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Empower the user -- product design assumptions for boomers and seniors

Socially and personally, information access empowers.  BCS (once known as the British Computer Society) published an interesting report this month called "The Information Dividend: Can IT Make You Happier?" This study of 35,000 examines the relationship between access to information and the means of getting it with responders' life satisfaction. It concludes that IT has a positive impact on life satisfaction for all levels of income and other factors that are typically used to determine well-being. And the study, according to the authors, demonstrates that access to information and technology "extends the sense of freedom/control which improves well-being." Most intriguing, it found that correlation with life-satisfaction as it relates to information technology was greatest among the most disadvantaged -- that is, those with lower incomes and the least amount of education.

Technology access empowers us -- but not 'them'?  Those who are reading this (including some recent blog comments about ageism) would agree that if they were cut off from any online access, if their smart phones, computers and networks were removed, they might be, at minimum, uneasy, if not miserable -- they would be suddenly 'unempowered.' So let's think about recent product designs for seniors -- whether it is computer-less e-mail, whether it is a single-purpose PERS device for emergency use, whether it is a device placed in a senior's home to reassure baby boomer children that their parents are okay, whether it is an automated phone-like device, or calling services to check on a senior. And during this ATA week, think about telehealth devices for reporting biometric status of elderly chronic disease sufferers -- these designs offer no mouse, no keyboard, and no information beyond disease-related questions at hand. All of these products are designed on an assumption:

Boomers will adapt, but mom and dad are tech-phobic and won't. Although their baby boomer children, the nurse, and the other responders are presumed to be fairly tech-literate to respond to transmitted information offered on multiple device platforms, the user -- that is the senior/care recipient/patient is deemed incapable and unwilling to do more than the single purpose device requires. And of course, designers know this because "their mother, grandmother, mother-in-law, father, uncle, etc. 'won't' use a computer or anything that resembles it" -- thus validating this anecdotal assumption -- or assumptions are confirmed by statistics that reflect the low penetration of internet and broadband access among older population groups.

But why not just think a bit about empowering the user?  What if designers of caregiving technologies or inventors and marketers of products that target 'computer-phobic' seniors are actually wrong about the user? What if the (fairly low)  Pew Research numbers about Internet use and broadband access among American seniors are misinterpreted as accurate inputs to product design, but are just artifacts of a society that assumes some, and therefore all, older people/patients/care recipients are tech-phobic? What if, as the BCS study demonstrates, women (the archetype for age-related products and services) gain the greatest sense of freedom and control over their lives with access to information, and therefore the oldest women would be the greatest beneficiaries in terms of well-being if they had access to IT beyond the single-purpose device or call?  Perhaps the target market for PERS devices, even automatically alerting ones, are also the optimal target for a computer and an Internet connection? For an 82-year-old frail woman living alone, how about co-marketing (or even mentioning) a solution that includes the PERS device and a touch-screen laptop? Maybe HP would sell more Touch Smarts if Philips co-branded them? And for the most tech-phobic, how about suggesting a training program and follow-on product that does have a mouse and a keyboard?

In the not-so-distant future, maybe even now, chances are that one or another of these products designed on assumptions of tech-phobia will fall into the hands of someone who may have a friend or a neighbor with full Internet access and wonders why the tech-phobic person is shut out. It's just a matter of time.



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Even as the CEO of a company who makes computerless email, I would be the first to advocate that all seniors should ideally learn to fully use a computer (or now an iPad or other device). That said, IT IS NOT REALISTIC! There is a huge group of people out there who 1) don't want a computer, 2) will not accept learning about a computer, and 3) will never be convinced otherwise. I would go as far as to say that Laurie's opinion -- and mine expressed in the first sentence above -- are actually ageist opinions. Those two statements presuppose "what is good" for someone. The Pew Internet and American Life Project trend data indicate that 38% of Americans over 65 years old "go on the Internet, even occasionally" and "send or receive email, even occasionally." What does this mean for the other 62%? That, as Laurie suggests, they are untrained, misinformed, or worse? What if, they have actually made an informed life decision that the pain and cost of using a computer is not worth their mental energy or pocketbook? And who is anyone to say that they are wrong?!! How about this: how about letting people decide for themselves what they want, without putting burden on a product developer as to whether they created a product that is "good" or "bad." In my humble opinion, pundits who make it their job to evaluate a product's worth are completely missing the boat. There is only one true evaluation of a product's worth, and that is if the people who own it, like it. In the case of my company, it's easy for me to stand behind the seventy-five five star user reviews on Amazon.com, and the twenty-seven five star on drugstore.com, and the flood of testimonials I receive from people for whom Presto is a Godsend. Should we shut down the company or make the product more computerlike because of some totalitarian vision of "knowing what is best" for everyone? I will take my chances with people voting with their pocketbooks, thank you very much. In a perfect world, would everyone use a full computer? Yes! Do we live in a perfect world? NO!!! Read the user reviews mentioned above by going to http://www.tinyurl.com/prestoamazon and http://www.tinyurl.com/prestodrugstore. These families have tried computers and their elder loved has said, "No thanks!" I, for one, enjoy living in a free society where companies are free to produce whatever product they want, and their company's life or death depends on whether people agree with their vision. As for user empowerment and making assumptions for seniors, I welcome all the hair-brained ideas that are out there. Through this cornucopia of ideas are where we will find the best solutions for the broad swath of user needs that exist in the world. Not through any autocratic definition of what is best for us. Peter Radsliff President and CEO, Presto Services Inc. and Ad Hoc Chairman of the Board, Aging Technology Alliance


