Ageism and risk of technological Darwinism

Glòria Galvez

Image by Flickr

According to the Spanish National Institute of Statistics (INE), in 2020 about half of the people over 75 years of age-connected to the internet daily. The pandemic and the need to feel integrated into society have forced them to enter the digital world, although their opinions, aptitudes or preferences have not been taken into account in the design of the tools used.

This may be one of the reasons why, according to the UDP Barometer, in the last two years more than a quarter of older people were unable to carry out some daily management that could only be done electronically. This percentage increases to almost 60% if they are also people with low income. Thus, although data on the use of ICT by older adults have improved, the intergenerational digital divide has not disappeared. A large part of older people do not have an internet connection or do not have the necessary skills to use digital devices designed without taking their needs into account. In addition, reduced mobility, disability, housing in rural settings or the fact of perceiving their ageing negatively are just a few of the many barriers to their digital inclusion, which continues to be a challenge for our society.

A large part of older people do not have an internet connection or do not have the necessary skills to use digital devices designed without taking their needs into account.

According to this same barometer, 14% of the telematic procedures that older people could not carry out were about heatlh care. According to the unified theory of acceptance and use of technology (UTAUT), chronological age, together with digital ageism, are the main barriers that older people encounter in accessing this technology. If we add to this double marginalization the lack of knowledge and the limitation of their sensory and motor skills, the result is a situation of isolation and loneliness that puts them at risk of social exclusion or technological Darwinism: either they adapt to the imposed conditions or they will be excluded.

Ageism and the limitation of sensory and motor skills of older people cause a situation of isolation and loneliness that puts them at risk of social exclusion.

The sustainability of an ageing society largely depends on our ability to create inclusively designed technology environments where older adults can participate regardless of their health status. Otherwise, if we focus healthcare accessibility exclusively on digital media, inequalities will inevitably be generated. To avoid this, it is necessary to guarantee that web accessibility guidelines for people with disabilities are met, promote digital literacy, carry out designs with the participation of older people and have a viable, effective and safe alternative that respects the right to consent or oppose the use of digital tools for the care they are going to receive.

The challenge of our society is to create inclusive design technological environments so that older people can participate regardless of their health status.

In this sense, gerontechnology or AgeTech as it is known in many European countries and the United States, puts into practice "inclusive technology for age", designed with and for older people, going beyond the design of devices with large buttons. and loud sounds. Age Tech tries to put older adults at the centre of the design process to meet their needs and aspirations.

The International Society for Gerontechnology (ISG) publishes an open-access academic journal that encourages and promotes technological innovations that respond to the needs of older people. A recent review in this journal explores the factors influencing mHealth adoption among older adults: 1) Disposition barriers, 2) Mobile device usability, and 3) Social influence.

Disposition barriers are related to older people's lack of confidence in their abilities and in technology, which in turn generates anxiety. Additionally, age-related physical and cognitive decline can also be a major barrier to mHealth use. Older adults who overcome these barriers depend on the social support of the family and health professionals to recognize mHealth as a good tool for their health care.

Older people's lack of confidence in their abilities and technology, in addition to age-related physical and cognitive decline, can be a major barrier to mHealth use.

For its part, the Spanish Patient Forum proposes 10 priority issues to avoid the digital isolation of older people in healthcare:

1. Provide alternatives to online access to health centres and hospitals (for appointments and waiting lists).
2. Guarantee access in written form to information about your treatment. 
3. Alternative telephone access for those over 65 years of age.
4. Special measures to facilitate access to health benefits and services for the elderly with sensory diversity.
5. Alternatives in access to the health system for older people living in rural areas with no or low connectivity.
6. Basic training for the elderly on the internet and health.
7. Agreement with patient associations to develop actions against the digital isolation of elderly patients.
8. Agreements in the Interterritorial Council to solve the problems that the digital transformation of the National Health System may entail for the elderly.
9. Inclusion of the digital health gap in the Digital Health Strategy.
10. Finally, the Forum asks the General Secretariat of Digital Health to set up a table on digitization and healthcare for older patients to identify the necessary improvements to access healthcare and interact with professionals, adapted to the level of  the current digitization of the more than nine million people over the age of 65 in Spain.

Ageism is a very common type of discrimination, although subtle and without the explicit intention of harming. Avoiding it requires understanding what digital technology older people need, what their ability to use it is, and how they are included to give them a 'voice' in the design process and related policies. In this way, they will not be forced to depend on third parties and we will be able to respect their right to information and their autonomy in decision-making.