Addressing Access to Care in Diverse Older Adult Populations Using Information and Communication Technologies

KEYWORDS:

• Caregiver
• Digital
• Technology
• Telehealth

Dear fellow clinical gerontologists,

Information and communication technologies (ICTs) have the potential to support mental health of underserved populations of older adults and their caregivers. ICTs span many domains including social networks, mobile applications, digital sensing, social robots, and telehealth interventions (Aceto et al., 2018). These technologies hold promise for addressing inequalities among diverse older adults in underserved populations and communities; however, technologies also may widen existing inequities due to differential access to devices and broadband and/or lower digital literacy. Thus, these interventions may pose special challenges for persons living in rural areas and for older adults from diverse racial, cultural, or social identities who often face barriers accessing and using technology in their daily lives. This special issue compiles a number of investigations regarding the use of ICT in assessing, delivering, and facilitating behavioral health, mental health, and self-management services for older adults and their caregivers.

This special issue begins with two studies that remotely deliver cognitive training programs to support brain health. DAmico et al., (2022) describe the feasibility and acceptability of a guided e-learning memory intervention in a study of 139 healthy older adults. This and the following study by Stypulkowski et al., (2023) highlight how internet-based interventions or video telehealth could be used to increase access to brain health and memory care for patients who might not otherwise have access to it.

The next series of studies in this issue focuses on caregivers and/or persons living with cognitive impairment. Rosell et al., (2023) describe Internet use by informal caregivers in Chile, with findings pointing to characteristics such as older age and lower education being associated with reduced Internet use. These findings highlight the risk of digital exclusion among older informal caregivers that indicates a need to consider access and digital literacy in this population. Montoro-Rodriguez et al., (2023) present a randomized controlled trial of the Caregiver Thrive, Learn & Connect program as adapted for video telehealth delivery compared with a waitlist group intervention. Perales-Puchalt et al., (2022) used a text-messaging based intervention, CuidaText, to successfully deliver psychoeducational and tailored text messages to 31 Latino familial caregivers. Other studies in this series examined the use of a mindfulness mobile application by 15 caregivers of older adults with cognitive impairment (Llaneza et al., 2022) and an in-home ambient sensing system for detecting falls and wandering in care recipients (Levenson et al., 2023). Iyer et al. (2023) describe an e-consultation program that delivers specialty dementia care to Veterans residing in rural communities. Another study (Greenaway et al., 2023) investigated the feasibility and psychometrics of webcam-based eye tracking technology to detect attentional biases among older adults with Alzheimer’s disease, potentially allowing for future ways of examining the perceptions and experience of living with this disease.

The next series of studies in this special issue focus on ICT interventions for mental health conditions, chronic pain, or loneliness. Alfaro et al., (2022) describe a coaching program to help older Veterans learn to utilize VA mental health mobile apps. Then, two studies provide evidence for the value of telehealth interventions for chronic pain through a study of brief Cognitive Behavior Therapy for Chronic Pain delivered in a group telehealth setting (Martinson et al., 2023) and telehealth-delivered emotional awareness and expression therapy (Yarns et al., 2022). The final studies use varied technological approaches for reducing loneliness, including providing tablets to family caregivers to access caregiver support resources (Nguyen et al., 2022), trialing social robots for a small study of older adults in South Korea (Lee et al., 2022), and implementing virtual group-based support for older adults in residential care in a Canadian study (Millett et al., 2022)

The COVID-19 pandemic has underscored the need for innovative approaches to delivering supportive services to caregivers and mental health services to older adults through periods of social isolation and decreased access to in person care. These 15 articles highlight the potential for ICT to expand access to assessment, monitoring, and supportive mental and behavioral health services for caregivers and older adults. This special issue encompasses a myriad of technologies and approaches being used to increase older adults’ and caregivers’ access to evidence informed care. Additionally, these papers suggest areas of further study, such as addressing digital literacy, in order to prevent digital exclusion, particularly for diverse populations of older adults as well as the oldest old. Finally, the innovative ICT approaches discussed in this issue underscore the importance of integrating ICT across the care continuum where older adults and their caregivers receive care. We thank all the authors for their contributions to this special issue.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

The contents do not represent the views of the US Department of Veterans Affairs or the United States Government.