Britt Östlund: Technology is made by people – so we can influence it

“We expect little from older people and have an outdated image about them as users of technology. But we all live in a technological landscape, and today many older people move in to their old person’s home carrying a PC. They also have completely different expectations than before,” says Britt Östlund, Professor of technology in health care.

Certain physical functions do indeed deteriorate with age, for instance eyesight and hearing, but at the same time the ability to learn from experiences increases. 

“This means there is a great potential here,” she says.

She is the last speaker at the conference “The Future of Work in the Nordic countries – the impact of technological development on work and skills”. When we meet the week before the conference, she is a bit disappointed that the focus on the users of technology is at the bottom of the programme.

“It is typical that the users’ perspective of new technology ends up in last place.”

She is also not happy about the original title of her talk ‘Focus on the users’ perspective’, which becomes clear when it is changed to ‘Why the users’ perspective is part of the problem’. Britt Östlund is opposed to the word ‘user’ when it comes to the application of welfare technology. It gives the wrong connotations, she believes.

“A user plays a passive role, simply receiving welfare services which we provide. I think it is a derogatory term signalling low expectations. We should be asking ‘what can we help you with?’ I think operators or citizen is better and more respectful.”    

Unclear aims

Britt Östlund has been doing research on technology development, older people and design for nearly 40 years. Her interest grew out of being a young activist in the 1980s, protesting against the JAS fighter jet. She could not understand who something could be granted so much money with such diffuse aims. 

“The argument was that it would create more jobs, but we did not know whether that would actually happen,” she says.

Welfare technology started developing towards the end of the 1980s, spurred on by more liberal tendering rules for municipalities, which meant they were given more autonomy to purchase welfare technology. The aims were often unclear and were often based on the argument that it would help older people stay in their homes for longer, says Britt Östlund.

“I thought it was similar to the broad formulations used when arguing for JAS. I became interested in safety alarms and applied for a course in technology and social change at the University of Linköping.”

Listen to them!

In 1995 she got her PhD with her thesis ‘The old are the oldest. A study of the importance of technology in older people’s lives’, and since then she has focused on technology in home care, but also on older people as operators, consumers and citizens. From the beginning she was told that technology had nothing to do with older people. 

“The wold of research was divided into silos of technology and operators. This is still the case, but to a lesser extent. There is a growing interest in involving older people in the design process, and to use their needs as a starting point,” she says.

To her this is a crucial factor if welfare technology is actually going to work. It is not enough to sit in a lab and invent technology aimed at making everyday life easier for older people, or to protect them. In order for welfare technology to be useful, it must stand the test of implementation in people’s homes ‘out in the wild’ as she puts it. The technology must be tamed and adapted to the situation and the person in order to be useful. A technological aid might work in a hospital, for instance an oxygen cylinder, but it does not fit in a home. 

“If you look at the development of robots, for instance, we perhaps think that older people want company from a cute robot, or that they need technology which can monitor them in case they should fall over. But that is just following our own prejudices. Older people might want other things, and might be particular about having a nice home without ugly technology lying around. I am constantly surprised,” says Britt Östlund.

Some innovations pass the test, others not, but failing technology can lead to new insight too. The bread making machine was a short success, but inspired a development which has seen almost every grocery shop now selling bread baked in store.

It is possible to influence technology

Both meeting Britt Östlund and listening to her talk reveals a person who is deeply engaged in what she does. After spending nearly 40 years studying how older people use technology, she has strong opinions about both faults and opportunities when it comes to welfare technology and its use. Cutting across her friendly demeanour is also a severe tone when she talks about stereotypical images of older and ageing people. But also concerning ideas about how new technology can help the future of home care and care for the elderly.   

Britt Östlund describes home care as the cornerstone for a well-functioning society. That is why it is important to gather knowledge about how the working environment looks and how the technology can be applied in a way that actually benefits the older people as well as those working with them. It is often said new technology in elderly care should save time and money, but research does not support this notion.

“But technology can make the job simpler and more flexible."

Right now, Britt Östlund and her colleagues are involved in a research project together with the University of Lund and five municipalities. The researchers are looking at the working environment in the home care sector, and ask ‘What would be interesting to you?’ They also look at how the introduction of new technology in home care can influence the working environment and leadership. As part of their work, they have been investigating how many science articles have been written about the working environment in the home care sector, where so much new technology will be introduced and used. The researchers found only 16 articles, despite a world-wide search. The knowledge of elderly care is fragmented. 

“We talk about those who work there, but they are not part of the conversation themselves,” says Britt Östlund. 

National support for purchasing welfare technology

What has been uncovered, is that employees have high accident and injury rates and that sick leave figures are high. The sector is also nearly completely dominated by women – what does that mean? There is also a belief that this is an occupation where you do not need a lot of knowledge.

“We also know that they have dealt with new technology every day over many years, and that they are hugely experienced in the use of technology. Now they get a chance to tell us what they know.”

Britt Östlund first and foremost wants to improve the working environment in elderly care. If you want innovation and welfare technology to work, the working conditions must be improved and you need to make use of employees’ technological knowhow. But the municipalities must also stop buying ‘gadgets’ without any thought or strategy behind it. She is also very aware that it is difficult to get to grips with everything that is happening in this area, and wants to see national support for the municipalities.

Britt Östlund’s starting point is that technology is created by people, and so it is possible to influence how it is made. That is why she wants a debate about who is in charge of the technology and she wants a dialogue about digitalisation. How is responsibility shared? What about the ethics?

“The basic idea around the world is that technology is magic, and we have two choices – adapting to it or protecting ourselves from it – and people with low education levels or the users come last. Digitalisation means we have to think in new ways. We must not be blinded by the new technology but be critical of it in order to gain an informed view of technology. When it comes to technology aimed at older people, it is we – researchers and politicians – who perhaps need to learn new things, not the elderly. It is more important to talk to, and not about, people.”