Technology and technology-enabled interventions have become central to the lives of older adults, family caregivers and the workforce supporting older adults. Although often an unseen element, for many elders, smart phones and apps, electronic health records, tech-driven schedules or smart homes and the Internet of Things are woven into the fabric of their lives.
Yet, based on decade-old pronouncements by technologists and futurists, it is clear that technology has not achieved all the goals and promises that had been presented to policy makers or to the gerontological workforce—much less to older adults. Technology falls short of its promise because it can be overly complex; in other cases market and economic forces have stalled progress; and all too often it is due to resistance around adopting something new and different.
However, just as often, the high expectations we have held out for technology simply have not been met. The promise of breakthrough technologies such as autonomous vehicles, robotics, the Internet of Things and even predictive analytics still has not made as significant an impact on the world of older adults as had been promised.
Presidential Promises
Four years ago in Aging Today I summarized a report, “Independence, Technology, and Connection in Older Age,” submitted to President Obama by the President’s Council of Advisors in Science and Technology. Not so ironically, many key recommendations and anticipated technology innovations highlighted in that article remain as important, but just as unfulfilled today as they were in 2016. Key among such recommendations are the following:
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Improve education and training in online technologies for older adults to ensure access to online services and protection from scams and fraud—all tailored to the learning needs of older adults.
- Develop a technology-enabled system to support vulnerable older adults in disaster and emergency situations.
- Support banking and financial services sector efforts in developing technology-enabled programs to protect older adults from fraud and exploitation.
- Improve regulation and payment to reflect the benefits of telehealth innovation.
Support enhancing regulations and financing to improve home design that will sustain independence.
Again, in some cases it is the technology that has not been able to keep up with expectations, but more often than not there are policy and regulatory constraints, limitations in funding and even a lack of basic information about the benefits of a specific technology that has kept technology advances at bay and from reaching older adults. The implications of limited access to technologies are many, resulting in poorer health and safety, restricted information and services, less engagement and greater social isolation, and ultimately, a poorer quality of life for many older adults.
Promises Undelivered—Promises to Come
Ways in which older adults could use technology are easy to see; technology can improve health, safety, knowledge and education, provide access to information and to each other. But there are several key barriers that need to be overcome. Older adults, as well as their families and providers, have not been quick to adopt many technologies. Often this stems from a lack of digital literacy or even fundamental training in how to use technology. And there may be limitations in the “user interface”—or how easy or difficult it is to operate a technology-enabled device or product.
Yet these challenges can be overcome: incentives can induce adoption, digital device training can be made universally available and barriers from poor design can be tackled through applying human-centered design and co-design principles.
Rather than viewing the promise of technology as a glass half empty, we can see it as a glass half full, especially as the potential benefits become clearer and more pronounced. Analysts have predicted that within the next few years, voice will be the primary way in which we interface with digital devices and the world around us, reducing a major barrier for older adults who have difficulty operating new products.
The digital literacy of the workforce, as well as that of older adults, is steadily increasing.
The onset of the COVID-19 pandemic has reinforced the need for all individuals in society, not just older adults, to have access to broadband for immediate access to information. Similarly, telehealth has expanded exponentially, dramatically changing healthcare delivery. The Internet of Things, which connects digital devices, will exceed 50 billion connected devices this year alone. The use of embedded sensors and wearables is becoming far more common, providing more information on our health status and controlling our environment. And the rapid emergence of 5G and Artificial Intelligence (AI) and Machine Learning will exponentially increase the speed and power of data analytics to anticipate our needs or actions.
Even the digital literacy of the workforce, much less older adults, is increasing as each generation becomes more facile with the use of technology. Finally, there are new imperatives to using technology to respond to the challenges brought on by a pandemic and recession: technology-enabled solutions offer a rapid, efficient, cost-effective means to address the safety and well-being of older adults, persons with disabilities and other vulnerable populations. Technology can improve the means by which providers and family caregivers alike can protect and support at-risk populations in response to COVID-19.
Continuing Challenges
Whether potentially game-changing technology solutions offer immediate assistance or promise future gratification, there remain significant barriers to obtaining their full benefits. First and foremost, disparity in access to technology remains the central challenge. Many of our most vulnerable older adults do not have access to even the most basic of technologies, such as connection to the Internet and smart phones. Second, when older adults have access, there is frequently an equity issue in that while some older adults have ready access to sophisticated technologies, many other older adults cannot afford the most basic technology.
Yet in an era where older adults are being buffeted by a pandemic and a recession, new technology solutions, whether in the form of advances in personal protective equipment, enhanced communications to reduce social isolation or data analytics to improve the efficiency of services, can be vitally important as a partial solution to addressing these added challenges.
As I posited four years ago, “employed to its fullest, technology has the potential to improve the quality of life of older adults while concurrently improving access to care, efficiency of care and reducing costs of care.”
Yet for these new technology options to be truly efficacious, it still comes back to the human element: from how we design new products to whether we adopt new forms of support, it is the person who uses technology-enabled products and interventions who ultimately determines if they are beneficial. As we see new technology advances come about with increasing frequency, it is critical to ensure that the person who will use a specific technology-enabled solution drives which technologies we need. Older adults will act as the barometer of whether the promise of technology is ephemeral or beneficial.
David Lindeman, Ph.D., is director of Health, Center for Information Technology Research in the Interest of Society (CITRIS) and the Banatao Institute, University of California, Berkeley, and director of the Center for Technology and Aging.
