Experiential Value of Technologies: A Qualitative Study with Older Adults

Enhancing prompt perception in dementia: a comparative study of mixed reality cue modalities

Introduction

Dementia impacts millions worldwide and is challenging individuals' ability to engage in daily activities. Active living is crucial in mitigating dementia's neurodegenerative effects, yet people with dementia often struggle to initiate and complete tasks independently. Technologies offer promising solutions to engage people with dementia in activities of active living and improving their quality of life through prompting and cueing. It is anticipated that developments in sensor and wearable technologies will result in mixed reality technology becoming more accessible in everyday homes, making them more deployable. The possibility of mixed reality technologies to be programmed for different applications, and to adapt them to different levels of impairments, behaviours and contexts, will make them more scalable.

Objective

The study aimed to develop a better understanding of modalities of prompts that people with dementia perceive successfully and correctly in mixed reality environments. It investigated interactions of people with dementia with different types of visual (graphics, animation, etc.) and sound (human voice, tones, etc.) prompts in mixed reality technologies.

Methods

We used the Research through Design (RtD) method in this study. This paper describes the findings from the user research carried out in the study. We conducted observation studies with twenty-two people with dementia playing games on off-the-shelf mixed reality technologies, including both Augmented Reality (HoloLens, ArKit on iPhone) and Augmented Virtuality (Xbox Kinect and Osmo) technologies. The interactions with the technologies during the gameplay were video recorded for thematic analysis in Noldus Observer XT (version 16.0) for successful and correct perception of prompts.

Results

A comparison of the probability estimates of correct perception of the prompts by people with dementia suggests that human voice, graphic symbols and text are the most prominently perceived modalities of prompts. Feedback prompts for every action performed by people with dementia on the technology are critical for successful perception and should always be provided in the design.

Conclusion

The study has resulted in recommendations and guidelines for designers to design prompts for people with dementia in mixed-reality environments. The work lays the foundation for considering mixed reality technologies as assistive tools for people with dementia, fostering discussions on their accessibility and inclusive design in technology development.

Exploring Smartphone App Use in Older Adults with a Chronic Respiratory Disease: The biggest Problem I have Is I Don't Understand My Phone At All

INTRODUCTION

In older people with a chronic respiratory disease, we explored (i) usual Smartphone application (App) use, (ii) the time taken to download and use an App, and (iii) changes in self-efficacy for downloading an App after a single practice session.

METHODS

Participants were invited to attend one or two separate assessment sessions (Part A and B). Those who attended Part A had data pertaining to their App usage over the previous week extracted from their Smartphone. Those who attended Part B were asked to download and use a pedometer App and "think out loud" during the task. Before and after the task, participants rated their self-efficacy for downloading an App using a Visual Analogue Scale (0-10).

RESULTS

Twenty-seven participants (mean ± SD 74 ± 5 years) completed Part A. Commonly used Apps related to communication (e.g., texting; median [interquartile range] 15 [9-25] min/day) and interest (e.g., news; 14 [4-50] min/day). Fifteen participants completed Part B (mean ± SD 73 ± 7 years). The median time taken to download and use the App was 24 (22-37) min. The "think out loud" data converged into four domains: (i) low self-efficacy for using and learning Apps; (ii) reliance on others for help; (iii) unpleasant emotional responses; and (iv) challenges due to changes associated with longevity. Self-efficacy increased by 4 (95% confidence interval: 3-6).

CONCLUSION

This population used Apps mainly to facilitate social connection. It took participants almost half an hour to download and use an App, but a single practice session improved self-efficacy.

Three Perspectives on Older Adults' Daily Performance, Health, and Technology Use During COVID-19: Focus Group Study

Background

During COVID-19 lockdowns, older adults' engagement in daily activities was severely affected, causing negative physical and mental health implications. Technology flourished as a means of performing daily activities in this complex situation; however, older adults often struggled to effectively use these opportunities. Despite the important role of older adults' social environments-including their families and health professionals-in influencing their technology use, research into their unique perspectives is lacking.

Objective

This study aimed to explore the daily activity performance, health, and technology use experiences of healthy independent Israeli adults (aged ≥65 years) during COVID-19 from a 3-dimensional perspective: older adults, older adults' family members, and health professionals.

Methods

Nine online focus groups, averaging 6-7 participants per group, were conducted with older adults, family members, and health professionals (N=59). Data were analyzed using thematic analysis and constant comparative methods.

Results

The intertwining of daily activity performance and health emerged as a central theme, with differences between the groups. Older adults prioritized their self-fulfilling routines based on motivation and choice, especially in social-familial activities. In contrast, family members and health professionals focused on serious physical and mental health COVID-19-related consequences. A consensus among all three groups revealed the meaningful role of technology use during this period in bridging functional limitations. Participants delved into technology's transformative power, focusing on the need for technology to get engaged in daily activities.

