Age Action Alliance - a useful resource

I would like to draw attention to the Age Action Alliance, a network that resulted out of the European Year for Active Ageing.

The Age Action Alliance is a useful resource covering a wide range of topics and provides lists of organisations as well as reports.

I'm particularly interested in Digital inclusion.

Ofcom press release: Tablets help drive increase in older people going online

From the Ofcom press release:
"The number of people aged 65 and over accessing the internet has risen by more than a quarter in the past year, driven by a three-fold increase in the use of tablet computers to go online, new Ofcom research reveals.

This has helped to drive overall internet use up from 79% of adults in 2012 to 83% in 2013, according to Ofcom’s Adults’ Media Use and Attitudes Report.

The proportion of people aged over 65 that are accessing the web reached 42% in 2013, up nine percentage points from 33% in 2012, which is a 27% increase over the year. One reason for this is an increase in the use of tablet computers by older people aged 65-74 to go online, up from 5% in 2012 to 17% in 2013.

Nearly all adults under 35 years old now go online (98%). The increase in internet use was driven by three different age-groups: 25-34s (98%, up from 92% in 2012), 45-54s (91%, up from 84%), and, most notably, those over 65."

There are many reasons why tablets are supporting the "drive" to get older people online, for example:

• the touch interface makes it "easier" to use, than keyboard and mouse (or not)

Syed Murad, Michael Bradley, Neesha Kodagoda et al. (2012) Using task analysis to explore older novice participants’ experiences with a handheld touchscreen device, 524. In Contemporary Ergonomics and Human Factors 2012: Proceedings of the International.

Lim, F. S., Wallace, T., Luszcz, M. A., & Reynolds, K. J. (2013). Usability of tablet computers by people with early-stage dementia. Gerontology, 59(2), 174-182.

• the shape of the device is more inviting, aesthetically pleasing and easier to handle
• the operating systems are more smart phone like rather than PC like and potentially easier to handle (and more familiar to current users of smart phones)

Read the full press release here

Virtual smart house to showcase different Telecare options

The MI (More Independent) DALLAS project offers a link to a virtual smart house to showcase the different forms of Telehealth technologies that exist. I have recently been to the AKTIVE conference and already there it struck me how large and varied the range of Telehealth devices are. Going through this virtual smart house, it brings home again, that many of those technologies are useful for anyone of any age and health.
For example, the MagiPlug, which stops overflowing and indicates when the water temperature is too hot, should be useful for anyone who also has small children.
At the same time the 'Bath SPA Light Experience' are a nice to have, but I can't see the direct relevance to Telehealth apart from creating a nice and relaxing atmosphere. The selection of the technologies featured in the house may have been chosen with economical interests, nevertheless it promotes awareness of technologies around.
View virtual Telecare smart house 

Telecare in the UK - my summary from the AKTIVE conference

I have just been to the AKTIVE conference in Leeds. It was very insightful since it refreshed my knowledge about Telecare. I have always been careful not to have my research (Teletalker) placed into Telecare since I didn’t want to come directly from the health related angle. When I went to the ISG conference in 2012 in Eindhoven – the message was very clear: the acceptance rate of Telecare was very low, making pilot projects costly and - with a few exception - unsuccessful.

Now 2014 this is still the case, but at least researchers and other (steering parties) involved are coming around to understand that the components to achieve success with Telecare are complex, context dependent, nuanced and subtle. They realized that a truly multidisciplinary approach involving “end users” (patients, health personnel, carers and technicians) is needed to achieve the potential of Telecare.

A bit of back ground to Telecare or Telehealth as it’s also frequently referred to (based on this Eurohealth paper and other sources): 

Since 1998 UK and other European country governments – and later also the EU - have been pushing for ways to introduce technology to assist with the delivery of care. Europe is faced with the first time phenomenon of lots more older people than younger people because of longevity due to healthier living conditions and no wars, combined with a reduction in birth rates. By 2030 about a quarter of the European population will be over 65 years old, leaving Europe with a 'person to care for ratio' (or potential support ratio PSR, Clarkson & Coleman 2013) of 1:4, which has not existed before. Therefore the drive to use technology to assist and manage health care seems to be a logical step, so fewer people can look after more people. Numerous pilot projects have been taking place in the UK and in the EU, all with moderate success. The range of Telecare technologies range from “low tech” such as pill dispensers, to “more service related” such as pendants for fall alarms (if triggered a carer will contact you), to “high tech” devices and integrated systems such as smart houses equipped with sensors and video connectivity. 

