“I Have to Keep Going”: Why Some Older Adults Are Using the Internet for Health Information

Abstract

This study used an ethnographic approach to understand why older adults in the United States are using the Internet for health information and how this activity may or may not relate to their ideas about aging. Eight (N = 8) older adults were visited in their homes during 4 months. Semi-structured interviewing, informal conversations, and observation techniques were used. Data were thematically coded and analyzed. Findings suggest that older adults’ ideas about aging influenced their definitions of health, health information seeking, and what they considered to be health information. They were using the Internet to demonstrate their independence and remain active. “Health” information went beyond the health/disease/illness constructs and incorporated their ideas of aging and how they were using the Internet for information that they hoped would help them maintain their independence. Insight into why older adults are engaging in this electronic form of health information seeking provides an opportunity to understand how effective this form of health communication is currently, and how it can be optimized to design technologically based health information/programs that are applicable and relevant to older adults’ lifestyles. This study was limited by the small number of individuals that participated, which limits its generalizability. However, it does demonstrate that broader definitions of health, ones which incorporate notions of aging, may help us better understand the types of information older adults consider to be health information- and how these definitions could potentially influence health information seeking via the Internet.

Appendix

Appendix A: Description of Participants

Five women and three men volunteered to participate. Participants’ ages ranged from 58 to 72 with 62 being the average. Educational levels ranged from high school diploma to Master’s degree. One had a high school diploma, four had Bachelor degrees, and three had Master’s degrees. All participants were active in various activities including volunteering, exercise/sports programs, and spiritual endeavors.

Appendix B: Sample of Main Interview and Added Questions

Health

• 1. How do you define health?

• 2. How do you know when you’re healthy?

• 3. What do you do to stay healthy?

• 4. How do you define illness?

Healthcare decisions

• 1. Have you recently had to make a decision concerning your health? If yes, can you tell me about that?

• 2. What did you base your decision on? Was there any information you used to help you with this process? Was it helpful or not?

• 3. Have you ever had to make a decision and did not feel like you had all the information?

Internet use

• 1. Did you use the Internet since the last time I was here? If yes:

  • a. What did you use it for?

  • b. How did you find the information?

  • c. Did you find what you were looking for?

  • d. Is there anything you still don’t know about…?

Internet use for health information

• 1. Did you use the Internet for health information since I was here last?

  • a. What did you use it for?

  • b. How did you find the information?

  • c. Did you find what you were looking for?

  • d. Is there anything you still don’t know about…?

  • e. Did you make any type of healthcare decision/choice given this information?

Added Aging Questions:

• 1. Can you tell me what it’s like being an older adult?

• 2. When you were younger, what did you think you would be like at (insert age)?

• 3. Do you think your role in society changed as you’ve gotten older? If yes, how so?

• 4. What do you think you will be like 10 years from now? What do you think your life will be like?

• 5. Is there anything that you know now about getting older that you wish you would have known when you were younger?

Appendix C: Supporting Quotes

Example 1: Activities they can perform online if they are to become disabled

Oh yes. I know I would be able to order groceries and do my banking. I’d never have to go out. I know my sister orders bulbs for her garden. They came straight to her door. All she has to do is plant them. It’s amazing nowadays. (Female Participant, age 63).

Example 2: Not wanting to become a burden

I’m sure if I got Alzheimer’s I wouldn’t know [laughs] but it’s the thought of someone else having to take care of me that I can’t bear [pauses]. I guess I wouldn’t know at that point but I know now. I mean, I’ve always taken care of my husband and I don’t think he would have a clue how to take care of me or himself for that matter [laughs] (Female Participant, age 58).

Example 3: Using preventive health information

Some…I know you have to keep active. That’s why I help my husband with his landscaping business. I do the books and plant flowers. I’m also going to start selling Avon [at home make-up business]. That will get me talking to people. (Female Participant, age 58).

Example 4: Seeking health information in relation to seeing their doctors

It’s hard to know when you should go to the doctor. As you get older, you have more aches and pains. You ask yourself, do I need to see the doctor for this or that? If you did, you could be at the doctor’s all the time. It’s just hard to know (Female Participant, age 66).

Example 5: Acceptance of physical changes

I am just now learning to accept the physical deterioration of my body. Pain is a constant reminder that I’m not young anymore even though I think so (Male Participant, age 58).

Example 6: Need to stay active

I play on the 50 and over hockey league. We’re slow. I didn’t realize how slow until my daughter’s boyfriend videotaped us and I watched it. I thought, “Is this in slow motion” [laughs] (Male Participant, age 58).

Example 7: Information needed as a result of their activities

My knee’s been giving me problems. I looked up information on arthritis and tendonitis, I had that in my shoulder not too long ago…I’ve been doing the hot/cold compress remedy. I don’t know, it’s just about getting old, I guess. What else can you do but keep going? (Male Participant, age 62).

Example 8: Need to participate in activities

I’ll tell ya, I feel it the next day. But, it’s nothing a few Tylenol can’t dull. I’m still going to be out there hitting those balls. It’s too much fun to not do it, know what I mean? What else would I be doing? I’ve never been one to sit still. (Male Participant, age 62).

Example 9: Use of the Internet to maintain well-being (internal)

I like to go to belief.net every morning. It gives me a sense of peace to know I’m not alone (Female Participant, age 60).

Example 10: Use of the Internet to maintain well-being (external)

(Male Participant [MP], age 62) I was just checking my e-mail before you came.

(MH)- Oh yeah? Can I ask for what?

(MP)- Sure, they changed the meeting for the [Historical Museum]. I’m the treasurer and I have to give the budget. That can wait, gives me more time. I don’t know how I ever had time to work [laughs].(MH)- Why do you volunteer?

(MP)- Well [pauses], of course, there’s, that, it’s good to give back sentiment but I also think it’s kind of selfish, I mean, I feel good having something to do and I can, and my wife likes me out of the house. Keeps me busy, moving [laughs].

Example 11: View on retirement

I wonder how I ever had the time to work. I feel like I’m doing more now than ever before. I guess I need to learn to say no but I don’t like to sit, it’s not good for my heart anyways. (Male Participant, age 72).

Example 12: No value found in health information available

I feel informed. I pay attention to my body, I know what to expect and I know what I can’t do about it. So, there’s no need, I already know, I won’t say everything, but I’m comfortable with what I do know (Female Participant, age 63).

Example 13: Reason why health information is not sought for chronic condition

(Female Participant [FP], age 63) spins in her chair, faces her computer and says, “I’ll just show you.” She pulls up a commonly used and popular search engine, types in Lupus, scans the search results and chooses one from the list. She is taken directly to the popular consumer health information site, WebMD. She begins scanning the information, quietly confirming what she is reading, turns to me and says, “I know all this, nothing new, I might check back once in awhile but why waste my time? Everything I have is autoimmune, it all relates. If I thought there was new information out there, yeah, I would read it.”

(MH)- How would you know?

(FP) I would hope my doctor would tell me. If not, I’m sure I would pick it up somewhere. You can’t go a day without hearing about some [health] story.