Technology acceptance

Technology has the potential to enhance the quality of life for older people receiving aged care services. It might do this by facilitating social connectedness or by supporting the workforce to deliver better quality, efficient care. Two examples of this are telehealth initiatives and electronic health or care records.  By automating certain tasks, technology can also alleviate the impact of workforce shortages and reduce the workload of carers and care providers. However, for technology to have a positive impact in aged care it must be accepted and used by the older adults, care providers, and other stakeholders for which it was designed. This requires careful consideration of the practical use of technology to ensure that users are comfortable with the involvement of technology in providing their care and understand how to use technology effectively.

Technology acceptance is a measure of how a technology is received by the people it was designed for. [1] Acceptance can be influenced by many factors, including how useful and relevant a technology appears to people, its ease of use, [2] and the extent that people are willing to use it. Technology acceptance is often influenced by fundamental principles that inform design features impacting ‘usability’. Useability refers to how intuitive a technology is to use, and the degree of effort required for it to accomplish a task. For aged care, the difficulty is ensuring that technologies appeal to diverse older populations and the carers that use them. [3] Useability can be affected significantly by the product interface, the accessibility of its features and functions, and the speed and responsiveness of the system. [4] Compatibility with other systems and integration into existing workflows are also important useability considerations for the delivery of quality aged care services.

This evidence theme summarises one of the key issues we identified as part of a scoping review of research on human factors and technology in aged care. We identified 14 studies on this topic. [2, 5-17] These studies discussed acceptance of technology in aged care settings, and some provide recommendations for key features. If you require more information on this topic, try using our one-click PubMed searches provided below.

The extent of technology use in aged care is directly related to technology acceptance. [2] This suggests that if technology is accepted by care recipients and the aged care workforce it can be effectively integrated to support quality care delivery. The research indicates that:  

• There is a relationship between how well a technology is accepted by its intended users and the extent to which they see it as useful and easy to use. However, people living in residential aged care facilities may have little choice in the types of technology provided for them or used in their care. Technology decisions are often made for them. [2] This can limit the types of devices and technology that older people living in long-term care facilities can access. 
• The needs of older adults should be considered when integrating technology into aged care, especially when using devices such as iPads that may be difficult to use for individuals with limited eyesight, and for those with arthritis, who may experience difficulties using the touch screen. [2] Appropriate technologies that are suitable for the majority should be considered when introducing technology to support quality aged care. 
• Where care delivery involves robotics, older adults may prefer interacting with more humanlike robots that carry out specific functional tasks. This preference should be considered in the future design of robots intended to support aged care delivery. [11] 
• Aged care providers need to understand the importance of aged care workers’ perceptions of technology, as their role can be crucial in motivating older people to use and engage with socially assistive technology. [5] 
• As people can be reluctant to use technology due to security concerns, it is important that designs incorporate robust data security features to ensure technology acceptance by providers, caregivers, and older care recipients. [10] For more information on the importance of privacy and safety see the evidence theme here.

Overcoming barriers to technology acceptance is essential for the uptake of technology in aged care delivery. The included studies reported the following potential barriers for consideration.  

• Some people expressed ethical concerns about the quality of care that might be provided via technological means as well as the importance of maintaining their personal privacy. [7] 
•  Older people might express anxiety about having a robot in their home. [6] 
• Personal and professional traits might prevent the uptake of monitoring technology, influenced by previous experience (i.e., technical issues and time restraints), lack of trust in technology (i.e., cybersecurity concerns), negative peer attitudes, computer literacy issues and poor staff engagement. [7] 
• Poor usability features such as lack of personalisation and difficulties integrating technologies into daily tasks can lead to poor acceptance of technology. [8] 
• Care workers’ use of technology can be limited by lack of support for its implementation from aged care providers, as well as organisational factors such as limited leadership support, time restraints, and unclear incentives for introducing a novel approach to carrying out daily tasks. [7]

Technologies that are easy to use have the potential to improve the quality of care for older adults. The included studies suggest that:  

• Early engagement of older people in the design process can ensure technology designs are user friendly. [2] 
• Technology that is accessible to people with varying physical and cognitive abilities and products that meet the specific needs of end-users are more likely to be implemented and used on an ongoing basis.  [14] 
• Appropriate training, adaptation of work processes to support communication, and restructuring of teams and tasks could improve usability and sustainability of telehealth in residential aged care. [17] 
• Regular training and support should be provided to ensure that intended users have the digital literacy skills to be able to interact with technology. [2]  
• Sufficient technical support from the technology provider should be available to address any problems in using the product. [13] 
• Technologies should integrate features that support security and privacy for the intended user. [7] 
• Technologies should be compatible with existing software systems. [5] 
• The potential discomfort and appropriateness of technology for certain population groups should be considered on a case-by-case basis (i.e., VR can agitate some older adults with dementia). [18] 
• Residents and staff alike appreciate hands-free activated technology, where content ‘popped-up’ on the screen rather than having to navigate the platform content themselves. This feature was helpful for residents with lower computer literacy and may be an important consideration for technology acceptance in aged care. [16] 

For more information on how to implement technology in aged care services please see our Implementing technology theme.

