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Assistive technologies: It’s not for me, I’m not there yet!

The Bottom Line

  • Assistive technologies can improve independence and autonomy, mobility, security, as well as social and community involvement.

  • Identity and self-image play an important role in the decisions of older adults to use (or not use) assistive technologies. Their need to preserve an identity associated with autonomy, competence and independence, may lead them to reject assistive technologies which can be perceived as stigmatizing or ageist.

  • To promote and foster the adoption of assistive technologies, it is necessary to ensure that they do not reinforce existing stereotypes related to aging.

The World Health Organization predicts that by 2050, the number of people aged 60 and over will reach two billion.(1) Many of them will experience physical and cognitive changes associated with aging: vision loss, hearing, memory, strength and mobility.

To reduce limitations or improve physical and cognitive functions, it is possible to use what are called "assistive technologies". For example, walkers, canes, motorized scooters, hearing aids, and wheelchairs allow people with disabilities to stay active and mobile in the community. Likewise, smartphones and tablets can be used to support people with dementia, providing them with reminders, storing information and keeping track of events.

As the older adult population continues to grow, assistive technologies can play an important role in promoting healthy aging and independent living. Of those living with a disability in Canada, 81% report using some sort of assistive technology (for example, hearing aids, magnifiers, wheelchairs, and hand and arm supports), and 30% of those aged from 45 to 74 report experiencing unmet need for assistive technologies, which increases to 44% among those reporting severe disability.(2; 3)

Despite the potential benefits and unmet needs for assistive technologies, some older adults remain reluctant to use them. Some even say that "it is not for me, I am not there yet" ... What can explain this reluctance?

What research tells us

A systematic review of 49 articles examined how the desire to maintain an identity compatible with competence, independence and autonomy influences the decision-making processes of older people about assistive technology adoption.(4) Despite the great diversity of populations and technologies studied, the importance of self-image in decision-making was evident.

This review revealed five themes:

1. Resistance to stereotypes related to aging or disability

The fear of being stigmatized or discriminated strongly influences older adults not to adopt certain assistive technologies. Robots, alarms and mobility devices are seen as a visible sign of aging in a society that too often equates aging with disability.

Additionally, some older adults fear that they may be the only person using assistive technology in public spaces. However, if others around them use similar technologies, their self-image seems to be improved.

Conversely, some older people feel compelled to adopt modern technologies to avoid being labeled as old or outdated.

2. Independence and sense of control

Maintaining independence and autonomy is essential for healthy aging, and older adults do not want to be seen as a burden. This is why technologies which extend autonomy in daily activities can be seen in a positive light. Older adults want to be in control of their lives and prefer to use technologies they can control.

For others, on the contrary, the use of assistive technologies confirms their loss of independence and they reject this negative image and the technologies associated with it. Some also fear becoming dependant on assistive technologies.

3. Aesthetics

Until recently, the design of many technologies for older adults was largely dictated by function, regardless of aesthetics (which refers to appearance, feel and size). However, older people prefer low-profile technology to avoid possible embarrassment and stigma that may be associated with it.

4. Technologies of last resort

Many older adults only consider assistive technology as a last resort, if they become disabled, ill, lonely or demented, or if their doctor advises them to use one. And again, they can still question this recommendation if it is perceived as incompatible with their perception of their own capacities.

Often, older adults would rather stay at home and forgo participating in social and community activities they hold dear rather than using technology that puts their disability first.

5. Privacy

While some older adults are willing to accept technological inclusion into their lives in exchange for greater security, independence and autonomy, many fear that someone may be spying on them and their data may be stolen or used against them.

What can be done to promote the adoption of assistive technologies?

Findings from this research can shed light on how to approach conversations and decisions about the use of assistive technology. If you are a caregiver would like to engage in a conversation with their loved one about assistive technologies, remember the following:

1. Be sure to discuss with them about their needs, preferences and concerns;

2. Highlight how these technologies can meet their needs (increase their independence and autonomy, increase their mobility and social interactions, help them age at home as long as possible or improve their quality of life);

3. Examine whether certain technologies can better respond to their needs and concerns, whether in connection with the aesthetics of the technology or fears relating to their privacy; and

4. Ask their healthcare professional if decision aids are available to help make decisions about assistive technologies, but also resources that can help you and your loved one navigate publicly-funded programs and charities to obtain assistive technologies.

 

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Author Details

References

  1. World Health Organization. Ageing and health. 5 February 2018.

  2. Mattison CA, Waddell K, Wang RH, Wilson MG. Citizen brief: Enhancing equitable access to assistive technologies in Canada. Hamilton: McMaster Health Forum, 5 May 2017.

  3. Mattison CA, Waddell K, Wilson MG. Panel summary: Enhancing equitable access to assistive technologies in Canada. Hamilton, Canada: McMaster Health Forum, 5 May 2017

  4. Astell AJ, McGrath C, Dove E. ‘That’s for old so and so’s!’: Does identity influence older adults’ technology adoption decisions? Ageing & Society (2020), 40: 1550–1576.

 

DISCLAIMER: Many of our Blog Posts were written before the COVID-19 pandemic and thus do not necessarily reflect the latest public health recommendations. While the content of these blogs identify activities that support optimal aging, it is important to defer to the most current public health recommendations such as social distancing and frequent hand washing. Some of the activities suggested within these blogs may need to be modified or avoided altogether to comply with current social distancing recommendations. To view the latest updates from the Public Health Agency of Canada, please visit their website.

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