Older Adult Perceptions of Smart Home Technologies: Implications for Research, Policy & Market Innovations in Healthcare

Abstract

Advances in information communications technology and related computational power are providing a wide array of systems and related services that form the basis of smart home technologies to support the health, safety and independence of older adults. While these technologies offer significant benefits to older people and their families, they are also transforming older adults into lead adopters of a new 24/7 lifestyle of being monitored, managed, and, at times, motivated, to maintain their health and wellness. To better understand older adult perceptions of smart home technologies and to inform future research a workshop and focus group was conducted with 30 leaders in aging advocacy and aging services from 10 northeastern states. Participants expressed support of technological advance along with a variety of concerns that included usability, reliability, trust, privacy, stigma, accessibility and affordability. Participants also observed that there is a virtual absence of a comprehensive market and policy environment to support either the consumer or the diffusion of these technologies. Implications for research, policy and market innovation are discussed.

eFRIEND: an ethical framework for intelligent environments development

“…Coughlin et al, for example, found that service providers and policy advocates were particularly passionate about ethical considerations in smart home technologies, especially trust and privacy issues, 24/7 home monitoring and third party use of behavioural data by commercial entities (Coughlin et al, 2007). However, van Hoof et al in their research into the prototype of a home-based autonomous surveillance system for older users, found that users themselves were not worried about privacy issues, and did not feel watched or monitored (2011).…”

Ethics of the health-related internet of things: a narrative review

“…Personal privacy can also be understood as a freedom, to "escape being observed or accessed when desired" (Essén 2008, p. 130), implying a social duty to respect the desire for isolation of others. The introduction of H-IoT may cause a gradual loss of personal privacy (Steele et al 2009), particularly among smart home systems (Coughlin et al 2007;Demiris 2009;Dorsten et al 2009). Monitoring technologies can create a psychological disturbance, sometimes called obtrusiveness (Hensel et al 2006;Nefti et al 2010), expressed in a feeling of 'being watched'.…”

“…On the social side, personal privacy concerns control over social interaction through geographical distance, group membership, and location. It is connected to physical privacy (Bagüés et al 2007b;Coughlin et al 2007;Little and Briggs 2009) and can contribute to social isolation. For H-IoT used in chronic illness management, potential violations of personal privacy can be justified on the basis of 'need' for the technology, derived from safety concerns (Zwijsen et al 2011;Steele et al 2009) or the delay of a move to residential care (Townsend et al 2011;Remmers 2010;Essén 2008;McLean 2011).…”

“…The ethical acceptability of the latter solution must, however, be questioned, as it violates the norm that H-IoT should only be used as needed, based on the particular situation of an individual (Mittelstadt et al 2014) "monitoring for monitoring's sake" (Bowes et al 2012), or pursuing monitoring as an end in itself (Coughlin et al 2007;McLean 2011) is to be avoided.…”

“…Concerns over data control are common in research assessing the privacy experiences of H-IoT users (Coughlin et al 2007;Courtney 2008;Little and Briggs 2009;Melenhorst et al 2004;Wilkowska et al 2010;Henze et al 2016). Expectations of control must adapt to "a world of numerous interconnected machines constantly talking to each other and observing the real-world environment."…”