Connecting through technology – using technology to alleviate loneliness and improve social outcomes

Description

Connecting through technology was borne out of the Covid-19 pandemic. Occupational therapy staff conducted in-depth discussions with service users (older people with mental health difficulties) following the first lockdown to establish the barriers to participating in a meaningful routine. Loneliness and lack of confidence with using technology were identified as the most significant difficulties facing older people. Service users’ opinions and needs have been incorporated throughout this project.

While most of the population had been able to connect with others and adapt their activities by doing so online, there was a fear amongst many older adults with regard to using technology. This led to further social isolation and deprivation.

The occupational therapy staff conducted research into what pieces of technology were available that were age-friendly and could have data inbuilt for those service users without wifi/broadband. ACORN was the only tablet on the market which had been designed specifically for older people living in Ireland. This includes older people with cognitive impairment.

ACORN is an age friendly smart tablet solution, purpose-built to solve the challenges of online adoption and to improve the quality of life for the user. Acorn’s universal design principles are based around easy navigation and accessibility. Optimum screen size, clear colour-coding, uncluttered screens, a consistent navigation system, large fonts and zoom functionality help build fast familiarity and make it easier to use than mainstream smart phones, smart tablets and computers.

In order to build confidence with using technology, the OT staff felt it was important that our service users had opportunities to practice using devices in a meaningful way. We proposed the purchase of four tablets with data inbuilt which could be loaned out to service users for month-long periods. The occupational therapy staff would introduce the service user to the device and bookmark apps/webpages which would be of particular interest i.e. YouTube, Zoom, Bridge Base Online. The device would be reset and any identifiable emails, or links, or saved items used by the service user would be wiped following completion of the loan.

Aim of Initiative

The aim of “Connecting through Technology” is to improve older people with mental health difficulties’ access to and confidence with using technology.

Who is it aimed at

Older people with mental health difficulties (i.e. depression, anxiety, dementia) who attend the Psychiatry of Old Age service, Dublin North City Mental Health Service

3 Steps critical to success

1. Support of management in purchase of tablets. We decided to keep one of the four tablets with data inbuilt (as there was an increase in availability of wifi in people’s home and communities). The cost of this is €260 per year which management have agreed to continually fund.
2. Leadership and vision – OT staff saw the need via ongoing discussions with service users and looked at innovative ways to address the need.
3. Commitment – all OT staff are committed to promoting the computer literacy of our service users and ensuring that all things in life, technology included, are accessible to older people.

3 Challenges in Planning / Delivery

1. The time needed to teach a person (especially with cognitive difficulties) to use the tablet, and then the visits in order to follow-up on the person’s use of same.
   In order to support with this, we arranged for our Occupational Therapy Assistant to do training with ACORN so that she would be able to take more of a lead with the tablet loan induction and support.
2. During the initial pilot one of the tablets was damaged during a loan. Following this we developed a loan contract to ensure that any damages to tablets was the responsibility of the person it was on loan to. If the damage is small, we have an agreement with ACORN to provide repairs for a fair price.
3. While we initially ordered four tablets with data inbuilt into all of them (cost €1040 per annum), we realised following the COVID-19 pandemic that even if service users did not have wifi/broadband at home, they could access same in local cafes, which in itself promoted further community integration.

   Therefore we reduced our subscription with ACORN to only one tablet having inbuilt data (€260 per annum) and this has proven successful.

3 Outcomes / Benefits

1. Research was conducted in order to capture outcomes of the project.

   Outcome measurements used have been the MDPQ (Mobile Device Proficiency Questionnaire) or the Canadian Occupational Performance Measure (COPM).

   These measurements have demonstrated improvement in service users knowledge/skill/confidence with using technology; achievement of goals following completion of the tablet loan.

2. Most service users who have been provided with loans have purchased tablets or computer devices for themselves after the loans.
3. A qualitative interview was conducted with a service user who had participated in the ACORN tablet-loan intervention.
   The interview was semi-structured. The service user, who we will call Brigid, was a 75-year-old single lady who lives alone. She was a recently retired nurse. She had a diagnosis of mild cognitive impairment and dementia.

   The three themes which emerged from the data analysis – ‘I could never do that’, ‘I feel part of the world now’, and ‘I could try anything’ reflect the personal journey which Brigid has had with technology over her life and how her occupational identity has changed since being provided with the ACORN tablet.

   I could never do that – this theme describes the foundation of Brigid’s occupational identity and how this has affected her relationship with technology in the past.
   From a young age, Brigid felt inadequate in relation to education and learning. She spoke about her experience of getting a scholarship to the “posh” secondary school –
   “there I was with all these people from well-off families. Her father’s a doctor or solicitor and here am I…a poor little girl from a poor little farm with my shiny uniform”
   This poor self-confidence continued throughout her life and into her work. Brigid felt she was not able to participate in the world of technology, and that she had no choice in the matter. She spoke about asking colleague to relay emails to her, some of them personal.
   Brigid felt alone and ashamed due to her inability to engage with technology, and therefore with other people in the world around her.
   “I would always feel isolated from people. Isolated in the sense that I felt different. Especially when people would ask me for my email, it made me so isolated”

   I feel part of the world now – this theme describes Brigid’s new sense of self since being provided with the ACORN tablet.
   There are two subthemes which reflect Brigid’s new feeling of connectedness and belonging.
   A lifesaver that kept me in touch
   Brigid described all of the meaningful occupations which she has learned to perform through the tablet.
   “I have learned to send and to get emails and to be able to do things like read the paper every day , which is just great. I am able to tap into mass every day. I participated in courses, like in the Sanctuary and things like that …I’m still on two boards from work, although I’ve retired, and it’s great that I’m able to go on Zoom now. Before I used to have somebody setting it up for me and I’d go down to their computer but now I can!”
   Brigid spoke about how the tablet has enabled her to protect her social identity since retiring during the pandemic.
   “It was such a lifesaver… I’d be a person who loves to meet people face-to-face and I suppose the tablet has enabled me to do this.”
   As a single woman who lives alone, Brigid described the companionship and courage which the tablet has given her.
   “And I don’t feel as isolated, especially at my age now, and I feel in a way, it’s become a friend for me that I never had, you know . And I don’t have the same fear.”
   I don’t feel different anymore
   Brigid is now free of the old feelings of shame and fear which haunted her throughout her life.
   “And you know one of the things that is amazing for me, is the confidence I have gained, for when people ask for my email, that I am able to give them an email now! ‘She’s not different anymore’ which I always felt.”
   The symbol which Brigid felt represented her life-long sense of inadequacy was losing its hold over her.
   “The shiny uniform is disappearing.”

   I can try anything – This theme describes Brigid’s new found perspective as she looks towards the future, which is full of occupational possibilities.
   Brigid spoke about her confidence to try new things, and in particular in developing her skills with using technology even further.
   “I don’t want to be afraid anymore. I can try nearly anything now!…I’d love to do more training cause I feel there’s so much open to doing with this ACORN and I know it and I want to get into more and more.”
   Brigid even wants to share her experience with peers in order to help others to develop confidence and a sense of belonging through technology.
   “I would be somebody who would love to promote it. In fact, I know one or two who are like me, my age, and I’ve said it them and they’re like me – “no I wouldn’t be able”. So in fact I am going to bring it to them, show it to them and maybe get them interested.”