As an avid student of the ever expanding aging in place technology "space", I don't think that anyone can be seen to "have actually made an informed life decision" about the pros and cons of learning and using a computer until they've had the opportunity and assistance to use one.

I've seen older friends and family give up their resistance to learning the basics of computers and become daily users and advocates of computers. 

Presto definitely does have a unique contribution to the "connection" needs of seniors. 

Personal computers with more functions and applications, touchscreens, in-home service support, et al are also likely to be adopted more now as baby boomer caregivers help their elders on their learning curves.

What I like about Laurie's recent posts is the growing awareness within the AIPT space that many assumptions being made about the preferences of older adults need to be discarded along with the ageism that underlies them


LifeSpan Homes LLC







Hi all:

Great passionate comments here! Being the subject of the last Ageism thread, I would like to make the following (humble) comments:

- First, my personal feeling is that the use of words like "Ageism" is counter-productive: (1) it does not help the conversation by over-simplifying things to "Either-Or" as Peter put it, and (2) this kind of labeling lends itself to pre-judging rather than understanding.

- Susan mentioned the Universal Design example above. At Emota, our philosophy is that we will not build something that we ourselves would not enjoy using. Our first product, EmotaMe, has a social game like user experience designed to get family members of all ages engaged. In fact, one of our objectives is to encourage grand kid to grandparent engagement online. However, it seems from the last "Ageism" thread, a quick labeling was made that a fun or game like design equates to "Ageism". I personally believe that the reverse is true. Are we saying that a senior product design need to focus on functions and utility only? In my opinion, any product that is not pleasurable to use, or fail to connect with the consumer's emotion will fail.

- I do agree with Laurie regarding empowerment. I want to propose that we look at this empowerment thing as a journey or a continuum. On one end of the continuum, we have products that help senior achieve simple tasks, and on the other end, we have product that provide full online / computing / engagement. But these two are not necessary pulling to opposite directions. Stanford's BJ Fogg talks about the 3 factors, Motivation, Ability, and Trigger, that need to be presence in order to effect a behavior. As Peter and others have pointed out above, different seniors in different stage of their lives are our different part of that ability curve. So, I see nothing wrong with having a spectrum of products that help people with different needs.

- Finally, I want to say that I increasingly am believing that it may not be all that helpful categorizing seniors consumers based on age alone. Interestingly enough, I see some seniors getting more "empowered" as they age, and some in reverse. It seems more to do with a "state of mind". I do believe that technology products along the continuum described above is useful to nudge people forward down the empowerment path. It's not uncommon to see seniors starting with a JitterBug first, then onto a Kindle, and now onto the iPad. (i.e. the continuum).

Paul To

I like your  "continuum thinking" about adoption of AIPT.

Try overlaying Maslow's need hierarcy over Erickson's life cycle over B J Fogg's Diamond of User Emotion...and you'll see just how important consumer-centric product differentiation is to AIPT adoption. 

Peter Durkson


I would be very remiss if I did not temper my passionate comment on this article with a public statement of how much I respect Laurie Orlov and what she is doing with Aging in Place Technology Watch. If I have disparate and impassioned views on a particular subject, that in no way takes away from my enjoyment of her blog and practice and the importance they bring to our industry. The beauty of our country is the ability to disagree and in no way do I mean to be disagreeable in that process. Keep on, keepin' on Laurie. We are all reading with great interest…and passion.

I certainly agree with your main point, that designers often underestimate the willingness of seniors to adopt new technologies. There was a recent story of a 99-year-old woman reveling in her new iPad because it let her read again, a hobby she thought was gone forever: http://www.oregonlive.com/lake-oswego/index.ssf/2010/04/video_of_99-year....

Assumptions are more limiting than raw age can ever be!

