Hispanic Older Adult’s Perceptions of Personal, Contextual and Technology-Related Barriers for Using Assistive Technology Devices

Abstract

Assistive technologies (AT) are tools that enhance the independence, safety, and quality of life of older people with functional limitations. While AT may extend independence in ageing, there are racial and ethnic disparities in late-life AT use, with lower rates reported among Hispanic older populations. The aim of this study was to identify barriers experienced by Hispanic community-living older adults for using AT. Sixty Hispanic older adults (70 years and older) with functional limitations participated in this study. A descriptive qualitative research design was used guided by the principles of the Human Activity Assistive Technology Model to gain in-depth understanding of participants’ perspectives regarding barriers to using AT devices. Individual in-depth semi-structure interviews were conducted, using the Assistive Technology Devices Cards (ATDC) assessment as a prompt to facilitate participants’ qualitative responses. Data analysis included descriptive statistics and rigorous thematic content analysis. Lack of AT awareness and information, cost of AT, limited coverage of AT by heath care plans, and perceived complexity of AT were the predominant barriers experienced by the participants. A multi-level approach is required for a better understanding of the barriers for using AT devices. The personal, contextual, and activity-based barriers found in this study can be used to develop culturally sensitive AT interventions to reduce existent disparities in independent living disabilities among older Hispanics.

Progressive disability in elderly population among tribals of Telangana: a cross sectional study

“…The special needs of women in these cultural settings should also be part of the solution. Present disability modifying mobility Assistive Devices (AD) can help elderly in overcoming functional limitations, attenuate functional decline, improve independence, help in community integration and enhance the quality of life [ 31 ]. However, these assistive devices are primarily designed for built indoor and outdoor environments and may not be helpful in open and naturally rugged environment [ 32 ].…”

Assistive Technology Needs and Measurement of the Psychosocial Impact of Assistive Technologies for Independent Living of Older Hispanics: Lessons Learned

“…This result is consistent with previous studies conducted with individuals with neuromuscular disorders [ 33 ] and multiple sclerosis [ 34 , 35 ] using mobility devices, those with amyotrophic lateral sclerosis using wheelchairs, communication devices and environmental control units [ 36 ], and those with stroke [ 19 ] using a variety of AT devices. Social stigma associated with AT use has extensively been reported in the literature as a barrier to the uptake of AT devices [ 7 , 37 – 39 ]. It has been argued that the willingness to use assistive devices will depend on whether it supports or undermines the personal identity and self-image of the individual [ 7 ].…”

‘That's for old so and so's!’: does identity influence older adults’ technology adoption decisions?

“…I just don't feel in control if it [bed occupancy sensor] can't work properly. (Horton, 2008: 1188)Lastly, participants feared that relying on assistive technologies would contribute to further experiences of dependence and decline (Forlizzi et al , 2004; McCreadie and Tinker, 2005; Gooberman-Hill and Ebrahim, 2007; Johnson et al , 2007; Nihei et al , 2008; Hernández-Encuentra et al , 2009; Steggell et al , 2010; Davenport et al , 2012; Sanders et al , 2012; Wu et al , 2014 a ; Giesbrecht et al , 2015; Hill et al , 2015; Orellano-Colón et al , 2016). To distance themselves from this consequence, which directly contradicts the identity they wish to portray, many older adults resisted the use of assistive devices.…”

“…Only old so and so's use sticks. (Gooberman-Hill and Ebrahim, 2007: 572)Being stigmatised or discriminated against was an actualised fear for participants in many of the studies (Hirsch et al , 2000; Cohen-Mansfield et al , 2005; Southall et al , 2006; Courtney et al , 2007; Gooberman-Hill and Ebrahim, 2007; Demiris et al , 2008; Karlsson et al , 2011; Davenport et al , 2012; Long, 2012; Bowes and McColgan, 2013; Chen and Chan, 2013; Frennert et al , 2013; Wu et al , 2014 a , 2014 b , 2015; Claes et al , 2015; Giesbrecht et al , 2015; Pino et al , 2015; Orellano-Colón et al , 2016; Seaborn et al , 2016). This fear strongly impacted older adults’ willingness to adopt assistive technologies, whereby devices that could stigmatise older adults as ‘different’, ‘lonely’, ‘frail’, ‘dependent’ or ‘old’ were not popular.…”

“…(Forlizzi et al ., 2004: 44)Having things that you don't need yet and you're not going to use yet, like the remote controls, can make a person lazier and deteriorate quicker. (Orellano-Colón et al ., 2016: 681)No, I can't imagine myself using a wheelchair. If I did, I would surely end up bedridden.…”