Abstract

With the help of technology-based devices and services such as personal alarm systems, smart homes, and medication dispensers, older adults may be better able to "age in place", that is, to live in their homes and communities for as long as possible, hence reducing healthcare costs while increasing older adults' quality of life. Current research suggests that the adoption of quality of life technologies is a complex process of negotiating needs and anticipated impacts marked by the interaction of technological, personal, and social characteristics and circumstances. How these interactions play out is, however, unclear.

The purpose of this study was to analyze the meanings of Personal Emergency Response Systems (PERS) for older adults and the intrapersonal and interpersonal processes that lead to acceptance or rejection of such devices. In-depth Interviews with 18 participants, who were PERS users or were considering getting a PERS, were analyzed using grounded theory methodology.

Results indicate that older adults postponed their decision about PERS to an unknown future as they struggled to reconcile the meaning of the device for their self-image as self-sufficient individuals. At the same time, participants faced increasing pressure from their children, who use a variety of strategies to push their parents to get a PERS. In many cases, however, participants faced a discrepancy between their internal self-assessment and the external assessment, leading to the conclusion that they did not need a PERS. Although they internally disagreed with their children, participants rationalized their children's persistence as acts of love and care. Because participants felt indebted to their children who often provide crucial support, they did not want to risk their relationship and avoided conflicts by any means. Even when children unilaterally decided to get a PERS, participants rationalized their children's behavior, stating well-intended motives. The results also point to a severe lack of information about available technologies that can support older adults in the long term.

The insights gained in this study can support healthy aging by informing the development of appropriate and acceptable technologies as well as guiding the design of individual- and community-based intervention to promote technology use for aging in place. The results also have implications for care policy and provide insights into how technologies can be leveraged in informal care settings.