Identifying risks of mistreatment: Perspectives of stakeholders who used telemonitoring of activities of daily living Gerontechnology 25(s)
M. Couture, R.-P. Filiou, T. Tannou, P. Belchior, R. Wang, A., Aboujaoudé, S. Giroux, N. Bier
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AbstractPURPOSE: Studies have demonstrated that technology can be used to harass or threaten, steal from, locate, defraud, or victimize a person and cause physical or emotional harm to older adults [1]. When this type of behaviour is perpetrated by a person of trust and not a stranger, it can be considered mistreatment, and specific laws may be applicable depending on jurisdiction. In Canada, the prevalence of mistreatment is 10% in community-dwelling older adults over 65 years old, and risk factors include physical, cognitive, and mental health issues [2]. Given the risk of mistreatment among individuals using telemonitoring technologies-who often face multiple challenges, including difficulties with activities of daily living (ADLs) it is important to assess these risks in this particular context. METHOD: A secondary analysis was conducted using individual interview data. These data were collected within the Côte Saint-Luc Living Lab (CSL-LL) aimed at co-constructing a home support model anchored in smart environments [3]. Telemonitoring technology was implemented in the homes of 16 older adults aged 65 years and older. Thirteen women and 3 men with an average age of 84 years old consented to have their ADLs (sleep, meal preparation, hygiene and outings) remotely monitored using ambient sensors. Individual interviews were conducted with older adults (n=16), their caregivers (n=10) and social and health care professionals from home care services (n=3) before implementation and twice after implementation. Analysis of qualitative data from transcribed interviews was carried out according to the approach of Miles et al. (2019) [4]. Based on this approach, two processes were used: codification and matrix building. As mistreatment is defined as : "a single or repeated act, or lack of appropriate action, occurring in any relationship where a relationship of trust is expected to cause harm or distress to an older person" [5], codification and matrix were used to describe manifestations of mistreatment (potential or actual acts or lack of appropriate action), their consequences (potential or actual harm or distress) and the potential perpetrators (any relationship where a relationship of trust is expected). RESULTS: Interview data showed anyone who has access to the telemonitoring data or to the older adult's home can be conceptualized as potential perpetrators according to stakeholders. This includes caregivers and home care professionals, but also people installing the technology or managing telemonitoring data. Even if the telemonitoring data do not include images, some older adults still feel self-conscious, as they are being "watched." A few are also afraid that caregivers might scold them for being "careless" as they can see their ADLs through telemonitoring reports. Installing technology at home also opens the door to new people, such as technicians, which can create a sense of invasion of privacy and insecurity. There is also a fear that data will be accessed and sold for profit by companies. DISCUSSION: The findings indicate that it is important to not only look at ethical issues related to technology, but also at the potential risk of mistreatment. Stakeholders are increasingly aware of the downfalls of technology and hope to be better protected. Companies installing technology and managing data must also offer training to staff to reduce the risk of mistreatment. These insights could guide safer telemonitoring implementation by clarifying mistreatment risks and supporting the development of tools to raise awareness of all stakeholders.Keywords: telemonitoring, mistreatment, older adults, home care
M. Couture, R.-P. Filiou, T. Tannou, P. Belchior, R. Wang, A., Aboujaoudé, S. Giroux, N. Bier (2026). Identifying risks of mistreatment: Perspectives of stakeholders who used telemonitoring of activities of daily living Gerontechnology 25(s). Gerontechnology, 25(2), 1-10
https://doi.org/10.4017/gt.2026.25.2.1464.3