Senior citizens embrace change and make a new technology work for them

The Authors

Wendy Nasmith, Royal New Zealand Foundation of the Blind, Auckland, New Zealand

Mary Parkinson, Royal New Zealand Foundation of the Blind, Auckland, New Zealand

Abstract

Purpose – New Zealand's population is aging; government agencies realise the impact of this and are factoring it into their planning for the future. There is a perception that “Seniors” are reluctant to change, but a recent Royal New Zealand Foundation of the Blind (RNZFB) pilot project to test an internet-connected Digital Talking Book Player with 40 borrowers, most of whom were in their 70s and 80s, has shown the opposite. The purpose of the trial was not only to test an online talking book delivery system but also to ascertain if the RNZFB seniors, some of whom have little or no experience with computers, could cope with an internet capable Digital Talking Book Player. The purpose of this paper is to describe the RNZFB trial.

Design/methodology/approach – In total, 39 RNZFB library members between the ages of 60 and 93, most in their 70s and 80s and one 40 year old were selected to participate in a Digital Talking Book Trial. Each of the trialists were loaned a Digital Talking Book Player for approximately four weeks and were asked to read two books and two magazines per week.

Findings – The outcome of the trial was remarkable. The trial showed seniors do have a positive attitude to change and are not afraid of technology.

Originality/value – The trial showed that if the reward is greater independence and a better service, and seniors are given appropriate support they will embrace new technology and make it work for them. By moving ahead and using new innovative technology the library service will be able to provide a greater variety of titles and better access to information and recreational reading.

Article Type:

Case study

Keyword(s):

Electronic books; Elderly people; Blind people; New Zealand; User studies; Internet.

Journal:

The Electronic Library

Volume:

26

Number:

5

Year:

2008

pp:

673-682

Copyright ©

Emerald Group Publishing Limited

ISSN:

0264-0473

Introduction

According to the National Population Projections 2004 (base)-2051 (NPP 2004) released by Statistics New Zealand. New Zealand's population is growing and is projected to reach approximately 5 million by 2041 and 5.05 million by 2051. The NPP 2004 not only projects an increase in New Zealand's population but it also shows us that New Zealand's population is aging. This may be due to a combination of sub-replacement fertility, continued longevity and the aging of the baby boomers.

Statistics New Zealand states:

[…] in 1971 half of New Zealand's population was aged 26 years and over, by 2004 the median age had increased to 35 years and by 2051 it is projected to reach 46 years (Statistics New Zealand Tatauranga Aotearoa, 2004).

In 2004, 12 per cent of the population (490,000 people) were 65 years and over. By 2051 Statistics New Zealand projects 1.33 million people – approximately one in every four New Zealanders will be over 65. (Statistics New Zealand Tatauranga Aotearoa, 2004).

Whilst preparing for an aging population both social and economic planning is of utmost importance. Schemes such as “Kiwi Saver” (Inland Revenue, 2007) and “The New Zealand Positive Ageing Strategy” (Dalziel, 2001) both reflect the concerns of the government. Auckland City Council has also just approved the “Positive Ageing in Auckland Plan” (Auckland City Council, 2007).The main focus of this plan is access, safety, participation and socialising for the elderly. The plan also aims to encourage a culture which values older people.

The statistics clearly show us New Zealand's population is aging and as we enter into our golden years some of us will experience the later onset of vision loss.

Royal New Zealand Foundation of the Blind

The Royal New Zealand Foundation of the Blind (RNZFB) is New Zealand's primary provider of vision-related habilitation and rehabilitation services to blind, deaf-blind and vision-impaired people. Each year nearly 1,200 New Zealanders who have gone blind or experienced serious sight loss register as RNZFB members. The RNZFB equips its members with the adaptive skills, technology and resources they need to create new beginnings and lead independent lives. Currently the RNZFB provides support and services for approximately 11,700 members who have a vision impairment or who are totally blind. (RNZFB, 2007a, b, p. 7).

