How does technology influence issues of stress associated with aging and mental health?

How does technology influence issues of stress associated with aging and mental health?

(Wanck, 2017)

““As I started getting older, I realized, ‘I’m so happy!’ I didn’t expect this! I wasn’t happy when I was young”.

Jane Fonda – Oscars Speech

Mental health issues and issues of aging can be brought on by stressful life events (Segal et al., 2018). These events are fluid and change with age and/or mental disorder (Segal et al., 2018). 

Stress has been linked to suppression of the immune system, poor disease prognosis and negative perceptions of aging (Segal et al., 2018). Minimizing the effects of stress is key. But does technology improve coping skills and resilience?

Coping strategies can be protective against the effects of compounded stressful events and cognitive elements of the stress process when the older adult is able to better manage stress and adapt to change (Touhy et al., 2014). Touhy et al. (2014) has suggested that improved coping tactics can be protective against illnesses such as depression. WHO (2015) has also highlighted that effective coping tactics can lead to problem reframing, deficit mitigation and positive outcomes that include improves psychological reserves; which are instrumental to speedy recovery in cases of physical injury).

Successful coping occurs due to three factors: encountered stressors, unique vulnerabilities, and protective factors (Segal et al., 2018). The stress and coping theory surmises that technology can enhance care and act as a defensive factor to stress and mental illness by teaching individuals how to use of effective coping mechanisms (Segal et al., 2018). Subsequently this education can also increase older adults’ sense of control over the changing situations of stress (Segal et al., 2018).

The stress and coping model also highlights factors of strain, stressors and interactions as routes to ineffective coping strategies, and that factor modification is needed for the older adult to develop resilience to dysfunctional stressors (Segal et al., 2018). The continuity theory of aging suggests that these adaption strategies to normal aging changes through technological supports promote resilience, a positive sense of self, and patterns of consistent identity and self-esteem (Touhy et al., 2014, p. 92).

(Adobe Stock, 2017)

Touhy et al. (2012) suggests that effective coping strategies and resilience are vital to mental wellness, and that assistive technologies (ie. mobile applications, podcasts, social media websites, and robotic therapy animals) can be the non-pharmacological link between the older adult and improved coping strategies. These adaptive changes can create changes within the interactions between the individual and their environment and the older adult’s daily life.

Touhy et al. (2014) posits that inadequate coping mechanisms can be improved by forms of health promotion and by advances of individual resilience, and indicates that, to spark this change, coping strategies and environmental stressors must be assessed and supportive therapy must be implemented.

The stress and coping model also highlight factors of strain, stressors and interactions as routes to ineffective coping strategies, and that factor modification is needed for the older adult to develop resilience to dysfunctional stressors (Segal et al., 2018). The continuity theory of aging also suggests that adaption strategies to normal aging changes are critical to positive actions (eg. decision making), and that by supporting protective factors of resilience; positive sense of self, identity and self-esteem can be solidified as patterns of consistency (Touhy et al., 2014, p. 92). These adaptive changes can occur with changes to interactions between the individual and their environment, such as with the addition of a form of assistive technology within the older adult’s daily life.

(Naumov, 2020a)

Bryant et al. (2012) suggests that effective coping strategies and resilience are vital to mental wellness, and that assistive technologies – such as mobile applications, podcasts, social media websites, and robotic therapy animals – can be the non-pharmacological link between the older adult and improved coping strategies. Touhy et al. (2014) agrees that inadequate coping mechanisms can be improved by forms of health promotion and by advances of individual resilience, and indicates that, to spark this change, coping strategies and environmental stressors must be assessed and supportive therapy must be implemented.

Assistive technology can assess the two aspects of life stresses (the subjective and objective indicators of stress) by targeting older adults’ chronic strains, vulnerabilities, and personal protective resources (Segal et al., 2018). Mobile applications that provide older adults with questionnaires and checklists (eg. the Elder life stress inventory) can assess dispositional coping – the older adult’s current pattern of coping – explore individual values and act as social resources (Segal et al., 2018). These resources can guide individuals to a self-assessment of their own coping skills, which can lead to insight, positive attitudes towards aging, social participation, and decreased perceived effect of personal stressors. Assessing individual resources can also further the treatment process by helping to implement a treatment plan for the older adult with or without mental illness seeking support towards mental wellness (Segal et al., 2018).

