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Telehealth holds much potential for supporting older adults’ physical and social health. In particular, telewellness interventions to support the physical and social wellness of older adults are needed to overcome participation barriers with in-person programs. This paper presents guidelines for delivering telewellness interventions to older adults, which were informed by a human factors approach to developing a Tele Tai Chi intervention for older adults with mobility disabilities, including reviewing user needs literature and conducting user-centered needs assessment research. From these findings, we developed a protocol and support materials for delivering a telewellness intervention and conducted a feasibility study. We also established an adaptation committee to provide recommendations on the intervention. The outcome of our human factors approach was the establishment of research-driven design guidelines for delivering group exercise programs to older adults using videoconferencing. The guidelines provide direction for designing a telewellness protocol, supporting remote participation, and promoting socialization and engagement. These guidelines can be used to deliver interventions that increase access to socially-engaging, physical activity programs for older adults, which can ultimately help support their physical health, mental health, and quality of life.

Persons with disability are living longer and are at risk of experiencing greater disability as a result of additional age-related declines. These individuals, “aging with disability”, could benefit greatly from technology supports – if such supports are designed and developed with their capabilities and limitations in mind. To ensure technology interventions meet user requirements, it is important to identify and implement human factors considerations. This panel brings together leaders at the intersection of aging and disability research, who are members of TechSAge (Rehabilitation and Engineering Research Center on Technologies to Support Aging-in-Place for People with Long-Term Disabilities) – a multi-site, multi-disciplinary research collaboration aiming to understand the complex interaction between age-related changes and disability when designing and developing technology interventions. Specifically, the panel will address four overarching themes, integral to the success of TechSAge: (1) understanding user needs; (2) innovative environmental supports; (3) translational technology interventions; and (4) closing the gap between research and practice. This discussion will highlight the substantial research in the fields of aging and disability, yet emphasize the importance of bridging the gap between these two fields. Human factors, in particular, has potential to contribute much to this area of study, with the potential to improve the lives of older adults with disability wishing to remain longer in their homes of choice.

Background Persons aging with mobility disability (PAwMD) experience transportation barriers, which can hinder their ability to fully participate in society. Despite a vast infrastructure of federal laws and programs designed to ensure access to transportation, PAwMD remain a transportation-disadvantaged population. Objectives This paper presents detailed insights on transportation challenges experienced by PAwMD along with recent Federal programmatic initiatives designed to enhance access and mobility for transportation for older adults and people with disabilities. To identify policy gaps and opportunities to improve transportation services, we compared individual-level challenges from PAwMD to national survey data about barriers associated with delivering transportation services at state and local levels. Methods To assess individual-level transportation challenges, we conducted in-depth, structured interviews with sixty older adult participants with self-identified mobility disabilities for at least 10 years. We also conducted a content analysis of end-user transportation challenges and agency-level transportation coordination barriers to identify correspondences. Results Participants reported challenges utilizing public and private modes of transportation, related to availability; accessibility; safety; advanced planning; as well as societal attitudes. Barriers to the availability, delivery, and coordination of access and mobility services are linked directly or indirectly to the PAwMD reports of experiencing a shortage of accessible transportation options. Conclusions Findings highlight the complexity of federal transportation policies and programmatic initiatives designed to support older adults and people with disabilities, which contribute to implementation barriers and transportation challenges. Results highlight the importance of integrating end-user and state and local provider input into transportation policy development and program implementation.

Background There are growing numbers of adults aging with long-term mobility disabilities. Very little is known about the challenges this population experiences with everyday activities, and such challenges are likely to be greater and more complex than those of older adults who experience mobility declines later in life. Objectives The current manuscript presents in-depth insights on the specific activity challenges experienced by older adults with long-term mobility disabilities, and the response strategies they employ to overcome those challenges. Methods In-depth, structured interviews designed to assess challenges and response strategies for a range of daily activities were conducted with sixty older adult participants (ages 60–79) who self-identified as having a mobility disability for a minimum of 10 years. A coding scheme was developed to classify emerging themes. We identify the most common challenges and responses reported across all 6 broad categories as well as for a single activity category as an exemplar of an in-depth activity analysis. Results A needs taxonomy revealed challenges and response themes in relation to the most difficult activities identified by the participants. Frequently reported challenges included physical limitations and accessibility challenges. Common response strategies (e.g., utilizing tools or technologies, obtaining assistance from others, or modifying the approach to the task) were successfully mapped onto the Selection, Optimization, and Compensation model. Conclusions Findings reveal the unique challenges individuals face when engaging in everyday activities, and the potential of affordable and effective supports to promote aging-in-place, functional independence, and community engagement for adults aging with long-term mobility disability.

