Tag Archives: Family

Alone Together: Why We Expect More from Technology and Less From Each Other

Sherry Turkle is a professor at MIT who views artificial intelligence and technology through a sociological and psychological lens. In the first half of her most recent book, Alone Together: Why We Expect More From Technology and Less from Each Other,  Turkle addresses the impact of technology on older adults. Technology advances such as robotics and assistive technology are making headway in society, especially in elder care. These new technologies can provide some comfort or care for older adults with chronic diseases. Turkle’s focus, however, is on the substitution of robots for human interaction and the emotional aspect of care performed by another human being.

Turkle conducts experiments where she brings different types of robotic technology such as AIBO, My Real Baby, and Paro the Seal into nursing homes. These robotics provide companionship and not practical assistance. For instance, many older adults began speaking to their robots, going over important life events and reminiscing about old times. They found that spending time with the robot reduces anxiety and isolation. The impact of My Real Baby, an “interactive learning doll”, was particularly significant in experiments because it gave older adults a sense of purpose. The My Real Baby doll needed comfort, changing, and other activities that made older adults feel needed (105). This promotes higher quality of life for older people.

Turkle also conducts research involving children, where children discuss the role of robotic technology in their lives. The children profiled in the book worry about technology replacing real human interaction. One child says, “that grandparents might love the robot more than you… They would be around the robot so much more.” (75). Another child worries “that if a robot came in that could help her [grandmother] with falls, then she might really want it… she might like it more than me.” (75). In her discussion of experiments conducted in nursing homes with the doll, My Real Baby, Turkle finds that older adults do not want to give the doll back at the end of the experiment (111). One grandmother even ignores her grandchild who is visiting to take care of the hungry doll (118).

What Turkle does best in this book sharply contrasts the ideal situation of having loving children or family who can visit and provide social interaction to the reality of isolation in many older adults. While Turkle acknowledges the barriers to artificial intelligence and technology as companionship for older adults, they surpass the alternative of no social interaction at all. She notes, “If the elderly are tended by underpaid workers who seem to do their jobs by rote, it is not difficult to warm to the idea of a robot orderly”. (p. 107).  She then points out that when given the choice between interacting with robots and interacting with a member of the research team, almost all of the older adults chose a member of the research team (p. 105). At the end of the day, these robots are not capable of producing the same amount of interaction and support as a human being. Turkle muses, “An older person seems content; a child feels less guilty. But in the long term, do we want to make it easier for children to leave their parents? Does the ‘feel-good moment’ provided by the robot deceive people into feeling less need to visit?” (p. 125). Robots providing clinical care may be an ideal solution to the shortage of workers caring for an aging population, but are no replacement for social interaction.

Grace Mandel is the project manager for the Baltimore Fall Reduction Initiative Engaging Neighborhoods and Data (BFRIEND) at the Baltimore City Department of Health.


One Child: The Story of China’s Most Radical Experiment

One Child: The Story of China’s Most Radical Experiment by Mei Fong presents a compelling analysis of the impact of China’s “One-Child Policy” on older adults. The one-child policy, a compelling story of population control for economic growth, has long term implications that are only now apparent. Fong describes the challenges of a rapidly aging population as she focuses on families who are struggling to care for older adults, and those who have no children to care for them in old age.

Published November 2015

One of the book’s most gripping stories is of parents during the 2008 Sichun earthquake. According to official reports, “eight thousand families lost their only children in the disaster.” (p.3) These parents, and other parents who have lost their only children, face barriers in accessing nursing homes, health care, and burial plots. Fong notes, “they are also more financially vulnerable than ordinary retirees, and more prone to depression, studies show.” (p. 41) While these challenges are tangible, the emotional challenges of losing support systems in old age is also a prominent problem. Fong addresses the growth of China’s hospice industry, stating that many older adults without family feel unable to contribute to society. (p.151)

The book also digs into the cultural complexities in aging and filial obligation. In one notable story, that received national acclaim in china, Liu Ting brought his mother with him to college, when she was too ill to care for herself. His mother suffered from kidney disease and uremia. Although Ting received fame and attention, his job opportunities after college were limited at the expense and time required to properly care for his mother. (p. 92)

While Fong discusses other implications of China’s one-child policy such as rise in adoptions, increase in bride prices to compensate for the greater number of men than women, and the further consequences of sex-selective abortions, the primary implications of the policy relate to the care and treatment of older adults. With only one child per two aging parents, the traditional way of caring for Chinese parents will cause economic slow down, and place burdens on the younger generation.

Fong is at the forefront of a wave of journalism that will detail the challenges of aging in China. She acknowledged that it could be difficult to find many children who were burdened by caring for aging parents, as more parents of children from this time period are in their 50’s and 60’s (p. 86) However, her book is at the forefront of a problem that will only become more prominent in the coming decades.

Grace Mandel is pursuing a Master of Public Health in Health Systems and Policy at the Johns Hopkins University Bloomberg School of Public Health.

Technology for the Tech-Shy: Designing New Applications for Older Adults

In the digital and connected world, older adults are seemingly left behind. Tech companies continue to design products that cater to young adults, even in the generation of social media. As phone calls and snail mail are dangerously slow and outdated, why should the elderly not benefit from advances in communication? Fortunately there is a growing number of mobile and tablet applications that cater to the elderly population. These apps help to improve quality of life and communication channels with family, friends and healthcare providers.

For example, Oscar aims to enhance the lives of seniors as well as help seniors keep in touch with their family, friends or caregivers. Oscar is an easy-to-use, remotely managed communication tablet app that allows tech-shy elderly known as the ‘seniors’  to remain connected with family, friends and healthcare professionals known as the ‘juniors’. The app boasts of a simple interface which allows users to communicate via text, pictures, voice and video calls. Additionally, it provides a ‘Live View’ of the application on the elder’s tablet and allows the ‘junior’ to fix or update relevant items remotely. The technology also provides reminders, weather alerts and games. Apart from communication, Oscar is a platform for apps with the possibility of adding or removing applications depending on the user’s proficiency and interest. Keep your eyes peeled for the iOS version that is coming soon!

Photo Credit: Pixabay
Photo Credit: Pixabay

Two finance applications that target the elderly are Mint and Check. Like Oscar, both apps boast of simple interfaces which present relevant financial data in one simplified format. Both applications also provide reminders for paying bills, tracking payments, and helping with creating and managing budgets. A primary difference is that Check is only available on Apple iPads, while Mint is available on both Android and Apple operating systems.

In addition to communication and finances, healthcare is another important consideration with the elderly population. WebMD and Blood Pressure Monitor are great applications, allowing seniors to monitor and learn more about their health. Finally, there are a whole host of games apps to improve cognition and memory such as Luminosity and Elevate. Luminosity focuses on cognitive abilities, while Elevate focuses on reading, writing and mathematics. Both are fun, and we encourage everyone to check them out!

While being acutely aware that some of these apps are only accessible to people with adequate financial resources, such people can invest in mobile applications to remain connected, enlightened and lead an improved quality of life.

Seniors are part of the digital world, hence they should benefit from advances in communication than be left behind. The goal is to design products, free or cost-effective, which will improve the quality of life of older adults. It is, therefore, encouraging to see a number of companies collaborating with seniors to design great products. Since technology can also benefit this population, corporations are recognizing the value and contribution of older adults.

Oscar, Mint, WebMD, etc., have great potential to improve health outcomes among the elderly as well as provide a comfortable and healthy life. The video below shows more useful apps for the elderly.

Namratha Rao is pursuing a MSPH in Social and Behavioral Interventions in the Department of International Health at the Johns Hopkins University Bloomberg School of Public Health. 

Who Are You? Where Am I?

In an effort to increase awareness for the first annual National Memory Screening Week held Nov. 1-7, Vicki Tapia, author of Somebody Stole My Iron, has joined with four other authors of books about dementia/Alzheimer’s. This article describes the campaign and presents a brief synopsis of their books.

Photo Credit: City of Overland Park

It was the weekend of our family reunion and almost everyone was gathered together at my parent’s condo to celebrate a milestone. Our patriarch, my dad, was turning 90. When the front doorbell rang, Mom opened the door, took one look at her oldest granddaughter and asked in a perplexed tone of voice, “Who are you?” After a moment of silence, we all laughed a little uncomfortably, but brushed it off, rationalizing the comment as a manifestation of Mom’s stress in caring for Dad, who had been diagnosed with Parkinson’s disease. It was not mentioned again.

