Self-Care Practices of Older Adults Living Independently: An Interview Study

Core Concepts

Older adults living independently engage in a wide range of self-care practices across physical, emotional, psychological, social, and leisure domains, often modifying activities and utilizing technology to maintain independence and well-being.

Abstract

• Bibliographic Information: Casey, B., Marston, G., & Vyas, D. (2025). Self-Care Practices in the context of Older Adults Living Independently. Proceedings of the ACM on Human-Computer Interaction. Volume 9, GROUP, Article 26. https://doi.org/10.1145/3701205
• Research Objective: This qualitative study aimed to understand how older adults living independently practice self-care and how assistive technology could be designed to support these practices.
• Methodology: Semi-structured interviews were conducted with 12 older adults (aged 65-97) living independently in and around a retirement village in Australia. Interviews focused on participants' self-care practices across five domains: physical, emotional and psychological, social, leisure, and spiritual.
• Key Findings:
  • Participants defined self-care broadly, focusing on maintaining independence and performing daily tasks rather than solely managing medical conditions.
  • Participants engaged in various physical self-care practices, including regular interaction with health professionals, modifying activities to reduce discomfort, and engaging in exercise and healthy eating habits.
  • Participants demonstrated a positive mindset and engaged in activities to support their mental health, though some expressed reluctance to seek help when needed.
  • Social interaction, particularly with peers and through community groups, was crucial for participants' well-being.
  • Participants found enjoyment and purpose in hobbies and leisure activities, though some faced limitations due to health conditions.
• Main Conclusions:
  • Self-care for older adults living independently encompasses a broad range of activities beyond medical management, highlighting the need for a holistic approach to design and research in this area.
  • Assistive technology can play a significant role in supporting older adults' self-care practices, particularly in enabling continued independence and social connection.
• Significance: This research contributes to the understanding of self-care practices among older adults living independently and provides valuable insights for designing assistive technologies that cater to their diverse needs and preferences.
• Limitations and Future Research: The study was limited to a small sample size from a specific geographic location. Future research should explore these themes with a larger and more diverse population of older adults. Further investigation into the role of technology in supporting specific self-care practices is also warranted.

Stats

The number of adults aged 85 years and over in Australia has increased by 110% over the past two decades.
The total population in Australia has increased by only 35% over the past two decades.
Worldwide, the proportion of the population over 60 years old is projected to nearly double, from 12% in 2015 to 22% in 2050.

