As cited in the recent All-Party Parliamentary Group on Housing and Care for Older People Inquiry report, Housing for people with dementia – are we ready?, technology has enormous potential to support quality of life for older people, including those with age-related conditions such as dementia. Devices, apps and online systems may enable people to remain independent (opens new window), stay in their own homes and keep connected (opens new window) to friends, family and the wider community. Delivering on this potential is important not just for older people, but also for the services that support them, including health, social care and housing. However, the research evidence to date has been somewhat underwhelming, showing limited impact on wellbeing, independence, or demand for health and social care services.
So what’s gone wrong?
We reviewed the literature to explore the range of technology available, identify the problems that arise in its implementation, and find out what works in terms of involving older people to make assistive technology fulfil its promise.
We found real potential:
- There is a fast growing range of assistive and everyday technology which aims to address a diversity of age-related issues.
- The development of mainstream technology (opens new window) such as video calling and smarthome devices has accelerated things in recent years, and the pandemic has driven much wider adoption (opens new window).
Sadly, alongside all of this potential, multiple studies point to difficulties that can arise in the processes of identifying, installing and using technology.
Problems arise from:
- Preconceived ideas and worries about technology, as well as inaccurate assumptions about older people (opens new window).
- Gaps in IT skills, knowledge and confidence (opens new window) amongst older people and those around them can also create barriers, whilst organisations can encounter problems with funding, staff workload and strategic leadership.
- Some bits of assistive technology simply don’t work very well (opens new window), or are too difficult to adapt in order to suit the needs of individuals.
Underlying all of these difficulties, a central problem seems to be that technology is often introduced without fully involving older people (opens new window) or those around them in the process of choosing, installing and adapting it in use. Although the research evidence about involvement and co-production is relatively limited, there are useful points of learning. In particular, recognising the ways in which technology has to be continually adapted to fit everyday life is crucial in understanding how we can most effectively work with older people to explore new possibilities – from designing technology, to planning services and putting technology in place.
To make technology work, the evidence suggests that organisations need to:
Identify the desires, needs and capacity of residents
It’s important to focus on positive outcomes and capacity. The problems that someone experiences because of age-related impairments should not be ignored – people are likely to be more interested in technology if it addresses a problem – but the primary focus should not be on the negative. It’s also good not to talk about technology too much – focusing on existing knowledge of technology may limit the discussion of people’s actual needs and desires. And when you do explore existing use and confidence with technology, you need to do it carefully to avoid reinforcing any fears of technology.
Identify and introduce possible technology options
People need to see, explore and try out technology if possible. This will help people understand the potential and also identify any practical problems early. During this process, it’s crucial to recognise that people may have legitimate concerns that technology could replace face-to-face contact, undermine their independence or monitor them remotely. People may also be worried about comfort (for wearable devices), whether they will know how to use it, or that it might make them seem old and infirm. As in the first stage, it can really help to focus on what people want and need, not just what the technology can do.
In practical terms, it’s also important at this stage to talk about any support that people might need to use technology, being aware of physical and cognitive impairments, and to think about resilience – don’t set something up that is reliant on one staff member only. Money is vital too, so consider costs for buying, setting up and maintaining technology…and who has to pay them.
Use, adapt and continue to use technology
Installing a piece of technology is never the end of the road, so you need to think about how it can be adapted in situ, to best meet the needs of each individual user. This should also involve building the skills and confidence of all those involved, including older people themselves and those around them who may help with technology use. Regularly check whether technology is really doing what people want it to do is important, including the impact on family members, other caregivers and the workloads of staff.
So what then has gone wrong with technology and ageing? We conclude (opens new window) that the voices of older people and service users have not been centralised enough in the process. Therefore, technological changes are happening without real ownership or any link with people’s everyday lives and needs.
Co-production cannot solve every difficulty with technology, but engaging older people themselves, as well as family members, housing and care staff, can help to ensure that technology is appropriate, accessible, practically useful and therefore less likely to be abandoned.
Other contributors to the blog and the report are: Vikki McCall, Grant Gibson & Angela Pusram, University of Stirling
The Housing LIN is delighted to be on the Steering Group of this project. Download the full report (opens new window) here and feel free to sign up (opens new window) for more information on the INVITE (Promoting INclusive liVing vIa Technology-Enabled support Project).
If you found this of blog interest, check out other relevant resources on dementia, design and technology curated by the Housing LIN.
And, to coincide with Dementia Awareness Week 2021, join us at our acclaimed HAPPI Hour webinar this Thursday, 20 May at 4pm, to find out more about housing, mental health and wellness.
Lastly, if you would like to find out more about how the Housing LIN can support you develop your housing for older people strategic vision and/or operational plans to meet the future accommodation needs of older adults, please email us at: firstname.lastname@example.org