JMIR Publications

ABSTRACT

Background:

Aged care has recently undergone major transformations due to an increasingly prominent demographic ageing and the concomitant need to manage the costs of healthcare. New Emerging Technologies (ET) have started to play a central role in the daily management of older adults, also with a view to the so-called Active Ageing. In order for these transformations to effectively promote successful ageing, it is essential to understand the opinions of older adults on the impact that technology can have on their vulnerabilities and ageing process.

Objective:

This work aims to study the ethically-related impact of ET, in particular exploring the impact of ET on cognitively healthy older adults’ vulnerabilities.

Methods:

Using the PRISMA procedure, we conducted a systematic review of empirical (qualitative) evidence exploring the relationship between ET and older adults’ vulnerabilities as perceived by older adults without cognitive impairments. Five major databases (Pubmed®, Web of Science™, Embase®, CINAHL and Philosopher’s Index) were queried, covering biomedical, philosophical, bioethical, and anthropological literature. 11.631 results were obtained. After duplicates had been eliminated, titles, abstracts, and full texts were screened for relevance. Eventually, 70 articles were included. Data analysis and synthesis followed the preparatory steps of the coding process detailed in the QUAGOL methodology.

Results:

ET seem to have an ambivalent effect on the vulnerability of the still cognitively healthy older adults. These devices tame some already existing vulnerabilities, and, at the same time, they worsen already existing – or create new – vulnerabilities. For example, Unconventional Monitoring Techniques (e.g., wearables) often tame relational vulnerability, because they are perceived as a support to maintain independence and remain at home and in one's community. On the other hand, these same devices may negatively affect moral vulnerability, threatening older adults’ privacy, in the sense of confidentiality, as ET could violate their personal data.

Conclusions:

This systematic review, focusing on the perceptions of older adults without cognitive impairments, enriches the vast literature about the everyday management and care of the seniors, by exploring the ethical implications of ET. This research is a complementary work to another systematic review of the qualitative evidence, aimed at analyzing the views of older people with cognitive disorders on the same topic. Although a certain ambivalence in the use of ET is identified by both population groups, it is interesting how the cognitively healthy seniors give more importance to some dimensions of vulnerability, such as the moral and relational ones, which, in the case of the cognitively impaired older adults, are not as significant. Two issues which are emblematic and particularly felt is the respect of privacy and data security and the perceived risk of control and surveillance linked to the use of monitoring technologies. Clinical Trial: Not applicable. This is a systematic review, not a primary research article.