Technology use among older adults with and without cognitive impairment : exploring relations with daily life occupations and need of support

Introduction: Older adults with and without cognitive impairments are likely to be limited in their performance of and engagement in daily life occupations due to challenges in everyday technology (ET) use. The overall aim of this thesis was to gain knowledge of how ET use is related to daily life occupations and need of support among older adults with or without cognitive impairments. Methods: This thesis draws data from two separate samples of older adults. In study I and III 67 older adults with mild cognitive impairment (MCI) or mild stage Alzheimer’s Disease (AD) were included. These studies were quantitative cross-sectional studies investigating associations between performance of Activities of Daily Living (ADL) and ability to use ET and if measures of Ability to use ET and Amount of ETs perceived as relevant generated by a standardised instrument could predict overall functional level. Both study I and III used statistical analyses. In study II and IV a sample of 11 older adults that had either no known cognitive impairment, subjective cognitive impairment or dementia were included. These studies applied constructivist grounded theory methodology to explore older adults’ experiences of incorporating new ET into daily life occupations and utilization of support in relation to ET use.

Findings: In study I, hypothesized associations between ADL performance and ability to use ET among older adults with MCI or AD were confirmed. Within study II, hinders and driving forces for incorporation of new ETs as well as how changes related to ET use impacts daily life occupations among older adults with and without cognitive impairments have been explored in depth. A good match between ET and: 1) occupational purposes, 2) a desired identity as ET user and 3) needs for feeling safe and in control were found as driving forces for incorporating ETs in to daily life activities and for satisfaction when using ETs. Within study III, both measures of Ability to use ET and Amount of relevant ETs showed potential to identify need of support at different levels in daily life among older adults with MCI or AD. In study IV utilization of support from others in relation to ET use was found to be of major importance for ET use among older adults’ with and without cognitive impairments.

Conclusion: The findings of this thesis provide insights and new knowledge regarding how ET use is related to daily life occupation and the need of support among older adults with and without cognitive impairments by using different conceptualisations and methodologies. This knowledge is useful for facilitating older adults ET use and hence also their occupational performance and engagement both at an individual and societal level.

List of scientific papers

I. Ryd, C., Nygård, L., Malinowsky, C., Öhman, A., & Kottorp, A. (2015). Associations between performance of activities of daily living and everyday technology use among older adults with mild stage Alzheimer’s disease or mild cognitive impairment. Scandinavian journal of occupational therapy. 22(1):33-42.
https://doi.org/10.3109/11038128.2014.964307

II. Ryd, C., Malinowsky, C., Öhman, A., Kottorp, A. & Nygård, L. Performing and engaging in daily life occupations as everyday technology changes - experiences of older adults. [Submitted]

III. Ryd, C., Nygård, L., Malinowsky, C., Öhman, A., & Kottorp, A. (2017). Can the everyday technology use questionnaire predict overall functional level among older adults with mild cognitive impairment or mild-stage Alzheimer's disease? A pilot study. Scandinavian journal of caring sciences. 31(1):201-209.
https://doi.org/10.1111/scs.12330

IV. Ryd, C., Malinowsky, C., Öhman, A., Kottorp, A. & Nygård, L. Utilizing support in everyday technology use - experiences of older adults with and without cognitive impairment. [Manuscript]