RESNA 27th International Annual Confence
Computer Use by Middle-Aged and Older Adults with Disabilities
While technology and it's potential to assist elders with disabilities advances, many elders do not use a computer, or find using a computer difficult. In the present study we surveyed 667 older persons with disabilities to better understand how they use their computer, or why they do not use a computer, and their perception on computer accessibility. Survey methodology was employed and descriptive statistic was used to report sample characteristics. Results indicate that u sing a computer to contact with others beyond home is important for both groups. Non-computer users, for both age groups reported that cost, lack of knowledge and lack of perceived need were the main reason for not using a computer. The need for assessment and advice on workstation and computer setup seems evident for a large number in both age groups reporting discomfort and problems in using the computer.
Computers, Equipment Design, Workstation.
There are many ways a computer can assist older people with disabilities, and several studies have demonstrated benefits of computer use. Computer education and training for long term care residents was found to provide mental stimulation and increase competence and feeling of autonomy (1). Learning to use the web resulted in a sense of satisfaction, reduced loneliness, and improved sense of well-being (2). Social interaction is facilitated through email and participation in computer Internet interactive sites (3). Computer games can improve memory, and make people more comfortable with using a computer (4). Web based support services can provide information and psychosocial support for caregivers of older persons (5).
However, although all the benefits, computer is underutilized by the elderly population (6) It is possible that the lack of interest of the oldest Americans in using the Internet and computers could be related to common vision, motor or cognitive impairments (7). If computers and websites are not designated to accommodate for the needs of people with impairments, it will be difficult or impossible for them to use a computer (8). There are ways that elderly can compensate for impairments to gain access to computers. The importance of training in learning to use a computer has been demonstrated (9). While age may impact the time it takes to achieve computer skills, older persons can and do learn to use computers (10).
The objective of this study was to examine computer usage by older persons with disabilities.
This study explored computer use and satisfaction for middle age adults and older adults with disabilities. We also surveyed middle age and older adults who did not use a computer to determine their interest in using a computer and reasons for non-use. Six hundred sixty seven adults with disabilities were surveyed: 237 were conducted by phone interview and /or home interview and 430 were conducted by mail. Survey methodology was employed, in-home and phone interviews ranged from .5 to 1.5 hours to complete. Interviews were conducted by nurses and therapists experienced in interviewing older people with disabilities. Descriptive analysis was used to report sample characteristics.
Three hundreds and eighty six participants use computer while two hundreds and eighty-one are not users. Physical conditions most experienced by participants were: tire easily, muscular weakness, joint problems and difficulty with hand task (table 1). General information on computer use is summarized in table 2. A relatively small percentage of respondents use a computer without Internet access. Very few participants use a computer outside the home. High percent of both groups are satisfied with the computer and rate it as a very important device. The most frequently cited reasons for using a computer for both groups were to find information and social contact. The majority of respondents were self-taught in computer use (59 percent) with another 30 percent taught by family members. The most common response for not using the computer for greater lengths of time was to lack of knowledge, lack of available training, or they felt the computer was just too complicated. Table 3 addresses workstation adaptations: over half of both groups have not had any adaptations to address their impairments, yet 60 percent of the under 60 group and 49 percent of the over 60 group experience discomfort at their workstations. Responses from the 281 participants who do not use a computer are summarized in Table 4. A very large percentage of these respondents were interested in using a computer (86 percent of the under 60 group and 68 percent of the over 60 group). When asked what prevented them from using a computer, almost half of the respondents cited cost as a major factor. Knowledge of computers, lack of perceived need, and too complicated or confusing, also ranked high in reasons for not using a computer.
Type of condition (n=383) |
Under/60 (n=60) |
Over/60 (n=326) |
|---|---|---|
Tire Easily |
33 (59.0) |
198 (60.5) |
Muscular Weakness |
31 (55.3) |
189 (57.8) |
Joint Problems |
24 (42.8) |
174 (45.4) |
Difficulty with Hand Tasks |
33 (59.0) |
172 (52.6) |
Bladder/Bowel Control Problems |
32 (57.1) |
149 (45.6) |
Back Problems |
29 (51.8) |
136 (41.6) |
Paralysis of Legs |
29 (51.8) |
104 (31.8) |
Low vision |
17 (30.3) |
90 (27.5) |
Poor Hearing |
8 (14.3) |
90 (27.5) |
Memory Difficulties |
17 (30.3) |
84 (25.7) |
Paralysis of Arms |
10 (17.8) |
56 (17.1) |
Speech or Communication Difficulties |
8 (14.3) |
44 (13.4) |
Blind |
4 (7.1) |
13 (4.0) |
Learning Disability |
11 (17.6) |
11 (3.4) |
Deaf |
3 (5.3) |
9 (2.7) |
Other |
9 (16.1) |
66 (20.2) |
|
Under Age 60 (n=60) |
Over Age 60 (n=326 ) |
|---|---|---|
|
n (%) |
n (%) |
Type
of Computer |
||
Computer/no internet |
10 (16.7) |
18 (5.5) |
Computer w/ internet |
30 (50.0) |
240 (73.6) |
Computer w/ high speed internet |
20 (33.3) |
56 (17.2) |
Internet Only (Web TV or appliances) |
|
12 (3.7) |
Use at Home |
||
Yes |
58 (98.3) |
309 (95.7) |
No |
1 (1.7) |
14 (4.3) |
Satisfaction Level |
||
Very Satisfied |
33 (56.9) |
168 (51.5) |
Somewhat Satisfied |
23 (39.7) |
117 (35.9) |
Not Satisfied |
2 (3.4) |
19 (5.8) |
Not at all Satisfied |
|
12 (3.7) |
Importance Level |
||
Very Important |
44 (77.2) |
205 (65.5) |
Somewhat Important |
10 (17.5) |
95 (30.4) |
Not Important |
3 (5.3) |
10 (3.2) |
Not at all Important |
|
3 (0.9) |
Purchased by: |
||
Self |
44 (81.5) |
208 (70.7) |
Gift |
9 (16.7) |
39 (13.3) |
Other |
1 (1.8) |
47 (16.0) |
Number of hours used per week |
||
Zero |
1 (1.7) |
13 (4.3) |
1-3 hours |
12 (20.0) |
73 (24.0) |
4-6 hours |
14 (23.3) |
50 (16.4) |
7-10 hours |
8 (13.3) |
42 (13.6) |
More than 10 hours |
23 (38.3) |
118 (38.7) |
Other |
|
9 (3.0) |
Purpose for Using Computer (n=379) |
||
Information |
51 (89.5) |
267 (83.0) |
Social Contact |
43 (75.4) |
258 (80.1) |
Surfing the Internet |
37 (65.0) |
207(64.3) |
Document Writing |
46 (80.7) |
199 (61.8) |
Hobbies |
32 (56.1) |
172 (53.4) |
Shopping |
33 (57.9) |
130 (40.4) |
Record Keeping |
32 (56.1) |
126 (39.1) |
Managing Finances |
27 (47.4) |
96 (29.8) |
Geneology |
9 (15.8) |
60 (18.6) |
Other |
11(19.3) |
50 (15.5) |
How do you think using a computer has helped you? (n=340) |
||
Gathering Information |
51 (94.4) |
241 (84.3) |
Social Contact |
44 (81.5) |
229 (80.1) |
Organization/Record Keeping |
40 (74.1) |
146 (51.0) |
Finances |
26 (48.1) |
96 (33.6) |
Entertainment |
3 (5.5) |
51 (17.8) |
|
|
|
What prevents you from using the computer more often or for greater lengths of time? (n=307) |
||
Knowledge of Device |
18 (38.3) |
107 (41.1) |
Pain |
16 (34.0) |
65 (25.0) |
Too complicated or confusing for me |
10 (21.3) |
62 (23.8) |
Other |
17 (36.2) |
62 (23.8) |
Training not available |
4 (8.5) |
57 (22.0) |
Mobility |
10 (21.3) |
55 (21.1) |
Perceived Need |
3 (6.4) |
37 (14.2) |
Do not have enough time |
6 (12.8) |
33 (12.7) |
Visual Impairment |
2 (4.3) |
29 (11.1) |
Cost |
9 (19.1) |
26 (10.0) |
Too Hard/Too much work to learn |
|
26 (10.0) |
Privacy/Trust |
5 (10.6) |
23 (8.8) |
Lack of User's Manual |
5 (10.6) |
23 (8.8) |
Access |
4 (8.5) |
15 (5.8) |
Hearing Impairment |
|
9 (3.5) |
Cognitive Impairment |
2 (4.3) |
5 (2.0) |
Suggestions (n=122) |
||
Others |
8 (40.0) |
34 (33.3) |
Easier to understand |
3 (15.0) |
22 (21.6) |
Voice activated |
2 (10.0) |
19 (18.6) |
Adapted workstation |
2 (10.0) |
6 (5.8) |
Ergonomic Computer set up |
4 (20.0) |
10 (9.9) |
Training |
1 (5.0) |
6 (5.8) |
Make it faster |
|
5 (5.0) |
Initial Training |
||
Community Center |
|
25 (7.6) |
Family Member |
10 (17.9) |
108 (32.7) |
