Eileen Morrissey has always been independent. But at 91, she can no longer drive, which has made it hard for her to get to the grocery store.
At least once a week, she calls SilverRide, a San Francisco transportation service that takes elderly clients on errands of their choosing.
"When I went to do my Christmas shopping, they carried my packages to the car," Morrissey said. "They're easy to talk to and they keep you in conversation."
Morrissey is among those seniors who are eschewing nursing homes in favor of independent living. In an October poll conducted by the Associated Press and the baby boomer site LifeGoesStrong.com, more than half of respondents older than 65 said it was "very" or "extremely" likely that they would remain in their homes throughout retirement. The demographic has inspired new businesses that cater to the health needs and social lives of those who prefer to "age in place," as it's called.
"Technologies for aging in place is a $2 billion market now, but I project that it will grow to $20 billion by 2020," said Laurie Orlov, head of a market research firm that studies such technology.
Because of longer life spans, the rising cost of nursing homes and the difficulty of selling homes, only about 3.1 percent of Americans older than 65 lived in nursing homes in 2010, down from 5 percent in 1990, according to census figures. And the older population is surging; 10,000 people will turn 65 every day for the next 18 years, according to the Pew Research Center.
Jon Pynoos, a professor of gerontology at the University of Southern California, said although $20 billion may be optimistic, "it's not an unreasonable estimate."
"We're going to see more technology built into houses, and we're going to see more portable devices," he said. "The number of people in the old-age category will increase dramatically, and those peoples' homes are not well-equipped in terms of addressing the needs they have."
At-home devices for seniors have come a long way since Life Alert, the classic emergency-response system with its token tag line, "I've fallen, and I can't get up!" Although fall prevention is still a big part of the senior market -- tumbles are a leading cause of injury among older Americans -- the newest devices are more discreet. Researchers at Virginia Tech and the University of Virginia are developing a fall-prevention device that can be worn as a piece of jewelry. It measures changes in gait or stability over time.
"If a person decreases their walking velocity or is more prone to instability, we can use that information to identify health conditions and how that can influence the likelihood of falls," says Thurmon Lockhart, Virginia Tech engineering professor.
The innovations go beyond preventing falls. Inspired by studies showing that music can help with depression, Alzheimer's and other ailments, entrepreneur David Schofman grew determined to make music therapy available to the masses.
After more than a year of working with the Center for Mind and Brain at the University of California at Davis, Schofman's team found that music played at specific volumes in a certain order could reduce adverse mental-health symptoms.
The company, Coro Health, is essentially Pandora for the aging. For $9.95 a month, a customer can order playlists geared toward specific conditions -- each with a tailor-made mix of beats per minute, vocalization ranges and volume.
"Every person's music prescription is different. If you don't have memory issues, you wouldn't listen to same songs over and over," Schofman said. "And no country music for the depressed."
There are also countless low-tech solutions. Kathi Sitek of Macomb, Mich., was a caregiver for her parents. To better manage her mother's complex medication schedule, she taped the pills to a strip of cardboard and labeled them. "It's mind-boggling when you start having to manage medication," she says.
Thinking she was on to something, she manufactured a version using blue plastic and dubbed it the Pill Pouch. The Pouch's left side has clear pockets, and the right side has room to write the name and dosage. She has a patent pending and sells the pouch for $10 online and at retailers.
Jeff Maltz was thinking about starting a business in 2006 when a friend asked him to volunteer as a driver for seniors. The woman he helped, an amputee, told him that the volunteer drivers were "the only people I ever see." "These people want to get out and socialize," Maltz said, "but sometimes they just don't want to impose on their families."
The experience got him thinking about a taxi-type service that could take seniors on outings led by caring workers who share their interests.
With 70,000 trips so far, clients have ordered SilverRide to go to the grocery store, to visit the opera, even to go on a one-Walgreens-after-another search for discounted Elmer's glue (to each his own). The price is tailored to the nature and length of each trip.
The service has proved so popular that Maltz is expanding nationally. "Demography is destiny," he said, "and we have a massive older population."
These entrepreneurs have run into hurdles, such as navigating the complex insurance requirements associated with providing care for seniors.
"We had to work our procedures and insurance correctly so we could administer first aid, for example," Maltz said. The purchase of an in-home health product can bring up some uncomfortable emotions, says Maria Lipani, a social worker who runs a geriatric care management blog. After all, getting an iPad won't make someone feel unduly supervised, but getting a fall detector might.
"There are a lot of existential transitions that people go through," Lipani said. "And the big one is needing help."