ten Conclusions and final thoughts

Thoughts on implementing training programs for older adults

There are many people who would have you believe that older adults cannot or are not willing to learn to use ICTs. We reject this assertion. We have spent many years working with older adults, helping them overcome the digital divide. Older adults can and will cross the digital divide if they see the benefits and relevance of using ICTs in their lives, and they have adequate training to help them learn to use ICTs. They want to learn to use ICTs! The overarching goal of this book is to ultimately help older adults cross the digital divide to become engaged and proficient users of ICTs. We focus on older adults in CCRCs as we spent more than 5 years working in these communities to train residents to become proficient computer and Internet users, but the information is useful to any group preparing a training program for older adults.

Not all of the older adults who were part of our training became proficient users, but the opportunity to learn about computer and technology use was meaningful to them as well. It helped them to know that they were connected to the rest of the world because of the knowledge acquired through training. Not only did it prove to them that they could learn a new skill, but it also gave them the vocabulary necessary to converse in a meaningful way as a citizen of the technologically advanced twenty-first century. Even if they did not maintain their computer skills from the courses, there was still value in the training.

The purpose of this book is to provide a guide for others who wish to implement training programs in CCRCs. We wanted to tailor the material to help owners, administrators, and managers of CCRCs to think about the full range of considerations needed when trying to decide whether and how to train older adults to use ICTs. We believe that sharing our experiences in what worked and what did not work could be immensely helpful to those involved in formal or informal training sessions with older adults, particularly residents in CCRCs. We wanted this information to also be useful for technology designers who strive to develop and implement new gadgets, devices, and applications for older adults as well as for those who are nearing older age. We wanted these same individuals to understand the potential benefits to residents that technology use could offer.

In addition, the material presented here should be useful to researchers and policy makers who recognize the value of large-scale technology interventions and to those who work with older adults to examine factors that can help older adults to age successfully. Although it was daunting to write a book targeted at all these audiences, we think we have provided a useful resource that members of these groups will use to advance the successful aging and quality of life of older adults. In essence, this book serves as a case study to illuminate all of the issues that need to be considered to be successful in reaping the benefits of technology trainings and interventions in CCRCs.

Early chapters in this book discussed the demographic explosion in the older adult segment of the population in the United States and across the world, why and how technology use can be beneficial for older adults, and current trends in ICT use among older adults. Given the dramatic increase in the number of people turning 65 and older each day in recent years, as well as the projected increase in the number of people entering old age in the coming years, mechanisms are needed to help older adults maintain their independence and quality of life as they age. Isolation, loneliness, and depression increase among older adults, in addition to commonly expected declines in physical and cognitive health. Using ICTs may be one way to help older adults negate the negative effects of aging and to maintain their quality of life as they age. Through the use of ICTs, individuals can stay connected to geographically close and distant social ties, find information to help them make important life decisions, overcome social and spatial barriers, and stay connected to our larger information-based society.

In Chapter 2, we discussed the characteristics of CCRC communities, noting the range of services provided by these communities for residents. Individuals are waiting longer to move into CCRCs, as many people strive to age in place. By the time people move into CCRCs, and particularly into assisted living communities, many of them are frailer than were individuals 15 years ago or thereabouts who were moving into these communities. This presents challenges for those who seek to train older adults in CCRCs to use ICTs. However, this also makes the skills all the more relevant to overcoming issues of frailty.

Chapters 3 and 4 detailed our prototype study in which we trained older adults in assisted and independent living communities to use ICTs. These chapters also described best practices for and complexities of implementing technology training programs in CCRCs. We noted important factors to consider when deciding whether to conduct an ICT training in CCRCs, paying particular attention to how to engage residents, the staging of the training, and environmental factors. CCRCs are complex organizations. Having staff and administrators who see the value in ICT training is a key factor that can help predict success in the recruitment and retention of residents to training programs and the overall success of training programs. Adhering to these suggestions will help ensure that ICT training programs will fit the needs of the residents.

Although this training is a significant investment in terms of time, energy, and money, the resulting gains are considerable. Chapter 5 details the benefits to users. Findings from our longitudinal study showcase how simply identifying as a user can impact the quality of life and other mental health outcomes for a given older adult. It further discusses how the use of ICTs can change attitudes toward use and impact self-efficacy. Chapter 6 detailed best practices for recruitment and retention in ICT training programs.