Tele-technologies may be able to increase access to evidence-based exercise interventions for adults aging with long-term mobility disabilities. This population experiences substantial barriers in attending such programs in person, including lack of transportation to classes, inaccessible buildings where classes are held, and lack of appropriate modifications offered for this population of older adults. It is critical to overcome such barriers to ensure this population has an opportunity to receive the benefits of evidence-based programs. In this study we are translating an in-person evidence-based tai chi intervention, Tai Chi for Arthritis, to an online platform using videoconferencing software for those aging with long-term mobility disabilities. We will describe our approach of including users from the target population and industry representatives (videoconferencing software developer, Tai Chi for Arthritis program developer as well as local master trainer) in the adaptation of the intervention and present the key findings from doing so.

A growing number of new smart, internet-enabled technologies from smart phone applications, to teleconferencing, to the Internet of Things (IoT), provide great promise and potential to support successful aging-in-place for people with long-term disabilities. This symposium highlights ongoing research at the TechSAge Rehabilitation Engineering Research Center to identify technology needs and develop/adapt new technologies to promote independence, health, and participation of this population. To understand user needs, Harris et al. will present findings from a large-scale interview study with older adults with long-term vision and mobility disabilities (N=120) that explored specific task-based challenges with community activities (e.g., going to entertainment events, volunteering) as well as solutions and strategies to overcome them. Koon et al. will present findings on perceived facilitators and barriers to using digital assistants (e.g., Amazon Alexa) to facilitate a variety of everyday tasks at home, from shopping to communicating with others, among adults aging with mobility disabilities. Levy et al. will discuss findings from research driving the creation of augmented reality tools that can enable individuals to experience how IoT devices, such as smart thermostats and lightbulbs, could be used within the context of one’s own abilities and home. Mitzner et al., will describe the development of a Tele Tai Chi intervention for older adults with long-term mobility disabilities that employs teleconferencing software to translate an in-person, evidence-based class to an online, social experience. TechSAge Program Officer, Sarah Ruiz (National Institute on Disability, Independent Living, and Rehabilitation Research), will serve as the discussant.

There is a growing population of older adults with long-term sensory and mobility impairments, who may be “aging with a disability”. Little is known about their everyday challenges as they experience normative age-related changes, such as declines in vision, cognition, and motor functioning. The Aging Concerns, Challenges, and Everyday Solution Strategies (ACCESS) study is a large-scale, mixed method study investigating user needs of individuals aging with impairment. The goal is to enroll 60 participants (aged 60–79) in each of the three target populations (blind/low vision, Deaf/hard of hearing, mobility impaired); current sample size = 151). We are developing a taxonomy of needs, organized by activity (e.g., transportation, healthcare), challenge (e.g., accessibility, need assistance) and response to the challenge (e.g., persevere, use tool). The data provide insights into unmet needs among older adults with long-term sensory and mobility impairments and provide guidance for design of supportive technologies for this understudied population.

In designing technologies and environments to support people aging with disability, it is critical to consider the characteristics of the individual. There are a number of personal factors that can impact one’s ability to maintain daily living activities, independence, and quality of life. Developed by TechSAge investigators, the Minimum Battery is a core set of background measures designed to capture relevant descriptive information about participants with long-term impairments (e.g., demographics, health, functional capabilities and limitations, technology use). The Minimum Battery is a self-report, multi-dimensional questionnaire developed with flexible administration options to facilitate data collection across studies and a repository database to enable large-scale archival analyses. This presentation will provide an overview of the Minimum Battery, highlighting preliminary insights on the sample to date (n = 173). Data snapshots demonstrate the potential value of the Minimum Battery as a holistic assessment of characteristics and support needs for this understudied population.

Technology designed to support aging-in-place for people with long-term disabilities begins with understanding the specific tasks that need support, and individual abilities, preferences, cultural practices, and privacy concerns. Such understanding is best achieved through a multi-method approach that includes direct, detailed assessments of representative users as well as individuals who work with or care for them. Our target users are people who identify as having a sensory or mobility impairment prior to the age of 50, including individuals aging with multiple sclerosis, late-onset hearing loss, and late-onset vision loss. In the present study, we are interviewing Subject Matter Experts (SMEs) to identify the scope of the challenges that should be explored in more depth. The SMEs include caregivers and medical professionals to identify challenges that the target populations experience in their everyday activities, advice about research adaptations, and recruitment ideas.

People with disabilities acquired in early to mid-life are living longer, contributing to growing numbers of older adults who are aging with disability, an understudied population likely to be underserved.This paper demonstrates the usefulness of the TechSAge Minimum Battery as a holistic assessment of health for people aging with disabilities.Survey data of socio-demographic and health characteristics were collected from 176 older adults with long-term vision, hearing, and/or mobility disabilities. A series of descriptive and bivariate analyses were conducted to illustrate the heterogeneity of the sample. An in-depth analysis of the subsample with vision difficulty was conducted to highlight the tool's value in assessing detailed contextual information for a specific disability.Prevalence of health conditions (M = 4.1; SD = 2.5), prescription medications (M = 4.1; SD = 3.9), and serious functional difficulties (M = 1.6; SD = 0.85) indicated a fair degree of comorbidity, but with considerable variation in number and type among individuals. Subjective health ratings were high overall, but lower scores were correlated with additional comorbidities (r = -0.31-0.40, p =.001). Analyses of the subsample with vision difficulty demonstrated heterogeneity in functional capacity, degree of impairment, duration, and use of supportive aids.Findings highlighted the heterogeneity among people aging with disability and demonstrated the importance of capturing multi-dimensional factors inclusive of an individual's capacity, context, and personal factors, which the Minimum Battery provides in an integrated assessment. Potential healthcare applications of the tool are discussed with implications for bridging aging and disability services.

