Our Take on Technology

TABLE OF CONTENTS

Member's editorial	For further reading
Countdown to the 21st Century Tackling technology	For More Information...
What is technology?	Online please
Barriers of Technology	Tips List
Plus and minuses	Notes
Where to from here?

Member's Editorial

Our Take on Technology

What does technology mean to you? Medical miracles, or innovative inconveniences? E-mailing your grandchild on the other side of the world, or trying to negotiate the push-button maze of a voice message system? Technology is all these things - no wonder reactions to it diverge so widely. One person's handy invention is another's technological nightmare. Seniors, like other Canadians, are diverse - with varied lifestyles, distinct capabilities and preferences, different degrees of comfort with technology.

At NACA we recognize technology's benefits and drawbacks. It can extend our capacities and add zest to our lives - if we embrace its advantages and avoid the pitfalls. Technology can reveal opportunities and solve problems - but it seldom provides all the answers. "No technology is more important than the people who use it," observes the Canadian Health Network, which is exploring technological and other ways to deliver better health information to Canadians.

Benefiting from technology demands a deliberate and thoughtful approach. Two principles are important: appropriate use of technology and consumer choice.

Medical technologies, for instance, can improve seniors' longevity and quality of life, but they have to be applied to the right person at the right time. Consumers must be fully informed about the benefits and risks of using a technology, so they can make suitable choices.

Similarly, assistive technologies (furniture, appliances, tools and gadgets designed to help with daily chores or compensate for disabilities or sensory loss) can enhance independence and well-being. But assistive devices have to be appropriate, accessible and acceptable to senior users, and their availability should be publicized more widely.

With technology affecting so many aspects of life, these issues will not diminish. The answer, of course, is neither the wholesale embrace of technology nor its total rejection. The middle road is paved with information, options and choice - three elements of a successful relationship between people and technology.

Gérald Poulin NACA Member Ontario

Before sitting down to read this article, you probably made a cup of tea, flipped on a light switch, and put on your eyeglasses - all without a second thought. Yet corrective lenses and electric light were once fanciful fictions - and you couldn't have made tea without stoking the fire. Yesterday's fantasy is today's technology. We can hardly imagine what will be commonplace in the next century.

In the meantime, our relationship with technology can be ambiguous. It makes us feel powerful and masterful one day, helpless and frustrated the next. We like technology that makes life easier, more convenient, more pleasant. But we blame it if we feel isolated, dehumanized or incompetent.

In short, technology is as much about attitudes as it is about microchips. In this issue of Expression we look at some of the factors shaping our attitudes toward technology, the ways technology is embedded in daily life, and how seniors are using technology to expand their horizons and help them get more out of life.

Technology is the application of human knowledge and ingenuity to a task or problem. This definition embraces not only 'high' technology - computers, robotics, telecommunications, medical and biotechnology - but also 'low' technologies, such as light switches, can openers and the many assistive devices that help seniors with everyday tasks. Technology influences almost every aspect of life today - the home and the workplace, medicine and business.

Telecommunications technology helps overcome the challenges of Canada's geography, climate and transportation systems made unreliable by adverse weather. It can also help people with limited mobility.

The Northern Ontario Remote Telecommunications Health Network telemedicine project, launched early in 1998, allowed a 78-year-old Kirkland Lake senior to use a two-way television monitor and speaker to consult her orthopaedic surgeon in Timmins about knee surgery. " It's not always easy for seniors like myself to make the trip out of town. It's going to be a fantastic aid for all of us up here," she commented. Similar projects, sponsored in part by Health Canada's Health Infostructure Support Program, are under way across the country.

High-speed networks (the ones that bring pay-per-view movies into your home) can also be used to transmit records, test results, x-rays, ultrasounds and cat scans between hospitals and research facilities. This cuts down on waiting time for patient information and enables remote diagnosis, saving unnecessary trips to distant hospitals.

Telecommunications also support contacts and lifelong learning: video- and teleconferencing, internet and e-mail can bring a course to seniors who live far from educational facilities or cannot attend class because of limited mobility. Keeping mentally fit in this way is known to improve long-term vitality and health.

Medical technology (pacemakers, artificial joints, laser surgery for cataracts and short-sightedness) can replace or fix parts that don't work as well as they used to.

In fact, health-related technologies have contributed significantly to the growing proportion of seniors in the population. Research discoveries applied to diet and lifestyle are also helping people live longer, healthier and more independent lives.

Biotechnology and genetically engineered agricultural products, as well as pharmaceuticals and vaccines, have been on the scene for a while.

Disease- and pest-resistant grains, developed using these technologies, reduce the need for chemicals in agriculture and hence in the food supply. Leading-edge research now focuses on the quality of grains, such as their protein and starch content. The next century could see bread, pasta and other foods made with calcium-supplemented wheat - better nutrition and better health through technology.

