JMIR Publications

ABSTRACT

Background:

Continuous in-home monitoring of older adults can provide rich and sensitive data capturing subtle behavioral and cognitive changes. Our previous work has identified multiple metrics that describe meaningful trends in daily activities over time. The continuous, multi-domain nature of this technology may also serve to inform caregivers of the need for increased attention in order to maintain the health and safety of at-risk older adults. Accordingly, care decisions can be based on objective, systematically assessed real-time data.

Objective:

The present study deployed a suite of in-home monitoring technologies to detect changing levels of care needs in residents of independent living units in seven retirement communities.

Methods:

Continuous activity data were presented to staff involved in decisions regarding transitions in care. Comparisons were planned between outcomes for residents whose data were shared and those whose data were not made available to staff. Staff use of the data dashboard was also monitored over the course of the study.

Results:

Despite initial enthusiasm and an iterative process of refinement of measures and modes of data presentation based on staff input, actual inspection and therefore use of resident data was well below expectation. Survey data and in-depth interviews offered insight to the mismatch between intended and actual use.

Conclusions:

Most continuous in-home monitoring technology acceptance models focus on perceived usefulness and ease of use, and equate intent to use technology with actual use. Our experience suggests otherwise. We found multiple intervening variables exist between perceived usefulness, intent to use and actual use. Ethical, institutional, and social factors are considered in their role as determinants of use.