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Life-Long Learning
Abstract
As the number of persons over 65 makes a meteoric rise worldwide, there is a need for convergence of many fields to best prepare systems and technology that support older adults. These adults constitute a special population with capabilities, limitations, needs, and motivations that can only be addressed through interdisciplinary innovations. We situate the needs of older persons in an adaptation of the hierarchy of needs, first proposed by Maslow in the mid-twentieth century. Using such a framework can help create a culture of convergence between fields in cognitive/behavioral science, medicine, and engineering to ensure that new technologies are well designed for lifelong learning and fulfillment to the point of self-actualization – not just basic life support.
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This paper presents an ongoing effort to create added value complete services for end users on top of an AAL continuous data gathering environment. It first presents the general architecture proposed by the GiraffPlus project for long term monitoring of older users at home, then describes the main choices concerning the middleware (universAAL compliant), the long-term data storage, and a user oriented component, called DVPIS, dedicated to interaction with different users of the AAL environment. The current status of a deployed version of the system is then shortly described.
Given the rapidly ageing population, interest is growing in robots to enable older people to remain living at home. We conducted a systematic review and critical evaluation of the scientific literature, from 1990 to the present, on the use of robots in aged care. The key research questions were as follows: (1) what is the range of robotic devices available to enable older people to remain mobile, independent, and safe? and, (2) what is the evidence demonstrating that robotic devices are effective in enabling independent living in community dwelling older people? Following database searches for relevant literature an initial yield of 161 articles was obtained. Titles and abstracts of articles were then reviewed by 2 independent people to determine suitability for inclusion. Forty-two articles met the criteria for question 1. Of these, 4 articles met the criteria for question 2. Results showed that robotics is currently available to assist older healthy people and people with disabilities to remain independent and to monitor their safety and social connectedness. Most studies were conducted in laboratories and hospital clinics. Currently limited evidence demonstrates that robots can be used to enable people to remain living at home, although this is an emerging smart technology that is rapidly evolving.
An exploratory study was conducted to answer the following questions: What are older adults' perceptions of social media? What educational strategies can facilitate their learning of social media? A thematic map was developed to illustrate changing perceptions from the initial unanimous, strong negative to the more positive but cautious and to the eventual willingness to actually contribute content. Privacy was the primary concern and key perceptual barrier to adoption. Effective educational strategies were developed to overcome privacy concerns, including: 1) introducing the concepts before introducing the functions; 2) responding to privacy concerns; and 3) making social media personally relevant.
It is well documented that aging is associated with cognitive declines in many domains. Yet it is a common lay belief that some aspects of thinking improve into old age. Specifically, older people are believed to show better competencies for reasoning about social dilemmas and conflicts. Moreover, the idea of aging-related gains in wisdom is consistent with views of the aging mind in developmental psychology. However, to date research has provided little evidence corroborating this assumption. We addressed this question in two studies, using a representative community sample. We asked participants to read stories about intergroup conflicts and interpersonal conflicts and predict how these conflicts would unfold. We show that relative to young and middle-aged people, older people make more use of higher-order reasoning schemes that emphasize the need for multiple perspectives, allow for compromise, and recognize the limits of knowledge. Our coding scheme was validated by a group of professional counselors and wisdom researchers. Social reasoning improves with age despite a decline in fluid intelligence. The results suggest that it might be advisable to assign older individuals to key social roles involving legal decisions, counseling, and intergroup negotiations. Furthermore, given the abundance of research on negative effects of aging, this study may help to encourage clinicians to emphasize the inherent strengths associated with aging.
Can human beings relate to computer or television programs in the same way they relate to other human beings? Based on numerous psychological studies, this book concludes that people not only can but do treat computers, televisions, and new media as real people and places. Studies demonstrate that people are "polite" to computers; that they treat computers with female voices differently than "male" ones; that large faces on a screen can invade our personal space; and that on-screen and real-life motion can provoke the same physical responses. Using everyday language to engage readers interested in psychology, communication, and computer technology, Reeves and Nass detail how this knowledge can help in designing a wide range of media.
This study examined older adults' motivation to adopt technological innovation. Sixty-eight older e-mail users and nonusers discussed the use of e-mail and of traditional communication methods in 18 focus groups. The results show older adults' benefit-driven approach to new communication technology. Regardless of whether their decision about the new technology was positive or negative and irrespective of their e-mail experience, participants focused on benefits rather than costs. For traditional media, both costs and benefits were important. Results contradict the common belief that barriers such as usability problems determine whether older people use new technology and indicate the decisive role of perceived benefits for successful innovation.
