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Technology, Older Adults, and Usability

Understanding the Motivators and Barriers Associated with Use

Introduction

In the last decade, society has experienced what some have called a “digital revolution” (Weller & Anderson, 2013).  This shift away from face-to-face interaction as a means for social exchange, communication, and trading of goods has forced individuals to adopt certain modalities in an effort to keep in step with the changing nature of society, culture and technology. Companies, providers and consumers alike are increasing use of technology in most every industry.  This increase in usage is occurring simultaneously in a technology marketplace characterized by rapid evolvement in design and products (Betts & Gardner, 207).  Despite being digital immigrants, older adults illustrate a segment of the population that is increasing in number and are demonstrating an increase in the use of technology, particularly when considering utilization of the Internet. Notwithstanding, not all older adults are as comfortable with the adoption and utilization of technology.

Individuals and business interested in designing and implementing technological products and interventions for older consumers in market spaces focused on meeting the needs of older adults are interested in understanding the factors that influence and motivate older adults to engage with and use technology.  Recent years have witnessed the surge of various technological products and solutions in the aging-related market place, particularly in the area of senior living. Anecdotal evidence suggests that while these products stand to enhance the productivity of business and improve the life satisfaction, there remains the conundrum associated with lack of use on the part of the older client/resident. Many senior living communities are hesitant to invest in various technologies that rely on use by the older resident for concern regarding this lack of use. Regardless, these technologies and products have permeated the senior living industry, while scant research exists investigating use and impact for organizations and end-users/residents and families in these care contexts.

Older Adults and Utilization of Technology

Claims regarding the extent, frequency and factors of technology utilization for older adults vary in the scientific literature. It has been established that, on average, older adults use technology with less frequency when compared to their younger counterparts (Czaja, Charness, Fisk, Hertzog, Nair, Rogers, & Sharit, 2006; Gilly & Zeithaml, 1985). Despite the variations in use related to age and age cohorts, it is a myth that older adults avoid the use of new technology (Fisk, Rogers, Charness, Czaja, & Sharit, 2009). Additionally, research suggests that when older adults are presented with the need to use technology, they are likely to adopt and express a desire to use it (Czaja et, al, 2006). As a result, it is plausible that when creating opportunities for older adults to utilize technology, the “need for use” or the benefits of adopting these technologies need to be clearly communicated.

While the technology industry has focused on the products targeted toward older adults, efforts reflect more design, creation and promotion rather than understanding the factors associated with use. For example, technological tools in senior living are mainly designed to improve quality of life health related outcomes and business systems.  These tools are becoming increasingly popular in the marketplace, however little evidence exists to support their efficacy and benefit of use (Jake-Schoffman, Silfee & Pagoto, 2017). More work is needed to generate evidence for the use of technology for the older adult population and in specific contexts, for example technology use in senior living. Furthermore, researchers, practitioners, and those in industry need to better understand the motivators and barriers regarding implementation, adoption, use and satisfaction for individuals using these tools.

Technology in the Healthcare-Related Marketplace

Technology in healthcare-related systems has advanced from basic knowledge informational websites to fully immersive interactive systems designed to provide dynamic opportunities for acquiring new information, social engagement, and in some cases automated experiences that mimic the lived experiences of individuals in these settings. The senior living environment, similar to healthcare, is becoming increasingly technical. As a result, companies developing and administering technological services in the senior living marketplace need to ensure that their products have a degree of technological and gerontological readiness as well as serve as a tool to meet needs for senior living facilities and the older adults using the technologies/products.

Tools need to efficiently and effectively share information across several systems while providing education and training in the form of modules for users. Additionally, the use of avatars, robotics, and augmented/virtual realities are also gaining popularity in the healthcare and senior living arenas. Implementing an avatar feature and opportunities for augmented/virtual is estimated to become increasingly important to older adult users. In addition to offering a cloud-based solution intended to transform the delivery of services and enhance the resident, family and staff experience in senior living settings, technology companies in the senior living marketplace have the capability to harness the power of technology to continue to develop innovative and practical solutions for healthy aging and to improve the quality of life for older adults and those serving them. Companies that concentrate on addressing aspects of the bio-psycho-social model to support people as they successfully age while ensuring they have opportunities for control, mastery and dignity are novel in their design and approach.

Recently researchers and experts in the fields have identified loneliness as a public health crisis, impacting all populations but especially older adults.  There are many negative health impacts related to feeling alone and disconnected.  Technology has the potential to combat loneliness, create human connection, and bolster social integration both in and out of senior living facilities. Designers and companies selling these technologies would be well served to leverage their ability to foster social integration while improving health-related quality of life.

Additional questions to consider when exploring contexts and types of use, how can these technologies promote ability and empower people to have agency, dignity and power as they age in various environments, but especially within the context of senior living? It is becoming increasingly important to understand the facilitators, potential barriers and preferences for engagement and use of technology among the older adult population.