(Naumov, 2020b)

The perceived stress scale google play app and the digital mindfulness podcast are practical examples of digital tools that allow for insight and self reflection. Other stress relieving applications are available online, and many are easy to use and free.

These applications can help effective therapies to impact the older adult suffering from contexts of stress. Cognitive bibliotherapy – CBT self administered therapy, and life review therapy are all treatments that can be done anywhere and with cell phones and tablets (Touhy et al., 2014). These technologies are a big part of daily life – why not use them to aid therapy delivery.

In the course readings, Bryant et al. (2012) investigated how social support is a buffer for stress, and connections are made between positive attitudes of aging, physical and emotional wellbeing and the maintenance of social connection, which is encouraged. Segal et al. (2018)  also summarized social support (which could be in the form of a Facebook social media group for older adults suffering from depression) is a means to a shared sense of experience, and the first step to life reconstruction. Text message programs (eg. mAgeing; a WHO texting intervention that encourages personalized care provider interactions with older adults) work in a similar way providing social support in periods of crisis (World Health Organization, 2018). Segal et al. (2018) implies that messages that encourage self-reliance also provide advice as to how to maintain sense of control and limit the damage of stressful events that may be occurring due to the aging process and processes of mental illness.  

Damodaran et al. (2014) further reports that assistive devices that help older adults to achieve emotional wellness can also assist seniors with chronic illness to regain independence. Damodaran et al. (2014) posited that teaching coping skills with assistive technology could improve older adults’ knowledge and understanding about their own capabilities, by highlighting individual strengths and interests and the limits of their illness. Since chronic stress can impair overall health status and immune functioning of the older adult, applications that aid to identify individual needs through mobile therapies (eg. ACT therapy, which seeks to encourage the older adult to change what they can control and accept what they cannot control) can reduce perceived struggle from chronic illness and improve an individual’s dedication to value directed variations of behaviour (Segal et al., 2018).

(Carrie Stephens Art, 2020)

Assistive technology interventions are also a non-pharmacological solution. It is important to mention the link between pharmaceutical treatments and increased depression amongst older adults, Prescribed medications are commonly used in older adults to treat mental illness issues such as depression with mixed effect (Touhy et al., 2014). Medication is only an effective treatment for approximately half of the older adults they are prescribed to; which means that non-pharmacological solutions – like those including assistive technology – are in high demand (Touhy et al., 2014). The significant prevalence of anxiety disorders and depression in later life can be combatted by use of assistive technology (Touhy et al., 2014, p. 435).

For example, the non-pharmacological treatment of regular exercise has been established, using assistive technology, as an effective treatment to depression related disorders. Free assistive tech apps that encourage daily workout routines now include ones that signal your phone at a time that you decide is right for you. Assistive technology can identify individual needs based off of symptoms of depression specific more commonly seen in older adults (weight loss, memory loss and insomnia) and provide motivation to exercise, which can improve the older adults perception of control over their own treatment (Touhy et al., 2014).

Creation of assistive technology can finally lead to promotion and continued digital engagement. Damodaran et al. (2014). This has been made a reality with such inventions as TomBot; a robotic dog that has been determined an effective intervention to help older adults navigate through issues of aging and mental health illnesses (eg the memory loss that accompanies dementia) (CBS Los Angeles,2019). By acting as social support, the technology can help older adults cope with stressful situations of change and discomfort, and act as constant in a world of changing stressors. With additional means to realize their personal potential, older adults can learn to cope successfully with stress reduction support (World Health Organization, 2018). This added constant can increase perception of personal control, coping capacity and it can promote feelings of safety and perceived independence (Segal et al., 2018). Those topics are what we will discuss next week.

