Bridging the Therapeutic Divide: Age and Disability Discrimination in Tech-Based Health Settings
By Chorong Park
The intersection of ableism, ageism, technoableism, and metaeugenics reduce the accessibility and quality of health care for elders with disability experience.
They struggle with health care technology that is not built with their user profile in mind. Similarly, assistive technologies are focused on “normalizing” them to “improve” their abilities. Therapy that normalizes, or “corrects” for, disabilities are seen as “help.” Technologies are developed to reduce the burden on caregivers, and not solely for people with disabilities.
Contrastingly, technology for young people is often focused on joy and excitement. The suffering of older adults when using technology is not considered important. The technology that enables therapeutic and supportive environments (e.g., online communities such as Reddit and Discord) for people who seek help are mainly suitable for young people. The support systems that are available online are more difficult and frustrating to use for older adults.
The tendency to exclude older adults in the design process of technology is accelerating gaps in health care access and quality of life.
For example, in both South Korea and Japan, it is widely advertised that kiosks in doctor’s offices and hospitals can reduce labor costs while increasing efficiency for patients. Kiosks are touch screen-based interactive machines for patients to use, which minimize human interactions. Hospitals in South Korea have kiosks for patients to register information, and pay and print out prescriptions and bills. In South Korea, the humorous alternative term for kiosks is “the totem that chases away older adults and people with disabilities.”
When older adults go to register to see a doctor, they either wait hours to register in-person, or need to deal with the “totem.” This often results in feelings of frustration, challenges, and a sense of humiliation. They often say, “I cannot go to hospital without my kids.” Elderly individuals with questions regarding kiosks often get blamed for adding more workload for non-medical workers at hospitals, such as receptionists.
The cold attitudes toward elderly people who feel frustrated by the “totem” are based in ageism, ableism, metaeugenics, and technoableism. Seniors are perceived as a burden and as incompetent, due to physical or cognitive disabilities. Without considering the physical and cognitive issues they are undergoing, such as reduced dexterity and vision issues, blaming them as incapable is unjust. Kiosks are designed without consideration for user groups that include people with disabilities and older adults.
Instead of supporting older adults to thrive and share their unique abilities and knowledge built over the years, they are often treated poorly and unjustly categorized under the notion of metaeugenics that “older adults are somewhat broken, and there’s not much we can do.” Illness and disability are seen as a natural process of aging. This leads to the false notion that illness is intrinsic to their nature, and they should not seek or may not necessarily need assistance.
Similarly, another stereotype of aging suggests that older individuals must be tougher and more resilient to pain compared to younger generations. Regardless of age, pain and illness have a significant effect on an individual’s quality of life. Older adults might develop more effective coping mechanisms for dealing with pain compared to younger people. Nevertheless, older age does not indicate the pain that one experiences is less (or less important) than that which people who are younger would experience. It is viewed as unfortunate when young people get sick; they are received with stronger empathy and sympathy. Older individuals’ pain and decreases in quality of life due to illness and disability should be given equal consideration as younger individuals.
The false belief that illness is a natural part of aging, and older adults have a higher pain tolerance can lead to unequal treatment in health care between older adults and younger people. It is seen as “normal” for elderly people to have depression and loneliness. Not only is it more difficult to detect symptoms in older adults when the false belief prevails that it is “normal” to be sick when old, but also, this population may be unlikely to share their health concerns due to the same misconception.
It is likely for older adults to believe this same misconception because of the unclear blueprint of the journey of aging. The transition into becoming an older adult who may need a higher level of care due to their age and disability status is not well-supported, and it can be confusing and frustrating.
We’re missing a structured roadmap for dealing with changes in one’s body from a young person to an older adult. This needs to be addressed in the supportive and therapeutic environments in which young people and older adults find themselves, with a particular focus on educating people with less technology fluency, including people with disabilities and people of color.
The main reason why these groups are less familiar with technology is that they are excluded from consideration as the main users of a given technology. This habit of technoableism and exclusion will continue, with significant health effects, especially for elderly with disabilities. Put simply, there is a gap in medical technology design where it is not a primary concern if elderly people can’t use it, because it is less significant for them to receive medical care compared to younger people. As future health care technology increasingly will require people to have a certain level of technological fluency, these groups will have even less access to health care
I hope the misguided notion of “older adults are somewhat broken, and there’s not much we can do” can be changed to “It’s okay to be elderly, and there must be something we can do to reduce the gap in current and future therapeutic, tech-enabled environments for them.”
Chorong Park, a Ph.D. candidate at Purdue University, aims to improve technology usability and accessibility for individuals with disabilities, including older adults and those with dementia, to enhance their well-being and happiness.