Group exercise classes have the potential to provide physical, cognitive, and emotional health benefits, through the physical activity performed as well as the social interaction among class participants. Substantial barriers exist for adults aging with lower-body mobility disabilities to engage in group exercise classes, including lack of transportation to classes, inaccessible buildings where classes are held, and lack of appropriate modifications offered for this population of older adults. Just as telehealth interventions have reduced barriers to healthcare, telewellness interventions can reduce barriers to engaging in wellness activities, such as group exercise classes. We will discuss a research study employing teleconferencing software to translate an evidence-based group tai chi class for adults aging with lower-body mobility disabilities. We will present the adaptation requirements identified to test the efficacy of a telewellness intervention for improving increasing social interaction and positive health behaviors (i.e., physical exercise frequency) for adults aging with disabilities.

There are growing numbers of older adults with mobility and vision disabilities acquired in early to mid-life who are a part of a population described as “aging with disability”. For these individuals, the addition of normative age-related declines (e.g., vision loss, arthritis) on top of a long-term disability can create extensive barriers to community participation. We present findings on activity challenges with community participation among older adults with long-term vision and mobility disabilities (N=120) from the Aging Concerns, Challenges, and Everyday Solution Strategies (ACCESS) interview study. Results provide detailed insights on the specific task-based challenges experienced when engaging in one’s community (e.g., going to entertainment events, doing activities with a group or organization, and participating in religious services and activities) as well as the solutions and strategies employed to overcome those challenges. Findings provide guidance for the design of supportive technologies that promote participation and independence for this understudied population.

Technology holds great potential to support Deaf individuals as they age into older adulthood. However, it is unclear to what extent Deaf seniors are using technology in everyday life or whether they experience challenges in using technology. The current study explored technology use among older Deaf adults with regard to attitudes, adoption style, and frequency of use for a wide range of technologies, including assistive technologies (ATs) for persons with hearing loss and general, everyday technologies.We developed a questionnaire that assessed older Deaf adults' use of and experiences with technology. The questionnaire was made available in online and paper versions. Participants (N = 109) were recruited from national conferences and organizations for the Deaf.Overall, we found that the older Deaf adults were technology adopters and regularly use and feel comfortable with a variety of devices. However, we also identified a number of technologies that are not being used by this population, including an AT that appears to have become obsolete and technologies that use sound-based alerts.Insights on how older Deaf adults are embracing technology and which devices they are actually using can help policy makers, technology developers, and a range of aging services professionals, better meet the needs of this understudied population. Implications for Rehabilitation: Older Deaf adults use a variety of assistive and everyday technologies and must be considered as consumers and included in the design process. Older Deaf adults are generally positive in their attitudes towards technologies but they are infrequent users of potentially beneficial health technologies, highlighting opportunities for future research and development. Assistive technology for the Deaf (TTY/TTD) appears to have become obsolete with advances in modern communication technologies, which has implications for policy decisions.

Background and objectives There is a growing number of adults with long-term mobility impairment aging into the older adult population. Little is known about the experiences of these individuals in maintaining activities of daily living (ADLs) and instrumental activities of daily living (IADLs) as they face age-related changes in addition to a pre-existing mobility impairment. Research design and methods Through in-home interviews with 21 participants (ages 52-86) with long-term mobility impairment, the present study employed a qualitative description design to explore perceptions of how and why select ADL/IADL routines (e.g., bed transfer, toileting) have changed over time. The selection, optimization, and compensation (SOC) model was used as a framework to organize participants' adaptations. Results Among the ADL/IADL routine changes mentioned, elective selection strategies, in which a person continues to work at maintaining a task, were more frequently endorsed than loss-based selection strategies, in which a person does a task less or gets help from someone. Findings suggest that this population is actively adapting their routines to preserve their involvement in, and frequency of doing, these ADLs/IADLs. Counter to expectation, perceived age-related changes underlying activity routine changes were subtle and generally did not include sensory and cognitive declines. Discussion and implications Findings provide insights into the difficulties adults with long-term mobility impairment experience as they age, as well as the adaptations they employ to overcome those challenges. Results highlight the need for customizable, mobility supports (e.g., assistive technologies, home modifications) that can adjust to an individual's changing abilities across the life span.