Our family continued to somehow normalize or overlook the ever-increasing signs that something was not quite right with Mom’s behavior. Another two years passed before she finally agreed to be evaluated by her health care provider, around the same time Dad was diagnosed with Parkinson’s-related dementia. Although by this time, our family wasn’t completely surprised by Mom’s Alzheimer’s diagnosis, we were alarmed to hear she was already considered to be in the “moderate” stage of the disease. I later learned this scenario is typical.

Studies tell us that the delay in diagnosis can be attributed to the family’s own denial in not wanting to face the fact that something is wrong. In retrospect, this could be applied to our family, although in many ways, we were simply clueless in the beginning. Sometimes, a fear of diagnosis can result in reluctance on the part of the affected person to agree to an evaluation, particularly if it involves an adult child prodding an intractable parent. Healthcare costs may also be a factor in avoiding an assessment by a qualified health care provider (HCP). The oft-perceived stigma associated with a potential diagnosis of dementia/Alzheimer’s can be a barrier to evaluation for the entire family.

National Memory Screening Week

In an effort to promote the importance of early detection of memory problems, the Alzheimer’s Foundation of America (AFA) has launched the first annual National Memory Screening week scheduled for Nov. 1-7.

The screenings will be free and confidential, and if deemed necessary, refer people onto appropriate follow-up services. One of the goals of the screening is to work toward eliminating the stigma and fears associated with dementia. The AFA also hopes to alleviate fears for people who participate in the memory screening, but do not show a concerning memory problem.

For more information about the screening (date, time) and a list of participating sites, visit National Memory Screening.

Who should consider having a memory screening?

  • Anyone concerned about memory loss or experiencing any of the warning signs of dementia.
  • Anyone who feels they are at risk due to a family history of Alzheimer’s disease or another type of dementia.
  • Anyone who wants a baseline evaluation of their memory for future comparisons, even though they do not have a current concern.

If you or a loved one answer “yes” to any of the following questions provided by the AFA, it may be prudent to participate in the free memory screening.

  • Are you becoming more forgetful?
  • Do you have any trouble concentrating?
  • Do you have difficulty when performing familiar tasks?
  • Do you have trouble recalling names or words during conversation?
  • Do you sometimes forget where you are going or where you are?
  • Have friends or family told you that you are saying the same thing over and over or repeating questions?
  • Do you often misplace things?
  • Have you become lost when driving to a familiar place or walking in your neighborhood?
  • Have your family or friends told you they have noticed changes in your behavior, moods, personality, or desire to engage socially?

For more information, visit Information for Participating Sites on the National Memory Screening website.

The scene described in the opening paragraph of this blog post is based on an excerpt from my memoir, Somebody Stole My Iron, which details the daily challenges, turbulent emotions, and many painful decisions involved in caring for my parents. Laced with humor and pathos, reviewers describe my book as “brave,” “honest,” “raw,” “unvarnished,” as well as a “must-read for every Alzheimer’s/dementia patient’s family.” I wrote this story to offer hope to others whose lives have been intimately affected by this dreadful disease, and to reassure them that they are not alone.

Four other engaging books about dementia/Alzheimer’s disease that I am pleased to recommend include:


On Pluto: Inside the Mind of Alzheimer’s by Greg O’Brien

Greg’s story is not about losing someone else to Alzheimer’s, it is about losing himself. Acting on long-term memory and skill, coupled with well-developed journalistic grit, O’Brien decided to tackle the disease and his imminent decline by writing frankly about the journey. On Pluto is a book about living with Alzheimer’s, not dying with it.” 

Alzheimer’s Daughter by Jean Lee

Jean’s memoir details her journey caring for both parents who were diagnosed on the same day. It is written with wincing honesty about the cruel affects of the disease, but a World War II love story held together by faith and family is contained within the pages.

Blue Hydrangeas by Marianne Sciucco

Marianne describes herself as a writer who happens to be a nurse. She writes this work of fiction based upon her care for the elderly. It is a tenderly told love story about Jack and Sara, owners of a New England bed and breakfast. Sara is stricken with Alzheimer’s and Jack becomes her caregiver.

