JMIR Publications

ABSTRACT

Background:

Older adults with chronic illness and/ or dependency on care who strive to age-in-place need support and care depending on their illness. Digital technology has enabled the possibility of supporting older adults in their wish to age-in-place. However, current studies mainly focus on the solitary evaluation of individual technologies or on evaluating technologies for specific illnesses.

Objective:

This study aims at synthesizing research on the experiences of older people from Western culture with chronic illnesses and/or care needs and their families with digital technology for aging-in-place. From the meta-synthesis, a model is derived that can be useful for the development of assistive devices in old age and that can support healthcare providers and professionals in their work with affected persons.

Methods:

A systematic review and qualitative meta-synthesis was performed, using an inductive approach, as proposed by Sandelowski and Barroso. We did a systematic literature search in six databases from 2000 to 2019, with an update in 2021, and, in addition, conducted a hand search in two databases, relevant journals, and reference lists. The results of each study were analysed using initial and axial coding, followed by selective coding. A conceptual model was derived.

Results:

A total of 7,776 articles were identified. Articles were screened independently by two authors on the basis of the eligibility criteria. Finally, 18 studies were included in the meta-synthesis. The derived conceptual model describes older adults with chronic illness and/or dependency on care and their family members in an individual process of reflection and decision-making starting with the use of a digital device. Older adults live in times of change. They experience stable and unstable times of illness as they are part of a changing digital world. Hence, older adults and their families consider digital technology as a solution for their current situation. As they become familiar with the specific digital technology, they refine their needs and demands, gain confidence in its use, and note advantages and disadvantages. They weigh hopes, needs, demands, and experiences in a process of reflection to decide over convenience or inconvenience. Independent of their decision, they reach peace of mind either with or without digital technology. This process can restart again and again during older adults’ illness trajectories.

Conclusions:

The study promotes a differentiated understanding of older adults’ experiences with digital technology. The conceptual model can be useful for the development of assistive technology in old age and can guide healthcare professionals in their work with older adults and their families to provide individual counselling to find the appropriate digital technology for the respective situations.