The Digital Pickwick Club: A Nursing Home of the Future

By Bertalan Mesko MD PhD. Oct 4, 2018

This article was originally published on authored by Dr. Bertalan Mesko, The Medical Futurist.

Social companion robots, chatbots, telemedicine, digital tattoos, gamification – the necessary accessories of a nursing home of the future. Do you shake your head in disagreement thinking that’s science fiction and not the natural habitat of your grandma?

Our short story, the 21st century, digital reconstruction of Dickens’ Pickwick Club will convince you otherwise.

From Santa Fé to Sapporo:

An artist with a robot companion

24 May, 2054

In Santa Fe, New Mexico, the smart alarm tells Amy gently that it’s time for her to get up.

It’s somewhere between 5.30 and 6 a.m., wakeup adjusted to her very own circadian rhythm. The 76-year-old loves the early mornings, that’s when she gets the most creative.

Before retirement, she had a small art gallery in San Francisco but moved when the tech scene overtook the city, and rental prices went crazy.

Now, she lives in a hacienda-style house with a porch, two cats and her social companion robot, Liz.

At first, the tech-phobic grey-haired dame with tie-dyed clothes from her hippie era and thousands of bracelets on her arms and ankles, couldn’t get over the fact that technology would create unnatural vibes around her, so she refused her children’s Christmas gift.

However, after she spent two hours trapped on the floor of her bathroom after she had fallen over, Amy realized she needed company – and Liz takes care of her every need.

She reminds her to take her medication, keeps her agenda, makes sure she doesn’t forget her calls or feeding the cats. After preparing breakfast for Amy, Liz’ face lights up and tells her that it’s time for some fun. Some lightly caffeinated beverage and cereals are on the table, and her friends are waiting.

An engineer with digital tattoos

At the same time, Takashi is getting ready for bed in Sapporo. It’s already 8.30 p.m., and he likes to read the good-old-fashioned paperback books before going to bed.

That’s a challenge sometimes as he is in his 80s having diabetes with a high risk of developing diabetes-related eye disease. Thus, sometimes he lets an audiobook take over from where he left off the book.

And that’s why he wears several digital tattoos monitoring his blood pressure, his blood oxygen level, temperature, glucose and hydration level, ECG and heart rate.

If any value goes out of the normal range, the tattoo sends a notification to Takashi as well as his nurse, and when she sees something strange, she calls up the doctor.

The retired engineer doesn’t have to go anywhere for examinations, his own medical-grade portable diagnostic devices always do the trick, but sometimes a nurse goes to him and helps with the procedures.

Otherwise, he usually talks to his doctor with the help of telemedical applications and his huge screen on his living room wall.

Although he lives alone, he is surrounded by two social companion robots, owns and cultivates his very own, “pocket-sized” Japanese garden on the fringes of the city – he started it as one of his robots, Ilo, recommended it as a new exercise -, and often talks with his brother and his wife through Skype or FaceTime.

At 9 p.m., with his book in his hands, he receives a call. It’s from Amy. Although Takashi doesn’t speak English, the Babelfish real-time translator does the trick for them. And what do a retired American artist and a Japanese engineer have in common?

They are both members of the digital Pickwick Club, a network of book-lovers connected through their nursing home discussing anything from Stephen King to A Brief History of Time.

That’s their way of never feeling lonely and bonding with like-minded humans. As the nursing home operates throughout the globe, without the need for seniors to actually move from their homes, anyone could sign up to be a member of a similar club.

Tons of cognitive challenges, gamified apps connect members and preserve their abilities at the same time.

Moreover, the nursing home’s very own activity tracker makes sure every member pays attention to his or her physical fitness. They can even compete with one another if they wish to.

From VR worlds to exoskeletons: No boundaries, nothing’s impossible

And although members should be concerned about the troubles the time difference could cause, they are not.

It’s absolutely taken care of. An A.I. algorithm carefully analyzes the data of applicants for the Pickwick Club, and pairs members not only according to their interests but also according to their personality traits or medical histories.

That’s how Amy, an early bird was paired with Takashi, who used to work late into the night in his active years.

Today, Jane Austen’s Emma is on the agenda, but first, they have to wait a bit for Nadege from Rwanda and for Dipak from Kolkata.