Quotes

"If I do, on the odd occasion, go to the doctor once every year or two, it's only to get blood results and I crunch the numbers and make my own diagnosis and treatment.”
“that you can stay in your own home until it's time to go into a nursing home.”
“being able to do everything that I possibly can.”
“a minimal amount of help”.
“looking after everything myself,” which included “keeping my place together” and doing “housework.”
“Checking my calendar every morning to see what I have to do for the day or what for tomorrow. Making sure I have proper meals with plenty of vegetables. ... Drinking plenty of water. Oh, just in general looking after myself, having a shower every morning. And keeping clean. Going to the toilet. … It’s just everyday things.”
“You devise ways of doing things with as little effort as you can.”
“I just get online, place my order, pay for it online and they deliver it.”
“There's a little seat there in the kitchen. It's got wheels on it. I just sit on that and wheel myself around from the fridge to the sink or whatever needs to be done. And I can pack all that stuff away in the cupboards and the fridge and everything else.”
“I find if I've got to do the vacuuming, you know, you get a sore back and that. So, it is lovely to have the help.”
“I've got a shower chair. Or stool. And I've got a plastic chair in there to sit now. I never used to. … If I get a bit wobbly, I just grab a rail”.
“They [Care Agency] wanted someone to come in and shower me. I said, ‘I don't want anyone to come in and shower me, I'll shower myself.’ ‘Oh, well what about somebody coming in and being in the house?’ I said, ‘look, if anything's going to happen, I'll press the button [a personal alarm system], and I'll get help.’ … And she said, ‘well, what about somebody washing your hair?’ I said, ‘love, I'll wash my own hair. In fact, I washed it this morning.’”
“I'm a strong believer in natural stuff and most of my medications are natural.”
“I'm really fortunate. Very fortunate.”
“full,” “active,” and “a lot of fun”.
“I like to be dressed properly and I like, when I'm going out, I like to put a bit of makeup on. And I think that's important because it's all too easy to think to yourself, well, what's the point in getting up and having a shower and putting clothes on? I can just lie in bed. And I think I took that from my father because my father was, he never wasted a day in his life.”
“I want to be able to live my life to the fullness that I can at this stage. If someone sings out and says, you want to go to lunch today? Yep. Count me in. I'm in. … sometimes my brother will ring me up from Maroochydore and he'll say, “You coming up?” Then if I've got nothing on yeah, I'll get in the car and I'll go.”
“if you don't use it, you'll lose it.”
“you need to stimulate yourself sometimes.”
“sometimes you think I can't be bothered. But then I think, no, you get up and move!”
“I've got a machine that reads a book to me now. I think I was starting to get a little bit depressed up until about four or five weeks ago. I was sort of pretending I wasn't depressed, but I think I might have been. ‘Cause I was so frustrated I couldn't read a book or read anything properly. And I felt really bad about that.”
“I can feel whatever's coming on when it's coming on and how. And I know better than to put myself into a dark area. And if I do, I try to get myself out of the dark area. And the only way I do that is to go and jump on my scooter and get the hell out of there. So when you're out in your scooter, you're out of that dark area because you're concentrating on everything else.”
“when I'm worried or stressed, I actually like to keep things to myself.”
“There's nothing much you can do. That's it. Because you're here and you just got to sort it out.”
“Well my social [life] is with my support workers … because all my support workers, most of them I get along with really, really well.”
“It took me a while to adjust [to living in the retirement home]. But yes, I've made a few good friends so I'm feeling more comfortable here… There are a few of us that sort of get together and go to lunch and do different things, which is good… We'd catch up at least once a week.”
“were so supportive … I couldn't have wished for any more help. They've been so good.”
“Probably some days I don't see anyone, but most days there's somebody around, who just pops in. … we've got a thing. If my blinds up, I'm awake. If her [Pat’s] curtains are drawn, she's okay. And she goes to church on Sunday. Well, her car was there on Sunday. And I'm like, right. So, there's that sort of thing in here that people care. And they check on you.”
“I see my daughter that takes me shopping every week. But if I need anything extra, she'll come. But see, she's got all these grandchildren herself. And she's busy looking after her husband and the business that they have. They're all working. All got jobs. … I don't see them [grandchildren] very often because they're all working. They've all got children of their own and I can understand that.”
“I started playing when I was about 10. And I've been playing bits and pieces. Lots of long times that I don't play. … And then I came back to it again in my retirement and I do it now. My main interest is Irish music, Irish folk songs, ballads, that sort of stuff. I like those.”
“I record my own music as well. I record my own playing, my own singing. I'll put them together.”
“I like making things and I just like finding things to make. But I'm finding it harder and harder every time to do that. So, you’ve got to have some sort of drive, initiative to do it.”
“has been reclaimed, refixed, remodeled, re-something. All these fans, I've got them off the road and fixed them all up. They all work.”
“10 pin bowling, I did that for years. And I've still got my bowling ball there. I'd love to do it. But with the noise and with the ear and that, it's just, it's out of the question.”
“No, not really, because as I said, since I've got the vertigo, I can't go bowling, which I did love doing.”

Key Insights Distilled From

Self-Care Practices in the Context of Older Adults Living Independently

by Bridget Case... at arxiv.org 11-05-2024

https://arxiv.org/pdf/2411.01815.pdf

Deeper Inquiries

How can technology be designed to support both the physical and social aspects of self-care for older adults, recognizing the interconnectedness of these domains?

Answer:
Technology can play a crucial role in supporting both the physical and social aspects of self-care for older adults by addressing the interconnected nature of these domains. Here are some key approaches:
1. Promoting Physical Activity and Social Engagement:

Technology-enabled Social Exercise Platforms: Develop platforms that combine virtual exercise classes with social interaction features. This could include group video calls during workouts, shared progress tracking with friends, and virtual challenges that encourage friendly competition and support.
Gamified Rehabilitation and Exercise Tools: Utilize gamification principles to make physical therapy and exercise routines more engaging and enjoyable. Integrating social elements like leaderboards, team challenges, and virtual rewards can further motivate older adults and foster a sense of community.
Location-based Social Connection Apps: Design apps that connect older adults with shared interests living in the same area. These apps could facilitate meetups for walks, group exercise classes, or visits to parks and community gardens, promoting both physical activity and social interaction.
2. Facilitating Communication and Social Connection:

User-friendly Video Calling and Messaging Apps: Design interfaces that are intuitive and accessible for older adults with varying levels of technological experience. Features like voice commands, large icons, and simplified menus can make it easier to stay connected with loved ones.
Digital Storytelling and Content Sharing Platforms: Create platforms where older adults can share their life stories, experiences, and skills with younger generations. This intergenerational connection can combat social isolation and provide a sense of purpose and belonging.
Virtual Reality (VR) Experiences for Socialization: Leverage VR technology to create immersive experiences that simulate social interactions, travel, and cultural events. This can be particularly beneficial for older adults with mobility limitations, allowing them to engage with the world and maintain social connections from the comfort of their homes.
3. Supporting Independent Living and Access to Resources:

Smart Home Technologies for Safety and Accessibility: Integrate sensors, voice assistants, and automated systems to create a safer and more accessible home environment. This can include fall detection systems, medication reminders, voice-controlled lighting and appliances, and telemedicine capabilities.
Transportation Assistance and Mobility Solutions: Develop apps that connect older adults with transportation services, ride-sharing options, and community resources. This can help overcome mobility challenges and enable participation in social activities and appointments.
Online Platforms for Accessing Information and Services: Create user-friendly websites and apps that provide easy access to information about local events, support groups, healthcare providers, and government services.
By designing technology that addresses the interconnectedness of physical and social well-being, we can empower older adults to live healthier, more fulfilling lives while maintaining their independence.

