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Training Older People Using Electronic Assistive Devices

Original Editor - Yara Peterko Top Contributors - Yara Peterko, İbrahim Seker, Lucinda hampton, Alexandra Stead, Vidya Acharya and Tolulope Adeniji

Introduction

The number of individuals aged 60 and over is estimated to increase twofold globally from 2015 to 2050, imposing a significant burden on international healthcare infrastructure.[1] Additionally, this population is contributing to the number of chronic diseases, such as ischemic heart disease, stroke, and chronic obstructive pulmonary disease (COPD), which are among the top causes of mortality alongside Alzheimer's disease, lung cancer, diabetes, chronic kidney disease, and cirrhosis.[1] Given these challenges, both patients and health professionals need long-term, cost-effective, and easier solutions, which has driven growing interest in digital health solutions as a way to deliver more sustainable and accessible care. These electronic devices are meant to make patients' lives easier, whether or not they have a clinical diagnosis.For people who have not used these kinds of devices before, it can be a huge barrier to learn how to use them before being able to experience the benefits they provide.

Rehabilitation professionals can play a significant role in supporting these people, many of whom are older people, to learn how to use these devices and to benefit from them in their daily life. Older people often report barriers such as unfamiliar terminology, dexterity limitations, sensory changes, and confidence concerns when learning new digital device.[2]

Electronic Assistive Devices for Supporting Ageing in Place

Ageing in place saves healthcare costs while supporting client goals, but age-related cognitive, sensory, and motor changes create independence barriers. Electronic devices bridge these gaps.

An older adult using a tablet computer to browse information and communicate with family members.

Common Devices Older Adults May Use

  • Basic Communication: Mobile phones and communication devices support emergency contact, social connection, and have been shown to significantly improve older adults' quality of life.
  • Smart Safety Features: Sensor-equipped devices with departure reminders and automatic fall detection with emergency calling help older adults remain safe in their home environment.
  • Independence Tools: Tablets enable older adults to manage daily tasks such as online shopping and email, and are particularly beneficial for those with mobility limitations who are unable to attend in-person appointments.

In terms of clinical reality, device variety is wide and highly individualised based on specific needs. However, the common challenge is learning to use these technologies before experiencing their benefits.

As rehabilitation professionals, understanding these devices helps you support clients in developing the motor skills, cognitive strategies, and confidence needed for successful technology adoption - directly supporting their ageing-in-place goals.[3][4][5] [6]

Barriers and Facilitators to Technology Use

Electronic devices require different skills in terms of use, such as hearing, memorising, sharp vision, and clear speech. A variety of internal factors can affect an individual's ability to use electronic devices, creating significant difficulties in engagement. Several internal factors can be categorised under cognitive impairment, motor, and sensory areas.[7]

Cognitive Changes

Cognitive impairments include reductions in working memory capacity, processing speed, and the ability to retain sequential information. Sensory decline is common as people age and can present significant barriers to engaging with digital devices.[7] Age-related vision impairment, including reduced visual acuity, contrast sensitivity, and conditions such as macular degeneration and cataracts, may make it difficult to read small on-screen text and distinguish interface elements.[7]

Sensory Changes

Hearing loss, one of the most prevalent age-related conditions, can further impede the use of audio-dependent device functions, including voice commands, notifications, and video call audio, creating additional barriers to engagement with technology.[8]

Motor and Dexterity Changes

Age-related decline in fine motor skills and manual dexterity can affect an older adult's ability to perform precise touchscreen interactions, including tapping small icons, executing multi-finger gestures, or maintaining a steady grip on a device.[9] Conditions such as arthritis, essential tremor, and reduced tactile sensitivity further contribute to these difficulties and are highly prevalent in older populations.[9]

External Barriers

there are a variety of barriers except internal factors, that are external factors such as limited digital literacy, lack of confidence, poor internet access, high costs, lack of integrated technical support, fears regarding privacy, mistrust, and dissatisfaction with existing services.[1]

Facilitators

On the other hand, the facilitators are user-friendly design and training, trusted health care provider endorsement and hybrid care models, perceived benefits of digital health and positive user experiences.[1]

Learning New Skills as an Older Adult

Learning something new at an older age differs from learning earlier during your life. Not only do cognitive abilities change, but also the motor and sensory abilities and functions decrease. This can lead to difficulties during the use of these devices.

