Ethical dilemmas related to the use of safety technology in service house environments

The use of technology in care of older adults has increased rapidly in recent years and is anticipated to increase further in the future. Technological devices and appliances have been developed to promote the safety and independence of older adults living in different settings. However, technology may also be perceived as a threat, and using technology could involve characteristics that may restrict especially patients' autonomy.

The aim of this study was to explore ethical dilemmas as experienced and expressed by older adults living in service house environment and their family members. The study was carried out in two service house units in Southwest Finland by conducting thematic interviews of service home residents aged 80-92 years (n = 12) and their relatives (n = 5). The interview data were analysed using inductive content analysis to identify similarities and differences across the data. The findings were categorised under three categories: supervision vs. privacy, fear of losing human contact, autonomy and freedom.

The participants appreciated the homely environment they had and preferred increasing the amount of staff over increasing technological surveillance. However, the residents were willing to accept also technological systems and solutions if they strengthened one's feeling of security. Fear of losing human contacts and one's privacy due to implementation technological systems was expressed by the older adults. Both the residents and their relatives emphasised the autonomy of the older adult in decision-making concerning the use of technological services.

In conclusion, thorough discussion about autonomy, freedom and privacy is needed before applying new technologies to service house environments. Possibilities for drafting a 'technological will' where the resident could define under what circumstances technology can be used in his/her case and who can decide about it should be explored in the future.