Friends and Neighbors |
8 (14.3) |
51 (15.5) |
Place of Purchase |
|
7 (2.1) |
Self |
44 (78.6) |
181 (54.8) |
Other |
19 (34.0) |
80 (24.2) |
How Computer Support is Provided (=385) |
||
Community Agency |
3 (4.8) |
17 (5.3) |
Family |
22 (35.5) |
125 (38.7) |
Friends and neighbors |
21 (33.9) |
96 (29.7) |
On line technical Support |
20 (32.2) |
60 (18.6) |
Phone Technical Support |
25 (40.3) |
124 (38.4) |
Self |
37 (59.7) |
119 (36.8) |
Other |
25 (40.3) |
64 (19.8) |
|
Under Age 60 (n=60) |
Over Age 60 (n=326) |
|---|---|---|
|
n ( % ) |
n ( % ) |
Workstation Adaptations (n=384) |
||
Yes |
28 (46.7) |
154 (47.5) |
No |
32 (53.3) |
170 (52.4) |
|
|
|
Currently experiencing discomfort while at workstation (n=381) |
||
|
n ( % ) |
n ( % ) |
Yes |
36 (60.0) |
158 (49.0) |
No |
23 (38.3) |
164 (51.0) |
|
|
|
Workstation difficulties when working an extended period? (n=371) |
||
|
n ( % ) |
n ( % ) |
Yes |
40 (66.7) |
185 (59.2) |
No |
19 (31.7) |
127 (40.7) |
|
Under 60 (n=10) |
Over 60 (n=271) |
|---|---|---|
|
n (%) |
n (%) |
Do you have interest in using a computer? (n=244) |
||
Yes |
6 (85.7) |
106 (67.5) |
No |
1 (14.2) |
131 (55.2) |
Do you have interest in owning a computer? (n=227) |
||
Yes |
6 (85.7) |
92 (41.8) |
No |
1 (14.2) |
128 (58.1) |
What has prevented you in the past from using a computer (n=220) |
||
Cost |
7 (100.0) |
124 (58.2) |
Knowledge of Device |
2 (28.6) |
52 (24.4) |
Perceived Need |
|
47 (22.0) |
Too complicated or confusing for me |
2 (28.6) |
47 (22.0) |
Other |
|
43 (20.1) |
Too hard to learn |
1 (14.3) |
32 (15.0) |
Visual impairment |
|
29 (13.6) |
Privacy/Trust |
|
26 (12.2) |
Mobility |
|
25 (11.7) |
Training not available |
|
25 (11.7) |
Access |
1 (14.3) |
25 (11.8) |
Pain |
|
15 (7.0) |
Hearing Impairment |
|
10 (4.7) |
Cognitive Impairment |
|
9 (4.2) |
Lack of User Manual |
|
4 (1.9) |
What do you foresee preventing you from using a computer in the future? (n=245) |
||
Cost |
7 (100.0) |
124 (52.1) |
Knowledge of Device |
2 (28.6) |
72 (30.2) |
Other |
2 (28.6) |
61 (25.6) |
Too complicated or confusing for me |
1 (14.3) |
59 (24.8) |
Perceived Need |
|
53 (22.3) |
Too hard to learn |
1 (14.3) |
47 (19.7) |
Access |
1 (14.3) |
36 (15.1) |
Visual impairment |
|
33 (13.9) |
Mobility |
1 (14.3) |
32 (13.4) |
Privacy/Trust |
|
27 (11.3) |
Training not available |
|
27 (11.3) |
Pain |
1 (14.3) |
15 (6.3) |
Hearing Impairment |
|
14 (5.9) |
Cognitive Impairment |
|
12 (5.0) |
Lack of User Manual |
|
8 (3.4) |
While a higher percentage of the middle age adults than the older adults were computer users, a higher percentage of the older adult computer users were Internet users. Using a computer for contact with others beyond the home is important for both groups, but appears important for larger numbers of the older adult group, possibly compensating for difficulties they experience in getting out beyond the home. The need for assessment and advice on workstation and computer setup seems evident from the large number in both groups reporting discomfort and problems in using the computer. This could be an important service role for therapists and rehabilitation engineers. Non-users of computers show a high interest in using a computer, but a very large percentage of these individuals feel cost is a major barrier. Few middle age and older adults feel their impairment is a reason for not using a computer.
This study was funded by the National Institute on Disability and Rehabilitation Research of the Department of Education under grant number H133E010106
Patrícia da Cunha Belchior, OT, Ph.D. student,
Research
Assistant,
Rehabilitation Science Doctoral Program,
University of Florida,
PO Box 100164,
pbelchio@hp.ufl.edu