Abstract
Background: With growing emphasis on technology-enabled care in long-term care (LTC), telecare services offer potential to enhance independence and quality of life for older adults, yet research to date has not comprehensively considered the wide range of factors that influence their acceptance.
Approach: This study addresses the gap by extending the Technology Acceptance Model (TAM) with factors, such as living arrangement, eligibility for LTC (indicating impairments in autonomy), receipt of formal care, duration of telecare use, psychosocial impacts of telecare use (adaptability, self-esteem and competence), and use of an automatic fall detector on telecare acceptance. The Psychosocial Impact of Assistive Devices Scale (PIADS) was used to evaluate psychosocial impacts of telecare use. Telecare services assessed include personal emergency alarms, automatic fall detectors, motion and magnetic sensors, GPS tracking systems, and environmental detectors (gas, smoke, temperature, and water leakage). This one-group post-test-only quasi-experimental study, conducted as part of two national projects commissioned by Slovenia’s Ministry of Health, involved 217 older long-term care (LTC) recipients who tested various telecare services for an average of 310.2 days. Data were collected through face-to-face interviews conducted between May and August 2020 and between April and June 2022, with responses recorded on an online platform.
Results: Most participants reported telecare as easy to use and useful, with many older adults reporting improved independence, control over their lives, and quality of life, alongside an increased sense of security. Regression analysis showed that TAM variables (perceived usefulness and ease of use) explained 25.8% of telecare acceptance, while the extended model explained 38.1% of the variance in telecare acceptance. Statistically significant predictors of telecare acceptance included perceived usefulness, impact of telecare use on older adults’ self-esteem and competence, and use of a fall detector. In contrast, receiving any formal care services and having higher impairments in autonomy were negatively associated with telecare acceptance.
Implications: These findings suggest that telecare can significantly improve independence, quality of life, and security of older adults, particularly when tailored to individual needs and health conditions. Extending TAM to include psychosocial impacts of telecare use and care dependency factors offers a more comprehensive model of telecare acceptance. Future research should examine additional contextual factors to refine understanding further. These insights can guide policymakers and practitioners in developing personalized, effective telecare solutions to promote adoption and sustained use among older adults.