Technology to Support Aging in Place: Older Adults' Perspectives

Shengzhi Wang, Khalisa Bolling, Wenlin Mao, Jennifer Reichstadt, Dilip Jeste, Ho-Cheol Kim, Camille Nebeker, Shengzhi Wang, Khalisa Bolling, Wenlin Mao, Jennifer Reichstadt, Dilip Jeste, Ho-Cheol Kim, Camille Nebeker

Abstract

The U.S. population over 65 years of age is increasing. Most older adults prefer to age in place, and technologies, including Internet of things (IoT), Ambient/Active Assisted Living (AAL) robots and other artificial intelligence (AI), can support independent living. However, a top-down design process creates mismatches between technologies and older adults' needs. A user-centered design approach was used to identify older adults' perspectives regarding AAL and AI technologies and gauge interest in participating in a co-design process. A survey was used to obtain demographic characteristics and assess privacy perspectives. A convenience sample of 31 retirement community residents participated in one of two 90-min focus group sessions. The semi-structured group interview solicited barriers and facilitators to technology adoption, privacy attitudes, and interest in project co-design participation to inform technology development. Focus group sessions were audiotaped and professionally transcribed. Transcripts were reviewed and coded to identify themes and patterns. Descriptive statistics were applied to the quantitative data. Identified barriers to technology use included low technology literacy, including lack of familiarity with terminology, and physical challenges, which can make adoption difficult. Facilitators included an eagerness to learn, interest in co-design, and a desire to understand and control their data. Most participants identified as privacy pragmatics and fundamentalists, indicating that privacy is important to older adults. At the same time, they also reported a willingness to contribute to the design of technologies that would facilitate aging independently. There is a need to increase technology literacy of older adults along with aging literacy of technologists.

Keywords: artificial intelligence; co-design; privacy; research ethics; retirement community; robots.

Conflict of interest statement

The authors declare no conflict of interest. A representative of the funding agency contributed to the writing of the manuscript; however, did not contribute to the study design; collection, analyses or interpretation of data; or in the decision to publish the results.

Figures

Figure A1
Figure A1
Technology by Domains.
Figure 1
Figure 1
Westin Privacy Concern Index Results.
Figure 2
Figure 2
Westin Privacy Segmentation Index Results.
Figure 3
Figure 3
Internet Users’ Information Privacy Concerns (IUIPC) Results.
Figure 4
Figure 4
Sensitivity of Personal Information Analysis.