An older adult practising independent device use during a supervised training session

The learning process for older people includes trial and error; because of that, learning new skills is highly challenging. For instance, after a certain age, people find it difficult to remember the sequence of steps, such as finding the “way back”.[1] In addition, they are often afraid of breaking a device and are therefore reluctant to simply try it and require training from an instructor.[1] Finally, longer-term use of the new technologies is also promoted if people are trained in how to use them.[1]

Learning success, the acquisition of new skills, is not only dependent on cognitive factors, but also directly related to motivation.[1] Rehabilitation professionals should therefore clearly explain the benefits of the device right from the start so that there is motivation to learn how to use it.

Conceptual Framework for Training and User Integration

Based on Yara Peterko's Master's thesis and supplemented by recent research,[1] [10][11] comprehensive four-step training framework supports older adults in developing the skills needed to use electronic assistive devices independently. This framework specifically targets the use of tablets for home system management, digital communication, and other daily activities.

  1. Information - Why should you be using it? What is the advantage of using it?
  2. Demonstration - What functions does the device have? This is how to use it.
  3. Try it - Self-awareness, test functions. Step by step with verbal assistance
  4. Feedback - Exchange about first experiences

Information

Evidence demonstrates that older adults are significantly more likely to engage with a new device when they understand its direct relevance to their health and daily life; providing clear, personalised information about the purpose and benefits of the device at the outset is therefore a critical first step in any training approach.[1] Additionally, simplifying complex relationships without concealing the function of the device is a crucial parameter. Furthermore, older adults are also interested in understanding how technology functions. To enhance understanding, both verbal instructions and device interfaces should use familiar, action-oriented terms like 'Call a friend' rather than abstract app names. Moreover, in the information phase, the barriers and facilitators have to be defined, informed, and motivated regarding the situation of the person and devices.[10]

Demonstration

Device functions must be demonstrated in advance to clearly show their relevance. Since older adults are primarily motivated by meaningful activities, it is crucial that the device includes and highlights features like communicating with relatives. For instance, instructors can install applications for breaking news or simple cognitive games to increase user engagement.[10] Additionally, cooperation with a health portal may also be possible, since older people also like to find out more about health topics online. Beyond these applications, instructors must also remember to demonstrate basic device functions, such as switching the device on and off and charging it.[1][10][11]

It is important that they can try it by themselves after they had an introduction and demonstration and then get to ask questions and to receive feedback

Try it

The supervised practice phase provides older adults with the opportunity to attempt device use in a supported environment. The professionals can provide immediate verbal guidance and reassurance. Additionally, when working with a group of people, it is good if the teaching team consists of two people. In this way, one person can explain in general, and the other person can support the learners at the same time. If the participants have very different previous knowledge or if there is a larger group, the number of teachers should be increased, or a division of the group should be considered. Evidence consistently identifies a fear of making errors and concerns about breaking the device as significant barriers to independent exploration of new technology in older adults. Allowing individuals to test each function step by step, starting from the same point in each session, reduces anxiety. Experiences with this process bring together motivation and can make further training more applicable.[10][1][11]

Feedback

The feedback phase serves both to consolidate learning and to sustain motivation; evidence suggests that personalised feedback, including acknowledgement of progress, correction of errors without attribution of blame, and reinforcement of the device's relevance to the individual's goals, is a key facilitator of ongoing engagement with digital health technologies in older adults.[1] Rehabilitation professionals are the best people to provide this feedback within their existing clinical knowledge, particularly given that endorsement from a trusted clinician has been identified as one of the strongest facilitators of technology adoption in this population.[12]

Ask - Explain - Invite - One on One - Understand - Approach (AEIOU Approach)

The AEIOU approach is a practitioner-developed communication framework designed to support instructors working with older adults who are new to digital technology. Each letter represents a sequential principle:

