Lessons learned in deploying independent living technologies to older adults’ homes

Abstract

Independent living technologies are fast gaining interest within both academia and industry, amid the realisation that the world's population is ageing. Technology can increase the quality of life of older people, allowing them to age in-place and helping them to remain physically, cognitively and socially engaged with their environment. However, little research in this area is applied. We argue the necessity of moving such technology out of the research lab and into the home, where its real impact on the lives of older adults can be assessed. This paper outlines a series of recommendations encompassing the life cycle of independent living technologies, from ethnographic assessment, through to design, deployment and evaluation. This work is based on lessons we have learned deploying such technologies to older people in over 200 homes. We believe this paper can act as a guide for other researchers interested in developing technologies with older people.

Factors that influence older people’s engagement with digital health technology

“…Users also had less intention to continue their use of DHT when they experienced malfunctions (Reade et al 2016, Hamblin 2017) even when some of these were related to them forgetting to charge a device. However, Doyle et al (2014) found that this potentially negative experience in DHT use among older people could be overcome through pro-activity in the design features and support service. Their devices reminded users when to replace batteries, components to be swapped or fixed remotely via an internet connection, and they had fast technical help response times when users identified problems.…”

“…OIder users' understanding of the function of devices such as modems and routers can influence their engagement, particularly with home telehealth equipment such as online applications provided on an iPad or smart phone (Sanders et al 2012;Doyle et al 2014). However, more recent studies suggest that a lack of prior technological knowledge is not a barrier to DHT uptake and it is the design that is the important factor (Middlemass et al 2017), with older users preferring simple user interfaces (Doyle et al 2014), and preferring avoidance of excessive text in large blocks and medical jargon (Algeo et al 2017). Co-creation of the DHT interface with older users can improve uptake success, particularly when developing electronic assisted living technologies (Holliday et al 2014).…”

“…Older people are concerned about the nature of data that is collected by DHT, that the technology might record aspects of their lives that they have not consented to sharing, and they want confirmation that this isn't going to happen before use (Doyle et al 2014). This anxiety and distrust barrier can be reduced by clearly explaining the purpose of the DHT devices in person, a strategy shown to reduce user anxieties about this issue (Doyle et al 2014). Users also want to understand how their data is presented to others and have control over this (Lie et al 2016).…”

“…Although these are most commonly aimed at changing unhealthy behaviours in people without long-term conditions, a number of these DHT interventions include behaviour change techniques that enable users to set individualised goals (Devi et al 2014, Algeo et al 2017) and encourage them to monitor their progress using diaries, such as recording the amount of exercise they take or trends in symptoms (Devi et al 2014, Williams et al 2014. Exercise-based interventions can give positive feedback at regular intervals and reassure or inform users of their progress and thereby encourage ongoing use (Doyle et al 2014, Essery et al 2016). The literature shows that a perceived lack of feedback is viewed negatively by users of DHT, such as within the studies for people using DHT for managing their respiratory or heart disease, and these users expressed that they who would have preferred input on their progress from medical staff (Middlemass et al 2017).…”

“…However, it is also important to acknowledge that there are some prevailing attitudes among older people that indicate severity of illness and age are factors in engaging with DHT, with some feeling people need to have a high level of need or be "ill enough" to warrant use of DHT devices (Sanders et al 2012;Doyle et al 2014;Lie et al 2016) and that certain interventions such as web-based programmes are for younger age groups (Currie et al 2015). Such perceptions are important to consider and manage if DHT is to be encouraged among older people.…”