Abstract
AT can help OA age in place. OT practitioners should consider how OA make decisions about AT, since OAs’ general decision-making process and strategy differs from that of younger adults. This exploratory qualitative design used semistructured interviews to explore OA decision-making regarding AT. Findings from the seven community-dwelling OAs generally supported Löckenhoff’s older-adult decision-making model.
Primary Author and Speaker: Kay Graham
Contributing Authors: Morgan Robinson, Mary Salter, Molly McLaughlin, Hannah Ikeler
Adults aging in place may use assistive technology (AT) to improve their daily functioning and independence. AT is defined as any product that assists older adults in meaningful activities to promote more functional independence and improve their quality of life. AT can assist older adults in the aging in place process by enabling them to maintain some level of independence (Boger, Quiraishi, Turcotte, & Dunal, 2014). Occupational therapy practitioners (OTs) can assist older adults in their decisions about AT. Decision-making process can change as a person ages; therefore, it is important to better understand decision-making processes specific to older adults. Older adults when compared to younger adults more commonly delegate or defer choices, prefer fewer choices, use simpler evaluation strategies, and generally are more positive about choice outcomes (Löckenhoff, 2017). When considering AT, older adults reported high cost, privacy issues, ease of use, perceived need, other alternatives, and key influencing people as important factors in AT use (Peek et al, 2016). Although there is research on general decision-making in older adults, there is limited research specific to older adult AT-related decisions and implementation. Enhancing practitioner understanding of the decision-making processes that older adults engage in regarding AT can optimize care provision regarding AT recommendations for those seeking to age in place. The purpose of this study was to develop greater understanding of how older adults make decisions in relation to AT. The research question was: How do older adults engage in AT decisions? This study used an exploratory qualitative design with grounded theory methodology. Participants were recruited using purposeful sampling from older adults, 60 or older, who were community dwelling and had visited or attended an AT lab demonstration from the local area agency on aging. Seven participants completed semi-structured 30-60 minute interviews. Four of those participants also completed brief follow up interviews used for interpretive verification after core categories had been identified. Researchers reported the older adult participants moved through a series of processes during AT decision-making from a pre-decision phase through a post-decision phase. Using their personal lenses (prior experiences and thoughts), participants used a pre-decision process to seek more information before engaging in a deciding process where they typically valued fewer options, expert opinion and prior experiences. Implementing or choosing not to implement depended on barriers (personal and technical) and facilitators (similar to old AT, easy to use, making life easier). Post-Decision included participants considering continuation of use or decision to discontinue use which often included practical considerations such as battery life or loss of device. Although participants reported wanting more options and the chance to try out AT, participants generally reported choosing the first recommended item and none actually tried the AT before purchase. Findings support prior research and theory regarding older adult decision-making; participants typically settled on first item presented and highly valued expert opinion. With the professions considerations of the person, occupation, and the environment, OTs are uniquely situated to make AT recommendations to older adults aging in place. These results may assist OTs’ effectiveness and efficiency when communicating AT information to their aging clients.
Boger, J., Quraishi, M., Turcotte, N., & Dunal, L. (2014). The identification of assistive technologies being used to support the daily occupations of community-dwelling older adults with dementia: A cross-sectional pilot study. Disability & Rehabilitation: Assistive Technology, 9(1), 17–30. doi:10.3109/17483107.2013.785035
Löckenhoff C. E. (2017). Aging and decision-making: A conceptual framework for future research - A mini-review. Gerontology, 64:140-148.
Peek, S. T. M., Luijkx, K. G., Rijnaard, M. D., Nieboer, M. E., van der Voort, C. S.,Aarts, S., Wouters, E. J. M. (2016). Older adults’ reasons for using technology while aging in place. Gerontology, 62(2), 226–237. https://doi.org/10.1159/000430949