  • Ask about the individual's current experience and needs
  • Explain the purpose and benefit of the device in accessible language
  • Invite questions and active participation throughout
  • One-on-one, ensure time for individual support where needed
  • Understand the person's perspective, anxieties, and goals
  • Approach the session flexibly, adapting pace and method to the individual

The following video by Isabella Martinez introduces this framework and illustrates how each principle can be applied in practice.[13]



Things to Consider as an Instructor When Training Older People

Preparation and Planning

Establish Direct Relevance and Benefits: Older adults often have preconceived notions about new technologies, making it important to explain the specific benefits of each function.[1][10]

Anticipate Stumbling Blocks: Attention should be drawn to possible stumbling blocks in advance to prevent frustration and build user confidence.[1][10]

Creating a Safe and Trusting Environment

Build Trust and Address Privacy Fears: Mistrust and fears regarding privacy are noted barriers to technology use among older adults. Because endorsement from a trusted healthcare provider is a strong facilitator, instructors should utilise their trusted position to reassure users and clearly explain data privacy.[1][10]

Mitigate the Fear of Errors: Older learners often relate technical mistakes to themselves and fear they might have broken the device. This fear of making errors is a significant barrier to independent exploration. Instructors should check technical components in advance and focus on correcting errors without attributing blame to the user.[1][10]

Communication and Instruction Style

Eliminate Unfamiliar Terminology: Unfamiliar terminology is a major barrier when learning to use a new digital devices. Instructors should use consistently simple language and avoid computer jargon.[1][10]

Accommodate Physical and Sensory Changes: Ageing can decrease motor and sensory abilities, and older adults often report dexterity limitations and sensory changes as barriers to using digital tools. Instructors should ensure the training accounts for these physical needs, such as adjusting screen brightness or providing styluses for dexterity support.[1][10]

Avoid Trial and Error with Structured Guidance: Older people typically do not learn by trial and error. They require step-by-step instructions, including written manuals, and each individual tutorial should start from the exact same starting point (such as the home screen or desktop) to prevent confusion.[1][10]

Sustaining Engagement and Motivation

Provide Personalised Feedback and Reinforcement: Personalised feedback is a key facilitator for sustained engagement with digital health technologies. Instructors should acknowledge the user's progress and continually reinforce how the device aligns with the individual's specific goals.[1][10]

Encourage Learning: Older adults often like to learn in groups because it reassures them that they are not alone with their problems. Additionally, older adults often need more time to learn functions. Instructors should be patient, invite questions at any time, and provide materials like A5 notebooks and flashcards.[1][10]

Relevance for Rehabilitation Professionals

The rising global population over 60 and the number of chronic diseases are leading to a lack of healthcare facilities and posing a major public health burden.[1] These conditions typically require ongoing long-term management and monitoring, such as blood glucose tracking for diabetes, blood pressure tracking for cardiovascular disease and digital rehabilitation for older adults.[14] As a rehabilitation professional, to address these pressures, innovative strategies are needed to enhance chronic disease management, particularly in settings where health care access is limited.[15][16]

Additionally, rehabilitation professionals are likely to be training relevant skills with clients that they need to be able to use the device that is meant to support them. For instance, therapy frequently targets essential abilities such as fine motor skills, cognitive functions, and language comprehension.[12]

Even where a rehabilitation professional has not been directly involved in device selection, older adults are likely to seek guidance from the clinician they trust most and see most regularly. Furthermore, when rehabilitation professionals understand how to effectively assist clients with these devices, it significantly strengthens the therapeutic alliance between patient and therapist.[12] Lastly, healthcare providers can play a significant role in the client's use of the device by helping them to understand the functions, to see the benefits and to stay motivated.[12]

Additional Resources

[13]

Summary

Digital assistive devices are essential for supporting independent living in an ageing population, but older adults often face physical, cognitive, and psychological barriers to adopting them. To overcome this, they need structured, step-by-step training that emphasises clear personal benefits, avoids jargon, and provides blame-free, supervised practice rather than trial-and-error learning. Rehabilitation professionals are uniquely positioned to lead this training, as the fine motor and cognitive skills required to operate these devices perfectly align with standard clinical therapy goals.

