What is this research about?
Despite the many benefits offered by assistive technologies, the rate of adoption among older adults is lagging far behind the rate of creation. The role that identity plays in older adults’ decision-making about assistive technology adoption has been suggested but not fully explored. To address this gap, the authors conducted a scoping review of the literature to better understand how older adults’ self-image and their desire to maintain this, influences their decision-making processes regarding the adoption of assistive technologies.
What did the researchers do?
The authors used the five-stage scoping review framework as proposed by Arksey and O’Malley (2005). A total of 25 search terms related to aging, technology adoption, and identity were searched across nine electronic databases, resulting in a final yield of 49 articles. Each article was read, in full, and decision-making patterns were coded by hand in an iterative process. These decision-making patterns, as related to the preservation and portrayal of an identity consistent with competence, independence and self-reliance, were grouped into five overall themes.
What did the researchers find?
From these 49 articles, five themes emerged regarding older adults’ desire to maintain an identity associated with independence, competence and self-reliance:
- Resisting the negative reality of an ageing and/or disabled identity
- Many older adults across the reviewed studies rejected devices that were viewed as a blatant indicator of ageing and/or disability in a society that equates ‘oldness’ and ‘disability’ with helplessness, dependence and incompetence. For example:
“It must be for people who are very handicapped. It’s not for me … It makes me think that my life is terminated. I’d rather die than live with a robot.” (Wu et al., 2014a, p. 8)
- Independence and control are key
- While technologies that enabled or prolonged independent performance in meaningful activities were met with great enthusiasm by older adults, technologies that acted as both a symbol and reminder of loss of independence were resisted altogether. For example:
“A walker to me is giving up … A walker to me just takes away an awful lot of independence.” (Resnik et al., 2009, p. 84)
- The aesthetic dimension of usability
- Participants overwhelmingly supported the notion of ‘fashion over function’ while advocating for ‘discrete’ or ‘unobtrusive’ aesthetic designs, such as devices that fit in a purse or pocket. For example:
“It should be unobtrusive, so that everybody doesn’t say ‘look at that woman, she’s wearing one of those things’.” (Steele et al., 2009, p. 796)
- Assistive technology as a last resort
- Many participants acknowledged that although they were not presently using assistive technologies, they would in future if they became ‘handicapped’, ‘sick’, ‘incapacitated’, ‘lonely’ or ‘demented’, all of which are value-laden terms that depict the negative connotations older adults commonly associate with assistive technology use. For example:
“I am not indifferent, but I wouldn’t want it [fall detection system]… I would feel handicapped.” (Londei et al., 2009, p. 386)
- Privacy versus pragmatics
- Participants’ concerns about privacy and the subsequent threats to maintaining control over one’s personal information and environment superseded any perception of need, resulting in the rejection or abandonment of devices perceived as ‘intrusive’. For example:
“I don’t like for anyone to know that I went out and didn’t get back until midnight or something like that – I don’t think anyone needs to know that.” (Demiris et al., 2008, p. 122)
Why does this research matter?
This scoping review confirms that identity strongly influences older adults’ decision-making patterns regarding technology adoption. The findings highlight the importance of older adults’ desire to portray an identity consistent with independence, self-reliance and competence, and how this desire directly impacts their assistive technology decision-making adoption patterns, including rejecting devices that are ‘disabling’ or ‘for old people’.
It is recommended that the findings of this review be utilized to inform the development of future assistive technologies that are more acceptable to older adults, in order to leverage the benefits of these helpful devices. That is, designers of assistive technologies (e.g. AGE-WELL members!) should include older adults as equal partners throughout the development process, to ensure that devices created for this population are made to equally support identity and function.
Older adults; identity; self-image; decision-making; technology adoption
Astell, A., McGrath, C., Dove, E. (2019). That’s for old so and so’s!: The role of identity in older adults’ technology adoption decisions. Ageing & Society, 1-27. doi:10.1017/S0144686X19000230
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About the Researchers
Arlene Astell, PhD, C. Psych, is an Affiliate Scientist at the Toronto Rehabilitation Institute and an Associate Professor at the University of Toronto, with affiliations in the Department of Psychiatry, the Department of Occupational Sciences & Occupational Therapy, and the Rehabilitation Sciences Institute. Dr. Astell is also a Professor of Neurodegenerative Disease at the University of Reading, in the School of Psychology and Clinical Language Sciences.
Colleen McGrath, PhD, OT Reg. (Ont.), is an Assistant Professor in the School of Occupational Therapy at Western University.
Erica Dove is a Research Analyst II at the Toronto Rehabilitation Institute and a Master of Science (MSc) student in the Rehabilitation Sciences Institute at the University of Toronto.