Self-image associated with the use of assistive technologies among older adults

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(7): 1550-1576.

Review question

•      How are older adults’ decision-making processes regarding assistive technology adoption influenced by their desire to preserve their self-image?

Background

•      As people age, they experience physical and cognitive changes in several domains, such as vision, hearing, memory, strength and mobility.

•      To reduce further decline and maintain participation, many of these impairments can be lessened by the use of assistive technologies, which can support occupational performance, mobility, safety, community involvement, and self-confidence.

•      For example, assistive devices targeting mobility such as walkers, canes, motorized scooters, prosthetic devices and wheelchairs can enable people with physical impairments to remain active and mobile in the community. Similarly, devices such as smartphones and tablets can be used for assistive purposes by people living with dementia.

•      Despite the many benefits offered by assistive technologies, their rate of use among older adults is lagging far behind the rate at which they are being created.

•      The aim of this scoping review is to understand better how older adults’ self-image influence their decision-making processes regarding assistive technology adoption.

How the review was done

•      Review authors conducted a search of nine research databases for suitable English-language studies published between 2000 and 2017.

•      Additional articles were identified by searching the reference lists of included articles.

•      A total of 5,576 articles were identified from the database search, of which 49 were included in this review.

•      This work was supported by the Social Sciences and Humanities Research Council of Canada; and the Ontario Shores Foundation, through the Ontario Shores Research Chair in Dementia at the University of Toronto.

What the researchers found

•      Five themes emerged from the literature: a) resisting the negative reality of an ageing and/or disabled identity; b) independence and control; c) the aesthetic dimension assistive technologies; d) assistive technologies as a last resort; and e) privacy versus pragmatics.

•      37 included studies addressed the theme of resisting the negative reality of an ageing and/or disabled identity. Assistive technologies like assistive robots, pendant alarms, and mobility devices are often viewed as indicators of ageing or disability, which in our society may be associated with helplessness, dependence, and incompetence.

•      49 included studies addressed the theme of independence and control. For many older adults, the desire to remain independent stemmed from their wish not to be perceived as a burden to family, friends or society more generally.

•      23 included studies addressed the theme of the aesthetic dimension of assistive technologies. Across the studies in this review, participants advocated for “discrete” or “unobtrusive” aesthetic designs, such as devices that fit in a purse or pocket.

•      23 included studies addressed the theme of assistive technologies as a last resort. Many participants reported viewing the adoption of assistive technologies as a last resort. Many participants reluctant to use assistive technologies felt that they were not there yet.

•      20 included studies addressed the theme of privacy versus pragmatics. Although technologies such as mobility aids, and devices for hearing loss were not found to elicit privacy-related concerns, concerns about privacy infringement were expressed when discussing wireless sensor networks, bed occupancy sensors, and fall detection monitors.

Conclusion

•      The findings of this review highlight the extent to which older adults’ desire to portray an identity consistent with independence, self-reliance, and competence influences their adoption of assistive technologies.