The RNZFB's 2005/2006 Annual Report (RNZFB, 2006, p. 31) shows that more than half of its members are over the age of 80 years. The complete membership breakdown by age reveals:

Age related eye conditions

The RNZFB's 2005/2006 Annual Report also indicates the number of members with different eye conditions. Some members report several conditions. However, the leading cause of vision impairment amongst members is age related macular degeneration (AMD), 4,997 members have this eye condition (RNZFB, 2006, p. 31).

AMD is one of the four major causes of vision loss in older people. Glaucoma, cataracts and diabetic retinopathy are also conditions related to the aging process (Bailey and Hall, 1990; Desai et al., 2001; Hargrove, 1998; Klaver et al., 1998; Munier et al., 1998, as cited in Ryan, 2002). The RNZFB describes AMD as the “loss of central vision which makes reading, recognizing faces and close work difficult” (RNZFB, 2006, p. 75).

Another age related change which affects almost everyone is the loss of flexibility within the eye known as Presbyopia (the loss of focusing ability). “Around the age of 40 to 45, vision at our normal reading distance becomes blurry and we have to hold print further away to avoid tired eyes” (New Zealand Association of Optometrists, 2007a, b). For most of us corrective lenses or reading glasses may be enough to enable us to carry on living the way we are – others may not be so fortunate.

“The two major losses usually experienced with developing low vision are the ability to read and the ability to drive” (Bishop, 1996, as cited in Ryan, 2002). Not being able to read newspapers, billboards, magazines, packaging on items in the supermarket and books is a huge loss of the ability to gather information. The grieving that is a natural part of this loss often leads to the loss of self-confidence, self worth, self esteem and independence. “With the loss of confidence, older people may become housebound and develop feelings of insecurity, loneliness and worthlessness” (Advisory Council for the Community Welfare of Disabled Persons, 1989, as cited in Ryan, 2002).

Accessibility

Over 5,600 RNZFB members use the Braille and Talking Book Library (RNZFB, 2007a, b, p. 15) and some also access The National Library of New Zealand's Print Disability Collection through their local library. Many other New Zealanders are print disabled but do not meet the RNZFB's membership criteria.

Stroke victims, arthritis sufferers, people with dyslexia or neurological conditions such as Parkinson's disease may all have difficulty reading print, holding a book or acquiring reading material in a format that best suits their individual needs. In some cases isolation is a contributing factor to how a person acquires their information or recreational reading material.

The housebound and outreach services provided by New Zealand Public Libraries are much appreciated and well received by isolated and disabled library users but often the manual processes and systems used to deliver these services are time consuming and expensive for the providers.

The Christchurch City Libraries provide a very personalised Storyline Service. Staff make selections on behalf of their customers. A special collection is held at the Outreach Division, where the housebound services and the mobile library are also managed. The library provides customers with a catalogue, which is produced annually. The customer marks the titles they are interested in, often with the help of a librarian and then returns the catalogue. The catalogue then becomes the customer's personal reading record. Everything is manually recorded and is very staff intensive, but to this end gives a very individual personal service. (A Pavitt, personal communication, 19 July 2007).

Five of the seven libraries based on the North Shore in Auckland also provide a Housebound Service which is run independently by a librarian at each branch. The Housebound Librarian visits the new customer and gathers information such as reading preferences, how often they would like the service, how many items they require and in which format. The items are chosen for the customer by the librarian, based on their preferences, and hand delivered by a volunteer driver. The main difficulty North Shore Libraries face is the availability of volunteer drivers and relief drivers. It can also be time consuming and challenging finding something a customer has not had before. (S. Roberts, personal communication, 13 June 2007).

These staff intensive door to door delivery options may meet the need now but as our population grows and ages public libraries housebound and outreach services could be stretched to their limits.

The RNZFB's Talking Book and Braille Library

The RNZFB's Talking Book and Braille Library provides a door to mailbox service and issues over 20,000 talking books and 14,000 audio magazines every month. Talking books are currently recorded and distributed on Library of Congress four track analogue cassettes and the library loans its members four track capable talking book machines (TBMs) to play them. As with the public libraries housebound and outreach services the RNZFB's library service is very staff intensive. Slow postage, damaged or lost books and long waiting lists for that ever popular new title often means members do not always get what they want when they want it.