Types of Use

We have witnessed over the last decade a significant increase in the self-initiated use of technologies, particularly related to healthcare, by older adults (Kuerbis et. al, 2017).  Common types of technologies used include the internet, email, cellphones and smartphones, text messaging, tablets and most recently virtual assistive technologies. These technologies and their advocates purport to make life easier and tasks more efficient and effective. Additionally, healthcare related technologies, particularly those in the senior living marketplace, aim to help older individuals stay connected, navigate their environments, manage their health and coordinate care (Joe & Demiris, 2013). Regarding types of technology being used, Internet/email, cellphones/smartphones and text messaging are the most commonly used types of technologies for individuals between the ages of 55 and over (Kuerbis et. al, 2017).

Older adults are the fast-growing segment of the online-using population. It is estimated that the majority of Internet users are between the ages of 50 and 70; use drops off after the age of 70 which is likely to be related to generational (cohort) use and are mainly using the Internet for health-related information.  Cellphones and smartphones are the number one mechanism used for calling for people over the age of 65 and in 2011, people over the age of 55 sent on average at least two text messages per day (Smith, 2011). The disproportionate use of technology can be seen with respect to tablet use.  It is estimated that older adults use tablets half as much as their younger counterparts. For example, in 2017, roughly 35% of people ages 65 and older owned tablets (Kuerbis et. al, 2017) and ability to navigate pages was slower when compared to younger individuals.  A conclusion to be determined is that despite continued myths, older adults can and are often willing to engage with technology utilized, particularly when it concerns health-related activity.

Motivators and Barriers of Use

It is important to consider a broad context when attempting to understand the factors that impact how older adults will engage with and adopt technology and to the extent that they will demonstrate initial and continued use. Chen and Chan (2013) suggested that there are essentially three types of key factors that impact adoption and use: personal, technical and environmental. According to Kuerbris et. al, 2017, personal factors that impact use involve functional and cognitive status, knowledge or previous experience with technology, attitudes about learning something new, dispositional characteristics and conceptualizing self as capable, physical safety and perceived confidentiality. Technical factors include device-related design and complexity or usability and environmental factors encompass financial costs, social influences and the ability to learn the use of new technology. While the interplay between these key factors impacting use are complex, there are key themes that can be understood with regard to the use of technology in older adult populations, particularly in the context of senior living.

Existing research suggests that for older adults to adopt technology, particularly products used with tablets, they must feel confident and empowered through use as opposed to inadequate and unskillful (Damodaran, Olphert, & Sandhu, 2014; Joe & Demiris, 2013). This translates into creating and offering technologies that include support for older users as well as family and staff to feel self-assured when utilizing the technologies (i.e., voice prompts, avatars, conversational artificial intelligence and on-going training tutorials).  Furthermore, research indicates that older adults are more likely to adopt and use technology when there are available resources for learning/confidence building in place.  These resources involve step-by-step manuals and personal, face-to-face instruction, direct access to trouble-shooting and a supportive environment in which to learn.  All resources need to target an older learner. Technology and related devices also need to be appropriately designed and calibrated for older adults to use. For example, individuals prefer more simplistic design with less steps involve in reaching the desired outcome (i.e., less click-throughs when considering websites or apps). Issues related to declining motor coordination as well as changes in vision and hearing also need to be considered when designing and offering technology to older adults.

Promoting and Bolstering Use

It is safe to assume that all users of technology, regardless of age, desire products and experiences that are useful and use-worthy, functional and meaningful.  As a result, product designers, marketers and consumers should heed suggestions proposed in the scientific literature concerning the promotion and successful adoption of technology for older adults. As stated previously, older adults are more likely to successfully engage with technology when a clear case for the benefits of use are communicated. In other words, there must be a meaningful purpose and benefit of use and those benefits should be evident to the consumer/end user. Furthermore, technology should bolster an older individual’s quality of life, safety, wellbeing and independence (Salovaara, Lehmuskallio, Hedman, Valkonen & Nasanen, 2010).

Kuebris et. al, 2017 suggested several recommendations about the essential aspects involved in providing the optimal circumstances for older adult engagement with and utilization of technology. These key features include making sure that there is a supportive learning environment as well as instructor or ambassador in place, addressing issues of affordability, providing feedback to let the user know that they are doing an adequate job using the technology, and putting mechanisms in place to help identify and correct errors in usage.  Moreover, designing and selecting technologies that are universally accessible is important, having technologies that are transparent or easy to learn is important.  Lastly, it is encouraged that technologies are invisible or that do not intrude into the everyday lived experiences of older adults.

Given the information and recommendations in the scientific literature and from leading industry experts, Oneview Healthcare calls for a needed discourse that addresses technology and gerontologically informed and sound solutions for technologies that target the senior living audience. Those in the fields of technology and healthcare should ensure that issues of universal design ability are being addressed with the products that companies create and market.  User interface technologies targeted toward older adults should involve measures and modalities that seek to maximize accessibility and usability.  If we aim to have older adults successfully adopt and use various technological solutions, then work must be done to make these solutions user-friendly. Additionally, efforts must be made to offer technological solutions that are useful, functional, meaningful and age appropriate.  For more information on Oneview’s Senior Solution, contact Delaine Blazek.

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