As Canada celebrates its 153rd birthday this July 1, the population of aging Canadians continues to expand with more than 6.5 million people aged 65 and older and approximately 7% of these individuals living in nursing homes or other assisted care facilities. With an increasing population of older adults, it is expected that the demand for care facilities will also increase significantly. The implications of this shift from community living will result in increases in healthcare spending alongside the potential for negative physical and psychological implications for older adults themselves. Consequently, there have been increasing calls by the Canadian government to facilitate “aging in place” - to create environments in which older adults can remain in their preferred dwelling for as long as possible.
Older adults generally prefer to live at home, avoiding institutionalization for as long as possible. Forced relocation and institutionalization are associated with a host of negative health-related outcomes, ranging from decreased quality of life to increased mortality alongside increased healthcare expenditure and caregiver burden. For older adults that are able to live in their own homes for longer, they enjoy the benefits of maintaining their social networks, daily routines, and environmental familiarity. Systems and structures that permit older adults to age in place have become a high priority for older adults, caregivers, and policymakers.
Canadian policymakers have implemented a range programs that are designed to enable more older adults to age in place for longer. In British Columbia, for example, the BC Housing’s Home Adaptations for Independence provides funds to assist older adults in modifying their home environment as a way of maintaining their independence. There is a lot of optimism about the potential of assistive technologies to offset some of the challenges of age-related disorders and sensorimotor challenges. Rates of institutionalization in Canada increase sharply with age - from 7% of Canadians aged 65+ to 30% aged 80+; and the projected growth of this 80+ population had added a sense of urgency to the development of technologies for aging in place.
Many of the technologies that are used to facilitate aging in place, including communication platforms such as Skype or Zoom, have relevance to older adults who are self-isolating during the COVID-19 pandemic. In the context of the pandemic, with stay-at-home orders being enforced by the authorities, reliance on assistive and communication technologies has risen dramatically. Social connectedness amongst older adults is a critical component of wellbeing, and the situation is particularly challenging for those who do not have the devices or the skillsets to use relevant technologies. In the absence of devices that are able to connect people remotely, the pandemic has proven to have significant negative implications for the mental health of older adults.
The ‘digital divide’ is a major issue in the uptake, usage, and engagement with technologies for older adults. Many people simply do not have the time, money, or the need to familiarize themselves with devices that were developed without the older adult in mind, which means of course that they were designed to the special needs of some individuals in these older age groups. For people live with age-related disorders such as macular degeneration or arthritis, it can be prohibitively difficult to try and use devices that require high levels of visual acuity or manual dexterity. The fact that the development and design of digital technologies generally does not cater to older adults is an important factor is explaining the low rates of usage among these individuals.
Incorporating the views of older adults in the design and development of technologies that facilitate aging in place has myriad benefits for the uptake and usage of these platforms. A critical aspect of technology development is the identification of the needs of older adults. Instead of developing a solution in the hope that the demand for it will grow as people figure out ways of adapting it to their special circumstances, there is a lot to be gained from adopting a proactive approach to identifying the barriers to aging in place. Part of this process should include actively involving older adults in articulating their needs and in determining how they can be best addressed given the available options. A person-centred approach to designing aging in place technologies has myriad benefits and great potential to facilitate positive outcomes for older adults. Through activities such as co-design and co-production with older adults, technologies can be developed that are tailored to the unique circumstances older adults encounter in their own homes as they grow older.
For the approximately 93% of Canadians aged 65+ that live in their own homes in the community, being able to age in place is a high priority. The individual and societal benefits of being able to age in a location of their choosing are immense and mechanisms that can be invoked to facilitate this process are of great import. Aging in place technological solutions are an avenue that is receiving increased attention particularly in the context of the COVID-19 pandemic. In order to facilitate the uptake and usage of these technologies we must actively seek to incorporate the perspectives of older adults to ensure the acceptability and feasibility of these solutions. Through these technologies it is hoped that aging Canadians can maintain their capacity to age in the place of their choosing.
About the Author
Theodore D Cosco joined the Oxford Institute of Population Ageing in 2016 as a Research Fellow. Dr. Cosco is a Chartered Psychologist (British Psychological Society) trained in applied social research methods (MSc 2011, Trinity College Dublin) and epidemiology (PhD 2015, University of Cambridge), and Assistant Professor of Mental Health and Aging in the Department of Gerontology, Simon Fraser University. His research interests include resilience, mental health, and the interface between technology and healthy 3ageing.
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