Technology and Older Persons Issue Overview
Gene Loeb, Ph.D.
Center for Mental Health of Elderly,
United State
Today there are large-scale efforts globally to provide older persons with technology. From a small village in Zambia, to an eye clinic in Ireland, and to an elder community in Hong Kong, technology is being utilized in a variety of ways to enable older persons to communicate, play, to obtain telehealth information, and to remain in their homes instead of being institutionalized.
This escalation in technological applications is propelled by several circumstances, coming together at the same time--a large increase in the numbers of elderly in many nations such as the United States and China, revolutionary developments in the technology itself, increased knowledge about aging and the needs of the elderly, and a growing concern for the care of older persons.
Additionally, economic considerations drive the quest for technology able to provide maximum care while minimizing costs. In the United States, there is a concerted effort aided by technology to help older persons remain in their home as they age rather than go to a nursing home including through the use of such devices as sensors to monitor health issues, and computers and related devices to enable emergency and other communications.
This issue reports on the use of technology in support of older persons and particularly focusing on older persons in their communities and with their community relationships and it draws from a variety of settings and a variety of technology enabled applications. These latter include technology to support telehealth, leisure, obtaining information, communications, and gaming; psychological supports including to avoid loneliness and game playing; the installation of infrastructure to bring broadband or radio connections based safety to an elder community; internet training and intergenerational communications; and including a closeup of one researcher's long term membership in a computer learning group, with deep insight into the member's psychological changes as they age in a computerized environment.
One major element connecting each of these studies and uses of technology for older persons is the Information and Communications Technology framework understood within a community focussed -- community informatics orientation. Each application has, at its roots, a community. These articles could not be understood without realizing the effects of the technology applications upon a community, or the community's effect upon the application.
Only by examining a group of studies and reports of technology use such as this one by and for older persons does one recognize the profound interaction between the elder's community and the ICT applications which are directed towards them, usually as individuals. In the case of telehealth, for example, sensor derived information and reports are sent through the Internet to a community of medical providers collaborating to care for the patient. In the use of online communities, groups of persons link together online for a common interest. Even in the use of Wii for physiological development of the older person, the activities were done in the context of a group for social reinforcement.
This community information focus is seen globally in the design and implementation of the applications as well. In the rural Zambian village of Machsa, residents worked together to get the radio and internet technology and maintain it. The elderly of a small Hong Kong community are protected by an alarm system linking them with caregivers to provide services when needed. In the United States, a group of seniors take computer classes led by another senior while another group plays “brain training” or cognitive growing activities online.
A purposeful effort was made to select studies that 1) reflected a variety of technical applications representative of a community informatics framework, 2) a variety of geographical locales, and 3) significant and promising research approaches. An intention of this special issue and this selection is to stimulate further research and applications development reflecting this strong element of community as a core contributor to the well-being o fthe elderly.
Thanks are offered to the dependable cadre of reviewers, the assistance of the capable Jennifer Dicman, the special efforts of Dr. Wayne Lamonde, of the University of Denver for his exceptional reviewing and editing work, and to the chief editor and prolific community informatics professional, Dr. Michael Gurstein.
Overview, comments on Studies
While it is true that the use of technology makes a large difference in the lives of many elderly, the technology itself cannot be designed in a vacuum. The lives and environment of the technology user needs to be considered in its development. In Life-based Design Against Loneliness Among Older People, Leikas, et al, apply what they call a "form-of-life based design" approach to understanding the daily lives of the elderly and drawing from this direction as to their needs as a basis for technology design. Development of technology interventions must start with a knowledge of the environment of the user and in this instance the elderly user.and particularly those who are suffering from loneliness..
Barbara Barbosa Neves, et al, in Too Old for Technology? How the elderly of Lisbon Use and Perceive ICT, examine the attitudes of elderly of Lisbon, Portugal, concerning their use of cell phones, computers, and the internet linking it with their use of technology. Their results provide insight concerning social participation and access to information, and, overall how to increased technology confidence and skills.
Paula J. Gardner, et. al, in their useful study, Getting Turned On:, Using ICT Training to Promote Active Aging in New York City, used the premise that a planned, consistent thorough ICT training program would show positive results. This program, OATS, took place in four New York City locations. This program provides a model by partnering with over 50 non-profit organizations.. Among the results of participation in the OATS computer training program are "increased and sustained computer use, improved ability and confidence with computer and internet technology, and a substantial and positive effect on social connectedness, access to information, and social and civic participation.”
Helen R. Feist, et al, in their report of the initial part of a pilot study, Older And Online, Enhancing Social Connections In Australian Rural Places, focus upon increasing the social relationships of the rural elderly. Their study provides insight into supporting the use of ICTs by the elderly and give useful vignettes of several of their participants.
In a small city, In Canada, Susan O'Donnell et al, in Older Adults And Video Communications: A Case Study, present the use of visual tools for communications among elderly including Skype, and video conferencing.
In an exciting preliminary study, A.J. Kok et al, Seniors Skyping: A Professional, Academic, and Community Collaboration, also presented the use of visual tools for inexperienced users in a nursing home in the United States and one in China. There study present a practical exploration of the preparations that needed to be made, such as training in use of the camera and the need for cueing of participants and thus provide important insight into the future design of such programs.
While many of these studies provide a close look at characteristics of the participants, Norma Linton, in Roadblocks and Resolutions in the Technological Journey, provides a unique 12 year longitudinal examination of the challenges of learning about new information and communication technologies by elderly members of a computer club. This valuable ethnographic study describes social networks and the difficulties of learning this technology late in life.
Use of technology for communications is highlighted by several articles, each differing in research methods. Burmeister, et al, in Sustaining Online Communities Involving Seniors, looks at two means for seniors to communicate, an email list, neat, and the web portal, greypath. The researchers briefly introduce these with two case studies, and then offer an in depth look at the factors leading to their continuation. The paper uses a conversational tone to describe many features operating within groups and positive effects on participant development while recognizing and utilizing the differing needs of group members.
In another study involving the greypath portal, Burmeister, in What Seniors Value About Online Communities, another research method, a new design methodology was employed to determine values resulting from technology use. The key moral and social values were emphasized. Consequently, social values were found to predominate for members of greypath, who were questioned what was important to them about an online community. They especially valued neighborhood as community.
Elizabeth Spradley, in Recareering Happily After: An analysis of Job transition Storytelling in AARP's Magazine and Related Message Boards, comments on an AARP magazine message board are analysed in relation to job experiences. The comments, termed histories uses communications theory to study the content and effects. This novel study of the use of the histories revealed a virtual community with this interest, as a means of social support and discipline unsupportive storytelling.
Several articles describe the provision of an ICT Infrastructure and its results on elderly.
Gertjan van Stam and Fred Mweetwa in this outstanding article, Community radio Provides Elderly a Platform to Have Their Voices heard in Rural Macha, Zambia report on community radio, accompanied by phone and internet. This rural culture relies on oral communications and the radio is valued highly by the community. The elderly are greatly involved inn putting on their own regular radio program. Most elderly persons mentioned the need to transmit information on culture and intangible heritage as it can shape the future of their children. Also many young persons mentioned the need for cultural information. Comments included “culture signifies where we come from", “there is no future without history", and “without knowing our culture a person does not have a future”.There was the strong desire to amplify the voice of the cultural custodians as enshrined in elderly people.
Don Samuelson and Jim Ciesla, in the United States, wrote in The Getting Illinois Low Income seniors and People With Disabilities Online Demonstration STOP SBA project, about a federal government funded program in which 24 apartment buildings in Illinois, with low-income elderly, fitted with broadband, internet access. A computer lab staffed daily with a professional, is there to explain services and train elderly residents.
Carmen Ng, in Hong Kong, reports on a unique emergency service for seniors using IC technology. After a disastrous cold spell in 1996, in which many homebound elderly died, the Senior Citizen Home Safety Association (www.schsa.org.hk) was established to give 24-hour emergency support service to the elderly. In Serving Seniors With Simple Technology-From Indoor to Outdoor Emergency Support and Care, A “personal emergency link service, an integrated communications system connected to landlines was started. It is now joined by personal locater service with a one button for service call device for those elderly outside. Financed by donations and fee for service, it is staffed by 300 employees and social workers. It has aided over 150,000 persons in 15 years.
Several articles looked at different ways to treat health issues of elderly.
Blaithin Anna Mary Gallagher et al, focused on social exclusion of elderly with vision problems in reviewing several ICT projects in Ireland and other European sites. They write, in Aging, Vision Impairment and Digital Inclusion in Ireland of several promising programs to provide computer literacy and adaptive devices to participants.
Jeremy Rich et al, in Empowering Chronically Ill Patients And Caregivers Using Remote Monitoring Technology, document the development and use of a remote, patient-operated monitoring system for elderly with certain health issues in the united states. The emphasis is the cooperative development of the system between the elderly participants, the medical community, and the instrument developers.
Brian Beitzel, in his Point of View article, How Not To Forget Your Next Appointment: Use Technology To Combat The Effects Of Aging, refers to research to explain the effects of using forms of ci technology for cognitive stimulation, exercise, puzzles, and games, to maintain mental health.
Maiga Chang, et al, in Tele-Physical Examination And Tele-Care Systems For Elderly People, describes a detailed technical CI system to diagnose and get treatment for elderly. The system, involving graphs and diagnostic tools, allows for the elderly participant to “examine” himself, using instruments, and sending the results to the medical community. This project demonstrates the cooperation of the scientific developers, the medical community, and the elderly participants.
Galit Nimrod, in Online Communities, As A Resource In Older Adults' Tourism researches the use of internet for the purpose of obtaining information rather than use for pleasure. He uses the seeking of tourism information as the objective and analyses the communications on several online communities
For topics pertaining to elderly, and the characteristics of the communications.
Several articles explore ICT and leisure programming.
Lynda Jeanine Sperazza et al, reports, in Tomorrow's Seniors: Technology and Leisure Programming, analysed recreational use of computers, dividing residents of a nursing home into two groups, the older seniors, and the younger just 65 and below “boomers”. The types of computer use was inspected, email, Facebook, and games. Recommendation of more game use was presented.
Justin Keogh, et al examine the benefits of using the Nintendo Wii video game product by elders in a New Zealand nursing home. The study, Can The Nintendo Wii Sports Game System Be Effectively Utilized In The Nursing Home Environment: A Feasibility Study? Views participant use of Wii, the social aspects ie. Interaction with others, and benefits in fall prevention. Residents mostly played Wii golf and interacted with others in this small community. It was also accepted by staff demonstrating that this is a viable device for adaptation in other nursing home communities.
Intergenerational use of ci technology was examined in two different studies
Ulla Bunz, in Revisited: Communication Media use in the Grandparent/grandchild Relationship, the use of technological devices between elderly and their grandchildren are studied. Two theories related to usage, “media richness theory”, and “social influence theory,” were used with the variety of communications media used in the grandparent-grandchild communications.
The differences in usage between the landline, cell phone, via email, via letters or cards, or by instant messenger were investigated. Other considerations were also observed.
Yunan Chen, et al, used a popular social networking online game, qq farm in an intergenerational communication study in china. In I Communicate With My Children In The Game: Mediated Intergenerational Family Relationships Through A Social Networking game, the communication was found to add to the richness of intergenerational communications helped by the characteristic that both didn't need to communicate simultaneously. The game displayed activities of each person and reassured them that each was fine. The game added to the richness of the family dynamics, not substituted for it. “for older people, getting in touch with their adult children and receive caring and loving messages are crucial for their health and well-being.”