The Betty Effect: On Ability and Access
Betty is an elderly woman for whom I have been providing care, for the past two years. In her younger years, Betty lived a migrant and sociable life. She engaged in backpacking trips, traveled extensively and lived in many different states before ultimately settling down in Berkeley, California about thirty years ago.
At the age of ninety-nine, Betty still deeply values socialization, leaving her home to walk two blocks up to the local coffee shop to meet with her friends almost every day. Her neighborhood is vibrant, scenic, and populous, allowing for the option to be stimulated outside of the home.
When inside, Betty enjoys listening to talkshows and classical music on the radio, watching murder mysteries, and spending time with her middle-aged cat, a most lovable companion.
I have observed the importance of consistency, attentiveness, and communication in Betty’s overall well-being. The overlapping themes of her concerns revolve around security, health management, and cognitive capacity. Learning a great deal about her needs, desires, and personal beliefs has encouraged my ambition to provide meaningful care to individuals of all socioeconomic backgrounds and personalities.
Betty has a keen interest in politics and history, talks vividly of the days she used to travel, and often recalls the fascinating people she met along the way.
A more recent development is that, despite the fact that she has never owned a computer or used the Internet, Betty enjoys hearing about the basic concepts of computer science that I explain to children in my current job as a teacher for an after-school enrichment program. These concepts are taught incrementally with tangible, real-world examples and can be learned by anyone who is able to follow the connection. Betty simply enjoys learning new things and having the opportunity to display her own knowledge.
While I have yet to conduct a worldwide survey of older adults, I suspect that this is a desire shared by many people.
“I would really like to see and be able to read. I like Agatha Christie. I read a lot when I could. I think they are working on something now to help your eyes. I bet a lot of people would be happy about that,” Betty once said wistfully.
Her desire to learn and keep her mind active is being directly suppressed by her low visual ability. In the past, she listened to many audio books but now feels that she may do better with some sort of physical copy or having stories read to her.
The more I listen to Betty, the more I realize how important it is to hear from the communities that we try to impact, to get a better sense of the different situations that impact a person’s aging experience.
Barriers to accessing assistive technologies, cognitive interventions, safe homes, or adequate health management very commonly stem from financial complications resulting from low income, retirement, or family hardships.
Additionally, for many people like Betty, barriers also arise from non-financial issues. Using data from the 2007 Health Tracking Household Survey to categorize dimensions of access to health care, Kullgren, Mclaughlin, Mitra, & Armstrong (2011) found four notable non-financial barriers of access to care. These include accommodation (difficulty finding time to seek out resources due to work or other commitments), availability (not being able to book an appointment), accessibility (difficulty in reaching a doctor’s office or care center), and acceptability (a doctor or hospital would not accept their health insurance).
Accessibility is an increasingly significant barrier when considering the various physical impairments people acquire throughout life. These non-financial barriers present great difficulty on their own and are often also simultaneously occurring with financial barriers, especially for certain underserved or marginalized populations.
Increasing accessibility to education, healthcare, and other services has the potential to change many lives in a significant way. Thankfully, with new advances in technology occurring every day, we’re on the right path toward an inclusive future.
