Uncovering new ways to help people stay comfortable and connected in their older years.
It shouldn’t be this hard.
Every morning an elderly woman gathers up her packaged food products that she can’t open herself, loads them into basket attached to her walking frame and goes and waits for the postman.
He obliges and opens the jars and other packaging that older hands, no longer as strong and dexterous as they once were, struggle with. Or she goes hungry. Dr Alison Bell is relating the story, which comes from a participant in her work that is looking at the difficulties older people have opening packaged foods, particularly in hospitals.
Associate Professor Helen Hasan meanwhile, is finding ways to use technology to help older people regain their independence, dignity and meaningful activity. Her research and work in aged care centres shows that even the simple mastery of everyday computer applications can contribute to an older person’s social and emotional wellbeing.
Both projects speak to core human needs: to be well fed and loved. Yet, a technology gap and a food industry more concerned with efficiency than practicality is putting those basic needs out of reach for an increasing number of older people.
Hard to open
Dr Bell places a range of food products on the table: a bottle of water, a single-serve packet of cheese, cereal, biscuits, a fruit cup; nothing that immediately suggests a problem. The products are also a cross section of what’s served to hospital patients. Yet, for many older people, they are at best fiddly, and at worst impossible to open.
Packaging certainly helps on one front. It means that small portions of perishable food can be kept longer, reducing handling and waste.
The researchers, supported by UOW’s Global Challenges program, looked at the different grips needed to open various products – from twisting a bottle top to pinching a piece of plastic together to rip open a packet of cheese – and the amount of time it took to open the product. The recently published research revealed that 10 per cent of patients couldn’t open water bottles and more than one-third found the small packets of cheese too hard.
It turns out that having the dexterity and strength to pinch the thumb and forefinger tightly are vitally important. Yet, these are the very physical attributes that conditions such as arthritis erode. The research leads to another question: if older people have difficulty with packaging, what does that mean for their diets?
By observing and measuring how seniors coped with opening packaged foods used in hospitals, the researchers discovered that an activity that for most people is a relatively routine task could be contributing to malnutrition among older people.
“Something we want to explore further is patients’ nutritional status,” Alison says. “We’ve shown with well people living in the community who are at risk of malnutrition, the packaging did impact the amount of food they ate.
“Poorly nourished people will impact on length of stay in the hospital, which means more cost to the health care system.
We might be saving money on packaged food service but if that food isn't delivering the nutrition people need for recovery and it’s leading to an increased length of stay, or re-admission, then we are saving money for no purpose.Dr Alison Bell
Alison is a senior lecturer in the School of Health and Society and has a professional background in occupational therapy and ergonomics. The insights from the study, she says, will help inform food types served in hospitals, how they are served as well as tackling the root issue of the packaging itself.
“From an ergonomics perspective we are looking for universal design, the principle where you design a product for everybody. Just think about taps, how taps have changed into beautiful, functional, single lever taps, they look funky but anyone can use them.”
While frustrations with opening packaged products are most acute in hospitals, it indicates a tip-of-the-iceberg scenario where countless older people could be undernourished or going without because of difficulties with packaging.
“Food today is a packaged commodity and everyone uses packaged products,” Alison says. “But a significant portion of our population is being excluded from easily accessing it, or accessing it without frustration, or having to resort to using scissors, a knife.
“People are living on low fixed incomes and might not be able to buy the big block of cheese. We know from consumer research with older people that they don’t want the big blocks of cheese, or the three packets for the price of two, they only want one packet.
“They are financially disadvantaged as well. So let’s improve the packaging and access to valuable nutrition.”
Using digital technology to overcome isolation
Whether they are playing Candy Crush or staying in touch with family and friends over Skype, Associate Professor Helen Hasan, from UOW’s Australian Health Services Research Institute (AHSRI), is finding that technology can add dignity to seniors’ lives.
“There is an ageist view that learning to use computers is beyond older people. We have plenty of examples where this is not the case,” Associate Professor Hasan said. Her research into technology began before most people had personal computers, when these boxes of mathematical wizardry were set up in dedicated rooms and operated by people in lab coats.
“I got interested in computer science in the 1960s and then I ventured into what is called information systems, which is much more about how people use computers,” she says. “So all my research has been about how different people use computers, what they use them for, how the changing eras have changed what you are able to do.”
The interaction between people and technology became more personal in recent years when she cut back on work to care for her husband, who had Alzheimer’s disease.
“He died five years ago. I guess it got to the stage where I couldn’t take him out anywhere so we were more or less isolated. I could do a lot things for myself online; I could get the groceries delivered, for example. But a lot of people can’t do that.
I see this everywhere now, people who are isolated in their homes and not able to get out and communicate with anyone very much.Associate Professor Helen Hasan
Over a period of two years, Associate Professor Hasan conducted research in the form of computer classes with residents at local aged-care facilities, testing the benefits of providing seniors with the capability to use a range of digital technologies on the internet.
The results showed that even the simple mastery of everyday computer applications can contribute to a senior’s social and emotional wellbeing in four well-established domains: social participation, meaningful activity, control over their lives, and dignity.
“They are doing something stimulating with their brain and doing something they are interested in. We just see them blossom when they are able to do something like look up things on the internet or do their own banking and keep control of their own affairs.”
She also discovered that people have different need and uses for technology, the implication being that a government grant to buy every senior citizen a tablet would not be an effective use of taxpayer money.
“I was looking after a 92-year-old lady and she had a problem with her iPad. She didn’t want email, she didn’t want Skype, she didn’t want anything else she just wanted to be able to get on to Facebook and keep in touch with her niece and what she was up to.
“There’s another guy that writes these beautiful stories and I keep trying to get him to blog them and put them on the internet and I said, ‘People would love to read this’. He said, ‘Oh no, I just want to do it’. All he wants is a computer with a keyboard and Office programs so he can just type up his stories. He doesn’t want anything else. So everybody wants something different.”
Not only can technology and the internet help overcome the isolation of the elderly, improving their wellbeing, maintaining an intellectually challenging mindset and engaging in personally satisfying activities can also reduce the amount of human support older people require. A win for the national bottom line.
“Having people looking after older people is very expensive,” Associate Professor Hasan says. “If you can teach an older person to do their own banking, to amuse themselves, to communicate with family, to write their memoirs, to do their family history, you have got built-in care that is doing them good at the same time.
“By helping older people to get technology that suits them and help in setting it up would help older people to be happier, to be more in control of their lives, to connect up, to do meaningful things as well as challenging the thinking that an ageing population is a burden on the economy.”
It shouldn’t be this hard.