Technology non-adoption of the oldest – it’s a bug, not a feature

Not adopting tech -- it's not okay. Lacking access to smartphones, Internet, in-home broadband/WiFi cuts oldest out of access to modern telehealth, communication and engagement, in-home sensors, outside-home GPS, fall detection, and device integration with smartphones. The issue of non-adoption, particularly as more health services move online, will become increasingly vexing for service providers of all types. Surveying of the oldest has fallen out of favor, though Link-ageConnect persists, thankfully --  see their 2019 report. But over the years much has been opined about the reasons – so here is some more opining. Rant on.

After so many years of sound and fury, why is adoption among the oldest so low?  Pew surveyed and noted that technology use drops off in the older age ranges.  This non-adoption is despite White House reports recommending products be made more appropriate to boost adoption, first in the PCAST report of 2016, and then again in 2019. So what are the barriers and problems that prevent older adults from using the technology that could increase access to telehealth (now reimbursed!), social engagement technology, online services, consumer health advice, and on and on? Is the coverage spotty? The price too high? The benefit still unclear? Or are the devices still too difficult to use? As my cousin, the retired rheumatologist says, he only uses his iPhone as a telephone. Everything else is too hard, even though he mastered two specialties and practiced medicine for 50 years. Of course, it isn’t just that phone. It is not only design that keeps non-adoption percentages so high. Consider the sum of:

• Thoughtless product design – see the smartphone.  As smart phone streamlining and cross-vendor imitation became a norm, out-of-the-box experiences for mainstream smartphones became a distant memory. You remember buttons, right? Ah, buttons. They disappeared on devices because they could.  As with most innovations on smartphones, there is no poll of the user base that precedes a change, just forums (not run by the vendor). The change is made, the people complain, some alternative that perhaps makes the vendor more money is provided, and life goes on. 

• Failure of well-meaning but hands-off services.  Over the years, community services including senior centers have toyed here and there with helping non-adopters use technology.  Volunteers take their own devices and show how they can be used. And long ago, huge training sessions were held at convention, run by an organization that at that time really wanted older seniors, to learn how to use smartphones and tablets, benefit from access to the Internet and go online.  But the conventions were canceled, the training became regional, and the organization began to recast itself as serving all ages. You may think I am kidding, but check the link.

• Failure of misdirected politics – reports published, but adoption barely budges. Task forces form every few years that are populated with well-meaning people.  Consider the White House 2016 and White House 2019 reports on use of technology by older adults.  Yet once the task force meetings were over, no entity was tasked (funded) with implementation of the recommendations, leaving it likely that in a few years, the same level of non-adoption, not-quite-there devices, and unsolved problems will remain. Within that continuum, in fact, his week a new Senate technology initiative was launched. Manage expectations accordingly.

• Failure of prolific but inadequate training.  When the device is unboxed, and whether it is a thermostat, a smartphone, a tablet, a new TV, there are manuals of instructions and online forums that must be studied or the device becomes a paperweight. Training seniors about technology is well-meaning and ubiquitous. But is it disciplined and state of the art? T-Mobile, AT&T, and Verizon offer training for ‘free’ as bundled into their services. But 1-on-1 training is rare, and because so many of these devices make us feel stupid because they are not even close to intuitive, individuals sheepishly go back again and again to the store. Or they pay for 1-1 sessions.  Or they give up and return to their status of non-adopter. Expect this to worsen with the pace of tech change. Who notices the people who are left in the dust? Rant off.