Members may make selections from a catalogue which they can access in print, audio or online. New titles or titles of interest are advertised on the RNZFB's Telephone Information Service (TIS) and may be requested by leaving a voice message. A supplement of new titles is also available every quarter and may be requested in print, audio or by e-mail.

The talking book collection contains over 8,200 titles most of which have multiple copies. Each copy has its own container, which is barcoded, print labelled and labelled with braille. When a book is issued to a member another additional address label is produced. There is quite a production handling process before the book reaches its intended audience.

DAISY

Since August 2002 the RNZFB has been recording talking books in Digital Accessible Information System (DAISY) format. DAISY talking books are recorded as structured computer files so that the reader is able to navigate around the book by section, chapter, page or phrase, giving a vision impaired reader an experience as close as possible to that of a sighted reader navigating a print book. You do not need a computer to play the book. You do, however, need a special talking book player to take advantage of the navigation features of a DAISY talking book.

Why change the service?

Owing to advancements in technology recorded material on cassette is becoming quite scarce and in the future cassettes themselves will become obsolete. The RNZFB can no longer purchase four track TBM, the cassette duplicating machines have become old and antiquated and spare parts for these machines are almost unobtainable. It is predicted this equipment will reach the end of its sustainable life by the middle of 2009.

Faced with a need to update their distribution the RNZFB has done a lot of research and given a lot of thought as to which direction the library service should endeavor to take. Transition to a digital format was a given but the question was, how to distribute the books.

Distribution of DAISY talking books

After careful consideration, the two most suitable options of delivery are either a “CD based service” or an “internet based distribution service”. With the former, DAISY talking books are burned onto CDs and distributed to members via the post. An average book will be contained on one CD but longer books may run on to two or more CDs. Our sister libraries in Canada, the UK and Australia have chosen to use CDs.

Under the internet-based service, DAISY talking books are sent down the phone line, via a broadband internet connection onto a Digital Talking Book Player that receives and plays them. At the present time no other library is using this method but many are experimenting with it.

The advantages of the internet based service are that:

What do the RNZFB members think?

In 2006, the RNZFB commissioned Phoenix Research to undertake a survey of approximately 400 RNZFB members of which 250 were library users and 150 were non-users. The purpose of the survey was to find out which of the two delivery alternatives would be most preferred, members attitudes towards the two alternatives and members' wider needs relating to the talking book service (Phoenix Research, 2007, p. 3). The general findings in the report are as follows.

Library service current users, but also foundation members who are not current users, are very positive about a new service being introduced. The strength of this positive response is supported by the new features that people consider are most important in a new service, with there being a good match between features rated most important, and what the new services can deliver (users relate good sound quality and wide range of reading material as especially important, and the digital technologies behind the two services are both very strong on these points).

After detailed explanations of the two possible new services, people indicate a preference for the internet-based service. Even those who prefer the CD-based service rate the internet-based service very positively. “Similarly, the larger number who prefer the internet-based service also rate the CD-based service very positively” (Phoenix Research, 2007, p. 7). Among those who are currently non-users of the Foundations library, there is a large proportion who are open minded about the new service (Phoenix Research, 2007, p. 52).

Listed below is the percentage per age group who are looking forward to a new talking book service (Phoenix Research, 2007, p. 54):

The other interesting factor the survey identified was the difficulty current users found when returning their books. The survey found that less than half of library users are able to return books to the Foundation without assistance. The most difficult aspect of returning books is getting to the mailbox (Phoenix Research, 2007, p. 28).

The survey results show members are strongly interested in both of the new services.

Three quarters of current library users (75 per cent) are looking forward to a new talking book service and say they would get it as soon as they could. Only 3 per cent of users rejected the idea and 21 per cent said they would consider and think about the new service. 1 per cent did not know. (Phoenix Research, 2007, p. 52).

The survey conducted by Phoenix indicated that “seniors do embrace change and will make a new technology work for them”. And the RNZFB's Digital Talking Book Trial certainly reinforced these findings.

