DIAGNOSIS: INTERNET PHOBIA

Dorothy Harris took two buses through the pouring rain in south Chicago a few weeks ago to improve her finances and possibly even her health--by using the Internet. With help from a volunteer and a Web tutorial in a class cosponsored by The National Caucus and Center on Black Aged, Harris, 81, went online for the very first time. She visited the Medicare.gov Web site and, after entering information about her complex drug regimen for heart-bypass surgery, Harris discovered she was eligible for $704 in savings on prescription meds in 2005. After signing up for the federal discount-drug-card program, she proceeded to explore the Web through the online tutorial and find photos related to her hobby, quilting. Her children have long urged her to get online, and now Harris admits, "You're never too old to learn."

Unfortunately, Harris is part of a disquieting minority in her age group. While the rest of society has enthusiastically embraced the Internet, a study by the Kaiser Family Foundation earlier this year revealed that today's elderly are resisting new technology. Previous studies had shown seniors migrating online en masse, but the Kaiser research got specific about demographics for the first time. The results: fewer than 31 percent of seniors older than 65 have ventured online, compared with more than two thirds of the younger baby boomers, 50 to 64. Of seniors older than 65 whose annual household income is less than $20,000 a year--a group that makes up the majority of the elderly on Medicare--an even slighter 15 percent have gone online.

The new statistics worry senior advocates and government officials. More than ever before, the Internet is being used as a tool for managing health-care decisions. Federal health-care reform now focuses on giving individuals new control over their medical options, and the government is using the Internet to convey information about all the available choices. Medicare participants, for example, are now asked to sort through a dizzying number of drug-discount cards for the plan best suited to their location, medical condition and drug regimen. The easiest way to find the drug card with the best government subsidy, as Harris discovered, is to visit the Medicare Web site, Medicare.gov. Yet the Kaiser study found that only 2 percent of senior citizens older than 65 have done so. Tobey Gordon Dichter, founder of the Philadelphia-based Generations on Line, a non-profit Internet literacy program for seniors, calls today's elderly "a generation in digital denial."

Advocates for senior citizens say their online phobia is understandable. Computers remain difficult to use and counterintuitive for those who grew up in the age of phonographs and black-and-white television sets. Then there's the problem of elderly-hostile Web sites with microscopic text and unnavigable labyrinths of information. Many seniors also point to a frustrating experience that engendered their distrust of the computer. Irene Brauer, 84, of Oakland, Calif., recalls using a PC a few years ago and being inexplicably instructed by the machine to turn it off. "After that, I had no desire to experiment at all," she says. "I'm not a very patient person at the computer."

But that doesn't mean seniors like Brauer aren't adapting. Her retirement community often hires instructors for the computer room, and she'll cautiously surf the Web when one is nearby. Five years ago, when she suffered from a sodium and electrolyte deficiency called hyponatremia, she recruited a family member--another popular Net-coping strategy among the elderly--to research the condition online for her.

There are also an increasing number of senior-friendly Web sites now that can make the experience more comfortable. On these pages the fonts are larger, the layout is simpler and the higher color contrast between the words and background improves legibility. The site of Generations on Line, for example, offers a simplified version of the Medicare discount-drug-card sign-up, at golmedicare.org. Another good site is nihseniorhealth.gov, by the National Institute on Aging, which has an easily navigated presentation on diseases like Alzheimer's, arthritis and diabetes. NIA educational-research specialist Stephanie Dailey notes, "If seniors can't get to the information in two or three clicks, you're going to lose them." In today's Web-centric health-care environment, seniors and society can no longer take that risk.