"Maybe we should talk about it anyway": a qualitative study of understanding expectations and use of an established technology innovation in caring practices

Abstract

BackgroundTechnological innovations are strongly promoted to meet the demands posed by increased pressure on home care services and to assist ageing in place in western societies. Although heavily advocated as plug and play solutions, technologies have proven difficult and unpredictable when integrated into home care services. We need greater insight into what happens when technologies are integrated into caring practices. All technologies come with expectations as to their function. This study explores how actors who are involved with the social alarm, which is an established technology innovation, relate to, perceive and articulate these expectations of the technology in everyday living.MethodsThe article presents results from a two-case study, using a triangulation of qualitative methods in order to gain an in-depth understanding of technology in use in home care services through “thick descriptions”. The study was conducted in Norway and data were analysed using a stepwise deductive-inductive analysis.ResultsThe empirical findings demonstrate that expectations regarding the social alarm, even though it represents a simple and well-established technology, are complex and multidimensional. The notion of script and domestication provided relevant tools for exploring these expectations and for understanding how actors interpret and adapt their practices of using the technology. This enabled a more comprehensive understanding of how technology opens up for different interpretations and puts values in play.ConclusionsThis article suggests exploring technology in use as scripted in multidimensional script, and offers a frame for doing so. It also reveals how technology scripts and articulation prove important for understanding the complex reality when integrated into home care practices, thus identifying how using the technology leads to the taming and unleashing of both technology and actors. The study offers an increased understanding of how and why technology is unpredictable and works differently in different contexts. Moreover, it stresses the importance of avoiding expectations of plug-and-play in a reality of complex interactions between different actors.

Narrative Review: Technologies in Eldercare

“…This also raises questions about power relations: Who has the power to affect technolog- Technology is fluid, has diverse and sometimes unexpected effects, and may change the expectations and aims of care (Mol 2008). As a result, it is important to acknowledge that technology in eldercare cannot be seen as a neutral tool that can be introduced to achieve a special effect (Stokke 2017). Technology is not prescriptive and deterministic in its ability to solve problems that have the same basic shape.…”

“…Ambivalence was found in the literature regarding expectations among older people regarding technology use (van Hoof et al 2011, Bouwhuis, Meesters, and Sponselee 2012, Milligan, Roberts, and Mort 2011, Pape, Kim, and Weiner 2002, Pols 2011, Stokke 2017). On the one hand, the pendant alarm that is attached to an emergency response system is often presumed to provide safety and security.…”

“…Controversies need to be handled through social negotiations that occur in an open and dynamic teamwork relationship(Obstfelder, Engeseth, and Wynn 2007, Shea and Belden 2015, Gillingham 2017. As indicated, effective policies and innovation strategies are needed to support the successful evolution of technology in eldercare(Bygstad and Lanestedt 2017); otherwise, there is a risk that local initiatives and projects will never move beyond the project phase or that technology procurement will be biased(Stokke 2017). Concern has been raised about the disproportionate amount of time that is spent on projects that never scale up(Gillingham 2017).…”

Older People Negotiating Independence and Safety in Everyday Life Using Technology: Qualitative Study (Preprint)

“…The script metaphor describes technologists' vision of a technology's function, the expectations of how the users will relate to the technology and vice versa [32][33][34][35]. Social alarms can be scripted in different dimensions: as technological devices, as integrated services, and how values come into play for the actors involved [36].…”

Metaphors to Think about Technological Tools and Patients Care in Family Medicine

“…The biomedical model and the technological emphasis affect the expectations and behaviors of the patient and the physician [14]. This model produces in society an expectation that implies the promise that the "fountain of eternal youth" is right here, if we find the keys to open certain gates of several diseases.…”