this experience is that my father is much more comfortable with change than I expected.
After the iPhone, next was getting him an Apple Watch to track more personal health information. We chose the iPhone over a Garmin or other wearable because of its seamless integration with his iPhone, iPad and Mac. He'd worn watches for years, transitioning from handsome but simple analog timepieces to a series of affordable digital Timex wristwatches until having a smartphone made them obsolete. Donning an unobtrusive black Apple Watch 8 was easy, just resuming his habit of wearing a pragmatic watch. Even the annoyance of charging it every night didn't deter him from dutifully wearing it every day. He didn't even feel like he had to replace the basic rubber sport wristband.
We went with the newest Apple Watch because we were concerned that older ones, with fewer sensors, might not detect crucial health irregularities.
My mom had worn an Apple Watch 3, which tracked her steps and heart rate but didn't have the capability of taking ECGs to watch out for heart arrhythmias, a feature added a year after hers was released in 2018's Apple Watch Series 4. As she got older, I pondered getting her a newer model, but since she struggled to keep her older one updated, I figured it was best to stay with what we knew.
I'll never be sure if buying her a newer Apple Watch would have flagged that her health was declining enough to get her into the hospital early. In fact, I asked Lubitz, the physician, and he didn't think any Apple Watch would've been able to detect a cardiac event of the kind we suspect she suffered. But I can take comfort in giving my dad a better chance, if only in our minds.
Growing pains and promises
While my father generally took to his new devices well, it wasn't perfect. He's set up his most important complication on his watch face – a pedometer – but hasn't embraced "closing" those less tangible fitness rings. Setting up sleep tracking took time as he learned to top up the battery on his watch before wearing it to bed. We really haven't gotten any helpful insights from all the data either – his daytime blood oxygen levels are normal, but experts warn the sensors may not be as accurate as we'd like.
While he hasn't found much use yet for the new skin temperature feature in the Apple Watch 8, he is paying more attention to his health generally, thanks mostly to that easy-to-see pedometer. "I definitely have made a point to get out and do more steps when seeing I'm only at 4,700 steps out of 10,000," he told me recently. He appreciates the nudges to get up and move around too.
But he wishes the Apple Watch could do more. He'd like more automatic tracking of stuff like blood pressure and the ECG. Like the rest of us, he wants his smartwatch to be smarter.
"I want to be sitting here and it goes 'beep beep beep, there's a problem!'" my father too. Preferably after that, it'd tell me too.
My father's primary care physician told him that if any of his results looked out of the ordinary, he could reach out to follow up, but their software doesn't easily work with data collected by his Apple Watch or iPhone. Even though the smartwatch's ECG function is FDA cleared, his doctor doesn't have a use for its data. (My dad also plans to talk to a cardiologist, but I suspect they'll say the same.)
This is how early we are in consumer tech's effect on health care, as Lubitz and his colleagues noted in their paper. Patients are still learning how best to use their devices, while health care professionals haven't decided how best to integrate all that device-generated data into their practice and treatment. And we're still waiting for Apple to integrate the holy grail of cardiologist health metric tracking – blood pressure – which could further warn when patients' hearts are in danger.
I know there isn't any device that will magically protect my father from the ailments that come with age. But having some of this data is at least reassuring, as is knowing the watch will be there if he gets in an accident or falls.
I hope he'll never need them. But it's comforting knowing they're there if he does.