A physician in a white coat is sitting in front of a computer to do a virtual appointment via telehealth. Better than using smartphones!
Dr. Charles Sawyer, 88, transitioned to telemedicine amidst the coronavirus pandemic. Photo credit: Monica Bracy.

By Thomas Goldsmith

As tech-literate adults age, older people in North Carolina and elsewhere are feeling more at home with computers these days. But as technology becomes increasingly complex, these same people often run into problems using smartphones, according to national numbers and leaders of Tar Heel senior centers.

Nationally, about three in four people 65 and older  use the internet, compared to virtually all people between 18 and 29. Growing computer skills among older people makes sense given the widespread use of technology in business and academia. But the smartphone use that’s virtually universal among the young only includes three out of five older people and can pose both operational and medical problems for them.

That’s the word from researchers and people including Brandi Bohanan, director of the Thomas A. Baum Senior Center in Dare County on the Outer Banks. She says requests for help with smartphones outpace asks for computer instruction among her members. So, what sort of issues require help for members?  

“It’s all or nothing,” Bohanan said during a recent telephone interview. “What I’ve found is people either really know how to use it or they don’t even know how to turn it on.

“When we do a class we’ll do basic instruction on, ‘This is how you turn it on; this is what data is,’” she continued. “We break it up into the difference between iOS and Android. Because if they’ve got an iPhone, it’s different from if they’ve got a Samsung.”

About 30 percent of people older than 65 have a cell phone but not a smartphone, according to Pew Research surveys. Geriatricians say that problems with using a smartphone, when someone was previously competent with them, can be an early indicator of dementia. Lon Schneider, a professor of psychiatry and neurology at the University of Southern California, told Kaiser Health News that older people with Alzheimer’s just stop using their smartphones as they lose the ability to operate them. 

Derrick Heffner, a U.S. Army veteran, has been recently hired at East Wake Senior Center in Wendell to offer one-on-one classes with members. A memorable recent contact involved an older woman, originally from Italy, who found her Android phone just too complicated.

“I want simple — I just want simple,” Heffner said she told him. 

Technical advisor Heffner suggested that she switch to the JitterBug phone made by the GreatCall company, now owned by Best Buy. The simplified phone worked fine with one catch: It had no GPS function and the GPS in her Nissan was outdated. So, Heffner coached her through getting the dealership to install new software free, and she’s on the road again.  

Watch out for scams, seniors

Kristen Brannock is vice president of Resources for Seniors, a Wake County agency with roles including coordinating the use of state home and community care block grants. Presiding over a recent senior center members forum, she agreed about the necessity of more instruction for older people on smartphone use, with a caveat. 

“We have to be really careful as to the folks that we bring in the door,” Brannock said, referring to the center’s use of telecommunications providers to offer instruction.  “They can’t be salespeople.”

An ongoing hazard of cell and smartphone use remains the enduring plague of scam artists. These criminals often adapt their pitches to older people, while making a practice out of scams that target the latest technology and financial instruments.

One survey published in May found that nationwide, the number of daily spam calls received by a smartphone user was 3.7 per day, while those same users received 1.7 spam texts per day. Of the more than 1,600 people surveyed, fully 71 percent feared that grandparents or older relatives would become targets for scammers. 

“Cryptocurrency is becoming more popular,” reads a warning on the North Carolina Department of Justice website. “Naturally, that means fraudsters are increasing their efforts to scam you and lock you out of your account by using hacking bots. Cryptocurrency is new – don’t let it be the reason you get scammed.”

In a recent report, DOJ cited 1,249 instances of scams targeted at older people across the state in 2019-2020, making it the fourth most common crime targeted toward consumers.

When using a smartphone can be painful

Health-related problems may arise from conditions that increase in incidence in old age, according to a raft of studies.

These conditions include hearing loss: “Approximately one in three people between the ages of 65 and 74 has hearing loss, and nearly half of those older than 75 has difficulty hearing,” according to the National Institutes of Health. “But, some people may not want to admit they have trouble hearing.”

In addition, some conditions mean a person’s hands no longer work at peak efficiency.

Even small differences in hand movements can affect a person’s ability to press the buttons on a phone, according to NIH: “Elderly participants developed fatigue rapidly and tapped more slowly when operating on smaller buttons and moving in the flexion–extension (compared with adduction–abduction) orientation. (In adduction-abduction movement, the thumb moves within the plane of the hand. In flexion-extension the thumb moves outside the plane of the hand, as seen in this video.)

According to the Johns Hopkins School of Medicine, the condition scleroderma can cause symptoms such as swelling and thickening of skin in fingers, painful joints, large areas of darker taut skin, and fingers that become limited in mobility or even immobile. Any of these changes could inhibit smartphone usage. Not to mention increasing incidence of arthritis as people age. 

‘We live on the beach’

Back at the Outer Banks, senior center director Bohanan says advances in technology use will march on for older people.

“What’s happened is people have self-taught if they weren’t already literate with both computers and cell phones, because it became a necessity,” she said. “I’ve been here 20 years and I found that 20 years ago, I’d say probably 75 percent of our folks didn’t even have email. Now it’s closer to 90 to 95 percent have email or have a family member that does. And they almost all have cell phones now.” 

She said a few years back they were teaching computer basics to folks who were just getting a desktop or laptop installed. In Dare County, she noted, computers aren’t a convenience, they’re often a necessity. 

“We kind of live on a peninsula; we live on the beach where we’re so far away from everything that they are kind of cut off if they don’t have that,” Bohanan said. 

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Thomas Goldsmith

Thomas Goldsmith worked in daily newspapers for 33 years before joining North Carolina Health News. Goldsmith is a native Tar Heel who attended the UNC-Chapel Hill, and worked at newspapers in Tennessee...