Population ageing is a global phenomenon. There are now opportunities for many people to live longer, healthier lives. But ageing does bring additional challenges for many people. Given the way in which technology has been rapidly developing in the fields of health and care, there are many new solutions supporting healthy ageing. But how do we ensure technology itself doesn’t become part of the problem?
Primary healthcare leaders set the standard and tone for our experience of any health system. For some older people, engaging with the healthcare system can be daunting, particularly if their expectations aren’t considered. For example, it’s becoming increasingly common to encounter a chatbot or virtual receptionist as the first point of contact.
It is essential, therefore, that our healthcare leaders carefully consider how and when to introduce technology.
Professor Andrew Sixsmith, Director of the Science and Technology for Aging Research (STAR) Institute at Simon Fraser University in Canada and Co-founder of AGE-WELL, Canada’s AgeTech network, was a recent visitor to the Global Research Institute in Health and Care Technologies at Heriot-Watt University. During his visit he delivered a thought-provoking session to stakeholders from across healthcare and academia addressing what he calls ‘the double-edged sword conundrum’.
AgeTech is about using technologies, such as e-health, robotics, artificial intelligence and mobile devices to support the health and independence of older people. While AgeTech has many benefits, it also brings ethical challenges. It may well lead to more efficient and cost-effective services, but if not carefully considered it can also create unintended disruption in people’s lives.
Take, for example, in-home health monitoring systems. These have the potential to be transformative for supporting healthy ageing but they also present ethical dilemmas around privacy.
Professor Sixsmith told a story about a woman involved in his research. She liked to get out of the house but every time she did, the monitoring system she’d had installed alerted her caregiver. So, she told the researchers she’d stopped leaving the house because she didn’t want to be add to their burden.
In terms of privacy, some people in Professor Sixsmith’s studies said they felt they were being ‘watched’ 24/7, even though the sensors in their homes were not cameras. When you ask people what ‘home’ means to them, you tend to get the same answer. It’s a private place to share time with family, an intimate space, away from the prying eyes of others. Any entry into that intimate space could have an impact on how someone experiences their home environment. When done carefully and with people’s needs and preferences in mind, these concerns can be addressed. And when done effectively, the in-home monitoring might mean someone can enjoy more time living independently.
Another issue with monitoring is data; where it’s stored, how it’s used, and who it’s shared with. Some people are prepared to talk openly with a GP or specialist but, for different reasons, we don’t always have such an open conversation with our families. If data is being collected then, it’s important that the person being monitored is aware of, and agrees to, who will get to see that.
There are environmental considerations too. Huge amounts of data are created and need to be stored, and the growth of data centres means extra power consumption. Like every other industry, healthcare needs to be sustainable, so when considering if a technological solution might be best for our health and care needs, we also need to think of the environmental impact.
And what about ‘the digital divide’, the unequal access to and the use of technology? If the potential users of any solution are included from the earliest stages of the design process, it can increase the likelihood that solution will meet the needs of those they’re intended for, including how they operate it or whether they can afford it.
Professor Sixsmith was also clear that when they set up their AgeTech network in Canada, they were aware that the vast majority of research never makes it into the real world. That needs to be addressed, and a first stage is ensuring diverse voices and partners are involved from the outset.
At our institute we’re exploring solutions drawing on robotics, artificial intelligence, smart homes and more, and by drawing on expertise from engineering and the physical sciences, textiles and design and the social and behavioural sciences, we’re leaving no stone unturned. At the heart though, are older people and the needs they identify to age well in the home of their choosing.
Professor Alan Gow, co-academic lead for healthy ageing, Heriot-Watt University’s Global Research Institute in Health and Care Technologies. He leads a team of more than 60 academics focussed on healthy ageing, with projects that span the university’s specialisms.
