Introduction Evaluations of telecare demonstrate disparate results, which are of little help for understanding what the users need from further policy and development. This study aims to provide a more nuanced approach to telecare evaluations. Methods Realist evaluation is used to scrutinize what it is about telecare that works for whom, why, how and in which circumstances. Sequential interviews were conducted with telecare users and relatives at pre- and post-implementation stages. Result Some users experienced the intended effects from telecare, such as increased feeling of safety, whereas others did not. Various contextual elements influenced how people reasoned about the resources provided by telecare and affected the individual outcomes. Discussion The desire to remain in own home appeared to be a major driving force in accepting telecare. Users had surprisingly high tolerance to side effects of telecare, which might indicate that much was at stake. Some users disapproved of having telecare due to contextual reasons; however, readjustments proved successful to some. Conclusion This study illuminates how and why telecare works differently in different situations, and thus leads to different outcomes. When telecare is correctly adjusted to match the user’s needs, abilities and contexts it enables them to feel safe and remain in their own homes.

Introduction: Telecare is important in future governmental health and social plans. Telecare acceptance is one of the factors that appears to be vital for uptake and thus important to understand. Different technology acceptance models have been applied but judged to be insufficient in assessing telecare acceptance with older people. The purpose of this paper is to review and evaluate why the existing technology acceptance models fall short when applied to telecare and propose an improved approach for assessing telecare acceptance.

Implementing telecare requires experience and knowledge from different disciplines and sectors; business, technology and care. The uptake of telecare has been slow, which is assumed to be caused by difficulties in co-operation within telecare partnerships. This article presents a new approach to improve understanding of telecare partnerships. The approach builds on theories of trust and partnership working and is informed by rational choice theory.  Within this article the approach is applied to recent experiences from a telecare project in Norway, to demonstrate how different ways of interpreting the complex social interactions in telecare partnerships yield new insight and understanding. Examples from the Norwegian project illustrate how different understandings of actions and choices affected trust and caused either improved or deteriorated co-operation in the partnership. The partners that were able to develop trust through a common evaluation of the problems co-operated better. However, when partners lacked or had insufficient knowledge, either of each other or of the situation, this led to disparate understandings that threatened trust and affected further co-operation. The new approach presented here is helpful in analyzing and understanding the actions of different partners within a telecare partnership and identifying why things worked well or went wrong. The approach may have wider relevance for other partnerships

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