The Digital Talking Book Trial

About 39 RNZFB library members between the ages of 60 and 93, most in their 70 and 80 and 140 year old were selected to participate in a Digital Talking Book Trial. Each of the trialists were loaned a Digital Talking Book Player for approximately four weeks and were asked to read two books and two magazines per week.

The purpose of the trial was not only to test an online talking book delivery system but also to ascertain if the RNZFB's seniors, some of whom have little or no experience with computers, could cope with an internet capable Digital Talking Book Player.

The outcome was remarkable. As a trial of this sort had never been undertaken by the RNZFB's library before, it was a learning curve for trialists, instructors and the dedicated team who were involved. A list of possible trialists was selected. The trialists were then contacted and asked if they would mind being part of the trial.

The responses were both enthusiastic and heartwarming:

You've made my day dear.

Of course I will participate – but I do not have a computer.

The Foundation has been good to me – it would be lovely to give something back.

It would be so good to be useful again.

The general consensus of the members who were asked to participate was that they are grateful for the service provided and they would be more than happy to help make that service better.

The preparation

Careful thought had been given to how the trialists would select their books and magazines. The RNZFB not only wanted a better player but they wanted a system that would encourage the members to be more proactive and more independent and to be able to choose books for themselves if they wanted to.

For the purpose of the trial a bibliography of approximately 838 Digital Talking Book titles and 22 magazine titles were put onto the TIS for trialists to select from. Trialists could call TIS, access and navigate the catalogue, which was read to them by synthetic speech. Trialists could then select specific titles using the digits on the telephone key pad. The titles were automatically transferred onto the member's request list ready to be downloaded from the server by the Digital Talking Book Player. Alternatively trialists could choose from a print catalogue of titles which would then be manually entered onto their request list.

The Digital Talking Book Player

The trialists were all impressed with the look, feel and portability of the new player. The player is a prototype developed especially for the trial. It is smaller and more lightweight than the TBM which is currently used by RNZFB library members.

The player is capable of downloading books from a server over the internet. It contains a limited memory which is divided between books and magazines. For example, there may be five books and five magazines residing on a virtual bookshelf. When the reader has finished listening to a book or magazine it is either placed back on the bookshelf or “returned” (deleted). If the reader has not finished the book their place is automatically marked for the next time it is opened. If the book is returned another book or magazine is automatically downloaded (delivered) it its place.

Instruction

Once the initial schedule for the trialists had been decided, broadband connections were activated and the first groups were ready to start. Five instructors were each responsible for their own group of trialists. Each instructor installed the new player, taught the trialists how to use it and supported them through the trial. Instruction was given on a one to one basis. The first lesson learnt “by the instructors” was that every trialist was different and although the instructors had a well rehearsed teaching technique it was evident they would need to adjust their teaching methods to suit the individual. For example, one trialist, who was 93, had never used a volume control other than a sliding switch or knob that turned. The concept of pressing a button several times to make the volume go up or down was fascinating.

The instructors found the best way to explain how the player worked was to use examples of what the trialists already knew by likening it to something else such as “Just like a fax machine”, or “like the aerial on your telly”. Within a short time, many of the trialists began to use their own terminology and the return button on the player soon became the “post it back to the library button”. Wording such as this all helped to create a better understanding of how things worked.

Navigation buttons

The navigation buttons on the player were placed in a diamond shape. The instructors used the analogy of a clock face instructing trialists to press the 12 o'clock button, 3 o'clock button, 6 o'clock button or 9 o'clock button to navigate around the book. This worked extremely well for most of the trialists but some did prefer to use other terminology – one gentleman likened the buttons to a compass. Whatever analogy the trialists used, it was soon discovered it was best to let the trialist guide the instructor.

However, not all trialists used the navigation features to there full potential and preferred to listen to a book from start to finish whilst others enjoyed skipping through the articles of a magazine. Some trialists were definitely very keen hands-on learners and as soon as the player came out of the bag it was firmly whipped from the instructor's hands and within seconds all of the buttons had been pressed – before any instruction had be given.

