Challenges with Safety, Security, and Emergency Preparedness for those Aging with Long-Term Disabilities

Abstract

Purpose Worldwide, people with disabilities acquired in early to mid-life are living longer, contributing to growing numbers of older adults aging with disability. Older adults with long-term sensory and mobility disabilities are likely to experience challenges performing everyday activities and have high support needs due to the combination of co-morbid conditions, age-related declines, and long-term disabilities (Mitzner, et al., 2018). They may experience barriers that impact their safety and security in the home and community, which can ultimately inhibit their ability to age-in-place. Technology holds great potential to support people aging with disabilities in preventing and responding to emergency situations. However, effective technology solutions must respond to real-world issues experienced by these individuals and engage target users in research and development. Method The Aging Concerns, Challenges and Everyday Solution Strategies (ACCESS) study is a mixed-method investigation of everyday challenges among people aging with disabilities that explores user support needs to guide technology innovation (Koon et al, 2020; Remillard et al., In Press). We conducted an archival analysis of the ACCESS data regarding reported challenges related to safety and security (e.g., getting help in case of an emergency). Participants were 180 older adults (ages 60-80) with long-term disabilities (i.e., at least 10 years) representing 3 subsamples (n=60 in each group) including: vision impairment (due to macular degeneration or glaucoma), multiple sclerosis (MS), and late-deafened. We conducted a thematic analysis to assess types of concerns (e.g., crime, fire, health episode), challenges, and response strategies, which were further categorized using the Selection, Optimization, and Compensation model of aging to understand adaptation to losses. Results and Discussion For the vision impairment group, key concerns included navigating unfamiliar places (i.e., unsafe part of town, getting lost) and having to trust others without being able to see what they are doing (e.g., taxi driver not going to intended location, potential theft among home service providers). Participants with MS reported concerns about falling as well as mobility challenges that could hinder their ability to respond to an emergency (e.g., evacuating in a wheelchair, inability to move quickly, poor reflexes). For late-deafened participants, concerns were primarily related to missing important sound-based alerts or alarms (e.g., fire alarm) or not having access to essential information in the event of an emergency. Across groups, challenges were primarily related to their disabilities, but were also attributed to other factors such as memory issues, falls, and other health conditions. Participants reported various solutions including technologies (e.g., emergency response devices, smart watches, phone apps); getting assistance from others; personal strategies (i.e., advanced planning and communication); as well as avoiding certain situations. Some participants shared they simply would not know what to do in an emergency. These examples of safety and security concerns from the lived experiences of people aging with long-term disabilities illuminate critical unmet needs and opportunities for technology innovation. Findings reinforce the need for emergency response technologies to provide multi-modal alerts (i.e., sound, vibration, lights) that can be customized to users’ needs and preferences. Emergency response plans must also consider how to be inclusive of those with limited mobility and accommodate mobility aids.