But I would add a proviso: seniors occupy the same continuum of techno-enthusiasm as everyone else. Just as not every teen is an SMS monster, so is not every Grandma dipping her quill in an inkwell. It's okay -- good, even -- that there is a wide range of products, offering everyone the level of technology adoption they are comfortable with. It's all about participation, right? I'd rather see a senior wielding a magnifying glass to read a print magazine than ignoring both the magazine and the screen-enlarger-equipped computer his well-meaning family dropped off.

This is a fascinating conundrum. And, it speaks most definitely to the concepts embodied in universal design. A great example of universal design is the vibration feature on cell phones -- originally created for people with hearing problems, but now used by everyone. Seniors, just like a lot of the rest of us, want products that are easy-to-use and deliver what they want. . Check out this paper from the Trace Center that discusses barriers and incentive for manufacturers to adopt universal design: http://trace.wisc.edu/docs/hfes98_barriers/barriers_incentives_facilitat...

When you think about many of the products we are evaluating, the market is more than just AIP. The fall monitor with cell phone connectivity and heart rate monitoring can be used by sports enthusiasts (my mountain biking husband comes to mind.) Touchscreen computers and monitors tied with specific appsare a more natural way to use computers -- and much easier to use for all of us. In home sensor systems can be used to "watch" your latchkey kid - make sure they got home from school and the house isn't full of their friends. The GPS bracelet can find your wandering kids in addition to your wandering adults. And, so can smart phones.

Peter's Presto system is a great first step for many who don't understand the value of being part of a family or neighborhood email 'chain' - Presto opens up their communications and is a simple and affordable solution since you don't have to make the leap to a broadband Internet connection. And, for some, it might be all they need. I was talking to a uber-tech colleague the other day whose mother refuses to adopt ANY technology and mentioned Presto. He thought it might be just the thing for her to get her into the family picture loop.

We need to show the value of connecting, contributing and monitoring to nonadopters in a way they don't have to spend a jillion dollars and get peeved by the unfriendliness of many technologies. Universal design is a good way to think and a good way to evaluate if technology is valuable to our market.

I am torn on this issue. I do believe that this is going to happen. I'm not entirely convinced that it is happening currently. At GrandCare, we offer ADL&Wellness monitoring ONLY along with a TV-based communication station OR the all-in-one interactive touchcomputer that provides all the benefits of the Internet on a touchpanel with a touchkeyboard - just no mouse (touchscreen). I do believe that as time goes on, our "seniors" are going to be more savvy, expect more, want to use more, want to feel empowered, etc.

This whole thing really depends on who we are talking about. There is obviously a huge difference between 65, 75 and 95. For our younger customers - the ones who really are choosing to "age responsibly", they are not choosing to ditch their computers to use GrandCare. They don't have to! They can use both and enjoy them for different reasons. I have a GrandCare System in my house. Why? To monitor various things, when the dog was let out, monitor the in-home temp, keep track of my weight/BP, and of course to see the montage of pictures, videos, etc on the touchscreen. My kids love it, it's a conversation piece and fun to watch. I do have older customers that you couldn't convince to use the touchscreen. It's not comfortable for them and we don't force it! They can simply watch the channel on the TV with the slideshow of information.

The important thing is they need to feel connected to society - all of these solutions help to do that in one way or another. They need to feel empowered - now if that just means being able to stay home, or being able to use the touchscreen or being able to have a pic of the grandchild on presto that they can bring along to the senior center... It really doesn't matter HOW they get the information. It only matters if they are comfortable with it, feel involved, feel in control and of course feel happiness overall!

I do appreciate this article, though, because even though I agree with many of Peter's comments, I think this issue is an important one to remember. Even in 2 years time, this will be even more relevant. As our boomers turn into seniors, that's a HUGE shift in thinking.

And I don't mind being continually reminded who we are serving and making sure we/our organization stays on target!

thanks Laurie & Peter(s) for another interesting and insightful conversation!

Laura Mitchell
GrandCare Systems

I find it very interesting, the responses from readers and passion found in comments concerning the assumptions related to Aging In Place Technology.  As the Vice-President and Chief Technical Officer of a technology development company, I find its even more interesting how the opinions differ so widely on what level of technology people are willing to accept and adapt to.  In my readings and research, I more often than not run into two words more than any other.  Assumption and Presume.

As an Automation and Control Systems Interface Designer in my early years, I assumed that if someone was willing to spent $250,000 on an automation and control system, then they would surely spend 15 minutes to learn how to operate the remote control.  It seemed to make sense.  It didn't take long to figure the error in my presumption.  Just because someone wants all those toys doesn't mean they want to know how they work, or work together for that matter. I found I had to design control systems that were so incredibly boring I could scream.  But, I learned and figured out simplicty and elegance always worked best.

