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Barriers to Technology for Successful Aging -- Same Old, Same Old

Technology adoption for successful aging has no deadline.   Much like aging itself, there is no schedule. So no one ever has to complete the job, or as with communication carriers, even begin the job. But well-meaning associations, committees, advocacy groups, and senior-centric organizations are united in encouraging forward motion. And so the task force initiatives, councils and recommendations are funded and catch the eyes of the media – even if the actual transformation cannot always be detected in surveys. And as with identity theft, phishing, and newly invented scams, tech adoption in the older age ranges can appear to be two-steps-forward, one-step-backward.

You may have read these words in a publication – now guess which year. Technology will be a major component of enabling healthy 'aging in place'.  But a few things stand in the way: "Other barriers that prevent effective use of technologies by older adults include: paying for devices on a fixed income, forgetting or losing the technology, low ease of use, physical challenges, skepticism about benefits, and difficulty learning to use new technologies." Did you guess that this quote: a) comes from an AARP report from 2008?  b) Healthy@Home 2.0 in 2011? c) Or any of a series of research reports published in the intervening years?  Or d) it's from a report published in May, 2016 by a Bipartisan Commission on Healthy Aging? 

Many famous people were on the committee that led to this publication. This was a very b-i-g-g-g-g report -- in fairness, technology adoption consumed only one chapter. Consider that a number of policy recommendations were included, with the intent of boosting adoption of telehealth. There roles for philanthropy, CMS, the private sector, and especially healthcare providers who are still foot-dragging despite incentives, etc.  The document also references the President’s Council of Advisors on Science and Technology report about maintaining independence in aging. That publication was just two months earlier and it energetically endorsed the role of technology's role in encouraging and supporting healthy aging of older adults.   

Connectivity is not free – maybe that's a barrier? Some older adults are not online. Surprise. This was noted in the 2013 Pew research Who is Not Online and Why. In fact, adults aged 65+ accounted for 49% of non-Internet users in that report. Perhaps that is because of lack of exposure, perceived benefit, training, devices, Internet access? One has to ask, with this committed encouragement about the use of technology among older adults, has the cost of broadband changed? Wouldn’t that make a difference in adoption of technologies to help people stay in their homes? Here is the 2015 report – the cost in the US is higher than most other countries. Is that a result of deliberate lack of competition among carriers in the various geographies in the US?  Okay, so perhaps older adults with low enough incomes will use the Comcast Internet Essentials plan ($10/month) in San Francisco. Or maybe not so much. Okay, forget broadband in the home – will older adults just use their upwards of $100/month smartphones to connect?  Oh, only 27% of the 65+ have a smartphone?  And finally, will we read another commission report next year that has identical recommendations but avoids tackling the real problems?


Elders do not use enough technology for only one reason. No one has helped them to WANT it.

In fact very few know what elders do want. They just think they know what would be good for them. And by the way over 55, or over 65, maybe not even over 75 are not the elders that need the technology the most.  It is the very old.  Very old is defined more by capabilities than by age.

What do the very old want?  Not to be a burden. Not to impose on other people. Not to be a problem. Not being able to help others any longer.

Elders quickly realize a cane helps them walk easier and they quickly adapt to using one.  When elders see technology in the same light as a cane, they will use it.

Thanks for provocative observations.  Suggest that slow adoption of technology is not limited to aging at home effort - instead, permeates the entire healthcare delivery system.  While the details reflect the particulars of older adults,  the same problems plague the acute care providers who still struggle to make the Electronic Health Record more than a warehouse of notes, but an actual clinical treatment platform shared across disciplines that is owned by the patient.  The pace of change will pick up when the general public sets an expectation by refusing to act like the docile patients of old, but instead insist on solutions to their problems rather than the current focus on the needs of "the system."


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