Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Apr 7, 2023
Date Accepted: Nov 9, 2023
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Understanding the value of a proactive telecare system in supporting older adults’ independence at home: a qualitative study
ABSTRACT
Background:
Telecare is claimed to support people to live in their own home for longer by providing monitoring services that enable responses to emergencies at home. Although most telecare technologies commissioned in the UK predominantly supply reactive services, there has been recent interest by policy makers to develop proactive telecare services, to provide additional understanding of older adults’ health and well-being needs to provide a means for more preventative interventions. Proactive telecare refers to providing regular well-being calls or encouraging users to regularly confirm their well-being, with the aim of anticipating and/or preventing crises through increased understanding of individuals’ needs and building social relationships with older adults. Such technologies have already begun to be introduced, yet little research has explored the potential value of proactive telecare.
Objective:
This paper explores the perceptions of different stakeholders to understand the extent to which using a proactive telecare service can support older adults to live independently, what potential health and well-being benefits may be elicited from its use, and what the limitations are.
Methods:
Semi-structured interviews were conducted with older people (those with experience in using proactive telecare and those without), family members of proactive telecare users, and proactive telecare staff regarding their perceptions and opinions on the value of a proactive telecare service. Data were analysed using inductive thematic analysis.
Results:
A total of 30 individuals participated in this study. Older adults described the value of proactive telecare in feeling safe and in control, and appreciated feeling connected. Family members and staff valued the potential to detect early health deterioration in older adults and all participants highlighted the benefit of strengthening access to social networks, particularly for socially isolated older people. However, telecare is often viewed as a last resort, and so anticipatory care may not suit all populations, as demonstrated by a mixed acceptance of the technology among older adults who did not have experience of using it. Participants also reported limitations, including the requirement for family, friends or neighbours to assist older adults in an emergency and the need for financial resources to fund the service.
Conclusions:
This study presents the first known qualitative inquiry into a proactive telecare system, which provides rich and detailed insights from different perspectives into the potential benefits of this intervention. Proactive telecare may promote and facilitate the accumulation of social and technological resources as individuals prepare to cope with age-related challenges, helping to avoid negative outcomes prematurely. However, like reactive telecare, proactive telecare must be matched to individual preferences, and existing financial and social resources.
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Copyright
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