(CBS Los Angeles, 2019)

Overall, awareness of the stress and coping perspective and the continuity theory of aging help us to understand the complex stress and coping process (Segal et al., 2018). The lifespan developmental perspective expresses stress and coping processes as fluid and allows for reflection about how we can use technology to adapt and develop personal resilience to stress (Segal et al., 2018). The stress and coping framework details the link between technology and the evolution of coping skills. Segal et al. (2018) notes – through the lens of this framework – how resources such as mindfulness or relaxation applications can be used to map out paths to emotional wellness, and reduce stressors of mental health illness such as anxiety and depression.

Specialized senior mental health services are in short supply, and the barrier of inaccessibility can limit effective coping strategy maintenance and adaptation (Touhy et al., 2014). Accessibility can be enhanced through phone and online apps, and assistive devices can maintain emotional wellness through older adult aging and mental health issues as they arise. Assistive devices should be implemented in all settings because they can bring therapeutic benefits to the older adults without geographical limitations (Touhy et al., 2014, p. 411). Assistive technology can harness this process and motivate older adults towards action, self-reflection and positive perceptions of aging and mental illness.

References

Adobe Stock. (2017). [Online image of woman blowing kiss]. nextavenue. http://www.nextavenue.org/loneliness-isolation-age/

Bryant, C., Bei, B., Gilson, K., Komiti, A,. Jackson, H., & Judd, F. (2012). The relationship between attitudes to aging and physical and mental health in older adults. International Psychogeriatrics, 24(10), 1674-83. https://doi.org/10.1017/S1041610212000774

Carrie Stephens Art. (2020). [Online Image]. University of California, San Francisco Department of Psychiatry and Behavioral Sciences. https://psychiatry.ucsf.edu/copingresources/covid19

CBS Los Angeles. (2019, April 26). This adorable therapy dog — isn’t a dog at all [Video]. Youtube. https://www.youtube.com/watch?v=2TcmjSYNaFo

Damodaran, L., Olphert, C. W., & Sandhu, J. (2014). Falling off the bandwagon? Exploring the challenges to sustained digital engagement by older people. Gerontology, 60(2), 163-73. https://doi.org/10.1159/000357431

Hill, S (2020). Virtual Reality for Health & Wellbeing with Sarah Hill [Audio podcast]. The Digital Mindfulness Podcast. https://digitalmindfulness.net/

Naumov, E. (2020a). Old lady travelling and texting [Online image]. 123rf Contributors. https://www.123rf.com/photo_61069073_stock-vector-old-lady-travelling-and-texting-bright-color-cartoon-simple-style-flat-vector-sticker-isolated-on-wh.html

Naumov, E. (2020b). Old woman listening music from smartphone [Online image]. 123rf Contributors. https://www.123rf.com/photo_61008593_stock-vector-old-woman-listening-music-from-smartphone-bright-color-cartoon-simple-style-flat-vector-sticker-isol.html

Scott, E. (2019). Using stress relief apps to transform your life. Very Well Mind. https://www.verywellmind.com/stress-relief-apps-that-can-transform-your-life-4147565

Segal, Daniel & Qualls, Sara & Smyer, Michael. (2018). Aging and mental health (3rd ed.). Wiley-Blackwell

Touhy, T. A., Jett, K. F., & Ebersole, P. (2014). Ebersole and Hess’ gerontological nursing & healthy aging. (4th ed.). Elsevier/Mosby.

Wanck, B. (2017). The 3 A’s of Successful Coping [Online image]. LinkedIn. https://www.linkedin.com/pulse/3-successful-coping-bick-wanck-md/

World Health Organization. (2015). World report on ageing and health. https://www.who.int/life-course/publications/2015-ageing-report/en/#:~:text=The%20World%20report%20on%20ageing,person%2Dcentred%20and%20integrated%20care.

World Health Organization. (2018). Be he@lthy, be mobile: A handbook on how to implement mAgeing. World Health Organization. https://www.who.int/ageing/health-systems/mAgeing/mAgeing-handbook-April2018.PDF?ua=1

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