Assistive technologies refer to various types of devices or systems and services that help older persons perform daily tasks that otherwise they would not be able to do, or increase the ease or safety with which the task can be performed. Advances in assistive technologies have helped in making them more accessible for everyone, including older persons.
There are different types of assistive technologies, ranging from low-tech devices such as mobility aids (eg, wheelchairs, scooters, walkers) and vision and hearing aids to more sophisticated high-tech devices (eg, robot vacuums and social robots) and smart home hubs (eg, smart lighting with voice command and smart security systems such as falls detection sensors).
Other categories of assistive technologies include medical alert systems such as telecare and telehealth to provide medical assistance in case of emergencies and monitor heart rate remotely, or track persons living with dementia using wearable GPS tracking devices.
Applications/services can be categorized into supportive technologies, that help individuals perform tasks they may find difficult to do unaided; responsive technologies to help individuals manage risks and raise alarms; and preventative technologies to help prevent dangerous situations from happening in the first place.
Undoubtedly, these technologies provide numerous benefits for home-dwelling older persons, their family members, health and social care professionals/organisations and the wider community.
For the older person and their family, assistive technologies increase choice, safety, independence and a sense of control. When used effectively, they can potentially reduce accidents and falls at home, improve community support for older persons with chronic conditions and reduce the burden on family members. Ultimately, they help improve the older person’s and family members’ quality of life by maintaining independence and supporting the older person to ‘age in place’.
Better communication on technologies’ perceived benefits and early access can help change perceptions among potential service users
For health and social care professionals, these technologies can support the integration of continuity of care between acute hospital and home, which can potentially reduce hospital admissions, enable a timelier hospital discharge and reduce the need for acute residential and nursing home care.
These benefits need to be seen from the perspective of older persons and with family carers in mind, so that these technologies remain meaningful to service users.
Although there is increased evidence of their benefits, there are still barriers to accepting and adopting assistive technologies by older persons and their family. A review of the literature on barriers to adoption of assistive technologies by older persons (Yusif et al., 2016), has identified the perceived fear of losing one’s privacy as the greatest barrier. Other concerns were the cost of devices/services, perceived ease of use and their suitability for daily use.
Qualitative studies have shown that older persons are unsure about accepting assistive technologies in their daily lives. This could be partly due to conflicting views of perceived benefits, as well as constraints such as fear of losing their dependence, autonomy or dignity (Dahler et al2016).
Moreover, older persons who use such technologies may also feel stigmatised or embarrassed. Lack of training and support in functionality and applicability may further contribute to their fears, mistrust and negative attitudes towards their use.
Changing the perceptions of older persons and their family members requires a concerted effort. However, the process of raising self-confidence and knowledge about potential benefits and safety is a complex one. Affordability is a common concern, even though over the past years these technologies have become more affordable.
However, there is a general belief that they are costly to buy and maintain. This financial burden was also highlighted in a local study by older persons who were interviewed about their experience of using assistive technology (Spiteri, 2018).
Better communication about perceived benefits, using clear and jargon-free instructions, as well as early access can help change perceptions among potential service users who might consider using them in the future.
Moreover, users and carers should be involved in the design and development of new technologies and listened to more. Besides, technologies should be accessible to everyone, individualised and tailor-made to the needs of the older person and their family members.
Service providers and health and social care professionals who offer advice to service users on using assistive technologies need to be fully aware about benefits and risks, so as to remove any misconceptions, especially since these can influence users in terms of trust and confidence.
Shared decisions about the adoption of assistive technologies need to be taken between practitioners, older persons and family members after the rights and risks of all parties have been thoroughly investigated. Moreover, their implementation should not be introduced in isolation, but as part of an integrated package of community care services.
Unfortunately, a local study (Spiteri, 2018) highlighted the paternalistic attitude taken by some local healthcare professionals when supporting older persons in making decisions to use assistive technologies; so much so that participants opted to ask for advice from friends or relatives.
Local studies such as the NATIFLife project, supported by the INTERREG Italia-Malta Programme, are needed to better understand how to develop assistive technologies for older persons, based on their views and needs.
The current COVID-19 pandemic has accentuated the benefits of communication technologies to reduce social isolation for senior citizens, especially during lockdown.
This has helped reduce negative views and fears associated with these technologies and their acceptance. However, there is much left to do in order to ensure that older persons are not left out and can reap the benefits of new technologies ‒ thereby reducing the digital divide between the younger and older generations and within different groups in the latter age cohort.
Anthony Scerri is a lecturer at the Department of Nursing, University of Malta, and vice president of the Maltese Association of Gerontology and Geriatrics.
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