This document discusses research on seniors' use of technology for out-of-hospital care. It summarizes three key studies: 1) online communities can benefit seniors' well-being, 2) internet-based interventions reduced stress in caregivers versus controls, and 3) a technology acceptance model predicted seniors' use of assistive social agents. It also notes the increasing elderly population in the UK and their burden on the health system. Statistics on Kent County show areas with the highest elderly populations and rates of nursing home residence and home care use.

1. SENIORS AND THEIR INTERACTION WITH TECHNOLOGY: A
QUANTITATIVE ANALYSIS
 INTRODUCTION
The focus is the elderly and how they interact
with out of hospital technology based care.The
population is livinglonger,meaningthat
treatments for age-related diseases area
necessity.
In the UK, the proportion of 65+ has grown by
47% sincemid-1974.Of this,the proportion of
75+ has increased by 89%. Consequently, the
burden on the National Health Service(NHS) to
meet the needs of the elderly has also
intensified.
There is evidence that application of technology
in health and social careof the elderly has grown
exponentially (Heerink, Krӧse, Evers, Wielinga,
2010).
 TECHNOLOGYINHEAALTHCARE
My part of the internship was to provide a literaturereview of quantitativemethods of assessingtheadequacy of the useof technology in the careof the elderly. These different
systems are envisaged to allowthe elderly to liveindependently. Of the many journalsI gathered, the three that stood out the most:
1) Elderly OnlineCommunities
 There has been evidence for the positiveimpactthat social networks haveon physical and health status (Avlund et al,2004). These communities could contribute to self-
preservation,provide social supportand serveas an opportunity for growth and self-discovery.After a quantitativecontent analysisof data from 14 leadingonlinecommunities
over a year, the study found that there was a continual increasein thedaily activity level duringthe research period and the overall tonewas more positivethan negative. The
overall databasein this analysis included over 19,963 threads and 686,283 messages. Active participation in thesesocial media may add to the well-beingof older adults;learning
computer and internet skillsenhances a senseof independence (Henke, 1999).
2) Elderly Caregivers and Technology
 The median rate of depression in caregivers is 22%,compared to community dwellingolder adults for whom the median rate of depression is 11%(Vitaliano, Zhang, & Scanlan,
2003).In one study in particular,where 66 caregivers were randomly delegated to either a no interference control group or an internet based intervention set; the results showed
that after an analysisof the stress responseoutcome data, there were substantial dissimilarities in between the two groups. M stress changescore2.519 (n=15) for the control
group; M stress score-1.326 (n=23) for the intervention group, a lower or negative scoredepicting a decrease in stress over the two time periods (P. Donahue and E. Marziali,
2006).Whilethe internet intervention group showed a notable reduction in stress,the control group experienced a comparableincrea sein their levels of stress.
3) Acceptance of AssistiveSocial Agents by the Elderly
 There has also been a study that proposed a model of technology acceptance that is expressly designed to test the acceptance of assistivesocial agents by elderly users (Heerink,
Krӧse, Evers, Wielinga,2010).This model was strongly supported accounting for 59 - 79% of the variancein usageintentions and 49 – 59% of the variancein actual use.The aimwas
to develop a model that a) is ableto explain acceptanceunder a wide variety of experimental conditions,
There are a wide range of emerging technologies that could go a longway to prevent health issues thatoften land elderly people in emergency care. For example:
 Sensors  GPS systems  ‘Hybrid’ locatingapproach  Mobileapps  Robotic home assistants  Onlinecommunities  Microprocessors  Nanotechnology  Biosencingchips 
 KENT AND THE ELDERLY
A clear viewof the statisticsregardingtheelderly in Kent was essential.
 Canterbury and Thanet  highestno. of people aged 65+
(over 30,000) & highestno. of people aged 85+ (over 3800).
 Dartford, Tunbridge Wells,Ashford and Maidstone  highest
rate of long term nursinghome residenceper 10,000
population aged over 65 and over; rates between 52.2 and
72.3.
 Highest rate per 10,000 population aged 65+ receivingHome
care Dartford, Gravesham, Maidstoneand Swale; they have
rates of between 138.4 and 188.4.
 Canterbury, Dartford and Thanet  highest admission ratein
Kent Local Authorities for emergency admissionsin 65+;each
havingadmission rates abovethe county average.
 REFERENCES
Avlund, K., Lund, R.,Holstein, B. E., Due, P., Sakari-Rantala, R., &Heikkinen, R.L. (2004). The impact ofstructural and
functional characteristics ofsocial relations as determinants offunctionaldecline. Journal ofGerontology:
PsychologicalSciences andSocial Sciences, 59B, p44-51
Heerink, M.,Krose, B.,Evers, V & Wielinga, B. (2010). Assessing AcceptanceofAssistiveSocial Agent Technology by
Older Adults: theAlmereModel. IntJ SocRobot. 2 (1), p361-375.
Henke, M. (1999). Promoting independencein older persons through theinternet. CyberPsychology &Behaviour,2,
521-527
Marziali,Eand Donahue,P. (2006). Caring for Others: Internet Video-Conferencing Group Intervention for Family
Caregivers ofOlder Adults With NeurodegenerativeDisease. The Gerontologist. 46(3), p398-403.
Rieland, R. (2012). 10Ways TechMakes Old Age EasierRead more: http://www.smithsonianmag.com/innovation/10-
ways-tech-makes-old-age-easier-1840093/#gOS603J8dQqeo7KB.99Give the giftofSmithsonianmagazine for only
$1. Available: http://www.smithsonianmag.com/innovation/10-ways-tech-makes-old-age-easier-1840093/?no-ist.
Last accessed5thOct 2016.
 CONCLUSION
 Studies with up to date quantitativeinformation regardingtechnologies in out of
hospital heath carefor the elderly are few and far between.
 Those that do show statistical evidencefor their findings often have limited sample
sizes and a substantial amountof dropouts from their control group  most
results need to be taken with a pinch of salt.
 Further studies areneeded with much larger samplesizes and perhaps more
funding
 With accuratestatistics,preciseprojections can bemade as to how technology is
being adopted and if it is actually makinga differencein their relianceon health
careservices
The NHS has looked to points such as the DHI Scotland and the Esther Project as
examples of innovation in elderly care.Originatingin Sweden, Esther was created by
careproviders to improve patient flow and co-ordination of the elderly.
 Esther is a persona:a grey-haired, competent elderly woman with a chronic
condition and occasional acuteneeds.
 Inadequate capacity for planned carewas forcingpatients to seek carein
inappropriatesettings.
 20% of bed capacity closed off and moved to where the need was bigger.
 Hospital admissionsfell from9300 in 1998 to 7300 in 2003
 Hospital days for heartfailurepatients fell from 3500 in 1998 to 2500 in 2000
The Digital Heath & CareInstitute (DHI) Scotland was set up in 2013 as partof
Scotland’s innovation centres and was funded by the Scottish Funding Council.They
bringtogether different sectors to cultivatenew technology that will expand and
improve.
 ESTHER& DHI PROJECT