References

  1. ↑ 1.00 1.01 1.02 1.03 1.04 1.05 1.06 1.07 1.08 1.09 1.10 1.11 1.12 1.13 1.14 1.15 1.16 1.17 1.18 1.19 1.20 1.21 1.22 Hepburn J, Williams L, McCann L. Barriers to and facilitators of digital health technology adoption among older adults with chronic diseases: updated systematic review. JMIR Aging. 2025;8:e80000. doi: 10.2196/80000
  2. ↑ Vaportzis E, Giatsi Clausen M, Gow AJ. Older adults experiences of learning to use tablet computers: A mixed methods study. Frontiers in psychology. 2018 Sep 3;9:1631.
  3. ↑ Cicirelli G, Marani R, Petitti A, Milella A, D'Orazio T. Ambient assisted living: a review of technologies, methodologies and future perspectives for healthy aging of population. Sensors (Basel). 2021;21(10):3549.
  4. ↑ Naudé B, Rigaud AS, Pino M. Video calls for older adults: a narrative review of experiments involving older adults in elderly care institutions. Front Public Health. 2022;9:751150.
  5. ↑ Harris MT, Blocker KA, Rogers WA. Older adults and smart technology: facilitators and barriers to use. Front Comput Sci. 2022;4:835927.
  6. ↑ Ziefle, M., & Bay, S. (2005). How older adults meet complexity: Aging effects on the usability of different mobile phones. Behaviour & Information Technology, 24(5), 375–389. doi:10.1080/0144929042000320009
  7. ↑ 7.0 7.1 7.2 Pelegrini-Pinto L, Calero MD, Navarro E. What happens to cognition and the daily use of technology in older adults? Working memory as a key cognitive function. Front Aging Neurosci. 2025.
  8. ↑ Swenor BK, Godfrey KM, Munoz BE, et al. Everyday challenges for individuals ageing with vision impairment: technology implications. Gerontologist. 2024;64(6):gnad169.
  9. ↑ 9.0 9.1 Wilson SA, Byrne P, Rodgers SE, Maden M. Systematic review of smartphone and tablet use by older adults with and without cognitive impairment. Innov Aging. 2022;6(2):igac002.
  10. ↑ 10.00 10.01 10.02 10.03 10.04 10.05 10.06 10.07 10.08 10.09 10.10 10.11 10.12 10.13 Peterko, Y., Ritschl, V. (2014). Die Schulung von älteren Personen im Umgang mit AAL- Technologie. Schulungsentwicklung anhand des Instructional System Design. Masterarbeit FH Wiener Neustadt
  11. ↑ 11.0 11.1 11.2 Pol M, Poerbodipoero S, Robben S, et al. Perspectives of rehabilitation professionals on implementing a validated home telerehabilitation intervention for older adults in geriatric rehabilitation: multisite focus group study. JMIR Rehabil Assist Technol. 2023;10:e44498.
  12. ↑ 12.0 12.1 12.2 12.3 Jain SR, Sui Y, Ng CH, Chen ZX, Goh LH, Shorey S. Patients' and healthcare professionals' perspectives towards technology-assisted diabetes self-management education. A qualitative systematic review. PLoS One. 2020;15(8):e0237647.
  13. ↑ 13.0 13.1 Isabella Martinez. Helping Seniors Cross the Digital Divide. Available from: https://www.youtube.com/watch?v=rSWbgNAgAE8 [last accessed 12/7/2022]
  14. ↑ Samal L, Fu HN, Camara DS, Wang J, Bierman AS, Dorr DA. Health information technology to improve care for people with multiple chronic conditions. Health Serv Res. 2021;56:1006-36.
  15. ↑ Ballesta García I, García Irles M, Domingo Espi M, et al. Wearable devices for remote monitoring of chronic diseases: systematic review. JMIR mHealth uHealth. 2026;14:e74071.
  16. ↑ World Health Organization. Global Strategy on Digital Health 2020–2025 [Internet]. Geneva: WHO; 2021 [cited 2025 May 29]. Available from: https://www.who.int/docs/default-source/documents/gs4dhdaa2a9f352b0445bafbc79ca799dce4d.pdf
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