1. Jarvis MA, Sartorius B, Chipps J. Technology acceptance of older persons living in residential care. Information Development. 2020;36(3):339-353.   
2.  Moyle W, Pu L, Murfield J, Sung B, Sriram D, Liddle J, et al. Consumer and provider perspectives on technologies used within aged care: An Australian qualitative needs assessment survey. J Appl Gerontol. 2022;41(12):2557-2565.   
3.  Hirsch T, Forlizzi J, Hyder E, Goetz J, Kurtz C, Stroback J. The ELDer project: Social, emotional, and environmental factors in the design of eldercare technologies.  Proceedings on the 2000 Conference on Universal Usability; Arlington, Virginia, USA: Association for Computing Machinery; 2000. p. 72–79.  
4.  Ghorayeb A, Comber R, Gooberman-Hill R. Older adults' perspectives of smart home technology: Are we developing the technology that older people want? Int J Hum Comput Stud. 2021;147:102571.   
5.  Khaksar SMS, Khosla R, Singaraju S, Slade B. Carer’s perception on social assistive technology acceptance and adoption: Moderating effects of perceived risks. Behav Inf Technol. 2021;40(4):337-360.   
6.  Fiorini L, Sorrentino A, Pistolesi M, Becchimanzi C, Tosi F, Cavallo F. Living with a telepresence robot: Results from a field-trial. EEE Robot Autom Lett. 2022;7(2):5405-5412.   
7.  Wild K, Sharma N, Mattek N, Karlawish J, Riley T, Kaye J. Application of in-home monitoring data to transition decisions in continuing care retirement communities: Usability study. J Med Internet Res. 2021;23(1):e18806.   
8.  van Doorn-van Atten MN, Haveman-Nies A, Heery D, de Vries JHM, de Groot L. Feasibility and effectiveness of nutritional telemonitoring for home care clients: A pilot study. Gerontologist. 2019;59(1):158-166.   
9.  Berridge C, Chan KT, Choi Y. Sensor-based passive remote monitoring and discordant values: Qualitative study of the experiences of low-income immigrant elders in the United States. JMIR Mhealth Uhealth. 2019;7(3):e11516.   
10.  Blinka MD, Buta B, Bader KD, Hanley C, Schoenborn NL, McNabney M, et al. Developing a sensor-based mobile application for in-home frailty assessment: A qualitative study. BMC Geriatr. 2021;21(1).   
11.  Chu L, Chen HW, Cheng PY, Ho P, Weng IT, Yang PL, et al. Identifying features that enhance older adults' acceptance of robots: A mixed methods study. Gerontology. 2019;65(4):441-450.   
12.  Ali H, Li H. Use of notification and communication technology (call light systems) in nursing homes: Observational study. J Med Internet Res. 2020;22(3):e16252.   
13.  Arends J, Thijs RD, Gutter T, Ungureanu C, Cluitmans P, Van Dijk J, et al. Multimodal nocturnal seizure detection in a residential care setting: A long-term prospective trial. Neurology. 2018;91(21):955-955.  
14.  Karsan Y, Anderson C, Boyd MJ, Thornley T. Exploring barriers to the sustainability of an electronic administration system in long-term care facilities: A case study approach. Res Social Adm Pharm. 2021;17(6):1066-1071.   
15.  Klein B, Schlomer I. A robotic shower system: Acceptance and ethical issues. Z Gerontol Geriatr. 2018;51(1):25-31.  
16.  Millett G, Franco G, Fiocco AJ. A qualitative study of the usability and likability of a virtual group-based social support program for older adults in residential care. Clin Gerontol. 2022 Dec 15:1-13.   
17.  Powell KR, Winkler AE, Liu J, Alexander GL. A mixed-methods analysis of telehealth implementation in nursing homes amidst the COVID-19 pandemic. J Am Geriatr Soc. 2022;70(12):3493-3502.   
18.  Baker S, Waycott J, Robertson E, Carrasco R, Neves BB, Hampson R, et al. Evaluating the use of interactive virtual reality technology with older adults living in residential aged care. Inf Process Manag. 2020;57(3).