What Flowers Remember by Shannon Wiersbitzky

Shannon writes this work of fiction through the eyes of a young girl, perhaps not surprising, as her author bio notes that her own grandfather had Alzheimer’s. In the story, when thirteen-year-old Delia Burns realizes that her elderly neighbor is beginning to forget, she involves the entire town in saving his memories.

Vicki Tapia, long-time lactation consultant and published author of numerous lactation articles, found her energies redirected to the other end of life when both her parents were diagnosed with dementia in 2004. Her diary documenting their journey resulted in the publication of Somebody Stole My Iron: A Family Memoir of Dementia, a 2015 finalist for the High Plains Book Awards. The mother of three grown children and eight grandchildren, Vicki lives with her husband and Mini Schnauzer in South Central Montana, USA.



Elderly Refugees: The Experiences of Cambodian populations under the Khmer Rouge

Photo Credit: Extraordinary Chambers in the Courts of Cambodia
Photo Credit: Extraordinary Chambers in the Courts of Cambodia

War, natural disaster and fear of persecution often result in the tragic displacement of people far away from their homes. These people, refugees, live in uncertainty and under significant psychological and physical stress. Among these refugees are the elderly who are a particularly vulnerable group. Aging is not limited to disease and disability, but also the sudden change and a loss of belonging. The experiences of Cambodian elderly refugee populations is a clear example.

The Khmer Rouge took over Cambodia in the 1970s, prompting several years of genocide and a mass exodus of Cambodians into Thailand, US and other countries. By 1979, there were 160,000 Cambodians in refugee camps in Thailand.

A 10 year study sought to capture the experiences of Cambodian Americans in Northern California. Most Cambodian Americans lived in run down neighborhoods with a high prevalence of criminal activity. Elderly immigrants were at high risk of occupying poor housing conditions. Despite this fact, some refugees chose to move back into inner city neighborhoods as they aged to be a part of the community they once were as recent immigrants. In the case of this refugee population, many elderly people did not want to return to Cambodia given the turmoil which influenced their flight. Of those who did, they were constantly reminded of the differences in living conditions between the two countries.

Many Cambodian refugees in the US had poor education. With low income and little to non-existent English skills, elderly refugees constantly needed support from other immigrant populations, their children, and resources from the government. One woman says, “At my age, I’ve nothing to do, but pray for my children. I know that now I am their pillar, but later when they all grow up and leave, I will be alone with only myself to rely on.”

The past experiences with the hardships of the Khmer Rouge are constantly woven into their current narratives. For instance, many elderly complain of diseases such as high blood pressure or sleeplessness, and attribute such ailments to the harsh lives under the the Khmer regime. Post-traumatic stress disorder and depression are also common among Cambodian refugees. According to one study, family-related anger is prevalent among refugee families because of the cultural gap between refugees and the general population, as well as between refugees and their children who are much better adjusted to American lifestyle.

There are many organizations working towards improving the lives of elderly immigrants. The International Rescue Committee (IRC), one of the world’s leading organizations for refugees, has an Elderly Refugee Program. This program provides English as a Second Language classes, and assists in part-time employment and obtaining citizenship.

Yet the question remains – What can be done about the sense of loss of loved ones, one’s home, country and citizenship?

Namratha Rao is currently pursuing her MSPH in International Health in Social and Behavioral Interventions at the Johns Hopkins University Bloomberg School of Public Health.

What Does Elderly Health Mean in the UAE?

They think they are elderly and it is a normal consequence of ageing to be in bed,” says Dr Al Suwaidi.

The United Arab Emirates (UAE) is a small country in the Middle East, nestled between Saudi Arabia to the West, Oman to the East and Iran to the North. A cross-sectional study reported that 95% of its participants, all adults over the age of 65 years, rated their health as satisfactory or higher. There is a general perception of good health among the elderly. Despite this fact, the UAE has the 2nd highest incidence of diabetes in the world, and 4th highest rate of glucose intolerance in its population. Very little in known about elderly health in the UAE and even less is known about elderly health beliefs in this population.

Dubai, United Arab Emirates. Photo by Paolo Margari.