Computers are what most people think of as the current technological revolution. Seniors are a fast growing segment of computer users today.¹

Seniors' computer use is limited only by their imagination (see Tips List), and newer technologies - voice recognition, text and image scanning, optical readers - are making computers more accessible to anyone with the will to learn.

Housing design is using electronic and other technologies to offer safety, security and convenience. An automated home can: open and close windows depending on the weather; identify callers at the door without opening it; turn off a stove element when a pot is removed; set water temperatures at different levels for dishwasher, washing machine, sinks, tubs and showers; call for help in an emergency; provide one-switch household controls (such as a 'goodbye switch' at the front door to turn off appliances when you leave).

Quebecers have even adopted a new word for the field of home automation - la domotique, a term that combines the concepts of 'technical' and 'domestic'. It's not as futuristic as it sounds, for technology is already a big part of domestic life. A typical home could contain as many as 225 controller chips (up from 75 in 1990) in appliances, audio-visual and communications equipment, heating and cooling systems, security systems and other household items.²

The assistive devices industry is a hotbed of technological innovation - and not just high tech.

True, there are some very sophisticated devices, like the one for measuring blood sugar, which states the result out loud, and a container that dispenses medication in pre-set amounts at pre-set times. But there are also many ingenious devices to help with everything from taking a bath to preparing meals and enjoying recreation and travel.

Sometimes the simplest devices make the biggest difference in terms of quality of life. In the 1980s, for example, the percentage of U.S. seniors reporting that a disability prevented them from using a telephone fell by 10%. The evidence suggests that the change occurred because of two simple improvements - speed dialling and larger keypads - along with the lower cost of adding phone.³

Today. cordless and portable phones and handsets adapted for hearing or dexterity loss are available, while three-way conference calling adds to the pleasure of staying in touch with family and friends. The 'new technology' of less than a century ago has become an essential device for safety, security and social contact.

In summary, technology is contributing to seniors' health, safety and security while also offering convenience and connections with the world - the stuff of which independent, fulfilling lives are made. But not all aspects of technology enjoy equal acceptance.

Often, the debate is framed in terms of why people resist technology. Perhaps a better question is what barriers prevent people from using or wanting to use technology, be it high tech or low tech.

Attitudes and knowledge. It might be a simple case of not knowing a technology exists, not knowing how to use it, or being reluctant or embarrassed to ask for help. Seniors are already strong technology users, although those they use most often - telephones and televisions - have become so much a part of daily life that we no longer think of them as 'technology'. But other technologies, especially assistive devices, have not been adopted as widely.

Lack of information about the availability and value of assistive devices has been identified as a barrier to use. With all the emphasis on high tech, it's easy to forget that ordinary low tech aids to compensate for changes in vision, hearing, dexterity and mobility can do a great deal to improve the quality of life. Assistive devices run the gamut from sophisticated electronic wheelchairs and scooters to simple bathroom grab bars (see box below).

Whether simple or sophisticated, comfort in using assistive devices increases with practice. An occupational therapist can help make sure there's a good fit between the user and the device and can demonstrate how to use it properly, so that it does the job it's intended for.

Seniors may not want to use assistive devices for fear of being pigeonholed as 'frail' or 'disabled'. Margaret Wylde, who has worked with seniors on product design and marketing, criticizes the tendency to label devices 'for the elderly'. Personal safety devices, for example, are often marketed as something to make you feel 'safe, secure and independent'. This approach emphasizes the limitations of potential purchasers and doesn't answer the main concern - that help be available when it's needed. Promoting the benefits, quality and reliability of the product and service would be more effective, Wylde says.⁴

Attitudes are important here too. If you look at the glass as half-full instead of half-empty, it is easy to see that assistive devices like scooters, walkers and motorized wheelchairs actually help counter images of frailty and incapacity - because they help you get out and about and enjoy the social contact and other experiences on offer in the community. It's all in how you look at it.

The mystique and intimidation of technology can also be barriers - "I couldn't possibly understand something so complicated." Senior computer users' groups have sprung up to counter this tendency. According to seniors' computer groups, older people are not averse to using new technology, just unfamiliar with it. Once they have access to new tools and knowledge about how to use them, technology enriches their lives. After studying seniors' technology use, Catherine Geoffroy concluded that their attitudes to technology are affected by

• the perceived benefits of using it
• positive past experiences with using technology
• the quality of information they received about the technology
• training and follow-up provided for people using a new technology hands-on experience, which increases their comfort level in using a new technology or product
• the extent to which a technology or product meets users' needs
• users' enjoyment of the product or technology.⁵

Cost. If the cost of using a technology is prohibitive for most people who could benefit from it, this should concern us as a society, because assistive devices, home safety and security systems, and connective technologies can help people remain independent longer. In addition to increasing the quality of life, this could also have benefits for health and home care arrangements.⁶

Design. There are significant opportunities to improve seniors' quality of life through better product design.

