Older people, assistive technologies, and the barriers to adoption: A systematic review.

BACKGROUND: Older people generally prefer to continue living in their own homes rather than move into residential age care institutions. Assistive technologies and sensors in the home environment and/or bodily worn systems that monitor people's movement might contribute to an increased sense of safety and security at home. However, their use can raise ethical anxieties as little is known about how older persons perceive assistive and monitoring technologies.

OBJECTIVES: To review the main barriers to the adoption of assistive technologies (ATs) by older adults in order to uncover issues of concern from empirical studies and to arrange these issues from the most critical to the least critical.

METHOD: A 4-step systematic review was conducted using empirical studies: locating and identifying relevant articles; screening of located articles; examination of full text articles for inclusion/exclusion; and detail examination of the 44 articles included.

RESULTS: Privacy is a top critical concern to older adults, registering a 34% of the total articles examined. Two other equally potent barriers to the adoption of ATs were trust and functionality/added value representing 27 and 25 per cent each respectively of the total studies examined. Also of serious concerns are cost of ATs and ease of use and suitability for daily use (23%) each respectively, perception of "no need" (20%), stigma (18%), and fear of dependence and lack of training (16%) each respectively. These underlying factors are generation/cohort effects and physical decline relating to aging, and negative attitudes toward technologies such as the so-called "gerontechnologies" specifically targeting older adults. However, more and more older adults adopt different kinds of ATs in order to fit in with the society.

CONCLUSIONS: The identified underlying factors are generation/cohort effects and physical decline relating to aging, and negative attitudes toward technologies. The negative attitudes that are most frequently associated with technologies such as the so-called "gerontechnologies" specifically targeting older adults contain stigmatizing symbolism that might prevent them from adopting them.