PDF icon Download PDF
Appl Clin Inform 2025; 16(04): 930-942
DOI: 10.1055/a-2591-4016
Research Article

Real-World Challenges of Using Assisted Living Technologies across Different Australian Aged Care Settings: A Qualitative Study of User Experiences

Nida Afzal
1   Centre for Health Informatics, Australian Institute of Health Innovation, Macquarie University, New South Wales, Australia
,
Amy D. Nguyen
2   Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, New South Wales, Australia
,
Annie Lau
1   Centre for Health Informatics, Australian Institute of Health Innovation, Macquarie University, New South Wales, Australia
› Author Affiliations
Funding This study was funded by the International Macquarie Research Excellence Scholarship (iMQRES) awarded to N.A.
› Further Information
Also available ateRef
   Permissions and Reprints
Preview

Abstract

Background

Aging populations strain health care systems. Assisted Living Technologies (ALTs) emerge as a potential solution for promoting independent living among older adults. However, the real-world effect of ALTs remains unclear.

Objective

This study explores benefits and challenges (anticipated and unanticipated) of ALTs for older adults and informal caregivers across three aged care settings (residential aged care facilities [RACFs], retirement villages [RVs], and home-dwelling communities [HDCs]) in Australia.

Methods

Three ALTs (fall detection sensors, sleep monitors, and smartwatches) were deployed across three settings. NASSS framework (Non-adoption, Abandonment, Scale-up, Spread, and Sustainability), informed by sociotechnical theories, guided analysis of the interplay between technology, user needs, and caregiving context in ALTs implementation. Semistructured interviews with 14 older adults and 9 caregivers from 19 households explored user experiences. Benefits and challenges of using ALTs for older adults and informal caregivers were categorized using the consequences framework.

Results

Setting-specific challenges alongside common benefits and challenges across care settings were revealed. The NASSS framework analysis showed how technology limitations, user needs, and caregiving context influenced these outcomes. In RACFs, where residents receive constant nursing assistance, informal caregivers faced uncertainty regarding who was responsible for monitoring residents. In RVs, with a strong sense of community, informal caregivers (often neighbors) were more prone to overreacting to false alarms. Shared sleeping arrangements among HDCs made interpreting sleep data challenging.

Conclusion

Implementing ALTs in elderly care settings requires a context-sensitive approach. In RACFs, clear role definitions for informal caregivers and staff are essential. For RVs, design should support help-seeking aligned with residents' social and geographical contexts. Home-dwelling settings may benefit from advanced sleep monitoring tailored to shared living arrangements. Future ALTs development should focus on real-world contexts to promote successful aging in place.

Keywords

ambient assistive technologies - older adults - caregivers - aging in place - qualitative

Protection of Human and Animal Subjects

The study was performed in compliance with the World Medical Association Declaration of Helsinki on Ethical Principles for Medical Research Involving Human Subjects. The study received ethical approval from the Macquarie University Human Research Ethics Committee (Ref number: 520221098339905).


Supplementary Material



Publication History

Received: 09 December 2024

Accepted: 17 April 2025

Article published online:
29 August 2025

© 2025. Thieme. All rights reserved.

Georg Thieme Verlag KG
Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany