Seniors and Technology Access

Getting it right

Woo-hoo! Internet usage is up! Those of us who are technology enthusiasts get all excited with these sort of data (from Pew Research, January 2009): "The biggest increase in Internet use since 2005 can be seen in the 70-75 year-old age group. While just over one-fourth (26%) of 70-75 year olds were online in 2005, 45% of that age group is currently online." And 24% of those aged 75-84 are online. And, of course, there's my favorite broadband statistic about broadband access among 65+ rising from 19% in 2008 to 30% in 2009.

Even centenarians read email, and web surfing keeps the aging brain active. The Evercare survey of 100 healthy centenarians could really look like a trend to technology optimists like me. You may remember that 19% of responders use cell phones and 7% were using email. And we know that surfing the web is good for the aging brain (studies show this through age 76). But let's not confuse technology optimism with reality. Questions remain about the oldest among us:

1. Who is the customer? I visited a Selfhelp independent living complex in Queens today, where I had a pleasant chat with a 90-year-old woman who still walks six blocks to the library for a concert, plays mahjong with her friends daily, and does her own shopping. She had QuietCare motion sensors throughout her apartment. I tried to interest her in the concept of a cell phone since her friends have them. No need, she said. Her dial wall telephone kept her nicely in touch with her adult children—when she is in. What about a computer? She smiled very graciously, told me that she took the training, and couldn’t see the point. Online mahjong? Order her groceries? Email with her kids? No thanks, she smiled. (Note: And Selfhelp has the wonderful benefit of a full-time tech administrator.)
2. What is the profile of those most served? On the other hand, home-bound seniors—those visited by care or case managers—who don't get out of their apartments, to the library, or anywhere else, seem like obvious candidates to use technology. But could you push a QuietCare (or WellAWARE or Healthsense or GrandCare) system into the home of the most stubbornly independent? Who will pay for a home-bound 90-year-old's system? How will he or she find out about such risk-avoiding technology? And, as in this example, if a senior is healthy and active, is a system necessary? Or just reassuring?
3. What is the compelling argument about cost of computing? Let's assume (1) that you could persuade the very independent that they would enjoy a computer, (2) that you could convince the frail and home-bound (or their families) that an enormous social benefit could be realized with a computer, and/or (3) that you could help them understand that hospitalization could be avoided with home monitoring (as studies have shown). Who buys the computer? Who pays the bill for tech support? Who provides the tech support arrangement or covers the ongoing service fee? Perhaps grants and state funds can help, as in the case of Selfhelp in New York and NewCourtland in Philadelphia.
4. Are adult children the right customers for home monitoring? I was reminded of this when a friend told me about his still-sharp 94-year-old father and 89-year-old mother, who has mild memory impairment. Both parents suffered bad falls in their house, but neither was discovered right away. The woman wasn't noticed by her husband, who can’t hear well and had the TV at high volume. And on another day, he fell backward off his chair and couldn't get up until someone looked in on him. Meanwhile, the adult children are trying very hard not to interfere with their parents' “independence” and denial, recognizing a looming crisis.

For the oldest, the profile of receptiveness and access appears narrow. So I wonder. Today, if you have technology advocacy in senior housing AND social work AND seniors are receptive AND family members are aware and interested AND a payer can be found, then 85-and-older individuals may encounter the risk avoidance of home monitoring systems. Similarly, access to a computer and the Internet is constrained by awareness, financial capability, availability of tech support, and, not least, adequate training.

More solutions are needed. Here are a few thoughts. I would like to see large corporate users of PCs examine their technology refresh cycles (typically three years) and donate their computers to senior centers. I would like to see volunteer networks of tech-smart individuals (including retirees) formed into well-organized clusters around neighborhood senior housing, homecare organizations, and senior centers. AARP could be that organizing entity, although its center of age gravity appears headed downward.

I would like to see computer vendors like HP, Microsoft, Dell, and IBM follow the example of Verizon and HopeLine (for victims of domestic violence): Donate technology to senior centers, but go one step further—donate train-the-trainer time and fund videos of training that can be circulated. Pay for public service advertising that could get the attention of adult children. Remember that one of two baby boomers has at least one living parent. The odds are good that this parent may be one of the 5.3 million aged 85 or older, the fastest-growing age group.

By Laurie Orlov
Aging in Place Technology Watch Blog

[Originally posted October 26, 2009, at Laurie's Aging in Place Technology Watch Web site.]