Dr. Al Suwaidi, Director of Geriatrics at Dubai Health Authority, provides insight into what elderly health could be. She suggests the norm to be a passive acceptance of poor health during aging. Religion also plays a significant role in health care seeking behavior. A recurrent theme is the idea that ‘Health is from God‘, discouraging individuals to take action for better health which can imply going against the will of God. Another factor influencing health care seeking behavior is the presence of symptoms. Good health is equated with lack of visible disease, making it less likely to seek care for silent or underlying cases such as diabetes and hypertension.

There is a high regard for elders within the family structure. Common features of the family structure include a practice of traditional values, religion and high economic resources. Understanding the role of elders within the family is essential to providing adequate geriatric care. Dr. Al Suwaidi suggests that there is a greater need for day care centres than long term nursing homes since families would not be receptive to placing their elders in old-age living facilities. This shows the importance of encouraging families and increasing geriatric care that focuses on home-based elderly care.

Geriatric care is a relatively new branch of medicine in the UAE. There is a high disparity of geriatric care provided between the seven emirates, or regions, of the country. The emirates of Umm Al Quwain and Fujairah have relatively poor geriatric care facilities. This is because different governmental bodies govern and offer different services to their respective elderly population. In addition to disparity by location, there is also disparity by citizenship. UAE has one of the world’s highest proportions of an expatriate population, accounting for close to 90% of the country’s total population. This vast majority have limited access to health insurance and social welfare programs.

Current government initiatives include the Elderly Happiness Initiative (EHI) and Weleef. EHI aims to improve the quality of life of elders living alone by providing funding for health care workers to visit and provide home-based care. Weleef is a program that imparts knowledge on best practices to health care providers on a regular basis. Both programs operate in the Emirate of Dubai and are accessible only to UAE nationals or Emiratis. In Dubai, the elderly population, constituting 0.5% of the total population, accounts for 5% of out-patient visits. In addition to improving health, revisiting the current situation of elderly health can also help defray the costs of aging. The UAE needs an inclusive geriatric care model that incorporates local ideas on elderly health. The UAE needs an inclusive geriatric care model that takes local models of elderly health into account

Namratha Rao is currently pursuing her MSPH in International Health in Social and Behavioral Interventions at the Johns Hopkins University Bloomberg School of Public Health.

Old and Homeless in Australia: It Can Happen to Anyone

In Australia, on any given night, 1 in 200 people are homeless.” One fifth of all people who are older than 55 years of age are homeless; many more live in unsecured housing.


What is homelessness and what may cause someone to become homeless? A person is considered homeless when he or she does not have a conventional home and lives on the streets or in a park. Someone may be at risk of homelessness when living in unsecured housing. There are certain reasons that can cause homelessness which may include lack of social bonding and support from family or friends. What if you are in a crisis and cannot receive help from the closest people in your life—your family and friends? What would you do? You may think it can never happen to you but that may not be the case. Homelessness can happen to anybody. Young, old, women, and men.

Today, Australia and most other developed nations face more issues with divorces, family breakdown, and higher rent for affordable housing. Due to the growing aging population, homelessness will become a rising issue because of the lack of money to build affordable housing or lack of space for seniors in existing homeless shelters.

ABC Australia reports that Australian older women outnumber the men in homeless shelters. In fact, 9% of single women over the age of 45 are in crisis accommodation and that number will continue to rise. The woman being interviewed by ABC makes it clear that it can happen to anybody. She notes that “there is a fine line between having a roof over your head and having nothing.” Imagine if you, from one day to another, lost everything and couldn’t turn to anyone.

The report “Homelessness and older Australians: Scoping the Issues” reports that there are systems in place in Australia that give the homeless population access to certain services. However, the homeless believe that their complex needs are not addressed. In addition, they have difficulties to access those services and obtain the needed information because the service system in itself is too complex. There needs to be an increased collaboration and integration of existing service departments.

Australia must think of sustainable ideas and strategies to increase and invest in the affordable housing stock. The government, non-governmental organizations and service providers also need to step up and create strategies to reduce the bureaucracy and make easier access to the services the homeless population needs easier.

Martina Lesperance
is a Health Educator and Screening Technician in El Paso, Texas.