Impact of Technology on Senior Health

Aging & Health Technologies

Theoretical perspectives on aging seem to suggest that people are either almost completely controlled by the social and normative expectations of being elderly, or that they are motivated by their own cycles of goals, outcomes and expectations. The phenomenological perspective of aging is an example of the first of these viewpoints. The life-span developmental models the second.

This piece seeks to review these two theoretical perspectives in regard to the newly emerging issue of the influence of technology on the health of aging people. It seeks to look first at the theoretical understandings. Then I provide an assessment of how different types of articles on the topic. Some tend to favor one (the phenomenological perspective) in that they often assume that older people are a unified group that basically acts with technology only in regard to serious health and care considerations. Other scientific and advocacy materials, on the other hand, approach their concerns from a life-span development approach as they look at the limitations of assuming that technology is only appropriate for disabling health concerns.

THE PHENOMENOLOGY OF GETTING OLD

"Social phenomenologists focus their attention on ideas and presumed facts about ageing and how these are understood by the people who experience ageing" (Pierce and Timonen, n.d.:3). From this mindset, one might say that older people are seen as being less agile than are younger people, and so they do more things that require less agility. In a similar way, it can be said that because older people may be working less, they may find significantly different levels of interest in certain kinds of tools, such as what technology has to offer today (Roapa et al., 2010:119. The phenomenological approach sees the world as a nearly complete social construct; those who function within these settings respond to the normative expectations that guide the context (Wertz, n.d.). It is not about genetic or psychological constructs in the sense that other theories are. If old people are "supposed" to act in a certain way, that's presumably what they do. Personal or even the collective needs and interests of a given group can be identified by studying what people do and aligning them with these perceptions (Wertz, n.d). "I" become what is expected of me because of these circumstances, and "I" live my life based on the experiences that result. Those who study issues from this perspective expect to hear from their subjects opinions that mirror their experiences. In an age when health care and technology are preeminent topics of interest, it should not be surprising to expect to find that both issues rise to the top of what the elderly themselves say (Pierce and Timonen, n.d.:5). The phenomenological perspective is a difficult approach in light of the fast-paced changes that technology offers.

LIFE-SPAN DEVELOPMENT

The life-span development perspective is quite different. It assumes that people move or evolve over the course of their lifetimes from one level of development (maturity) to something more advanced based on either internal (psychological or biological) or external (social) factors. This movement grew out of the works of Erikson (and others) (Brown and Lowis, 2003). He saw human progress as developing through a series of steps across the age levels commonly associated with our early years. Erikson's materials started by identifying "eight separate stages of development spanning from birth (basic trust vs. mistrust) to an age commencing at about 65 years (ego integrity vs. despair)" (Brown and Lowis, 2003:416). From growing into childhood and then to adulthood, people progress through each stage until the point where they face a conflict based on their belief that they have attained all that they can at that level. This conflict forces us to move to a more advanced stage where we react more to social and environmental factors. Erikson saw this movement from one stage to another as being fixed so all people went through each level as they developed their personalities (Brown and Lowis, 2003:416). Erikson saw the last stage as being a rather pessimistic stage where individuals were either happy with what they had achieved or they were not. Or at least that was what he seemed to believe until he and his wife and family got to their later years, during which he began to accept that perhaps there was at least a ninth stage of development for the elderly that may be more open to other influences (Pierce and Timonen, n.d.).

Erikson's early works were first presented in the 1950s. Since that time, the basic perspective has evolved considerably to go beyond Erikson's stages. Researchers have begun to take a deeper look at the elements of his theory with a much broader focus on the aging process (Heckhausen at al., 2010). These studies tie maturity to the fact that as we grow we seek to achieve certain types of tasks or personal objectives in order for us to gain the rewards or successes that we want from life. For example, as we mature through school we first achieve our required education and then move on toward a chosen college degree or perhaps the start of a particular career. While these advances are personal, they are not necessarily best understood in the same way in which we see people maturing from being an infant to an adolescent. Researchers such as Heckhausen et al. (2010:41-2) investigated the specifics of the primary and secondary goals of the life-span in the 1990s. The primary goals were those that people valued most highly because they would allow us as individuals to "change the world" to make success happen for us. The secondary goals arose more from those circumstances where we could not so easily change what was happening around us, so we adapted to accepting what our circumstances. Heckhausen et al.'s recent works on The Motivational Theory of Life-Span Development accepted these uniqueness as part of what we as people do in accordance with our personal desires and expectations, not just based on what is expected in a certain level of maturity. "The modern world with its rapid changes, increased interdependence of national economies, easy access to international travel, and stark contrasts between different societies' control potential brings about new challenges and opportunities for individual agency" (Heckhausen et al., 2010: 52). The resources we have in life and where we find ourselves become more important. How we related this to our health and to the technologies we are comfortable with determines their importance in our later years not predetermined stages.