Others were so gentle and a little concerned they may break or damage the player. These trialists had specific places designated for their players such as a special table by their bed, in a quiet room where the grandchildren could not fiddle with it, or right next to their favourite armchair.

Some trialists' enthusiasm had to be slowed down and others needed reassurance of their own capabilities and the player's durability. Encouragement and positive instruction was the key to the trialists gaining “a can-do attitude.” Most of the trialists seem to feel more at ease once they had been introduced to buttons that performed similar functions to the current TBM, such as the moving forward and back buttons which are very similar to the fast forward and rewind keys on a TBM.

There was slight confusion with the multifunction buttons such as the play/confirm/stop button and the information/key describer/sleep timer button. One trialist accidentally returned his unfinished book to the library. He pressed the play/confirm/stop button to listen to the remainder of the book and confirmed the return to the library button which his wife had accidentally knocked whilst dusting. The book was sent back to the trialist once he had notified the help desk.

Support

Ongoing reassuring support was given to the trialists over the telephone and if need be in person. Trialists also had the support of a user guide which had been permanently installed on the player. Some trialists preferred the personal one-to-one instruction whilst others made use of both and listened to the user guide from beginning to end. This helped to reinforce the instructions given by the instructors. However, if a trialist became stuck in a book they found it difficult accessing the user guide to find out how to navigate out of the book. It was anticipated audio instructions would suffice but several trialists also requested simple, written, step-by-step instructions whilst others wrote out instructions themselves.

At the beginning of the trial it was thought if trialists were left with their current TBMs and they began to find the new Digital Talking Book Player difficult, they may be tempted to give up and go back and use the old machine. This was certainly not the case. All the trialists were determined to put the new Digital Talking Book Player to the test and one of the most difficult parts of the trial, for the instructors, was prising the new player away from some of the trialists. One lady said “she would just go into her bedroom and cry whilst we disconnected everything and packed the player up”. Another trialist offered roses or chocolates as a bribe to one of the instructors.

Technical issues

All of the trialists coped with the technical issues extremely well and far better than expected. Problems with the RNZFB server, the internet service and faults with some of the players did initially affect some of the trialists confidence as they automatically assumed the problem was of their making:

What have I done wrong?

I'm stuck; I think I have pressed the wrong button.

I'm sorry, I've broken the machine.

I don't know what I've done, it won't go.

Once the trialists were reassured the fault was technical their confidence soon returned.

Underneath the player was a tiny red re-set button which was inset. If a player went off line an instructor would go out to the trialist's home and re-set it. However, once the trialists discovered the tiny red button they insisted on re-setting the players for themselves and some needed to use the sharp end of a pencil to do this.

Results of the trial

Despite the problems encountered, feedback for the player was positive. Only one trialist would not recommend the player to others and three quarters said it was about the same or easier to use than the old player. The navigation features and setting the sleep timer were the tasks that trialists found more difficult, although some trialists had no difficulty with these functions. One trialist was struggling with the more basic functions of the player and felt they still needed more time with it, but would still recommend it to others. Three trialists stated that the new player was somewhat difficult to use.

Improved sound quality and getting books from the library quickly were the most important features for most of the trialists. Nearly, three quarters thought that a wider range of reading material was also important. Most trialists would recommend to player to others first because it meant that physical items did not need to be posted and second because of the improved sound quality.

Decision

The board of the RNZFB has endorsed in principle the implementation of the transition from the current delivery method of analogue cassettes to a digital download model. It is hoped that implementation will commence in November 2008 and be completed by June 2010.

Conclusion

As the New Zealand population ages, libraries will find themselves providing services to an increasing number of senior citizens who are starting to experience age-related conditions such as vision impairment. Some of these people will also appreciate the housebound service that many public libraries offer. The libraries will be looking to new technology to help them provide a better and more efficient service and give clients greater control over how they access information and recreational reading.

There is a perception that “Seniors” are reluctant to change but the recent RNZFB pilot project to test an internet-connected Digital Talking Book Player with borrowers, most of whom were in their 1970s and 1980s, has shown the opposite. This positive attitude to change by seniors was also reinforced in a survey of library users and non-users conducted by the foundation. If the reward is greater independence and a better service, and they are given appropriate support they will embrace new technology and make it work for them.