Margaret Wylde gives the example of hearing aids. Designers have focused on the quality of the acoustical signal and on concelaing the hearing aid by making it very small. But the latter objective can raise another barrier - technology abandonment. Users quit using tiny hearing aids because they are too small to operate easily. The controls are hard to see or feel (who knew that O meant off and N meant on?), and replacing the battery is next to impossible.⁷

Consumer panels should be testing assistive devices in real-life situations, Wylde says, such as using a jar opener on jars of different sizes that have not previously been opened. Tests of an electric scooter should include operating it on various surfaces, backing up, turning corners, manoeuvring in tight spots, putting it together and taking it apart for travel, and charging batteries.

As a study for the Seniors Directorate of Alberta concluded, the issues of attitudes, knowledge, cost, and design suggest an extensive agenda for action by manufacturers, education facilities, seniors' groups and governments - along with any institution, service or business that has technology-based interactions with clients and customers.⁸

Pluses and minuses

Misuse or inappropriate use are the downside of technology. For example, electronic monitoring of an individual's history of prescription drug use can help support choices about medical care and may prevent adverse interactions with other drugs. But it also raises privacy issues. Could data be used for purposes other than those for which they were gathered? Similarly, digital records of a patient's medical history might enhance treatment and permit research with beneficial consequences for society generally, but could also endanger individual privacy.

Technology has opened up new realms in education, medicine and other areas, but has this occurred at the expense of other, more urgent needs? Has it widened the gap between have and have-not - the information-rich and the information-poor?

With 'smart' houses and wired homes, will technology be expected to replace some traditional services in areas such as health, social services and home care? What are the implications for individuals, for social interaction, for community responsibility? Will this technology be affordable to some and not others? The Canadian Home Care Association is one among many organizations examining these issues and challenges, including changing service expectations, privacy concerns, and the absence of national policies and standards.⁹

Catherine Geoffroy concluded from her study of seniors and technology that several steps would begin to bridge the gap between them:

• Ensuring the presence and active participation of older adults in the research and development process, particularly in the planning, testing and prototype stages and marketing of technology and its products.
• Encouraging partnerships between governments, institutions, the private sector and associations of retired persons in these areas.
• Developing standards and guidelines for the communications and information technology industries that are developing products and technologies intended for older adults.¹⁰

Technology can both enhance and inhibit freedom of choice - that most precious and fragile of human freedoms. When the environment lets us choose from a variety of options, we maintain our independence, and our quality of life is positive. An unyielding environment that limits choice reduces pleasure, independence and quality of life. Freedom to make simple choices - location of residence, the meals we eat, the furniture we use, the recreation we seek - will not remain unchallenged. If we live long enough, our ability to choose will be restrained by one or more functional limitations.

Technology can help bridge the gap between what we would like to do and what we can do. But decisions about technological change should proceed cautiously, respectfully, and incrementally. In this way, the products of technology will be developed and designed in ways that recognize the diversity of seniors and their right to make choices about technology use.¹¹

Canada, a society for all ages

Notes 1 Brink, S. "Blending Research...in the Information Economy", in Gloria M. Gutman, ed., Technology innovation for an aging society: blending research, public and private sectors (Vancouver: Gerontology Research Centre, Simon Fraser University, 1998), p. 135. 2 Brink, p. 132. 3 Fernie, G. "Bringing the product from the design concept to the marketplace", in Gutman, p. 23. 4 In Gutman, p. 49. 5 Geoffroy, C. Les technologies de communications de l'information et les aînés (Laval and Ottawa: Centre d'innovation en technologies de l'information and One Voice - The Canadian Seniors' Network, 1994) pp. 9 and 10. 6 Seniors Directorate, Alberta Ministry Responsible for Seniors, Looking to the future for seniors, Background discussion papers, "Technology and Aging", (Edmonton: March 1992), pp. 6-8. 7 In Gutman, p.47. 8 Seniors Directorate, Alberta, pp. 9-10. 9 At Home/Chez Nous, newsletter of the Canadian Home Care Association, October 1998 (chca@cdnhomecare, on.ca). 10 Geoffroy, p. 18. 11 Pirkl, J.J. Transgenerational Design, Products for an aging population (New York: Van Nostrand Reinhold, 1994).

Expression is published four times a year by the National Advisory Council on Aging (NACA), Ottawa, Ontario. K1A 1B4,
Tel.: (613) 957-1968;
Fax: (613) 957-9938;
E-mail: info@naca-ccnta.ca

The newsletter is also available on Internet: http://www.phac-aspc.gc.ca/seniors-aines
The opinions expressed do not necessarily imply endorsement by NACA.

ISSN: 0822-8213