Understanding and improving the quality of medication management is particularly important in the context of the Medicare prescription drug benefit that took effect last January 2006.
To determine the prevalence of physician-patient dialogue about medication cost and medication adherence among elderly adults nationwide.
Cross-sectional survey.
National stratified random sample of community-dwelling Medicare beneficiaries aged 65 and older.
Rates of physician-patient dialogue about nonadherence and cost-related medication switching.
Forty-one percent of seniors reported taking five or more prescription medications, and more than half has 2 or more prescribing physicians. Thirty-two percent overall and 24% of those with 3 or more chronic conditions reported not having talked with their doctor about all their different medicines in the last 12 months. Of seniors reporting skipping doses or stopping a medication because of side effects or perceived nonefficacy, 27% had not talked with a physician about it. Of those reporting cost-related nonadherence, 39% had not talked with a physician about it. Thirty-eight percent of those with cost-related nonadherence reported switching to a lower priced drug, and in a multivariable model, having had a discussion about drug cost was significantly associated with this switch (odds ratio [OR] 5.04, 95% confidence interval [CI] 4.28-5.93, P < .001).
We show that there is a communication gap between seniors and their physicians around prescription medications. This communication problem is an important quality and safety issue, and takes on added salience as physicians and patients confront new challenges associated with coverage under new Medicare prescription drug plans. Meeting these challenges will require that more attention be devoted to medication management during all clinical encounters.
This study investigated the hypothesis that age differences in memory performance may be influenced by stereotype threat associated
with negative cultural beliefs about the impact of aging on memory. Recall was examined in 48 young and 48 older adults under
conditions varying in the degree of induced threat. Conditions that maximize threat resulted in lower performance in older
adults relative to both younger adults and to older adults who did not experience threat. The degree to which threat affected
older adults' performance increased along with the value that these individuals placed on their memory ability. Older adults'
memory performance across experimental conditions was observed to covary with degree of activation of the negative aging stereotype,
providing support for the hypothesized relationship between stereotype activation and performance. Finally, stereotype threat
also influenced mnemonic strategy use, which in turn partially mediated the impact of threat on recall. These results emphasize
the important role played by contextual factors in determining age differences in memory performance.
Technologies are being developed and promoted with the aim of improving the health and quality of life of older adults, but
often without analyzing or planning around the human needs of users. Abraham Maslow’s model of the hierarchy of needs proposes
that people seek to satisfy progressively higher human needs, starting with physical needs like food and shelter, and advancing
through safety and security, belonging and love, esteem, and self-actualization. Each of these levels of need has relevance
for aging-related technologies. Lack of attention to user needs may be one factor that explains the limited adoption of many
aging-related technologies. It is important to consider the users’ current levels of need, the different needs of patients
and caregivers, the degrees of behavioral change expected at different levels of need, and the unintended consequences of
technologies. Insights from Maslow’s model can help developers, researchers, providers, and consumers in the process of producing,
evaluating, recommending, and purchasing technologies for older adults. One particular challenge is that assistive technologies
may undermine esteem needs by limiting independence. Scales to measure levels of need can help characterize which needs are
most relevant for different individuals, and can be used to ensure that technologies address users’ needs.
KeywordsAging–Gerontechnology–Technology–Assistive technology–Abraham Maslow–Human needs–Smart homes
This study examines the relationship of social ties and support to patterns of cognitive aging in the MacArthur Studies of Successful Aging (see L. F. Berkman et al., 1993), a cohort study of 1,189 initially high-functioning older adults. Baseline and longitudinal data provide information on initial levels as well as changes in cognitive performance over a 7.5-year period. Linear regression analyses revealed that participants receiving more emotional support had better baseline performance, as did those who were unmarried and those reporting greater conflict with network members. Greater baseline emotional support was also a significant predictor of better cognitive function at the 7.5-year follow-up, controlling for baseline cognitive function and known sociodemographic, behavioral, psychological, and health status predictors of cognitive aging. The findings suggest the potential value of further research on the role of the social environment in protecting against cognitive declines at older ages.
In a review of the literature from 1948 to 2001, 122 studies were found that correlated structural or functional social support with patient adherence to medical regimens. Meta-analyses establish significant average r-effect sizes between adherence and practical, emotional, and unidimensional social support; family cohesiveness and conflict; marital status; and living arrangement of adults. Substantive and methodological variables moderate these effects. Practical support bears the highest correlation with adherence. Adherence is 1.74 times higher in patients from cohesive families and 1.53 times lower in patients from families in conflict. Marital status and living with another person (for adults) increase adherence modestly. A research agenda is recommended to further examine mediators of the relationship between social support and health.
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