Ethical issues related to the use of gerontechnology in older people care: A scoping review

Abstract

Background:

Demographic trends indicate growth of population aged 65 and older in Western countries. One of the greatest challenges is to provide high-quality care for all. Technological solutions designed for older people, gerontechnology, can somewhat balance the gap between resources and the increasing demand of healthcare services. However, there are also ethical issues in the use of gerontechnology that need to be pointed out.

Purpose:

To describe what ethical issues are related to the use of gerontechnology in the care of community-dwelling older people.

Methods:

A scoping review was performed to identify and analyse studies concerning ethical issues when using gerontechnology in the home care of older people. The literature search was limited to studies published after 1990 and addressed to the electronic databases CINAHL, PubMed, Cochrane, Medic, IEEE Explore and Web of Science. The search was performed in July−August 2018. Data from empirical studies were analysed using thematic analysis.

Ethical considerations:

This scoping review was conducted in accordance with good scientific practice. The work of other researchers was respected and cited appropriately.

Results:

A total of 17 studies were identified. Two main themes were found. ‘Balancing between the benefits of using gerontechnology and the basic rights of older people’, consisted of the subthemes safety, privacy and autonomy. The other main theme, ‘Gerontechnology as a risk of insecurity for older people’, included the subthemes fear of losing human contact and concern and fear. Surveillance and monitoring technologies were mainly studied.

Conclusion:

These results suggest that there may be ethical issues related to the use of gerontechnology and they must therefore be taken into consideration when implementing technology in the care of community-dwelling older people.

Keywords

Technology older people ethics home care scoping review

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References

Thompson

Melia

Boyd

, et al. Nursing ethics. 5th ed. Edinburgh: Churchill Livingstone, 2006, p. 424.

Coughlin

Pope

Leeddel

Jr . Old age, new technology, and future innovations in disease management and home health care. Home Health Care Manag Pract 2006; 18: 196–207.

World Health Organization. 10 facts on ageing and health, http://www.who.int/features/factfiles/ageing/en/ (2017, accessed 31 January 2018).

Scott

Harvey

Felzmann

, et al. Resource allocation and rationing in nursing care: a discussion paper. Nurs Ethics 2019; 26(5): 1528–1539.

Piau

Campo

Rumeau

, et al.

Aging society and gerontechnology: a solution for an independent living?

J Nutr Health Aging 2014; 18(1): 97–112.

Micera

Bonato

Tamura

. Gerontechnology. IEEE Eng Med Biol Mag 2008; 27: 10–14.

Milligan

Roberts

Mort

. Telecare and older people: who cares where? Soc Sci Med 2011; 72(3): 347–354.

Bobillier Chaumon

Michel

Tarpin Bernard

, et al. Can ICT improve the quality of life of elderly adults living in residential home care units? From actual impacts to hidden artefacts. Behav Inf Technol 2014; 33: 574–590.

Beauchamp

Childress

. Principles of biomedical ethics. 7th ed. New York: Oxford University Press, 2013, p. 459.

10.

Lexis

. Activity monitoring technology to support homecare delivery to frail and psychogeriatric elderly persons living at home alone. Technol Disabil 2013; 25: 189–197.

11.

Zwijsen

Niemeijer

Hertogh

. Ethics of using assistive technology in the care for community-dwelling elderly people: an overview of the literature. Aging Ment Health 2011; 15(4): 419–427.

12.

Chung

Demiris

Thompson

. Ethical considerations regarding the use of smart home technologies for older adults: an integrative review. Annu Rev Nurs Res 2016; 34: 155–181.

13.

Arksey

O’Malley

. Scoping studies: towards a methodological framework. Int J Soc Res Method 2005; 8: 19–32.

14.

Peters

Godfrey

Khalil

, et al. Guidance for conducting systematic scoping reviews. Int J Evid Based Healthc 2015; 13(3): 141–146.

15.

Critical Appraisal Skills Programme (CASP). CASP checklists, https://casp-uk.net/casp-tools-checklists/ (2018, accessed 22 October 2018)

16.

Peters

Godfrey

Khalil

, et al. Methodology for JBI scoping reviews. The Joanna Briggs Institute reviewers’ manual 2015. Adelaide, SA, Australia: The Joanna Briggs Institute, 2015, p. 24.

17.

Boström

Kjellström

Björklund

. Older persons have ambivalent feelings about the use of monitoring technologies. Technol Disabil 2013; 25: 117–125.

18.

Claes

Devriendt

Tournoy

, et al. Attitudes and perceptions of adults of 60 years and older towards in-home monitoring of the activities of daily living with contactless sensors: an explorative study. Int J Nurs Stud 2015; 52(1): 134–148.

19.

Essen

. The two facets of electronic care surveillance: an exploration of the views of older people who live with monitoring devices. Soc Sci Med 2008; 67(1): 128–136.

20.

Harrefors

Axelsson

Savenstedt

. Using assistive technology services at differing levels of care: healthy older couples’ perceptions. J Adv Nurs 2010; 66(7): 1523–1532.

21.

Landau

Auslander

Werner

, et al. Families’ and professional caregivers’ views of using advanced technology to track people with dementia. Qual Health Res 2010; 20(3): 409–419.

22.

Landau

Werner

Auslander

, et al. What do cognitively intact older people think about the use of electronic tracking devices for people with dementia? A preliminary analysis. Int Psychogeriatr 2010; 22(8): 1301–1309.

23.

Landau

Auslander

Werner

, et al.

Who should make the decision on the use of GPS for people with dementia?

Aging Ment Health 2011; 15(1): 78–84.

24.

Melander-Wikman

Faltholm

Gard

. Safety vs. privacy: elderly persons’ experiences of a mobile safety alarm. Health Soc Care Community 2008; 16: 337–346.

25.

Mihailidis

Cockburn

Longley

, et al. The acceptability of home monitoring technology among community-dwelling older adults and baby boomers. Assist Technol 2008; 20(1): 1–12.

26.

Olsson

Engstrom

Skovdahl

, et al. My, your and our needs for safety and security: relatives’ reflections on using information and communication technology in dementia care. Scand J Caring Sci 2012; 26(1): 104–112.

27.

Percival

Hanson

. Big brother or brave new world? Telecare and its implications for older people’s independence and social inclusion. Crit Soc Policy 2006; 26: 888–909.

28.

Robinson

Hutchings

Corner

, et al. Balancing rights and risks: conflicting perspectives in the management of wandering in dementia. Health Risk Soc 2007; 9: 389–406.

29.

Savenstedt

Sandman

Zingmark

. The duality in using information and communication technology in elder care. J Adv Nurs 2006; 56(1): 17–25.

30.

van der Heide

Willems

Spreeuwenberg

, et al. Implementation of CareTV in care for the elderly: the effects on feelings of loneliness and safety and future challenges. Technol Disabil 2012; 24: 283–291.

31.

Werner

Auslander

Shoval

, et al. Caregiving burden and out-of-home mobility of cognitively impaired care-recipients based on GPS tracking. Int Psychogeriatr 2012; 24(11): 1836–1845.

32.

Wild

Boise

Lundell

, et al. Unobtrusive in-home monitoring of cognitive and physical health: reactions and perceptions of older adults. J Appl Gerontol 2008; 27(2): 181–200.

33.

Fassert

Rigaud

. Designing robots for the elderly: appearance issue and beyond. Arch Gerontol Geriatr 2012; 54(1): 121–126.

34.

Vaismoradi

Turunen

Bondas

. Content analysis and thematic analysis: implications for conducting a qualitative descriptive study. Nurs Health Sci 2013; 15(3): 398–405.