References

    1. Woolhead G., Calnan M., Dieppe P., Tadd W. Dignity in older age: What do older people in the United Kingdom think? Age Ageing. 2004;33:165–170. doi: 10.1093/ageing/afh045.
    1. Eckert J.K., Morgan L.A., Swamy N. Preferences for receipt of care among community-dwelling adults. J. Aging Soc. Policy. 2004;16:49–65.
    1. Matsumoto H., Naruse T., Sakai M., Nagata S. Who prefers to age in place? Cross-sectional survey of middle-aged people in Japan. Geriatr. Gerontol. Int. 2016;16:631–637. doi: 10.1111/ggi.12503.
    1. Boldy D., Grenade L., Lewin G., Karol E., Burton E. Older people’s decisions regarding “ageing in place”: A Western Australian case study. Australas J. Ageing. 2011;30:136–142. doi: 10.1111/j.1741-6612.2010.00469.x.
    1. Ball M.M., Perkins M.M., Whittington F.J., Connell B.R., Hollingsworth C., King S.V., Elrod C.L., Combs B.L. Managing Decline in Assisted Living: The Key to Aging in Place. J. Gerontol. B Psychol. Sci. Soc. Sci. 2004;59:S202–S212.
    1. Diehr P.H., Thielke S.M., Newman A.B., Hirsch C., Tracy R. Decline in health for older adults: Five-year change in 13 key measures of standardized health. J. Gerontol. A Biol. Sci. Med. Sci. 2013;68:1059–1067.
    1. González-Colaço Harmand M., Meillon C., Rullier L., Avila-Funes J.-A., Bergua V., Dartigues J.-F., Amieva H. Cognitive decline after entering a nursing home: A 22-year follow-up study of institutionalized and noninstitutionalized elderly people. J. Am. Med. Dir. Assoc. 2014;15:504–508. doi: 10.1016/j.jamda.2014.02.006.
    1. Task Force on Research and Development for Technology to Support Aging Adults . Emerging Technologies to Support an Aging Population. Committee on Technology of the National Science & Technology Council; Washington, DC, USA: 2019.
    1. Mihailidis A., Carmichael B., Boger J. The use of computer vision in an intelligent environment to support aging-in-place, safety, and independence in the home. IEEE Trans. Inf. Technol. Biomed. 2004;8:238–247. doi: 10.1109/TITB.2004.834386.
    1. Cody M.J., Dunn D., Hoppin S., Wendt P. Silver surfers: Training and evaluating internet use among older adult learners. Commun. Educ. 1999;48:269–286. doi: 10.1080/03634529909379178.
    1. Chiu C.-J., Hu Y.-H., Lin D.-C., Chang F.-Y., Chang C.-S., Lai C.-F. The attitudes, impact, and learning needs of older adults using apps on touchscreen mobile devices: Results from a pilot study. Comput. Hum. Behav. 2016;63:189–197. doi: 10.1016/j.chb.2016.05.020.
    1. Wang J., Carroll D., Peck M., Myneni S., Gong Y. Mobile and Wearable Technology Needs for Aging in Place: Perspectives from Older Adults and Their Caregivers and Providers. Stud. Health Technol. Inf. 2016;225:486–490.
    1. Hoque R., Sorwar G. Understanding factors influencing the adoption of mHealth by the elderly: An extension of the UTAUT model. Int. J. Med. Inf. 2017;101:75–84. doi: 10.1016/j.ijmedinf.2017.02.002.
    1. Aging Well in the 21st Century: Strategic Directions for Research on Aging. [(accessed on 2 April 2019)]; Available online: .
    1. Khosravi P., Ghapanchi A.H. Investigating the effectiveness of technologies applied to assist seniors: A systematic literature review. Int. J. Med. Inform. 2016;85:17–26. doi: 10.1016/j.ijmedinf.2015.05.014.
    1. Peek S.T.M., Wouters E.J.M., Luijkx K.G., Vrijhoef H.J.M. What it Takes to Successfully Implement Technology for Aging in Place: Focus Groups with Stakeholders. J. Med. Internet Res. 2016;18:e98. doi: 10.2196/jmir.5253.
    1. Renaud K., Karen B.J. Judy Predicting technology acceptance and adoption by the elderly: A qualitative study; Proceedings of the ACM International Conference Proceeding Series; Wilderness, South Africa. 6–8 October 2008;
    1. Lorenz A., Oppermann R. Mobile health monitoring for the elderly: Designing for diversity. Pervasive Mob. Comput. 2009;5:478–495. doi: 10.1016/j.pmcj.2008.09.010.
    1. Iwaya L.H., Gomes M.A.L., Simplício M.A., Carvalho T.C.M.B., Dominicini C.K., Sakuragui R.R.M., Rebelo M.S., Gutierrez M.A., Näslund M., Håkansson P. Mobile health in emerging countries: A survey of research initiatives in Brazil. Int. J. Med. Inform. 2013;82:283–298. doi: 10.1016/j.ijmedinf.2013.01.003.
    1. Designing for Older Adults: Principles and Creative Human Factors Approaches, Second Edition. [(accessed on 23 March 2019)]; Available online: .
    1. Scandurra I., Sjölinder M. Participatory Design with Seniors: Design of Future Services and Iterative Refinements of Interactive eHealth Services for Old Citizens. Med. 2.0. 2013;2:e12. doi: 10.2196/med20.2729.
    1. Ritter F.E., Baxter G.D., Churchill E.F. Foundations for Designing User-Centered Systems: What System Designers Need to Know about People. Springer; London, UK: 2014.
    1. Zarem J.E. Today’s Continuing Care Retirement Community (CCRC) LeadingAge; Washington, DC, USA: American Seniors Housing Association; Washington, DC, USA: National Investment Center; Annapolis, MD, USA: 2010.
    1. Kumaraguru P., Cranor L.F. Privacy Indexes: A Survey of Westin’s Studies. Carnegie Mellon University; Pittsburgh, PA, USA: 2005.
    1. Malhotra N.K., Kim S.S., Agarwal J. Internet users’ information privacy concerns (IUIPC): The construct, the scale, and a causal model. Inf. Syst. Res. 2004;15:336–355. doi: 10.1287/isre.1040.0032.
    1. Glaser B.G., Strauss A.L. The Discovery of Grounded Theory: Strategies for Qualitative Research. Aldine de Gruyter; Hawthorne, NY, USA: 1967.
    1. Willms D.G., Best J.A., Taylor D.W., Gilbert J.R., Wilson D.M.C., Lindsay E.A., Singer J. A Systematic Approach for Using Qualitative Methods in Primary Prevention Research. Med. Anthropol. Q. 1990;4:391–409. doi: 10.1525/maq.1990.4.4.02a00020.
    1. Golko A., Jol E., Schmidt M., Terlizzi J. Dual Orientation Connector with Exteral Contacts and Conductive Frame. US20130115821. U.S. Patent. 2013 May 9;
    1. Elueze I., Quan-Haase A. Privacy Attitudes and Concerns in the Digital Lives of Older Adults: Westin’s Privacy Attitude Typology Revisited. Am. Behav. Sci. 2018;62:1372–1391.
    1. Westin A.F. Intrusions Privacy tradeoffs in a free society. Public Perspect. 2000;11:8.
    1. Melenhorst A.-S., Rogers W.A., Caylor E.C. The Use of Communication Technologies by Older Adults: Exploring the Benefits from the User’s Perspective. Proc. Hum. Factors Ergon. Soc. Annu. Meet. 2001;45:221–225. doi: 10.1177/154193120104500305.
    1. Jeste D.V., Blazer D.G., Buckwalter K.C., Cassidy K.-L.K., Fishman L., Gwyther L.P., Levin S.M., Phillipson C., Rao R.R., Schmeding E., et al. Age-Friendly Communities Initiative: Public Health Approach to Promoting Successful Aging. Am. J. Geriatr. Psychiatry. 2016;24:1158–1170.
    1. Davidson J.L., Jensen C. What Health Topics Older Adults Want to Track: A Participatory Design Study; Proceedings of the 15th International ACM SIGACCESS Conference on Computers and Accessibility; Bellevue, WA, USA. 21–23 October 2013; New York, NY, USA: ACM; 2013. pp. 26:1–26:8.
    1. Spinuzzi C. The Methodology of Participatory Design. Tech. Commun. 2005;52:163–174.

Source: PubMed

Sponsors and Collaborators

Medical Conditions

Drug Interventions

3
Subscribe