Conclusions

This study illustrates the profound interplay between daily activity performances, physical and mental health, and technology use, using a 3-dimensional approach. Its focus on technology's uses and benefits sheds light on what older adults need to increase their technology use. Interventions for improving digital activity performance can be tailored to meet older adults' needs and preferences by focusing on motivational and preference-related activities.

"Like another human being in the room": a community case study of smart speakers to reduce loneliness in the oldest-old

This community case study examined the potential benefits of smart speakers to tackle loneliness in the oldest old adults living in supported accommodation. The program was established as a collaboration between the supported accommodation provider and a technology company to explore the feasibility of smart speakers to alleviate resident loneliness. Loneliness in later life often accompanies a shrinking social circle, loss of a spouse or increased disability. People aged 85 years of age and over are increasingly likely to experience these life events, leading to an increased risk of social isolation and loneliness. Five older people, mean age 90 years of age, who resided in supported accommodation, were given a smart speaker for 8 weeks to examine their experience with the voice assistant. The experiences of the five older adults are explored as case studies, with each person interviewed both before and after receiving the smart speaker. All five valued their smart speaker, recognised its potential for tackling loneliness, and wanted to keep it. The three most lonely individuals reported that their smart speaker made them feel less lonely and isolated through two mechanisms: (i) creating a presence and (ii) having some control over their situation. Although only a small study, these experiences suggest providing smart speakers for lonely and isolated oldest-old people, could be one way to help combat loneliness in community settings.

Older adults in the digital health era: insights on the digital health related knowledge, habits and attitudes of the 65 year and older population

BACKGROUND

The COVID-19 pandemic has increased internet use by older age groups to an unprecedented level in Hungary mirroring the general tendency in the total population. Nevertheless, international trends indicate that this group is less likely to use digital health technologies than younger ones. The aging population raises the question of successfully integrating elderly people into the digital health ecosystem. Our research aim is to investigate the digital health usage patterns and attitudes of the population aged 65 and over through a representative sample.

METHODS

A national representative questionnaire survey was conducted by telephone (CATI), interviewing 1723 respondents. Within this sample we examined 428 people in the over-65 age group, 246 in the 65-74 age group and 182 in the over-75 age group. Predictors of demand for digital solutions were tested using binary logistic regression model.

RESULTS

50.8% of people aged 65-74 and 37.1. % of people aged 75 + use the internet for health-related purposes, mostly to access websites. 85% of respondents in 65-74 and 74% in 75 + age group have used more than one digital health device and around 70% of both age groups have a need for more than one digital solution. 90.2% (64-75 age group) and 85.7% (75 + age group) of respondents are familiar with e-prescription, 86.4% and 81.4% of them use it. 77.1% of 65-74-year-olds have heard of and nearly half 45.5% have used online appointment. More than half (52.7%) of the respondents in this age group have heard of and used electronic transmission of medical records and data. A similar proportion has heard about and used apps: 54.3% has heard of them, but only 17.3% has used them. The multivariate analyses emphasized that the need for digital solutions increases with the level of education and the more benefits one perceives in using digital solutions.

CONCLUSION

Our research has shown that the senior age group has measurable needs in the field of digital health, so helping them on this journey is in the interest of the whole health ecosystem. Their high level of interest is indicated by the fact that more than a fifth of older adults would like to have access to between 7 and 10 of the maximum number of digital devices available. The differences between the two age groups - with younger people being more open to digital solutions and using them more - and the fact that the under 65s are better adapted digitally in all respects, raises the possibility that the specific trends in digital health for older people may virtually disappear in 10 years' time (when the under 65s now enter this age group).

Application of co-design in residential aged care: a scoping review protocol

OBJECTIVE

The objective of this review is to identify the extent and nature of the existing literature on co-design with residents residing in aged care facilities.

INTRODUCTION

Involving older people in their own care is a key challenge facing the aged care sector. Co-design is an approach that focuses on involving end users in the design of services. Mapping the evidence on co-design in residential aged care will identify the nature and extent of how older people living in residential care have been engaged in the design and delivery of their care.

INCLUSION CRITERIA

This scoping review will include peer-reviewed primary studies; systematic and scoping reviews; and gray literature, including abstracts and reports of governments and non-governmental organizations. Older people residing in aged care homes, including those from culturally and linguistically diverse backgrounds and/or living with dementia, who are involved in the co-design, co-creation, participation, involvement, and engagement in their care will be considered for inclusion.

METHODS

This review will be conducted in accordance with the JBI methodology for scoping reviews and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). The databases to be searched will include AgeLine, Cochrane, CINAHL, Embase, Emcare, MEDLINE, PsycINFO, ProQuest, Scopus, Informit Health Collection, and Web of Science. Gray literature searches will include, GreyMatters, BASE, Google Advanced, and World Wide Science. The search will be limited to articles published after December 31, 1999, and to those written in English or with an English-language abstract or summary. Screening and data extraction will occur independently in duplicate. The review outcomes will be presented in tabular format and supported by a narrative summary.

REVIEW REGISTRATION

Open Science Framework https://osf.io/6ukty.