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General Principles

  • Electronic assistive technologies for activities of daily living and safety are widely available, but the evidence base is limited.

  • Telemedicine includes remote patient monitoring for disease management, store-and-forward/asynchronous technology, and real-time videoconferencing.

  • Age is not a major determinant of technology use; however, factors such as geography, income, and education are associated with disparate levels of access to and use of technology.

  • Clinicians must participate in the ethical implementation of telemedicine technologies.

  • Older adults should be included in development of technologies meant for their use.

Technology is a fundamental yet rapidly changing aspect of modern life. Technology shapes how individuals live their daily lives and receive medical care. A greater number of older adults are using technology than ever before—6 in 10 of those age 65 and older now use the internet. For older adults in particular, the potential impact of technology on health and well-being is immense. Technology may be used to support the daily needs of older adults, enabling a new wave of aging in place. Additionally, technology may overcome the challenges of accessing high-quality, geriatric-focused care. For example, telemedicine can connect older adults to the small geriatrics-trained workforce and widen the reach of geriatrics expertise across health care sites and sectors. Ultimately, it may enable older adults to receive the care they need, when and where they need it. At the same time, enthusiasm for new technologies should be tempered by careful consideration of potential downsides and ethical implications. This chapter outlines established and emerging technologies for supporting the daily life of older adults and their health care needs.


Definition and Concepts

New electronic assistive technologies are continually surfacing that change the daily experience of older adults. There has been an explosion of devices, systems, and programs that rely on electronic technology to augment the performance of daily activities (Table 33–1). Automation of bill paying and direct deposit streamline the management of finances. Way-finding can be assisted by global positioning systems and mobile applications. In urban areas, ride share services may make transportation more affordable, convenient, accessible, and safe. Likewise, groceries and other goods can be directly delivered to home by most retailers. These types of services are most available to older adults who have the financial means and cognitive ability to access the internet or use a smart phone. With time, adaptations are being made to increase ease of use for all older adults. For example, ride shares can now be ordered over a push-button phone or by a remote caregiver who then receives real-time updates on the rider’s status. Additionally, versions of the smart phone—a gateway to so many assistive technologies—are available that have large buttons, voice activation, and enhanced volume.

Table 33–1.Examples of electronic assistive technologies for supported living.

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