Comfort and medical ambivalence in old age

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Highlights

  • Even the “oldest old” are technology users, or technogenarians.

  • Policy makers, designers, and caregivers can learn from elder technology users.

  • Technology may or may not deliver comfort or control in elders' lived experience.

  • Involve elders in policy-making and design to honor their experiences and needs.

Abstract

This article, based on three years of longitudinal research, analyzes the role of technology in creating or inhibiting comfortable lives in old age, from the perspective of elders themselves. By understanding the oldest old as technology users, we can appreciate elders as savvy tech-operators, ambivalent users, and non-users. Combining science and technology studies and medical sociology frameworks together provides a basis from which to examine technogenarians in action, (or chosen in-action), and the complex relationship between biotechnology and well-being.

Introduction

Old people's lives are filled with assistive devices, household technologies, pills, and other tools. Everyday technologies as well as biomedical interventions can be part of the way older adults pursue, maintain, and negotiate life. In this context, the old are cyborgs in contemporary life, blending machine and biology in both their personal identities and their relations to the external world [1]. And yet, this everyday relationship with new and old technologies varies. We need an understanding of technogenarians to fully comprehend their various reactions to biotech interventions. By understanding elders as technology users, we can appreciate elders as savvy tech-operators [2], ambivalent users [3] and non-users [4]. Combining science and technology studies and medical sociology frameworks together provides a basis from which to examine technogenarians in action, (or chosen in-action), and the complex relationship between biotechnology and well-being [5]. This article analyzes the role of technology in creating or inhibiting comfortable lives in old age, from the perspective of elders themselves.

Consider Alice, age ninety-four, who learned to depend on a talking watch and calculator, a walker and eyedrops, as her eyesight waned. Most, like Alice, learn to use such tools strategically for self-care—to enhance their own mobility, comfort, and quality of life. And yet, Alice disliked how eye doctor and nurse visits came to dominate her life as her blindness progressed, and came to see these as incursions on quality of life in old age. Like her, many elders express concern about the sheer number of pills and procedures in their lives, and may work to actively resist medicalization in order to accomplish self-care and personal comfort. Thus, in the context of active aging, elders employ technology selectively.

My research has explored how many among us are ambivalent and even questioning of medical solutions in our lives, prioritizing comfort above all else. In my two decades of research, I have encountered midlife and elder men and women talking back to and resisting the Viagra phenomenon; college students—the so-called Ritalin generation—expressing ambivalence about self-diagnosis and dosing; and the “oldest old” in America—elders 85 and older—expressing concern about medicalizing forces, or the sheer number of pills and procedures that fill their days. This cross-generational medical and technological ambivalence is a sign of our times; in an age of great technological progress and change. A small but growing field of research in medical sociology empirically addresses bio-medicalization and ambivalence in children and adults in relation to contested syndromes such as chronic fatigue, depression, ADHD, and mass vaccination [6].

Section snippets

Methods

Gubrium and Holstein [7] argue that knowledge of old age should come from the aged themselves. This research was conducted with this in mind, using in-depth interviews coupled with both life course and symbolic interactionist approaches. A life course approach emphasizes common themes, continuity and change across one's lifespan, and how these biographical aspects can shape contemporary realities, such as technology use. A symbolic interactionist framework focuses on how individuals actively

Technology as innovation and intervention

Ageism and paternalistic tendencies in design are often subtle and may occur despite intentions to the contrary [12]. Technology created for elders is perceived as innovation and intervention, to make activity possible. I argue that such material technology already exists in a field of activity. Elders, who are actively aging, inhabit this field of activity, and perform technology work to aid in achieving comfort and well-being. Yet, even when elders are included as designers in new, profitable

Everyday technologies for active aging and comfort

While we may not automatically think of elders as technology-savvy, research on the daily lives of the oldest old reveals a range of technology users, and technologies used [22]. Looking at their own lives and self-care routines, elders reveal how so-called aging technologies include much more than biotechnology and gerontech designed for the elderly. The nonagenarians I have interviewed and regularly observed rely on a variety of everyday tools, centered around communication, mobility, and

Biotech ambivalence

Pharmaceuticals and over-the-counter medications are generally associated with health and wellbeing. However, paying attention to the meanings nonagenarians attach to medical use and non-use can illuminate how these biotechnologies are positioned as an array of techniques elders use to practice self-care. When asked about their medications, nonagenarians tend to say very little, suggesting that biotechnology has limited symbolic importance in their daily routines. Lillian remarked on the sheer

Learning from elders: conclusions

Nonagenarians in this study help us to see how the active accomplishment of age and health is inextricable from science and technology. This study contributes to research that explores how old individuals creatively utilize and adapt everyday technologies to construct meaningful and healthy lives. Nonagenarians can teach us how everyday technologies can become technologies of ageing; instruments of continuity, control and health; or just the opposite. As we have seen, mundane everyday devices

Meika Loe is an Associate Professor of Sociology and Women's Studies at Colgate University in New York, where she teaches courses on Aging and the Life Course. She is the author of Aging Our Way: Lessons for Living from 85 and Beyond (Oxford, 2011), Technogenarians: Studying Health and Illness Through an Aging, Science, and Technology Lens (Wiley-Blackwell, 2010, with Kelly Joyce), and The Rise of Viagra: How the Little Blue Pill Changed Sex in America (NYU Press, 2004).

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