If elderly "presumably" won't learn or do not want to learn about computers, why are people still calling them that.  Computers, I mean.  With all the technology and tools at our fingertips are we still so arrogant to believe that we can change that about the elderly.  We like to believe that we don't, but we do try to find another angle to get the elderly to accept what they dont want.  As designers and integrators of technology products, we have to throw out all the assumptions and presumptions.  If the elderly are not comfortable with computers, why on earth do we still refer to them as computers?

Multi-Purpose devices can be built and designed to be incredibly successful.  I point to the itouch, iphone and ipad.  And the elderly freakin' love them.  Why?  Apple figured out that it is all about the interface, the interaction the user has with the device.  Is an iPad a computer?  Yes.  Do we call it one?  Nope.  All of this technology is dependant on the users interaction and enjoyment of that interaction.  The interface is such that you dont relize you are interacting with a powerful multi-purpose device and you dont care.  You point and it does.

What do the eldely know?  They know toasters and vacuums (no offense its a simplistic analogy).  The elderly want access to cool toys and access to information, just as everyone else does.  They want to text and email.  But it has to be presented and interacted with in a way they understand and a way that is natural and intuitive.  With Appliance like simplicity, i.e. toasters and vacuums.  Give the elderly what they want and understand, and build services from there.  If technology integrators stop "assuming" they can overcome the objections by building the next great tech gadget for the elderly we will start breaking down these so called "phobias"  We should all be building toasters and selling toasters.  So elegant and simple is the toaster and the vacuum, and we sure can learn a lot from them.

Mark Koopmans
CTO, Added Care Services




I think that using technology is not only a public decision of a sort, but also a personal decision. I think that the more technology is available, the more demand there is for people to use it-supply and demand! However, not everyone wants to jump on that bandwagon and go for the technological advances. Many people want the simplistic lifestyle without cell phones, a computer, or cable TV. I know a lot of people who personally decide that they will not get a computer because it is "too much hassle", "another bill to pay", or "gets in the way of family time". Whether or not you use technology at home doesn't mean that you should not learn the basics of the new technology. It is always good to understand how the new gadgets work, even if from a distance!

I recommend the technology of the internet to everyone because it is a valuable resource for everything-from news to social media, to learning about recalled foods, and new recipes- the information highway should be accessible to everyone!

www.GeriCareFinder.com is your Complete Online Source for Senior Care

I agree with Peter - I think much of the technology today, whether geared towards seniors or the general population, is devoted first to the technology, and second to the user. The idea is to make the user's life easier, not to impose our ideas and value judgments of what is appropriate or easier on them.

While people of any age can be taught to use technology, there are practical limits to this in terms of time and money. The same argument applies to education in general, and to the 2-3 billion people in the developing world. What if they had access to state of the art resources and one on one tutoring? The problem is not just in Los Angeles public schools or senior centers, its everywhere.

The ability of seniors to use technology will change over time, as kids today have vast experience with all sorts of gadgets, while the current seniors did not even have telephones or TVs when they were kids.

Of course, whether any of us will have the tolerance to use gadgets due to overloaded brain circuits is a different story!

...of mass research, with enough of a population to segment (age, income, education, etc.) to help us find out what older people REALLY want in access to information.

So many excellent points have been made already.

To me that last phrase--access to information--whether Laurie's or the study, is the key to a shifting in thought.

**Too often we are focused on resistance to technology, not information. We then ought to focus on how older people by age process information, what information they want most and tailor products to that need. (The horse before the cart.)
**Is this information what an older person wants or needs? What might it take (motivation) to get him or her to 'yes', and the tradeoffs?
**The continuum of familiarity as mentioned above. The less complicated and 'tech' it feels (intutitive) the better. But intuitive can be a keyboard, a touch screen or a mouse....depending on the learning curve.

Some other observations:
**Peer group--can be a help or hindrance. I like the model of seeding tech familiarity in senior groups/veterans groups. It then becomes 'their thing.' I think veterans groups are over-looked--yet the internet is a huge library of military history. (Cable companies and Verizon should be thinking about this.)
**Cost--yes, cost is a concern, particularly now. Even if their investments weren't hurt badly, there's resistance to high monthly recurring costs. No news that even affluents are cutting back, just in general, family needs and concern about medical bills is also there. Money is also a control area. Above mentioned cable companies and Verizon would do their business a 'solid' in offering senior discounts for internet services (and retain older customers who are cutting it all out).
**Support and customer service designed to speak in regular English (not tech-speak) and for comprehension. Newbies need help desks--didn't we all in early days?

And face it, there are going to be older people who are going to consciously choose to move 'off the grid' for various reasons, who have cognitive impairments (although many of these devices can be adapted for use), behavioral concerns or genuinely cannot afford it...but that's also true of the general population.