Could an overreliance on assistive technology lead to a decline in physical or cognitive function for older adults, and how can this be mitigated?

Answer:
While assistive technology offers numerous benefits for older adults, an overreliance on certain types of technology could potentially contribute to a decline in physical or cognitive function. This is often referred to as the "use it or lose it" principle. Here's how overreliance can be problematic and how to mitigate these risks:
Potential Risks of Overreliance:

Physical Decline: Overdependence on mobility aids like scooters or stairlifts, without engaging in regular exercise, could lead to muscle atrophy and reduced cardiovascular fitness. Similarly, relying solely on meal delivery services might discourage cooking, which can be a stimulating and engaging activity.
Cognitive Decline: Excessive reliance on reminders, calendars, and GPS navigation could hinder the use of memory, planning, and problem-solving skills, potentially contributing to cognitive decline.
Mitigation Strategies:

Promote a Balanced Approach: Encourage the use of assistive technology as a supplement to, rather than a replacement for, physical and cognitive activities. For example, use a mobility scooter for longer distances but encourage walking for shorter trips.
Incorporate Technology into Engaging Activities: Integrate technology into activities that challenge both the body and mind. This could include using VR for interactive games that require movement, online brain training programs, or video calls with family that involve playing virtual board games.
Personalize Technology Use: Assess individual needs and capabilities to determine the appropriate level of technological assistance. Avoid unnecessary reliance on features that could hinder independence.
Encourage Social Interaction: Promote the use of technology for social connection, as social engagement is crucial for cognitive stimulation and overall well-being.
Regular Reviews and Adjustments: Regularly evaluate the use of assistive technology and make adjustments as needed to ensure it continues to support, rather than hinder, physical and cognitive function.
The key is to strike a balance between utilizing technology for its benefits while also encouraging activities that maintain physical and cognitive health. By taking a proactive and mindful approach, we can harness the power of technology to enhance the lives of older adults without compromising their overall well-being.

If our homes and cities were designed with aging in mind, how might our perceptions of self-care and independence evolve?

Answer:
If our living spaces and urban environments were intentionally designed with the needs of aging populations in mind, our perceptions of self-care and independence in later life would likely undergo a significant and positive transformation. Here's how:
1. Redefining Independence:

Universal Design Principles: Homes and cities built with universal design principles would be inherently accessible to people of all ages and abilities. Features like wider doorways, zero-step entries, grab bars, and adjustable countertops would become the norm, reducing the need for costly and often stigmatizing retrofits. This seamless integration of accessibility would foster a sense of dignity and empower older adults to maintain their independence for longer.
Smart Home Technology as an Enabler: Integrated smart home technology could further enhance independence by automating tasks, providing safety and security, and facilitating communication. Voice-controlled lighting, appliances, and entertainment systems would empower those with mobility limitations, while telemedicine capabilities and remote monitoring systems could provide peace of mind and reduce reliance on in-person care.
2. Shifting from "Care" to "Self-Management":

Age-Friendly Communities: Cities designed for aging populations would prioritize walkability, access to public transportation, and proximity to essential services like healthcare, grocery stores, and social activities. This would empower older adults to manage their daily lives with greater ease and autonomy, shifting the focus from "being cared for" to "self-management" and active participation in community life.
Intergenerational Living Spaces: Homes and neighborhoods that encourage intergenerational living could foster a sense of community and mutual support. Shared common areas, community gardens, and social programs could bring people of different ages together, reducing social isolation and promoting a sense of belonging.
3. Evolving Perceptions of Self-Care:

Proactive and Preventative Approach: In age-friendly environments, self-care would likely shift from a reactive approach to managing decline to a more proactive and preventative focus on maintaining health and well-being. Access to fitness facilities, healthy food options, and social activities would be readily available, encouraging older adults to prioritize their physical, mental, and social health.
Emphasis on Social Connectedness: With reduced social isolation and increased opportunities for interaction, social connectedness would become an integral aspect of self-care. Community centers, parks, and public spaces designed for social gatherings would foster a sense of belonging and purpose, contributing to overall well-being.
By creating environments that support aging in place, we can challenge societal perceptions of aging as a period of decline and dependence. Instead, we can foster a culture that values the contributions of older adults and empowers them to live fulfilling, independent lives while prioritizing their self-care and well-being.