Designing Gerontechnology to Disrupt Dependence

November 25, 2020

By: Mary Lou Ackerman

Now more than ever, older adults are reluctant to forfeit their independence and leave the comforts of their own homes to live in institutions. However, it is no longer the default pathway, or only option, to be warehoused when one can no longer manage on their own at home. Emerging technologies are providing new opportunities for older adults to maintain or achieve greater independence, thereby disrupting their dependence on others to remain safely in their homes. The shift from institutional aging to living (and aging) in place has gained significant traction with COVID-19, amplifying the need for these emerging technologies that extend independence to become mainstream quickly.

Start with Mythbusting

There are several unfounded assumptions that we need to leave behind as a first step in looking forward to a new home-based paradigm for aging in place.  One myth that is commonly echoed is that “older adults cannot adapt to new technologies”.  Is it that they cannot adapt, or they don’t wish to adapt? Evidence suggests it is the latter (Anderson & Perrin, 2017). It calls into question – have we been designing and developing the wrong technology-enabled solutions? The primary focus of assistive technology for this population has revolved around their physiological needs in hearing, incontinence, vital sign monitoring, etc.  All of which are important and compensate for a physical deficit, but they may not be appealing to what the older adult wants for their own life and health goals.  The reframe in designing supportive Gerontechnologies is a shift from focusing on “what is the matter with you?” to “what matters to you?” This simple shift will help us to see and design for the older adult as a living person  with agency, versus a declining patient who has outsourced their care decisions to others.

Another often heard myth is that older adults are “not interested in new experiences”.  Is it that they are not interested, or is it that we have not designed and developed the “right’ experience for them? We need to shift from designing solutions that address problems (or a specific intended use) to solutions that offer a valuable experience.  Addressing a narrow problem (such as monitoring one’s oxygen levels) is important, but how that problem gets addressed in a life context is even more important.  For example, a device that can dispense medication may solve the problem of ensuring the right medications are taken at the right dose and time, but, if that device also says “good morning”, asks how are you doing today, provides reminders, shares photos,  plays music, etc. – an experience is created around the core use case of the technology.  Such experiences are meaningful for older adults living alone, and we need to encourage their technology adoption as we innovate in this area (Maple, 2020).  Further, these experiences cannot be designed without the input from the users who are most impacted by their adoption.  Co-designing solutions with older adults is tied to a unique set of considerations, needs, desires and capabilities.  When we can design solutions that encompass these, then we have designed a solution that will drive adoption through the value it offers and/or the impact it makes.

Don’t Forget These Five

To leverage gerontechnology to address the increasing demand (and opportunity) to disrupt dependence, requires solutions that reimagine how older adults experience their daily life. The human desire to have ownership over one’s everyday activities, lifestyle choices and physiological needs presents the sweet spot of opportunity in this space.  That is, to mitigate the effects of aging and its impact on dependence, we must understand what drives older adults’ desire for autonomy and how they see technology helping them achieve independence, or remain independent.  This will require us to change our approach to the development of new technologies with vastly different methodologies than we have seen in the past. Because older adults engage with technology in a values-based way, it’s important to involve them throughout the life-cycle of the solution.

Here are five important considerations for the future of Gerontechnology development:

  1. Usability: Consider physical and cognitive abilities as we age, ease of use is important. For example, varying abilities to hear, see, touch, comprehend language, etc miss the mark in the design of current Gerontechnologies.

    How might we ensure technology products follow are “plug and play”, whether you are 8 or 80?

  2. Consent: Consider the amount of autonomy and control people have already lost, do not add to it. Designing for agency, dignity and privacy is foundational.

    How might we design solutions that makes it explicit the ways in which it is being used and will continue to be used?

  3. Participation: Consider inclusive co-design, joint decision making and iterative implementation. Value creation from the lens of the ultimate user and beneficiary is the only reason you should be building Gerontechnology solutions.

    How might new technologies incorporate principles of participatory design with multiple points of access and engagement?

  4. Connection across Time & Space: Gerontechnologies can be a portal to a wider world of experiences that are difficult to access in the physical world. Socialization, connection, support are important.

    How might we recreate inaccessible social experiences as primary drivers for the user experience of the gerontechnology?

  5. Entertainment: The impact of Gerontechnologies can be amplified if the experience of using them is enjoyable, fun and memorable.

    How might we streamline and simplify access across multiple media to ensure users are delighted, inspired and entertained?

The Bottom Line: Value Creation for Older Adults

While some older adults will live and thrive without debilitating conditions affecting their minds and bodies, an overwhelming percentage of the population will develop one or more chronic conditions that will impact their independence.  Gerontechnology has a significant role to play in disrupting this dependence but only if solutions unlock real value that matters to the older adult.  We cannot create this value without understanding the shifts and signals that surround us from the viewpoint of the older adult.


Mary Lou Ackerman is Vice President of Innovation and Digital Health with SE Health. Mary Lou is a founding member of SONSIEL (Society of Nursing Scientist, Innovator, and Entrepreneur Leaders) and an active member of CHIEF (Canada’s Health Informatics Executive Forum) with Digital Health Canada. Her background is extensive – she has led the development and implementation of many business transformation projects, innovations and partnerships. Mary Lou joined Saint Elizabeth in 1987 as a visiting nurse, and she has augmented her clinical background with a graduate business degree and significant experience with health informatics and technologies. Mary Lou has a passion for community health care, combined with a desire to advance care, creating innovative service models supported by digital health technologies, to create a future that will provide a personalized, accessible, meaningful health experience for individuals, their families and the service providers that support them.