Market Overview for Technology for Aging in Place

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Technology non-adoption of the oldest – it’s a bug, not a feature

Not adopting tech -- it's not okay. Lacking access to smartphones, Internet, in-home broadband/WiFi cuts oldest out of access to modern telehealth, communication and engagement, in-home sensors, outside-home GPS, fall detection, and device integration with smartphones. The issue of non-adoption, particularly as more health services move online, will become increasingly vexing for service providers of all types. Surveying of the oldest has fallen out of favor, though Link-ageConnect persists, thankfully --  see their 2019 report. But over the years much has been opined about the reasons – so here is some more opining. Rant on.

After so many years of sound and fury, why is adoption among the oldest so low?  Pew surveyed and noted that technology use drops off in the older age ranges.  This non-adoption is despite White House reports recommending products be made more appropriate to boost adoption, first in the PCAST report of 2016, and then again in 2019. So what are the barriers and problems that prevent older adults from using the technology that could increase access to telehealth (now reimbursed!), social engagement technology, online services, consumer health advice, and on and on? Is the coverage spotty? The price too high? The benefit still unclear? Or are the devices still too difficult to use? As my cousin, the retired rheumatologist says, he only uses his iPhone as a telephone. Everything else is too hard, even though he mastered two specialties and practiced medicine for 50 years. Of course, it isn’t just that phone. It is not only design that keeps non-adoption percentages so high. Consider the sum of:

  • Thoughtless product design – see the smartphone.  As smart phone streamlining and cross-vendor imitation became a norm, out-of-the-box experiences for mainstream smartphones became a distant memory. You remember buttons, right? Ah, buttons. They disappeared on devices because they could.  As with most innovations on smartphones, there is no poll of the user base that precedes a change, just forums (not run by the vendor). The change is made, the people complain, some alternative that perhaps makes the vendor more money is provided, and life goes on. 
  • Failure of well-meaning but hands-off services.  Over the years, community services including senior centers have toyed here and there with helping non-adopters use technology.  Volunteers take their own devices and show how they can be used. And long ago, huge training sessions were held at convention, run by an organization that at that time really wanted older seniors, to learn how to use smartphones and tablets, benefit from access to the Internet and go online.  But the conventions were canceled, the training became regional, and the organization began to recast itself as serving all ages. You may think I am kidding, but check the link.
  • Failure of misdirected politics – reports published, but adoption barely budges. Task forces form every few years that are populated with well-meaning people.  Consider the White House 2016 and White House 2019 reports on use of technology by older adults.  Yet once the task force meetings were over, no entity was tasked (funded) with implementation of the recommendations, leaving it likely that in a few years, the same level of non-adoption, not-quite-there devices, and unsolved problems will remain. Within that continuum, in fact, his week a new Senate technology initiative was launched. Manage expectations accordingly.
  • Failure of prolific but inadequate training.  When the device is unboxed, and whether it is a thermostat, a smartphone, a tablet, a new TV, there are manuals of instructions and online forums that must be studied or the device becomes a paperweight. Training seniors about technology is well-meaning and ubiquitous. But is it disciplined and state of the art? T-Mobile, AT&T, and Verizon offer training for ‘free’ as bundled into their services. But 1-on-1 training is rare, and because so many of these devices make us feel stupid because they are not even close to intuitive, individuals sheepishly go back again and again to the store. Or they pay for 1-1 sessions.  Or they give up and return to their status of non-adopter. Expect this to worsen with the pace of tech change. Who notices the people who are left in the dust? Rant off.

Comments

This appears to me like a temporary transitional phase awaiting the arrival of the Gen xers who are all in with technology. This demographic, psychographic and cultural transition is present in a wide variety of elements in which caring for the Aging demographic will dramatically change in just one generation. Of course it causes challenges in how to address people now with change on the horizon.

I believe that there are two organizations that are positioned to (and capable) make a massive impact on senior adoption of technology as part of their ageing in place initiatives: Best Buy with their Assured Living and In Home Adviser programs and Comcast with their new initiatives under Sumit Nagpal's Health Innovation organization. They both have the geographical reach and technical/customer savvy to make this happen; they have finally begun to focus on this sector. 

Because technology has not met the needs of seniors. Adoption requires overcoming an obstacle that when attempted is failed. It is a classic supply and demand problem with a load on demand. Obviously technology suppliers must lower the barrier to use to the point it is equal to or lower than putting on your pants.

I agree in particular with inadequate training Laurie (and low patience with older adults in general)

Simpler interfaces, designed for them, would help.

I like the idea of the bill, but I don't think a spoon is goinf to revolutionize aging in place.

The direction of your article makes sense - lack of design thought toward those in aging. They are heavily under-served. However, instead of using Pew's stats from 2 years ago (42%), you might want to check out this year's AARP stats on Tech (65%). The data has changed a lot. Here is one resource for you: the AARP 2019 report.

The reason to use the Pew data is it offers age bands that subdivide the 65+. 

The AARP report from 2017 also subdivides the older age ranges.  The 2019 report you reference does not do that.

I can tell you exactly why my own mother and many of her co-residents in independent living do not use tech, and it isn't because they didn't use it before.  My mother used to help set up computers for her friends and give mini-lessons in her 60's and into her 70's.  Then things got faster and smaller and confusing.  Then security issues caused greater and greater anxiety.  Being able to navigate online became more and more frustrating.  She uses one tablet, the largest one we could find her, to read books on the largest font and play solitaire.  Other books she now listens to thanks to books on tape provided by the Library of Congress.  She has no smart phone and no email address any longer. She gave away her almost new desktop because it caused her too much anxiety to deal with anymore.  She is in her 80's and she is t-i-r-e-d.  As for the other residents around her age where she lives, over half are using flip phones or the simple large screen "...bug" phones. They don't want dots and talking towers, and would not trust one if given one.   They crave human companionship and someone to talk with.  The technology available for her medical care is amazing, and having a monitor in her home has truly been a lifesaver more than once.  She even has a robot pup for a no-care pet.  Lack of trust in products and anxiety over using them, if they can even see them properly, are two of the major reasons tech goes unused by the oldest old.  We all need to be sensitive to all the generations and where they fit on the tech spectrum.  Many in the "silent generation" are being squeezed by the adoption of tech in all areas of their lives and care.  Many are afraid when they are told they will either have to get on board, or be left behind.  There is no convincing many of them that online really can be more efficient and safer than what they've always done, and they will not trust someone else to take care of their personal stuff for them.  Caregiving for our oldest old has become more difficult.  

Maybe they want to talk to other human beings and read great books and go for walks instead of squinting at a smart phone. Maybe they’re anarchists!

After many years of adoption experimentation I have realized something that has been before me all along:  solutions that ALIGN with IMPORTANT goals of the ADOPTEE are a huge success.  Our past failures fall in to 2 buckets:  the solution creator did not create something that aligned to something important to the adoptee OR the solution was presented to the adoptee without making UNOBSTRUCTED link their goals.  We continue to miss EMPATHY.  Billy continues to learn this but there is massive room for improvement.

How many brands professing to be in this industry would be able to produce an ACCURATE 2 min commercial of who their USER is vs who their "buyer" may be?  <rant over>

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