A study in the Journal of Clinical Psychiatry.
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The oldest and technology access -- getting it right
Woohoo -- Internet usage is up. Those of us who are technology enthusiasts get all excited with this 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 age 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 e-mail and web surfing keeps the aging brain active. The Evercare survey of 100 healthy hundred-year-olds could really look like a trend to technology optimists like me. You may remember that 19 percent of responders use cell phones and 7% were using e-mail. And of course we know (studies show this through age 76) that surfing the web is good for the aging brain. But let's not confuse technology optimism with reality. Questions in my mind remain about the oldest among us:
- 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 6 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 and told me that she took the training and can't see the point. Online Mahjong? Order her groceries? E-mail with her kids? No thanks, she smiled. [Note: And Selfhelp has the wonderful benefit of a full-time tech administrator].
- What is the profile of those most served? On the other hand, home bound seniors -- those who are 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 Quiet Care (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 they find out about such a risk-avoiding technology? And as in this example, if they are healthy and active, is it necessary? Reassuring? Superfluous?
- What is the compelling argument about cost of computing? Let's assume that you could persuade a) the very independent that they would enjoy a computer, that you could encourage the b) frail and home bound (or their families) that an enormous social benefit could be realized with a computer or c) 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.
- 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 of whom separately suffered bad falls in their house -- neither were discovered right away. She wasn't noticed by her husband who had the TV at high volume and can't hear well. And on another day, he fell backwards 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 crisis is looming.
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.
Solutions -- more needed. Here are a few thoughts. I would like to see large corporate users of PCs examine their technology refresh cycles (typically 3 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, IBM, follow the example of Verizon and HopeLine (for victims of domestic violence): donate technology to senior centers, but go one step further -- and 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 1 out of 2 baby boomers has at least one living parent. The odds are good that this parent may be one of the 5.3 million age 85 or older, the fastest growing age segment.