23 September 2021
To help celebrate the United Nations International Day of Older Persons - 1 October 2021 – the theme being digital equity for older people. I thought it appropriate to write an update on my mother's progress using her iPad, here's a link to the first case study about my mum and her iPad.
Now that we’re no longer in a crisis my (fully vaccinated) mother feels comfortable and safe about going out food shopping, exercising outside and seeing friends again, but the downside is she has become unmotivated to use her iPad.
I think I have heard every excuse possible about why she doesn’t need an iPad anymore. I find this so disheartening, that she still doesn’t have any incentive to pick it up and be inquisitive about it. I feel I have failed and that my enthusiasm for her to use it just isn’t rubbing off onto her. One reason for this is that her peers aren’t talking enthusiastically about technology and she’s not communicating with them what she has learnt, so there is almost a cycle of un-learning. It is quite obvious that, during the Covid crisis, the lockdowns have made my mum’s world very small and she isn’t using her brain in the way that she was.
We meet every weekend and I ask her to bring her iPad with her every visit. Mum is in good health and has a lively mind but her iPad is still sadly not part of her daily routine. Mum now has a small table and stand for her iPad so this is progress, one of her excuses was that she couldn’t see the screen or the buttons very well so a raised table that can be pulled into her chair, over the arms, allowing her to see the screen better.
Our next mission is to buy her a keyboard. She said she’d find it easier to type on a keyboard rather than the screen, so that’s another barrier to tackle. Mum has been a secretary her whole working life so using a keyboard might be more instinctive and learnt behaviour, some things like caps-lock will come back to her.
It feels like breakthrough when mum takes her iPad out of its case and flips the screen cover over - she can now rattle off the passcode. Mum even says that her heart no longer races and she’s far less anxious when accessing her iPad. Her first reaction, once she’s lifted the lid, is usually bafflement at all the icons / apps. It takes a moment for her to reacquaint herself with them all. I have tried to keep them to a minimum. I ask her to think of something she would like to listen to or watch. She’s keen on ballet, old films and detective series on the TV. Although we have done this together numerous times, Mum somehow doesn’t recall how to watch, what the actions mean and so on. It takes at least five minutes of looking at the screen before mum recognises and presses the youtube app, I never point it out or try and hurry her. I have to remind mum to use her finger to tap in the small search box where she can type in a search term (a ballet dance or dance group). But she doesn’t read any of the results, she just randomly taps on an image of a ballet dancer in costume, not noticing that some videos are only 1:30 minutes long and some are over an hour. Once she’s selected a video I show Mum the icon to make the video full-screen but it’s a very small icon that she can barely see.
The fun begins when we enact an interruption whilst she’s watching the ballet. We pretend that it could be the phone ringing or doorbell or the overwhelming need for a cuppa! Mum has no idea how to stop or pause the video playing, her immediate reaction is to press the home key (a physical button is what she’s looking for). To me it is so blatantly obvious to tap the screen if you want to pause play, but that was clearly not at all obvious to her! I ask her to tap the screen anywhere on the screen and then press the pause key. I explained that the pause button looks the same as on any physical video remote handset. By the time she’s clear that she must press pause, the pause button disappears as she’s taken too long to tap it. I say to her that she has to be quick, once she’s tapped the screen, immediately tap the pause sign on the screen. This takes a lot of goes until she confidently taps the screen and then touches the pause button. I explain that you might touch the screen accidently but hadn’t intended to pause/stop etc., so the instruction only appears on screen for a fleeting moment. We go through the same routine when she wants to start playing it again from where she’d left off. After our Youtube lesson, asking mum to find the buttons to turn her iPad up and down to hear the ballet was an instruction too much. She tried to pause the screen by pressing the sound buttons. Mum has a real need to touch a physical button and this is a hard habit to break.
I do set her homework. I have asked her to ask Siri a question. I regularly tell her the command word to raise Siri. Mum will sit there and think for a bit and then politely say “Hello Siri” with no response. I know that she’s forgotten what the word is to get Siri to appear on screen. She also knows that if she holds the home key too long then that prompts Siri to speak, she has done this a lot accidently. To get mum to remember the prompt to raise Siri we ask “What do horses eat?” and then she immediately says “Hey Siri” and then asks a question, usually what the weather is today. Mum always, without fail, politely thanks Siri and remarks how knowledgeable he is.
Instead of using the home phone to ring my mum, I now try to FaceTime her. But it has taken months for her to remember how to answer when I call. Mum still tends to ring me using her landline, but she has tried a couple of times to FaceTime me and I’ve massively congratulated her, no matter what I’m in the middle of – I want to reassure her that it’s fine to contact me this way. She’s really keen to see my face and I find it reassuring seeing her and hearing about her day.
I find my mum’s use of the iPad is very passive. I have to steer her with it or suggest things she can do with it, repeating simple tasks over and over again. My mother is always apologising about her slowness, staring bewilderingly at the screen. We have had long conversations about trying to change her mindset, to think that she can do a task, and also that she needs to be inquisitive and questioning.
The tech terminology still makes my mum anxious. For instance, I asked her whether she’d like a zoom account so she can talk to my sister as my sister uses android. Mum’s instant reaction was negative because she associates ‘account’ with spending money. I have since learnt to ask her if she would like a ‘free account’ and this is far less daunting. Of course, my mum will think about the old meaning of account and worry about wracking up debt. Explaining to her that an account can be upgraded to a paid account, which then offers more functionality, is a difficult concept and a step too far. When our iPad session is done, I take charge of closing opened apps and checking for updates, but mum is happy to charge it up and it’s always on full battery when we start another session.
Nothing can beat face-to-face contact for mum but the iPad has allowed her more flexibility on how she goes about her daily life. She’s comfortable viewing the tv scheduling app and looking at email now. We will try to maintain a monthly online grocery shop.
The NHS app allows patients more flexibility about how they access their GP and prescriptions, so I’m keen to encourage mum to use the NHS app more fully. Mum may need to rely on her iPad as she gets older, when she might not be as fit and able, and it could even assist in an emergency.
The added consequence of the pandemic, and it is more extreme in my mother's generation, is her being 'deconditioned', her world has become very small. This has been done to her as a consequence of lockdowns to keep her safe but mentally this hasn't help her cognitively. Hence learning to use technology has seemed even harder.
Mum’s lesson this week will involve ordering a pack of lateral flow tests. I know the big green buttons on screen mean nothing to her unless I prompt her to tap them. It's ongoing but we're getting there. She's just asked me if she's the only older person struggling with technology. I reassured her that she isn't alone!
Find out more about our work at Wessex AHSN as we celebrate the International Day of Older Persons