How Telehealth Makes It Harder for Seniors To Get Healthcare

elderly smartphone tech

Is telehealth increasing access or creating barriers to healthcare for seniors? How can we design accessible telehealth service for seniors and the elderly? What must we consider for telehealth to help our seniors age well and age in place? Dr. Casey Pierce from the University of Michigan School of Information has been studying the effects of virtual health technologies — how patients make sense of complex health information online and how it is affecting physician and healthcare work practices. Her current project investigates what it takes to successfully create a telemental health program for an elderly population.

Telehealth – just another obstacle for seniors to work around?

Dr. Pierce notes that technology is typically not designed by or for older adults. It can and often does make it more difficult for them to carry out daily tasks. She points out, “a lot of the technologies that we take for granted might introduce unnecessary constraints or challenges…and…they’re trying to create workarounds in how they think about using them.”

For example, some seniors physically cannot manipulate a mouse. Others have no mental models for dropdown menus and how to get to the next screen. I’ve personally noticed (with my mom and some older VSee users) that hidden or overlapping app windows can be a navigational challenge. These design problems must be thought through to provide a successful telehealth service for seniors.

Why telehealth only works for retired whiz kids and tech geeks

Roughly four-in-ten seniors are smartphone owners

There is also the problem of technology access. “There’s a digital divide among seniors,” Dr. Pierce emphasizes. She refers to an in-depth Pew Center Research report on 65 and older technology use. The report shows that 67 percent of seniors go online but only 51 percent have access to high speed broadband. Another section of the report shows that only 42 percent own a smartphone.

She explains that while technology adoption and usage rates are increasing, there is a significant divide between seniors who are older or who have lower incomes, or who have less education. There is “a technology distance…not only in terms of use but in terms of ‘How comfortable do you feel using that technology. Do you require extra support and education to actually use the technology?’”

It’s the difference between the angel investor Silicon Valley tech geek who invented the MRI scanner versus the 101-year-old Virginia centenarian who retired because computerized systems got introduced.  And it’s often the case that those who have the least access to technology could benefit the most from telehealth services.

Can community centers make telehealth work for seniors?

One solution to increasing access, Dr. Pierce suggests, is to look outside of our traditional sites of care such as the home or doctor’s office. What are the places where seniors normally participate in the community? One principal place is the community center. And that’s where Dr. Pierce and her team have chosen to implement their telemental health service for seniors.

Community centers can have the advantage of bringing together high tech services (e.g. telehealth) along with high touch services (e.g. real people). They usually have an existing system of caregivers and volunteers along with a variety of other social supports — meal programs, clubs, hobbies, and activities. Thus, telehealth services may be more easily offered and more likely to be used when embedded into a senior’s existing social fabric.

For example, meal program delivery volunteers are on the ground and often have the clearest view of where an elderly person has difficulties. These may be problems related to poor vision, memory loss, being able to unlock the door or even just getting to the door. These existing relationships can make it natural to introduce telemental health services and more importantly to provide technology support.

Why start with telemental health for seniors?

An increasing number of seniors experience social isolation and loneliness. According to the 2010 US census, 28 percent or 11 million seniors 65 or older live alone. Statistics Canada reports that one-fifth of Canadian seniors do not participate in any weekly or even monthly social activities. The  situation is expected to worsen as the number of available family caregivers per senior drops, according to an AARP population study.

Loneliness and isolation in the elderly is known to contribute to faster physical and mental health deterioration. It can also contribute to a host of other health issues from high blood pressure to dementia and depression. This is just one of the ways that telemental health services can improve the lives of seniors and allow them to age well right where they are.

You can check out Dr. Pierce’s full talk and slides from our Telehealth Secrets conference here.

What do you think it takes to create telehealth services for seniors that they can readily use?

Photo by Max Pixel, license CC0

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