The latter is always late no matter how many notifications his social companion robot or chatbot sends him. And it’s not even about him not being at home or close to a digital device – he’s just too immersed in one.

Many years ago, he suffered a car accident, and he got paralyzed from the waist down. The doctors told him he would only be able to walk through an exoskeleton and he should, unfortunately, give up climbing.

It took a while until Dipak accepted that he cannot go to Nepal again, meet his favorite sherpas and conquer the Annapurna, the 10th highest mountain peak in the world.

However, when he realized that he can turn to virtual realityand continue his hobby in virtual worlds, his entire life changed. His passion for life returned, he needed much less medication for his back pain, and he started to take an active part in the daily events of his populous family again.

And how did he end up in the Pickwick Club? Before trying VR, his doctors suggested him to read as it could stimulate his brain and to have conversations with completely different people, as that would refine his social skills.

He was hesitant but gave it a try. He has been a member of this treasured Club for the last five years. And though he’s sometimes late due to VR climbing, he already promised the Pickwick Club to organize a VR group climbing experience so they would also know what it feels like.

When he realized he was late again, he jumped over to the screen to meet Amy and Takashi in a split second. Then he noticed, Nadege is still missing.

Nutrigenomics, smart forks and cooking together

Their favorite hummingbird, Nadege, who loves to sing, but has a lot of trouble with her metabolism, lives in Kigali, Rwanda and she was supposed to join them after her lunchtime.

It was around 2 p.m. in the country where digital health became real the earliest on the African continent.

The 72-year-old lady is surrounded by a swarm of trackers and wearables, which monitor her entire digestive system. She takes microchip-enabled pills every day which are connected with her doctor notifying him in case of emergencies.

It is a specially adjusted medication, completely in balance with her genetic background and medical needs: the advances in pharmacogenomics as well as in nutrigenomics enable Nadege to get indeed what her body demands.

And she doesn’t have to leave home for it. Her digital tattoos monitor her medical state, and her social companion robot takes special care of her diet. She is in constant touch with her doctor and her family through telemedicine.

Moreover, her daughter visits her every week, and they cook together.

Nadege loves cooking, but her hand tremor makes it difficult to follow recipes and ration the ingredients, so her daughter helps her.

Luckily, Nadege already figured out how to eat better: she uses smart spoons and forks for complicated meals.

So, she was eating out with her daughter when her mental health chatbot, Molly, reminded her that the Pickwick Club is waiting for her. Molly is a great virtual companion when she leaves home, and her social companion robot cannot follow her.

The A.I.-based chatbot knows her personality, schedule and even tells jokes when senses that Nadege’s mood is blue.

So, it’s time for Jane Austin. Nadege joined the conversation via her smartphone and noticed that the others are exchanging photos and videos of their grandkids and sharing stories about lost and found cats. It’s a promising start! T

hat’s the best in virtual nursing homes she thought to herself: you don’t have to leave your home, your beloved neighborhood, your friends or relatives, the healthcare services come to you when necessary, and you don’t feel alone at all. The digital Pickwick Club is waiting for you every week, at the same time.


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Bertalan Mesko MD PhD

Email contributor

Dr. Bertalan Mesko, PhD is The Medical Futurist analyzing how science fiction technologies can become reality in medicine and healthcare. As a geek physician with a PhD in genomics, he is also an Amazon Top 100 author. With 500+ presentations including courses at Harvard, Stanford and Yale Universities, Singularity University's Futuremed course at NASA Ames campus and organizations including the 10 biggest pharmaceutical companies, he is one of the top voices globally on healthcare technology. Dr. Mesko was featured by dozens of top publications, including CNN, the World Health Organization, National Geographic, Forbes, TIME magazine, BBC, and the New York Times. He publishes his analyses regularly on His popular website has had more than 5 million readers, and he is one of LinkedIn’s Top Voices in Healthcare. He is a member of Mensa International and has been selected by the Huffington Post as one of the 30 biotech thinkers with the biggest global impact. He is a member of the "Committee on Future Research" of the Hungarian Academy of Sciences. He received an MD and PhD in genomics from the University of Debrecen, Medical School and Health Science Center.

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