Understanding changes and stability in the long-term use of technologies by seniors who are aging in place: a dynamical framework

Abstract

Background: If technologies are to support aging in place, then it is important to develop fundamental knowledge on what causes stability and changes in the use of technologies by seniors. However, longitudinal studies on the long-term use of technologies that have been accepted into the home (i.e., post-implementation use) are very scarce. Many factors potentially could influence post-implementation use, including life events, age-related decline, changes in personal goal orientation, and various types of social influences. The aforementioned factors are likely to be interrelated, adding to the complexity. The goal of this study is to better understand changes and stability in the use of technologies by independent-living seniors, by using a dynamical systems theory approach.

Methods: A longitudinal qualitative field study was conducted involving home visits to 33 community-dwelling seniors in the Netherlands, on three occasions (2012-2014). Interviews were held on technology usage patterns, including reasons for stable, increased, declined and stopped use. Technologies were included if they required electric power in order to function, were intended to be used in or around the home, and could support activities of daily living, personal health or safety, mobility, communication, and physical activity. Thematic analysis was employed, using constant case comparison to better understand dynamics and interplay between factors. In total, 148 technology use patterns by 33 participants were analyzed.

Results: A core of six interrelated factors was closely linked to the frequency of technology use: emotional attachment, need compatibility, cues to use, proficiency to use, input of resources, and support. Additionally, disruptive forces (e.g., social influences, competition with alternative means, changes of personal needs) could induce change by affecting these six factors. Furthermore, long-term technology use was in some cases more resilient to disruption than in other cases. Findings were accumulated in a new framework: Dynamics In Technology Use by Seniors (DITUS).

Conclusions: Similar to aging, the use of technologies by older people is complex, dynamic and personal. Periods of stability and change both occur naturally. The DITUS framework can aid in understanding stability and instability of technology use, and in developing and implementing sustainable technological solutions for aging in place.

Keywords: Aging in place; Consumer appliances; Dynamical systems theory; E-health; Gerontechnology; ICT; Longitudinal qualitative research; Smart home; Technology acceptance; Technology adoption.

Fig. 1

Reasons for Elisabeth’s stable and frequent use of her computer (Templates of figures in this article can be obtained by contacting the first author)

Fig. 2

Reasons for Paul’s stable and infrequent use of his mobile phone

Fig. 3

Reasons for Linda’s stable and frequent use of her mobility scooter

Fig. 4

Shifts to other states of use as a result of disruptive forces

Fig. 5

Sheila’s use of her iron at time points at t_1, t₂ and t₃

Fig. 6

Elly’s use of her mobile phone at time points at t_1, t₂ and t₃

Fig. 7

Dynamics In Technology Use by Seniors (the DITUS framework)