HEALTHCARE ASSUMPTIONS

Various studies on the issues relating technology to health care for the elderly show aspects of both perspectives. Many of these materials take a distinctively phenomenological approach in that they have a clear presumption of aging being tied to health and health maintenance. In these materials, technology is seen almost exclusively as serving to assist in the care and control of seriously debilitating conditions, which is assumed to be something all people are worried about (Kenner, 2008). Other materials, including some produced by advocacy groups (such as the American Association of Retired Persons), have started to reflect the life-span perspective in that they see technology as a tool that fits into different people's need in many different ways -- based on their goals and objectives as they retire or live out a life that benefits from what technology has to offer (Orlov, 2011). The sections that follow provide an overview of these materials to highlight some of the distinctions.

THE HEALTH AND TECHNOLGY

The Use of Technology by the Elderly is the title of a 2010 article in an international publication called the Health Science Journal. The opening paragraph includes the following: "It is widely accepted that elder individuals show low adjustment to the advent of new technologies compared to younger generations, either because they do not have the technological experience or because of their current health status" (Roapa, et al., 2010: 118; footnotes removed). The authors then go on to further comment about how it is essential that young people take the time needed to teach the elderly how to get familiar with new technologies, specifically because the authors believe this will enable older people to enjoy a higher quality of life in the future. The article documents technological use patterns by the elderly in various countries by looking at a broad range of types of household equipment and communication tools. For the most part, their works demonstrate noticeably less interest in technology by the elderly. The authors seem to suggest that this is probably as it will remain even as they curiously suggest that there are ways that older people and younger people can use technology for better healthcare (Roupa, et al., 2010:122).

A 2008 publication by Intel takes a similar tone in regard to its Global Research Initiative on Technology for an Aging Population. While this title seems to be broadly-based with a focus on many age levels, its content suggests otherwise. They first identify the Common Themes, in regard to one of their motivations for their work:

Intel's ethnographic research in the United States and Europe uncovered several commonalities in the attitudes and needs of the elderly across all regions. In general, the researchers found that people were receptive to the concept of healthcare technology, as long as it continues to provide them with a sense of control and empowerment. The elderly want to retain control over their lives and be involved in decision-making about their care. (Intel, 2008:3).

What is meant by "control and empowerment" becomes relevant. Comparing the types of technologies that these types of materials highlight indicates a bias in many ways toward assuming what the elderly want when they turn to technology. Roupa et al. (2010:119) looked quite literally at everything from everyday electrical appliances to TVs to ATMS, PCs and mobile phones and noticed a lack of interest almost across the board (something that is no longer the case). Intel placed its emphasis on high-level monitoring technologies (sensors) that could be incorporated into a home or even a community setting to allow for full-scale tracking of the elderly who either stayed home or used these kinds of public resources (not something the people had to be directly involved with). Intel closed their discussion by talking about their "SHIMMER (Sensing Health with Intelligence, Modularity, Mobility, and Experimental Reusability) [which] is a project to develop a small sensing device that is suitable for long-term wear and can be used to capture physiological and behavioral data" (Intel, 2008:6). They believe their work will allow for the elderly to be able to "age in place" (stay home instead of moving to an assisted care facility) as they experience poorer health.

To see the issue from a life-span perspective, it is worth reviewing two additional sources of information. The first is a publication of the AARP, which they entitled Connected Living for Social Aging: Design Technology for All. As they noted about their focus, "A single conclusion emerged through a series of interviews with a range of thought leaders -- to ensure this outcome technology must be designed for all. To achieve this, the 'lens' of every user group must be a conscious part of the design function" (Orlov, 2011:2).

This tone is far different from those of the previous studies. AARP notes that baby boomers and those over age 50 are not only increasingly likely to have a cell phone, laptop or game console, they are one of the fastest growing segments to adapt to social networking resources (Orlov, 2011:3). But even this doesn't offer much guidance because the full reflection of the voices of older Americans has not yet been heard. What the AARP believes the elderly are saying is that they want a far greater reach of technological options that can help across the all age segments; this will allow them to make a much better judgment about health and non-health benefits. Older people want to be creative, innovative, interconnected and even active consumers of all types of products for their needs (Hough, n.d.), even if they actually do want technologies to help keep them healthier. Buying access to online medicines or other systems might be far different from being fully engaged in social networking opportunities where communities of people offer help or encourage empowerment.

A second published study in a related topic is also helpful in understanding the sense of broader reach that AARP wants. This piece is an impressive review of the impact of technology on the elderly who are living with or may be subject to dementia (Kenner, 2008). Though Securing the Elderly Body appears to approach the subject from the viewpoint of technology being just for helping with serious mental impairment, its voice is far more comprehensive. The article does an exceptional job of reviewing medical, caregiver and even law enforcement considerations on taking care of those who may be suffering from progressively advancing brain conditions. For good and for bad, technology is being used in this regard to offer some remarkable solutions to very serious caregiver circumstances. Kenner (2008:253) very much agrees that it will be possible to incorporate monitoring systems of all kinds into the homes of people who might have a proclivity to wander because of their impairments (something of concern to families and law enforcement). But the same underlying technology has much more to offer doctors and supportive professionals for serious and much less serious medical conditions of all types. In a great summary of the topic as a whole, the author concludes her assessment of the situation by noting that research and innovation can be important in either restricting or enabling freedoms in many ways: