by Mary A. Languirand, PhD

Magda grew up in a tiny, remote village in Yugoslavia, and likes to tell stories about how she helped with the farming tasks from her early childhood. She could carry a calf miles to market by the time she was 7, and competed with her brothers at plowing the fields and hauling heavy loads. Sometimes she won.

These strengths and skills came in handy when she worked in a few of New York's tougher neighborhoods later in life-in her words, "Nobody mess with me!" Now paralyzed on one side by a stroke, she can still do amazing things with her one able-and very strong-hand. However, one thing she cannot do is hit the tiny buttons on her cell phone. "This thing needs little chicken bone fingers like yours," Magda says.

Neither can she make sense of the English screen messages, nor the too-rapid verbal commands that tell her to enter her 10-digit phone number and passwords to retrieve her voice mails. All this leaves her frustratingly dependent on others to tell her who called her, and to help her make calls. Since the offending device gets hurled across the room with some regularity, it's now a little quirky, which isn't helping matters. It's a great phone, but it isn't very helpful for a person in Magda's condition.

Barbara was born the same year as Magda, but her Long Island home was, for all intents and purposes, on another planet. Her attitude toward unnecessary physical activity could reasonably be termed disdainful at best, so labor-saving devices were (and are) her thing. Comfortable with all things modern, she had her own car as soon as she was of legal driving age, and was the first on her block to have an electric can opener, a fridge with an automatic ice dispenser, and a microwave oven. "It was easy," so she says. "All I had to do was read the instructions."

As Barbara's dementia has progressed, we've been relying more and more on written cues and prompts to help her use her electronic picture frame and cordless phone (both gifts); increasingly she simply waits for someone to come along and show her what to do…again. However, when I entered her room to find the handyman trying to explain why her cable TV service now requires her to use two different remotes to work a single television set, I knew we'd reached information saturation (especially since she'd somehow managed to amass no fewer than four remote control devices for that one set). "I never had to do that before, and I don't have to now! Make it work with just one, and write down what I should do!"

Ellen prides herself on being quite up-to-date with her fancy laptop-unlike many of her friends, whom she pities as hopelessly old fashioned. I can count on daily emails from Ellen forwarding every joke, and every chain letter on the internet (none of which I open). She asked me to teach her the basics of remote access, and she opened her email inbox to have me walk her through the process. I was astounded to realize that Ellen's inbox contained no fewer than 5,000 messages. When I remarked on her popularity she questioned my sanity, insisting that she deletes everything promptly. I asked her to show me exactly how she did that, and eventually realized that she hadn't turned the laptop off in years. I explained the importance of doing so, and we went through the process in detail as she took extensive notes. She excused herself briefly, and I checked over the notebook to make sure everything was accurate. Another set of notes in another person's handwriting fell out of the book, detailing all the same steps. A quick check revealed two other attempts by two other writers, all saying more or less the same thing. I'm guessing none of us were able to make the concepts "click" for her.

It's easy to understand things one understands, but sometimes it's difficult-if not impossible--to convey that understanding to those for whom the basic tenets are not intuitive. Magda "gets" brute force, but not the idea that the squiggle over the little red button means somebody called her. Barbara and Ellen get the squiggle concept, but won't necessarily recall what the squiggle means without a cheat sheet (which they're likely to misplace or neglect to read). Nor are they amenable to the concept of life without somebody to explain each squiggle as needed-lacking an instruction book, there must be "a guy you can call." The idea of working on a problem until you figure it out is just too unsettling.

I've used a cell phone for years-including a prototypic "bag phone" that weighed about 5 lbs. and required a huge antenna suctioned onto my car roof to operate. I also remember the first personal computing devices, and have occasional nightmares about WordStar programs crashing and losing a day's worth of writing. I'm far too old to have grown up in a world of user-friendly icons, but I'm also increasingly skeptical of technology that is inaccessible to those with cognitive or physical limitations. Try manipulating a smart screen with an arthritic hand, or dealing with hearing aid feedback on a cell phone. Add in unfamiliarity, the resulting anxiety, and the likelihood of success drops to zero.

If you can teach my ladies how to deal with their various technologies, more power to you. When you're done come back and teach me to teach them.

Robert Bornstein and Mary Languirand are the authors of When Someone You Love Needs Nursing Home, Assisted Living, or In Home Care, published by Newmarket Press. The first edition, released in 2002, received the 2003 Caregiver Friendly Award from the National Association of Caregivers. The second edition, completely revised and updated to incorporate cutting-edge trends in late-life health care, was published in 2009.
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