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Originally published Tuesday, October 9, 2012 at 6:00 AM

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E-health care beckons older Americans

Personal Health: Connecting more older Americans to the Internet is expected to improve opportunities to protect their well-being and reduce national costs for care.

The New York Times

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Are you (or someone you know) among the 47 percent of older Americans who have not yet entered the digital age? If so, you're likely to be missing out on a lot of e-health opportunities available to help you live well despite chronic ailments and encroaching physical limitations.

Americans over 65, whose health stands to benefit the most from modern digital technology, are the least able and least likely to use it. As of April, according to the Pew Research Center's Internet and American Life Project, 53 percent of Americans 65 and older were using the Internet or email, but after age 75, use dropped significantly, to 34 percent. By contrast, nearly 90 percent of younger adults are digitally connected.

The challenges of getting more of the elderly connected to e-health, a catchall term for digital practices related to health care, are many: lack of awareness; fear of computers and smartphones; problems with vision, hearing, cognition or manual dexterity; limited finances or learning options; and concerns about privacy.

But these limitations are being addressed by experts who specialize in digital communication for older people — government agencies like the National Institute on Aging and the National Network of Libraries of Medicine; organizations like libraries, senior centers and residences, YMCA's and AARP; and a small but growing number of upstart companies that provide services in places like assisted living facilities.

"Seniors need to get on the technological bandwagon and become an integral part of their own health care and health care delivery," said Sara J. Czaja, scientific director of the Center on Aging at the Miller School of Medicine at the University of Miami. "Many older adults don't see the relevance of having access to the Internet, but more and more medical services are becoming available online."

Getting more seniors digitally connected, either personally or through caregivers, is expected to greatly enhance opportunities to protect the health and well-being of older people and, at the same time, reduce both individual and national health care costs.

How can e-health help you? Current and future possibilities listed by Czaja and others include:

• Learn more about your health problems and how best to manage them.

• Become an informed and active participant in decisions about your health.

• Remain independent and in your own home longer.

• Maintain an electronic personal medical record with everything in one place for easy access.

• Enhance emotional health and longevity by staying socially connected to friends and relatives.

• Communicate directly with your doctors by email or Skype.

• Have a technologically based home visit by sending vital information, like blood pressure, heart rate and oxygen saturation, digitally to your doctor.

• Find and facilitate access to medical specialists.

• Identify the best Medicare options for your needs.

• Order prescriptions and groceries online.

• Develop an at-home fitness program tailored to your needs and limitations.

• Find recipes and menus suited to your tastes, availability and nutritional requirements.

As more baby boomers who used digital devices during their younger years reach Medicare age, the proportion of the over-65 population that is e-savvy is expected to increase dramatically. But that will still leave a significant portion of the aging population in the Dark Ages of the typewriter.

Michelle Eberle, a consumer health information coordinator for the National Network of Libraries of Medicine in New England, said: "Older adults often are embarrassed by their lack of familiarity with computers and the Internet, and they try to hide their discomfort. But there are many places where seniors can overcome their technological disparities and get free training on the use of computers."

In a 2006 report, the federal Office of Disease Prevention and Health Promotion noted that "8 in 10 of today's seniors who have not yet used the Internet do not think they ever will." But a Pew Center study last year concluded that "80 is the new 60" — more and more older adults now use computers and the Internet, and two-thirds of seniors using the Internet have looked for health information online.

If you have still not caught on to e-health's advantages, it's time to think again. Websites and tools are increasingly being designed with the special needs and challenges of the elderly in mind.

For example, e-health sites developed by the National Institute on Aging use cleaner sans serif fonts in easily adjustable point sizes and contrast, and clear backgrounds uncluttered by advertising. Dense blocks of type, complex phrasing and medical jargon are avoided. Links are easy to identify and follow. Check it out at NIHSeniorHealth.gov.

Contact a public library, senior center or other local organization and ask whether it offers computer training for older adults. Locally or regionally sponsored SeniorNet Learning Centers offer basic and advanced computer classes and are managed primarily by older volunteers. Ask someone to find a center near you by visiting www.seniornet.org/php/lclist.php.

In New York City, a nonprofit called Older Adults Technology Services offers free computer labs and computing courses for seniors in English and Spanish. The "Hyper-Linking the Generations" program matches high schoolers and older students to learn technology. For more information, visit its website at www.oats.org.

You'll want to avoid having an impatient computer-savvy person — young or older — as your teacher. As you learn, write down the steps in full sentences, if possible, and keep the crib sheet handy until your use of the device becomes second nature.

Of course, if you have a handy friend or relative to teach you, someone who does not assume digital familiarity, that will work, too. Even though I've been using computers for decades, the technology keeps changing, and I often get stuck not knowing what to do next or how to get out of a digital jam. That's when I call on my sons, grandsons and younger friends for help. If only I had my 10-year-old grandson (who, unfortunately, lives in Los Angeles) constantly at my elbow when I'm on my computer or iPhone...

It helps, my sons keep telling me, not to be afraid of the machine. Early in the life of personal computers there was a constant risk of "crashes" and lost material, but you would have to work very hard to lose entries on today's sophisticated machines. (Note how easily forensic specialists retrieve computerized information that people thought they had deleted for eternity.) Finally, if you can possibly afford it, or if someone who loves you is willing to underwrite it, invest in broadband, which will provide far better e-health access than dial-up. Contact your phone service provider and ask about discounted bundling of available services.

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