The largest technology (and response) provider in the UK and Europe appears to be Tunstall. Difficulties in delivery Telecare successfully lies with several layers such as interoperability of the systems, technological failures, low awareness with professionals and patients, low acceptance rate (stigma), cost and disjointedness of services (Telecare is seen as an ‘bolt-on’ service).

The Technology Strategy Board has commissioned several projects (SALT, MALT, AKTIVE, ATHENE, COMODAL, COBALT), which are due to disseminate their findings in early summer 2014.

For example, COMODAL looked at reaching consumers in the electronic assisted living technology market. Dr Gillian Ward presented a talk about their work at AKTIVE event. They were interested in the 50-70s age group, either as consumer for themselves or for someone for someone they care for. They employed as methods: literature review, market analysis, product reviews, street surveys, industry telephone interview, focus groups and co-creation workshop. From the interviews with consumer and industry they found that there was a large mismatch between expectations on each side. Industry underestimated the concerns consumers have around perceptions of the use of technology. Cost is important but not the most crucial influence in the purchasing decision. People (consumers) were looking for managed solutions, not products. The design of Telecare should address aspirations, not disability.

Other themes of the conference addressed issues around measuring the performance of Telecare  and insight into the patient & carer relationship and the role of Telecare technology in there. The topic of loneliness and the multifold aspects around caring arrangements were brought out in the open. For example a neighbour would not mind being the first point of contact during day time, but not necessarily during night time. Rob Procter and Joe Wherton reviewed people’s adaptions to Telecare devices, which they termed “bricolage”. They called for more “co-production” in the shape of telecare devices i.e. where users can adapt / make the device to their needs. Paul Clitheroe from the MI-Health, Dallas project in Liverpool, suggested not to “talk” about telecare, but to reach people through activities they enjoy and to communicate the message of self-care. In his view, once people took on responsibility for their own health, people will look for solutions offered on the market in order to manage their health.

I thoroughly enjoyed the conference and the people I met. This little summary does not do justice to the full range of great projects and the wealth of knowledge that has been generated through the critical review of Telecare options and impact.

Themes that I felt were missing:

•  The delicate and problematic relationships between (informal) carers and older people in regards to abuse – can Telecare play a role in reducing abuse?
•  The issue of managing unpredictability in the caring circle, it may be that the carer  (the spouse) falls ill too … how quickly can the new carer get introduced to the telecare set-up?
• There was frequently a call to offer more choice to the patient or carer, but I can also see a danger in the “terror of choice”. Particularly when your mind is already occupied with other realizations that you have to come to terms with e.g. cancer, diabetes. In my view it’s not enough to talk about choice, but to consider where it is helpful to offer choice (e.g. it might be useful to offer a fall alarm either as pendant or wrist band) and when to intervene with a set plan based on professional experience.

 

Could the mixing of generations be a problem for Facebook?

With great interest I read the BBC news article about Facebook's 10th birthday. Of particular interest to me was this sentence: "Parents can be embarrassing on Facebook - they post pictures of their offspring that they find hilarious but their children don't, they add ill-advised comments to their children's status updates and they often fail to understand the basic etiquettes of online discourse."

During my research I found that there was a benefit at aiming towards transgenerational (i.e. acting across multiple generations) use of online social media. This article, I suspect, assumes the middle age parent and teenager relationship, but I wonder if it also holds true for the older parent and adult child relationship. 

My own mother is still not online, but my mother-in-law is, although not on Facebook. In so far, my husband and I are protected from any of these embarrassing moments of too much information sharing on Facebook.

I have a friend in her 30s and her mum is in her 50s and I’m able to see their activities on Facebook. To me their online exchange seems happy and full of banter and I hope it stays that way for the next 30 or more years.

Read full BBC article here

 

NAPA's useful list of links to activities / charities working with the oldest old

Thanks again to Jeremy from KIT: He made me aware of NAPA, which has a great page with external links to organisations working with the oldest old. For example I really liked what Jabadao does by getting people with dementia to dance.

see the page with links from NAPA

When do you call a metal arm on which an ipad can sit a robot?

From the Presence newsletter I received the news items labelled:

"The robot that doesn’t roam: KUBI ditches the wheels for stronger interaction".

But to my surprise when I followed the link to the Revolve Robotics website (the manufacturer of KUBI), it just showed a metal arm that is fixed to the location but very moveable.

This development of KUBI is interesting to me since I did appropriate existing software and devices for my Teletalker system too. To me it was obvious that Telepresence did not need wheels, when it's about connecting two static locations. But now I wonder, when do you actually call a device or a construction a robot?

Comments welcome.

 

Paper: "Older people and online social interactions: an empirical investigation"

The "Older people being online" - research conducted by Open University mirrors very much my research findings during my requirements collections phase (before I decided to build the Teletalker as a tool to demonstrate the benefits of online connectivity to older people www.teletalker.org).

Their initial findings are: "

• that older people need an incentive to get and stay online;
• that relatives and trainers need to structure their help and use repetitive strategies to aid retention; 
• that social networking is a step further than most older people take while email, Skype, and closed mailing lists or forums related to their interests are the most common applications for social interactions."

Read the full paper here.

I find particularly interesting their reflections on the research process, which shows that the research had become an act of collaboration between older people and researchers rather than a directional investigation. In my view it's not easily possible to research older people empirically without getting involved in some way. 

Now, I'm wondering whether this would be true for researching any age group (which most likely is because it involves human beings). 

BSG launches youtube channel "Ageing bites"

From the BSG newsletter:

BSG is pleased to announce the launch of its new YouTube channel, AGEING BITES!

 http://www.youtube.com/user/AgeingBites/videos

Ageing Bites is a series of short films each highlighting a different aspect of ageing or ageing issue. The films are also available to view on the BSG website: www.britishgerontology.org/ageing-bites.

If you would like to film an ageing bite or already have some material from a research project or through work that you think would be suitable, please share it with Rachel Hazelwoodrhazelwood@britishgerontology.org

Elderly and dangerous driving

Reading the BBC article "Who, what, why: How dangerous are elderly drivers?" I had some reactions to it. I didn't like the perspective. The article was basically confirming that elderly drivers don't necessarily cause more accidents, but if accidents happen they are usually more critical or fatal in their consequences. The latter has to do with the fact that when an elderly person is involved in an accident they are more likely to be seriously injured due to the frailty of the bones. I would have preferred if the article had been written more from a more inclusive viewpoint. Rather than selecting elderly drivers to be the main focus, the article could have investigated who are the safest drivers. Or which age groups cause the majority of accidents. 
In many ways I feel that the focus on elderly in the news is frequently re-inforcing the views that growing older could be an issue. I would like to see more positive news about the elderly population. The fact that many are still driving (after health checks) shows how they keep active and participate in social life. It would be nice to remind everybody to drive with considerations for others particularly on weekends and bank holidays where people socialise with their families and friends. 
  

annual BSG conference - great program

I'm currently at the BSG conference and heard about fascinating research - in particular about the unconsidered use of the term "loneliness"(often mixed up with social isolation and being alone) (Christina Victor), the representation of older women (Sukey Parnell) and their choices of dress (Julia Twigg).

My own talk "Using constructive design research to develop online social technologies for older people" is later today. Here is a link to the conference and program.

"Alive" - a charity working with ipad and older people

I have been very busy in the recent months with the final part of my practical PhD. In July I ran a participatory design workshop to discuss the future of the Teletalker. One of the outcomes is that the form of technology, albeit important, is secondary to its role within society. But the functionality must be kept simple. The ipad, as a more approachable technology for non-computer literate people, came up in the workshop's discussions several times.

So this reminded me to blog about Alive - a charity, which uses ipads to involve and stimulate older people in care homes, next other activities they offer such as reminiscence workshops.
As it was pointed out in my workshop during discussions, not all older people are in care homes - more needs to be done to address older people who are at home. Maybe Alive could also give ipad sessions for an older person at their home?

InTouch - a video link system for people with dementia

I found this project, which is similar to my current field research where I connect with the Telewalker (yes, the Teletalker on wheels - teletalker.org) residents with each other in different lounges of a care home. Since I'm still in the preparation phase I can't report much about my field research.
Though reading about this project it shows me how current my research is and whilst there are many similarities, my research is different.

InTouch is aimed at people with dementia, to reduce their social isolation, so that friends and family can contact them with an intuitive video link system. I found it particularly interesting that they choose to use a traditional telephone handset combined with a touch screen, which supports the argument to choose technology people are familiar with, well with the hand set at least.

My research focus less on the video call, but more on the notion of presence by connecting two lounges with an online window.

I plan to contact the organisers of this project to learn more. In particular, how they worked with data gathering by older people with dementia.

Find out more about InTouch on this website.

Interesting blog entry on: How the Internet and digital technology can combat social isolation

I read this blog entry in the blog: Connecting Social Care and Social Media.
Shirleyayres presents 7 internet based or digital resources to keep socially isolated older people connected. I list them here with my comments.

• DropBy - a functionality laden website, for which you need to have web literacy to access it 
• The casserole club - you need to have web access to find your neighbour cooking a spare meal - I assume that once a relationship is established you can check with your neighbour by phoning them
• Good Gym - usually when an older person is active (physically fit) they are not socially isolated - I wonder how the project accesses the socially isolated older person
• Mindings - technology needs to be bought / set-up, so the dispersed family member is connected and this will include technical support - who is giving this?
• Gen2Gen - a young volunteer gets trained to give computer support to an older person. I think it is a great way to bring generations together... I suspect not only older people would like to have some IT support
• Alive - a reminiscence work with help of the internet's resources... absolutely great, but notice the emphasis would be on the 'therapist' working with the older person
• Chill4usCarers - lots of carers are older people and that is great, though web literacy is required again in order to make use of this site 

Overall, it brings home to me that real connectivity can only be done through people and that the technology can only support the 'connector' or carer.... I don't think that any of the technologies listed here are made easy enough for a computer in-experienced older person to use, except the Gen2Gen project. There I'd say it's important to understand that the relationship, which will be built with the older person is based on trust and that volunteers should not change frequently. 

I look forward to further developments in technology to combat isolation...

Thanks Shirley for starting to compile a list. 

Older people as inexperienced user

Last week (7th March 13) I took part at Open University's workshop: Older People and Online Social Interactions - Examining Usability, Accessibility and Online Safety aspects.
It was a very interesting and useful workshop where Shailey Minocha and team presented the results of their current research into older people and social online interaction. The workshop consisted of a mix of people either designers or people working in accessibility, representing organisations working with older people, researching older people and older people themselves. We were asked to input with our feedback on their research results such as feedback on personas and guidelines they had created.
One interesting aspect for me was the feedback at the end of the day. One woman said that she didn't feel old and that she felt patronised by the way issues were discussed. She pointed out that many of the problems occur due to inexperience of using the web or the computer and that this hasn't got anything to do with age. I completely agree with her. Many of the issues that we experience when using online technology (e.g. password management) are the same tricky / confusing / dangerous / risky for anyone of any age, but particularly disconcerting for someone who is inexperienced. It doesn't matter whether they are young or old.
But watching this BBC video just now makes me think again about the difference between an inexperienced young person and an inexperienced older person. In this video they keep on mentioning how the older person is used to the analog world where you, for example, press the button harder if it didn't work the first time.

An inexperienced (with online technology) young person hasn't got necessarily pre-conceptions on how they think the technology works. Younger people are known to learn more through trial and error. They try things out and see what happens. Younger people are better connected through groups. Either in school / circle of friends / hobbies. In those groups they can discuss their experiences.

An inexperienced (with online technology) older person has got life experience in using other technologies. Learning strategies of older people are usually by applying existing knowledge, to read instructions and to work things out by understanding them first. They might have pre-conceived ideas from previous technologies on how things might work. They are more cautious in trying things out. And here comes the greatest difference I think, older people are less well connected to groups where they could easily discuss experiences or ask questions about their computer use. Note: I use the term older people, meaning people starting from the age of 65 years plus. Many people in their 60s and 70s are still very active and likely well connected to groups / family members. But with the group of 80+ year old the social connections and activities reduce to due various reasons such as health issues, mobility problems, peers dying.

So I wonder how much having previous knowledge of using technology actually hinders a person (of any age) to understand the new technology? Or is it the lost connection to groups, which stops people from trying things out and sharing their experiences?

Go on UK (ex Race online 2012) estimates for 3-3.5 million active resistors in the UK for online connectivity

Go on UK, the charity, which was formerly 'Race online 2012' and championed up by Martha Lane Fox to get everybody in the UK connected, shows on their website a diagram including statistics & persona information of who the target group is.

source: Go on UK
Go on UK concentrates their work on 'potential users' and 'narrow users' as they classify them.
An interesting point for me is the fact that they call a group of 3-3.5 million people "active resistors". In my research in statistics for numbers of Non-Internet users I found that there is a group of resisting internet users, but it wasn't as large as this. The Oxford Internet surveys with their 2011 report differentiated between ex-internet users (people who used to use a computer) and non-Internet users. With this not to be forgotten the group of proxi-users; people who don't use the computer themselves, but get their son / daughter / carer or grandchild to do it for them. Are they active resistors, or simply comfortable with the set-up their have? In the OXIS report 80% of the ex-users and 60% of the non-Internet users indicated that they have someone they know if they needed to go online. In my calculations at the time (in Jan 2012) I concluded that less than 2 millions people are really digitally disconnected.
Link to Go on UK Link to Oxford Internet Surveys

Skype call it "ambient video"

The basic concept of the Teletalker i.e. providing a constant online window into the other space is not new, although the means to activate the volume is. On Skype's blog they call it "ambient video". Skype refers back how they have their offices around the world connected in this way, but interestingly the skype computer is not near the work place, but in the break out area near the water cooler - a place that invites for a chat. read full skype blog here

Conference proceedings: Age & experience - ludic engagement in a residential care setting

Authors: Blythe, M., Wright, P., Bowers, J., Boucher, A., Jarvis, N., Reynolds, P., Gaver, B. wrote "Age and experience: Ludic engagement in a residential care setting" for the Designing Interactive Systems conference in Aarhus, Denmark 2010
The article is about findings from a 2 years study at a residential care home where ideas for cross-generational engagement through ludic systems were developed. Huizinga introduced with his book "homo ludens" the idea that humans are essentially playful creatures. In this research ludic activities were explored which engage people's curiosity, diversion and humour rather than logic or labour effectiveness. For this they developed:
1. video window
2. projected portraitures
3. blank canvas
4. soundscape radio
In opposite to the notion of a "ticket-to-talk" - which could be an exhausting experience for the residents - they introduced the idea of the "ticket-to-be-silent". In this project two artists worked with the residents; one of them drew portraits of individual the residents. It was an opportunity to be part of the creation, but not having to talk. Those images were later exhibited in the local town.
I really enjoyed reading this article since the researchers describe how they constantly had to resist the urge to design something 'useful' and to think of ideas that are playful. The article also stresses the challenges working with the group of the oldest old where getting from one chair to another or having a conversation is exhausting. The concept of inter-passivity was also introduced to describe the 'passive' use of technology by the oldest old (which isn't passive, but the obverse of interaction) in those cross-generational uses. Particularly appealing to me was the idea of the video window - a camera set on top of the roof and the view was displayed in a picture frame in the room. Residents would not spontaneously comment how they like it, but complain when it was forgotten to be switched on the next day.

Article of the Teletalker research in the Age UK Barnet newsletter

(Instead of a button) I used a light sensitive receptor, which activated the volume by just touching the area i.e. covering the receptor, so no 'pushing strength' needed.

Over one in three 3-4 year-olds use the internet

In Ofcom's annual Children’s Media Use and Attitudes report I found some information interesting. The users of smart phones and tablets are getting younger. This year the report looked for the first time media use among 3 and 4 year-olds. "The findings indicate that 37% use the internet via a PC, laptop or netbook, 6% via a tablet computer, and 3% via a mobile phone." Also impressive (and scary) for me to read was how many friends a child aged 8-15 have on their social networking profile has. "Children aged 8-11 have an average of 92 friends and children aged 12- 15 say they have, on average, 286 friends. Children aged 8-11 estimate that they have not met around one in eight (12%) of these friends in person (an average of 11 people per child) while 12-15s say they have not met around one in four (25%) - an average of 72 people per child." Read the full report here