Prompted by advancements in technology and the need for greater levels of service, the RNZFB conducted two successful projects. A survey of RNZFB library users and non-users, and a Digital Talking Book Trial. The results from both the survey and the trial showed seniors are not afraid of technology or change. With a little patience, positive instruction and support, seniors will learn and adapt to a new talking book player and a service which will provide more independence, a greater variety of titles and better access to recreational reading and information, which will enrich their lives. The trial results also imply that such a system could also be successfully used in other countries with aging populations.

References

Auckland City Council (2007), "Positive ageing in our city", City Scene, June 3, .

[Manual request] [Infotrieve]

Dalziel, TheHon.L. (2001), The New Zealand Positive Ageing Strategy, Ministry of Social Policy, Wellington, available at: www.osc.govt.nz/documents/nzpositiveageingstrategy.pdf (accessed 25 July 2007), .

[Manual request] [Infotrieve]

Inland Revenue (2007), "Kiwisaver", available at: www.kiwisaver.govt.nz/ (accessed 25 July 2007), .

[Manual request] [Infotrieve]

New Zealand Association of Optometrists (2007a), "Macular degeneration: what is it?", N.Z.A.O Cataracts, available at: www.nzao.co.nz/pdf/Cataracts.pdf (accessed 17 June 2007), .

[Manual request] [Infotrieve]

New Zealand Association of Optometrists (2007b), "Presbyopia", N.Z.A.O Presbyopia, available at: www.nzao.co.nz/pdf/Presbyopia.pdf (accessed 23 June 2007), .

[Manual request] [Infotrieve]

Phoenix Research (2007), New Talking Books Service: Establishing Likely Uptake Levels – Understanding the Needs of Talking Book Users and Non-users, Royal New Zealand Foundation of the Blind, Auckland, January, .

[Manual request] [Infotrieve]

RNZFB (2006), Royal New Zealand Foundation of the Blind Annual Report 2005-2006, Royal New Zealand Foundation of the Blind, Auckland, September, .

[Manual request] [Infotrieve]

RNZFB (2007a), "About us", Royal New Zealand Foundation of the Blind, Royal New Zealand Foundation of the Blind, Auckland, (Brochure), pp.7.

[Manual request] [Infotrieve]

RNZFB (2007b), "Becoming a member", Royal New Zealand Foundation of the Blind, Royal New Zealand Foundation of the Blind, Auckland, (Brochure), pp.5.

[Manual request] [Infotrieve]

Ryan, K.M. (2002), "Rehabilitation services for older people with visual impairments", View, available at: http://search.ebscohost.com/login.aspx?direct = true&db=f5h&AN = 6863237&site = ehost-live (accessed 7 June 2007), Vol. 34 No.1, pp.31-48.

[Manual request] [Infotrieve]

Statistics New Zealand Tatauranga Aotearoa (2004), "Population to reach 5 million by 2004 and 2005", National Population Projections: 2004(Base)-media Release, available at: www.stats.govt.nz/products-and-services/media-releases/national-population-projections/national-population-projections-04%28base%29-51-mr.htm, 16 December (accessed 25 May 2007), .

[Manual request] [Infotrieve]

About the authors

Wendy Nasmith has worked in the Royal New Zealand Foundation of the Blind Talking Book and Braille Library for almost 13 years supporting members of the Foundation to access the library service. During this time, she has completed a Diploma in Library and Information Studies. Currently, she is User Services Librarian. She was involved in the recent Digital Talking Book download trial as an instructor who installed the new players, taught the seniors how to use them and then supported them through the trial.

Mary Parkinson has a BA and DipLIS and is a Manager, Library Lending and Information Services at the Royal New Zealand Foundation of the Blind where she has worked for nearly eight years. For five of those she held the position of Librarian Homai Special Formats Library. The Homai Library provides service to children and young adult members of the foundation. Her role in the Digital Talking Book download trial was to recruit the participants, co-ordinate the installation of players and training of participants by the instructors, and to man the “help desk”.