For CCRC administrators and staff members who are interested in having their residents gain ICT use and skills, they need to decide whether to do training via someone internal to the CCRC or contract it to an outside organization. There are pros and cons with each of these approaches. Chapter 7 detailed factors to consider when deciding whether to do the training internally or through an external organization, as well as provided suggestions for how to find external organizations who could help CCRCs with training initiatives. The key, regardless of whether the trainers are internal or external, is to have trainers who are effective communicators and who relate well to older adults. The trainers also need to have an understanding of the barriers to learning and usage faced by many CCRC residents. Even good communicators will be unsuccessful in providing technology training if they fail to understand some of the unique issues that older learners must overcome in learning how to use technology.

Although it may seem obvious, the issue of Internet access is important in thinking about ICT training in CCRCs, a topic that was also covered in Chapter 7. Several of the communities where we did our training had Internet access, but we often needed to extend the range and make it wireless to effectively use it in our training sessions. In order for CCRC residents to maintain ICT use and skills they have developed through training, they need to have access to the Internet and to devices.

In Chapter 8, we discussed how needs and ICT use are changing for older adults. This includes the cost, method of access, support, and system interface. Financial challenges may make it impossible for residents to pay for their access, so it is important that CCRCs provide access to Wi-Fi throughout the community if possible, but at least in the common areas that offer comfortable and private places for residents to sit and use their devices. In our training, we provided desktop computers to CCRCs that the residents could use during and after our training sessions ended. If residents are not able to continue use, the skills they have acquired will deteriorate quickly.

In a similar vein, it may be necessary for CCRCs to maintain some type of ICT assistance within the community when residents have problems after the training programs have ended. Our experiences indicate that this often occurs, particularly when software updates occur or when new devices are purchased. We found anecdotally that the older adults were more likely to continue using ICTs if they had someone in their CCRC or a family member who could troubleshoot for them or provide continued ICT education, even informally.

In Chapter 9, we tried to think proactively about the future of technology and issues that will affect training older adults in CCRCs to use ICTs. We noted some of the anticipated issues, but technology development moves at such a fast pace it is likely that there will be many more developments that can benefit older adults, as well as significantly affect training programs, within a short period of time. CCRCs, as well as those helping older adults to cross the digital divide, want to stay abreast of the latest technology enhancements that can make life easier for older adults. CCRCs and trainers also want to stay informed and familiar with problems that may arise from these enhancements, such as updating training protocols when a new interface is introduced.

Having Wi-Fi access throughout CCRCs, ensuring privacy concerns are addressed, and providing materials via an intranet may help encourage residents to use ICTs in CCRCs. This is not only beneficial to residents but can also be beneficial to the administration and staff because of time and effort saved in the communication and dissemination of information throughout individual CCRCs. In addition, newer software and hardware developments are making it increasingly easier for older adults to learn to use ICTs. Voice recognition, touch-based interfaces, and virtual reality are three technology developments that we anticipate being particularly applicable to older adults in the future. Touch-based interfaces are already becoming increasingly used with tablet use among older adults. Although this interface does not resolve all issues for older adults in using ICTs, it can help many older adults overcome barriers to using ICTs associated with the use of a keyboard, mouse, and clicking. Mobile devices are also increasingly being used by older adults. The ease of use and portability makes mobile devices especially attractive options for older adults, but there is an added design challenge of the smaller size reducing the display space.

The potential for mobile health, or mHealth, applications through mobile devices is strong. Similarly, the Internet of things (IOT) has the potential to improve the quality of life for many older adults by linking together multiple devices to enable older adults to function more effectively in their homes and larger environments. In addition, recent studies have found evidence that novel and diverse activities may be useful in mitigating the effects of cognitive decline in older adults. What better resource for novelty and diversity than the Internet? When older adults are equipped with the tools for technology use, the benefits to them, cognitively and socially, and to their health are numerous.

Many companies do not currently focus on older adults when designing new devices. We encourage them to begin to focus on this vastly expanding demographic group. Each new generation of older adults will face many of the same challenges we observed in the older adults in our training. Lack of previous computer use will be less of an issue, but keeping up with new technology will always be a challenge for those in their later years. We encourage these companies to partner together to provide resources that will enable older adults to maintain a high quality of life, especially through technology that is accessible and usable for older adults, rather than each trying to develop the latest device or app that will revolutionize the way older adults use ICTs.

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