A Conceptual Model of Experiences With Digital Technologies in Aging in Place: Qualitative Systematic Review and Meta-synthesis

Abstract

Background Older adults with chronic illnesses 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 wishes to age in place. However, current studies have mainly focused on the solitary evaluation of individual technologies or on evaluating technologies for specific illnesses. Objective This study aimed to synthesize research on the experiences of older people from the Western culture with chronic illnesses or care needs and their families with digital technology for aging in place. From the meta-synthesis, a model was derived that can be useful for the development of assistive devices in old age and that can support health care providers and professionals in their work with affected individuals. Methods A systematic review and qualitative meta-synthesis was performed using an inductive approach, as proposed by Sandelowski and Barroso. We performed a systematic literature search in 6 databases from 2000 to 2019, with an update in 2021 and, in addition, conducted a hand search in 2 databases, relevant journals, and reference lists. The results of each study were analyzed using initial and axial coding, followed by theoretical coding. A conceptual model was derived. Results A total of 7776 articles were identified. Articles were screened independently by 2 authors based on the eligibility criteria. Finally, of the 7776 studies, 18 (0.23%) were included in the meta-synthesis. The derived conceptual model describes older adults with chronic illnesses 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 a solution to their current situation. As they become familiar with a specific digital technology, they refine their needs and demands, gain confidence in its use, and note its advantages and disadvantages. They weigh hopes, needs, demands, and experiences in a process of reflection to decide on convenience and inconvenience. Independent of their decision, they achieve peace of mind either with or without digital technology. This process can restart repeatedly during the illness trajectory of older adults. Conclusions This 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. Moreover, it can guide health care professionals in their work with older adults and their families to provide individual counseling to find the appropriate digital technology for their respective situations.

Promoting Universal Equitable Accessibility: An Overview on the Impact of Assistive Technology in the UN, UNICEF, and WHO Web Portals

“…The research reported 19 systematic reviews [43][44][45][46][47][48][49][50][51][52][53][54][55][56][57][58][59][60][61]. Almost all the reviews dealt with aspects of effectiveness and/or acceptance in some way, and several also dealt with multiple issues at the same time.…”

“…Five systematic reviews [44,45,53,55,60] emphasize the significance of the interplay between electronics, the internet, and assistive technologies (ATs).…”

Design and Evaluation of Personalized Services to Foster Active Aging: The Experience of Technology Pre-Validation in Italian Pilots

“…Today, technology represents one of the solutions to overcome this process. The concept of “aging in place” has been pointed out in many works [ 3 , 4 ]. As defined by Hechinger et al [ 4 ], “ aging in place is living in one’s own home as long as possible while maintaining social and care networks and autonomy in deciding the type of assistance ”.…”

“…The concept of “aging in place” has been pointed out in many works [ 3 , 4 ]. As defined by Hechinger et al [ 4 ], “ aging in place is living in one’s own home as long as possible while maintaining social and care networks and autonomy in deciding the type of assistance ”. However, as is highlighted by this work, the existing literature is fragmented and lacking in effective solutions.…”

“…Recently, Choukou et al [ 11 ], in their scoping review, remarked that other stakeholders such as caregivers and professionals should be included in the evaluation of assistive devices, Indeed, less than 50% of identified studies evaluated acceptance in more than one population. At the same time, different works have attempted to define a methodology [ 3 , 4 , 14 , 15 , 16 ]. In particular, the LIFE methodology [ 17 ] underlines the necessity of conducting in-field tests before the long trial in order to fine-tune the systems, and Choukou et al [ 11 ] remarked on the necessity of adopting a mixed-method research strategy, investigating usability, efficiency, and effectiveness beginning in the early stages of the project.…”